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Purpose: To estimate the frequency of aggressive behaviors in health care institutions, and determine their influence on emotional reactions of medical workers. Materials and methods: The study involved 201 health care professionals from the regions of Lower Silesia and Opole in Poland. The authors employed the exposure to patient aggression inventory, based on the questionnaires of Merecz and Nowicka & Kolasa; this inventory divides patient aggression towards medical workers into seven different forms. Results: In over 90% of cases, health care professionals fell victim to patient aggression in a workplace. It mostly took forms of verbal aggression, a raised voice and shouting. A physical attack was reported by 45.6% of the surveyed; it resulted in physical injuries in 27.9% of psychiatric hospital workers and 24.7% of general hospital workers. As a reaction to patients' verbal aggression, medical workers usually calmly explained that such behavior was improper. Violence and aggressive behaviors of patients evoked workers' anger, fear, a feeling of resignation and the loss of their sense of safety. In most case's victims of patient aggression either coped with the problem themselves or asked their co-workers and superiors for help. Conclusions: Aggressive behaviors of patients arouse in medical staff, mostly anger. Medical workers usually cope with patient aggression themselves; nurses more often than other health care professionals ask their superiors and coworkers for help. It is necessary to conduct further research into the problem of patient aggression towards medical staff so that actions ensuring safety for workers can be taken. [ABSTRACT FROM AUTHOR]

Cessation of continuous analgesia and sedation in patients with acute respiratory distress syndrome (ARDS) receiving venovenous (VV) extracorporeal membrane oxygenation (ECMO) facilitates early extubation, family, patient and provider engagement, and mobility. Outcomes associated with an awake ECMO strategy have not been well described in the literature. The purpose of this study was to evaluate outcomes in patients receiving this strategy. This was a retrospective review of ARDS patients receiving awake VV ECMO. The primary outcome was survival to hospital discharge. Secondary outcomes included days requiring ECMO, time from cannulation to extubation, complications, patients requiring tracheostomy, hospital and intensive care unit (ICU) length of stay (LOS), and discharge disposition. In a subgroup analysis, outcomes were compared between non-COVID and COVID ECMO patients. Sixty-two patients were included with a survival to hospital discharge of 85.5%. Days requiring ECMO was 33.0 (0.0-75.0) and cannulation to extubation was 6.0 (4.0-11.0). Three patients received a tracheostomy (4.8%). Bleeding and infection were reported in 80.6% and 82.3% of patients, respectively. Intensive care unit length of stay was 46.0 days (29.0-90.0) and hospital LOS was 51.0 days (32.0-91.0). Over half of the patients (51.6%) were discharged to an acute rehabilitation facility and 27.4% were discharged home. There was similar survival to hospital discharge between the COVID and non-COVID awake ECMO patients (85% in both groups, p = 1.000). This study highlights the impact of an awake ECMO approach on survival to hospital discharge. Future studies are needed to evaluate this approach as compared to current practice to determine if this should become the standard., Competing Interests: Disclosures: Antone J. Tatooles (Abbott, LivaNova). The remaining authors have no conflicts of interest to report., (Copyright © ASAIO 2022.)