The alarming increase in opioid use in the United States, particularly during pregnancy, over the past few decades underlines the need to thoroughly investigate the consequences of opioid use within the context of reproduction and development. Opioid exposure has been linked to a number of effects on the various physiologic processes involved in embryonic development. Opioids have been shown to hinder the preimplantation embryo from progressing into the blastocyst stage and implanting into the uterus. Maternal opioid use has also been shown to be neurotoxic to the embryo. Exogenous opioids negatively affect the somatosensory cortex, hippocampus, and cholinergic system in the developing embryo, leading to consequences ranging from poor memory function to learning disabilities. Additionally, opioids have the potential to negatively affect the embryonic heart. Opioid use has been shown to slow down the growth of cardiac tissue, decrease fetal heart rate, and increase the incidence of congenital heart defects. Through review of existing studies, we conclude that opioid use during pregnancy has a significant risk of being detrimental to the embryo. Based on the available scientific literature, we recommend reevaluating current guidelines on opioid use during pregnancy to ensure that opioid exposure to the embryo is limited as much as possible.

Introduction Sudden cardiac arrest remains a common and critical disease burden. As post-cardiac arrest care grows in complexity, communication between pre-hospital providers, emergency department personnel, and hospital consultants is increasingly important. Methods This study evaluated the use of a standard handoff tool between pre-hospital personnel and hospital staff, including emergency medical services (EMS), emergency department nurses, physicians, and cardiologists. Personnel were surveyed regarding attitudes surrounding the important aspects of cardiac arrest care, challenges faced, and preference of handoff mechanism. Results Most of the survey respondents (58, 76%) found that the initial rhythm was the most important factor in post-cardiac arrest care, followed by the presence of bystander cardiopulmonary resuscitation (CPR; 55, 72%) and the presence of ST-elevation on initial electrocardiogram (46, 61%). Both emergency physicians (7, 63%), as well as cardiologists (3, 100%), preferred to have this tool performed over radio prior to arrival in the emergency department. Conclusion The importance given to various post-cardiac arrest factors varied amongst specialty and clinical background; however, all agreed on common features such as the initial rhythm, electrocardiogram (ECG) morphology, and the presence or absence of bystander CPR. Additionally, the timing and structure of how this information is delivered were further elucidated. This data will guide future handoff methods between specialties managing patients after cardiac arrest.