91 Impact of Intermittent Versus Continuous Infusion of Fentanyl After Rapid Sequence Intubation on Intensive Care Unit Delirium

Abstract

we performed a multi-center survey study at 9 emergency medicine residencies nationally, administering the MBI and four additional validated wellness instruments. Quality of Life (QOL) was assessed by a single-item linear analog scale assessment: "How would you rate your overall quality of life during the past week?" High QOL was defined as >80, moderate 60-80, and low <60. Work-Life Balance was assessed with the question "My work schedule leaves me enough time for my personal/family life." Responses of strongly agree and agree were categorized as positive for work-life balance. Career satisfaction was assessed by a single-question: "If given the opportunity to revisit your career choice, would you choose to become a physician again?" Responses of "likely" and "very likely" were categorized as positive for career satisfaction. Provider depression was screened using the first two items of the Primary Care Evaluation of Mental Disorders (PRIME-MD) instrument. A "yes" response to either question was considered a positive screen for depression.Results: A total of 261/334 residents responded, for a total response rate of 78%. Data were analyzed using Pearson's correlation, chi-square, or t-test as appropriate for continuous or categorical variables. Residents' impressions of their quality of life was significantly correlated to burnout indices with lower QOL being associated with higher emotional exhaustion (r ¼ -0.437, p<0.0001), higher depersonalization (r ¼ -0.18, p<0.005), and lower personal accomplishment (r ¼ 0.347, p<0.001). Scores on the work-life balance rating correlated with MBI emotional exhaustion (p<0.001) and depersonalization (p<0.009) though not personal accomplishment. The feeling of having made an appropriate career choice was significantly associated with lower emotional exhaustion (p<0.0001), lower depersonalization (p<0.005), and higher personal accomplishment (p<0.05). The prevalence of a positive depression screen in our survey sample was 40%. Screening positive for symptoms of depression was also significantly associated with higher emotional exhaustion, higher depersonalization, and lower personal achievement (all p<0.0001).Conclusions: In this multi-center survey study of emergency medicine residents we found that increasing levels of burnout were associated with perceived lower quality of life, poor work-life balance, lower satisfaction with the choice of medicine as a career, and a higher rate of screening positive for depression. Use of the Quality of Life Scale, Work Life Balance rating, assessment of career satisfaction, and Primary Care Evaluation of Mental Disorders instrument in addition to the MBI may provide a more global assessment of resident wellness and inform decisions about targeted wellness interventions. These findings also support the development of a formal wellness curriculum that can be incorporated into resident education.

The complications of opioid use during and post–intensive care admission: A narrative review

“…There was no difference in the duration of mechanical ventilation and ICU length of stay between the groups. 110…”