Emerg. Care Med., Volume 2, Issue 4 (December 2025) – 2 articles

Background/Objectives: In-hospital cardiac arrest (IHCA) remains a critical event with high mortality, requiring coordinated multidisciplinary response. Return of spontaneous circulation (ROSC) and hospital discharge rates are key quality indicators in resuscitation efforts. In Costa Rica, there is limited published data on team performance, protocol adherence, and the pharmacist’s role in code blue events, despite similar evidence gaps across Latin America. This study aimed to evaluate clinical outcomes and operational performance of in-hospital cardiac arrest events at a Costa Rica hospital. Methods: This retrospective cohort study included 77 adult patients who experienced IHCA at Clínica Bíblica between 2020 and 2024. Data collection was conducted between February and May 2025 from electronic medical records and code blue activation logs. Clinical variables, comorbidities, pharmacologic interventions, and outcomes were analyzed. Predictive models (Charlson Comorbidity Index [CCI], IHCA-ROSC, RISQ-PATH) and Kaplan–Meier survival analysis were applied. Results: ROSC was achieved in 55.8% of patients, and 21% were discharged alive. Asystole was the predominant initial rhythm (76.6%), and comorbidities such as renal disease and myocardial infarction were most frequent. A higher comorbidity burden was significantly associated with lower discharge rates (p = 0.032). Despite 98.7% of patients being classified as low probability for ROSC by the IHCA-ROSC model, observed outcomes exceeded expectations (predicted: 5.53% vs. actual: 55.84%; p < 0.000001). The code team adhered to institutional protocols in 100% of cases, with clinical pharmacists playing a key role in documentation and medication tracking. Conclusions: Structured multidisciplinary response was associated with ROSC rates notably higher than predicted by validated models. Opportunities for improvement include post-event laboratory testing, pharmacist-led documentation, and therapeutic hypothermia in shockable rhythms. Full article

Background/Objectives: The COVID-19 pandemic caused a widespread shift to remote work, significantly altering child supervision. In Australia, prolonged lockdowns created unique conditions where many parents were working from home while simultaneously caring for children. This study aimed to investigate potential changes in the epidemiology of paediatric injury-related presentations to emergency health services among children in Southwest Victoria, Australia, during the COVID-19 pandemic. Methods: A retrospective cross-sectional study was conducted using deidentified emergency presentation data from ten health services in regional Victoria for children aged 0–14 years between 2018 and 2023. Injury data were analysed across three timeframes (Pre-COVID, COVID, Post-COVID). Chi-squared tests assessed differences in injury presentations by age, gender, and service type. Significance was determined at p < 0.05. Results: A total of 21,072 child injury-related presentations occurred. Males accounted for 57.6% of presentations, with the 10–14 age group comprising 39.8% of cases. During lockdown, injury presentations increased among 0–4-year-old females (from 30.2% to 32.0%), likely reflecting reduced supervision as parents juggled work-from-home responsibilities. Conversely, rates declined among older children, particularly 10–14-year-olds, potentially due to reduced participation in sports and outdoor activities. More than half of all cases (59.1%) were presented to Victorian Emergency Minimum Dataset (VEMD)-reporting emergency departments. Conclusions: The shift to working from home during the pandemic had a measurable impact on childhood injury patterns, particularly among younger children. These findings highlight the importance of considering parental work and childcare arrangements in injury prevention strategies and highlight the benefits of additional regional data to provide a more accurate picture of regional health service use. Full article