Objectives: To identify the prevalence of COVID-19 antibodies among operating room and critical care staff. Methods: In this cross-sectional study, we recruited 319 Healthcare workers employed in the operation theater and intensive care unit of King Abdulaziz University Hospital (KAUH), a tertiary teaching hospital in Jeddah, Saudi Arabia between August 9, 2020 and November 2, 2020. All participants completed a 20-item questionnaire on demographic data and COVID-19 risk factors and provided blood samples. Antibody testing was performed using an in-house enzyme immunoassay and microneutralization test. Results: Of the 319 participants, 39 had detectable COVID-19 antibodies. Five of them had never experienced any symptoms suggestive of COVID-19, and only 19 were previously diagnosed with COVID-19. The odds of developing COVID-19 or having corresponding antibodies increased if participants experienced COVID-19 symptoms (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.2-7.5) or reported contact with an infected family member (OR, 5.3; 95% CI, 2.5-11.2). Disease acquisition was not associated with employment in the ICU and involvement in the intubation of or close contact with COVID-19 patients. Of the 19 previously diagnosed participants, 6 did not possess any detectable COVID-19 antibodies. Conclusions: Healthcare workers may have undiagnosed COVID-19, and those previously infected may not have long-lasting immunity. Therefore, hospitals must continue to uphold strict infection control during the COVID-19 pandemic.

Background: Social media (SM) has become an integral part of many medical students’ lives, blurring the lines between their personal and professional identities as many aspects of their medical careers appear online. Physicians must understand how to responsibly navigate these sites. Objective: This study aimed to identify how medical students use SM and their awareness and adherence to ethical guidelines of e-professionalism. Methods: This is a cross-sectional study delivered as an online voluntary survey to senior medical students at King AbdulAziz University Hospital in Jeddah, Saudi Arabia. We investigated how many students used SM, their privacy settings, their possible breaches of ethical standards, and their portrayal of their training institute online. Results: A total of 400/1546 (26%) senior medical students responded to our survey. Among the participants, 95/400 (24%) had public SM accounts, while 162/400 (41%) had both private and public accounts. As for breaches in e-professionalism, 11/400 (3%) participants posted a picture of a patient on SM without their permission, while 75/400 (20%) posted part of an excised organ or x-ray on SM without their permission, and 60/400 (16%) discussed a patient. With regards to sharing medical school information, 108/400 (29%) discussed an incident at their medical school, and 119/400 (31%) participants shared a lecture online without the presenter’s permission. Approximately 66% of the participants reported that they were unaware if their institution had a professional code of conduct for SM use, and 259/371 (70%) did not receive training on the professional use of SM. Conclusions: Medical students must be taught to recognize inappropriate online behavior, understand their role as representatives of their medical school, and know the potential repercussions of unprofessional conduct on SM. This could be accomplished by providing workshops, regular seminars on e-professionalism, and including principles of SM conduct in existing ethics courses.

The new novel coronavirus is having a major impact on healthcare systems internationally. Hospitals are struggling to manage the sudden influx of critical patients. Anaesthesiologists and critical care physicians are front liners in the fight against COVID-19 and carry the highest risk of getting infected. Due to the rapid response of the Saudi government to the WHO’s early warning, we were fortunate at our hospital to see a slower rise in COVID-19 cases allowing us some time to prepare. We had to make room for the expected rise in highly infectious and critical patients, while at the same time protecting non-COVID-19 patients, staff and trainees. Additionally, the team continued to provide essential and specialized care to all patients in the hospital and maintain its academic and non-clinical services within the university. This review presents the different protocols, challenges and lessons learned during the development of a COVID-19 anaesthesia and critical care department plan in a major teaching hospital in Jeddah, Saudi Arabia. Our ultimate aim is to share our experience with other similar institutions.

In Saudi Arabia, nearly a quarter of a hospital’s blood supply is consumed in operating rooms. However, blood is a scarce resource, and its unavailability has led to the cancellation of many surgeries. This study aims to identify risk factors for perioperative blood transfusion in colorectal surgery, thus providing valuable insights for better blood management and transfusion planning. We conducted a retrospective cohort study of patients who underwent colorectal surgery at King Abdulaziz University Hospital from 2013 to 2022. Data on patient demographics, comorbidities, surgical details, and transfusion outcomes were collected and analyzed. Statistical analyses included logistic regression to identify predictors of transfusion and over-transfusion. We collected data from 434 patients. Women were almost twice as likely (OR = 1.98; 95%CI = 1.35–2.90) as men to receive one or more units of RBCs. Also more likely to be transfused were patients with a higher ASA score; a lower pre-operative serum hemoglobin (Hgb) level; and malignant disease as the reason for surgery (all p < 0.001). On multivariable analysis, receiving a transfusion of packed blood cells (RBCs) was statistically linked to volume of intra-operative blood loss and Hgb level (both p < 0.001); as well as to pre-operative body mass index (BMI), with patients who were under-weight and of normal weight most at risk, and patients with a BMI between 25 and 35 less likely to be transfused. Patients whose pre-operative serum Hgb level was 12 g/dL or higher were more than twice as likely to not receive a transfusion, while those with pre-operative Hgb levels from 8.0 to 9.9 g/dL were three times more likely than not to receive blood, and those with a pre-operative Hgb under 8.0 g/dL almost five times as likely as not. Key risk factors for perioperative blood transfusion in colorectal surgery are preoperative anemia, diabetes, low BMI, and significant blood loss. Addressing these through a multidisciplinary approach and the development of perioperative protocols may reduce transfusion needs. Future prospective studies are needed to validate these findings and refine transfusion risk assessments.

BackgroundEpidural insertion is one of the more complex skills that anesthesia residents must master by the end of their training.MethodsWe performed a retrospective cohort study investigating the relationship between labor epidural failure and anesthesia residents’ level of training.ResultsThere was a statistically significant difference in success rate (p = 0.04), number of pricks (p = 0.001), and time to insertion (p = 0.04) between senior and junior anesthesia residents.ConclusionsThese findings may be a result of the resident passing through the cognitive and integrative stages of skill development. In an effort to improve anesthesia residents’ training experience and provide a safe environment for both patients and trainees, simulation should be used when possible, to develop the basic techniques required for epidural insertion.