Background: The goal of preoperative fasting is to prevent pulmonary aspiration during general anesthesia. Fasting times are often prolonged leading to patient discomfort and risk for adverse events. This retrospective quality improvement survey evaluated effective nil-per-os (NPO) times and causes for prolonged NPO times with the aim to suggest improvement strategies by a newly founded fasting task force. Methods: Data from all electronic anesthesia records from 2019 at our institution were reviewed for fasting times. Our NPO instructions follow American Society of Anesthesiology guidelines and are calculated based on the patient’s arrival time (90 min before OR time). Primary outcome was the effective NPO time for clear liquids, secondary outcomes were incidence of delays and the parental compliance with the NPO instructions. Data are presented as median (interquartile range). Results: 9,625 cases were included in the analysis. NPO time was documented in 72.1% with a median effective NPO time of 7:13 h (7:36). OR in room times were documented in 72.8%, 2,075 (29.5%; median time 0:10 h [0:21]) were earlier and 4,939 (70.5%; median time 0:29 h [0:54]) were later than scheduled. Parental NPO compliance showed a median deviation for clear liquid intake of 0:55 h (8:30). Conclusions This study revealed that effective NPO times were longer than current ASA guidelines. Contributing causes include case delays and parental non-compliance to NPO instructions. Thus, task force recommendations include change NPO instruction calculations to scheduled OR time versus arrival time, and encourage parents to give their child clear liquids at the instructed time.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has drastically changed lives, challenging all to adapt new norms and survive. Safety guidelines for physician have been set, yet fear for health and safety hounds the physician. OBJECTIVE: The aims of this study were to segment cardiologists’ viewpoints according to perceived stressors and coping mechanisms in their clinical practice during the COVID-19 pandemic and to draw implications to coping in the light of the model of salutogenesis. METHODS: Q methodology, a mixed-method type of research, was used after approval from the UST Hospital Research Ethics Committee. Using convenience sampling, 30 adult cardiologists were included in this study. Following an informed consent to participate, they ranked-order 33 statements that answer the questions: “What are the stressors has this COVID-19 pandemic brought in your clinical practice of cardiology? How did you cope?” This was done on a Q grid with two “most agree” statements and two “most disagree” statements (Q-sort). A short interview followed the sorting to understand their most agree and most disagree statements. Q-sorting and interview were done via teleconferencing and in person. The Q sorts were then entered into a web-based PQMethod software (http://schmolck.org qmethod/downpqdos.htm). Typologies were generated through inductive approach. RESULTS: Three typologies were generated: the profession-driven cardiologists, the protocoldriven cardiologists, and the faith-driven cardiologists. CONCLUSION This study painted different personas of cardiologists as they conduct their practice in this pandemic. These typologies enabled the formulation of individual and group salutogenic measures that can help health care providers cope in this COVID-19 pandemic.
Cardiology ; COVID-19

Background: Leukemia is a leading cause of morbidity and mortality among pediatric patients in the Philippines, but it also significantly affects family dynamics and behaviors. Aside from the parents, siblings are also vulnerable to the effects of a chronic disease within the family but are not usually the topic of family studies. Objective: To determine if having control-oriented or escape-oriented coping mechanisms is associated with the different levels and dimensions of family functioning among children ages 13 to 18 years old who have siblings diagnosed with leukemia. Methodology: This case control study was conducted in two Kythe-affiliated hospitals in Luzon, Philippines. Using McMaster Family Assessment Device, adolescent siblings of leukemia patients who belong to dysfunctional families (n=8) were considered as the cases, while siblings who belong to functional families (n=5) were the controls. KidCOPE was used to identify coping mechanisms. Odds ratio for escape- and control-oriented coping mechanisms were computed using Fisher’s exact test through MedCalc, while association of coping mechanisms with demographics was determined using Chi square test through SAS 9.4. Results: Siblings of leukemia patients who belong to dysfunctional families are more likely to use escape-oriented coping mechanism (OR = 2.2; 95% CI = 0.0746 to 64.9082; p = 0.648) but also more likely to feel that it is not helpful to them (OR = 0.6471; 95% CI = 0.0111 to 37.6665; p = 0.8337). However, an association between coping mechanisms and family functionality cannot be established because the computed odds ratios are not significant. A significant association was found between the number of extended family members living with the sibling and efficiency of control-oriented coping mechanisms (p = 0.024). Conclusion Association between coping mechanisms of adolescent siblings of leukemia patients and family functionality was not established, but further studies with larger sample sizes are needed to confirm this.
Siblings ; Leukemia ; Philippines