The Journal of Canada’s Physician Assistants

Cricothyrotomy Following Airway Hemorrhage from a Hypopharyngeal Cancer: A Clinical Case Study

Natalie Dies, CCPA — 2021-10-12

This clinical study describes an emergency cricothyrotomy on a hospital inpatient awaiting major head and neck surgery for a hypopharyngeal cancer. The clinical presentation of this patient highlights the emergent interventions for a bleeding upper airway, that can quickly lead to complete airway obstruction. Early recognition of an unstable airway is critical for patient outcomes in the head and neck cancer population.

Investigating Physician Assistant Burnout Amidst the COVID-19 Global Pandemic: A Qualitative Survey Response From Practicing PAs in Canada

Evan Nanni, MPAS, PA — 2021-10-12

The purpose of this study was to determine if there is an underlying element of burnout among practicing Physician Assistants (PAs) across Canada during the global COVID-19 pandemic and uncover any potential solutions for this arduous problem. A survey encompassing the Maslach Burnout Inventory (MBI)and qualitative questions were emailed to practicing Canadian PAs. A total of 118 practicings PAs fully completed the survey; the majority reported high levels of burnout, specifically on depersonalization and emotional exhaustion subscales, while all maintained a high level of personal accomplishment simultaneously. The majority of respondent PAs listed increased staffing, increased time off/consistent scheduling, and pandemic pay among others as major solutions to alleviate burnout in the future. In conclusion, Canadian PAs working during the global pandemic are indeed experiencing burnout, all while displaying a high level of resilience in certain MBI subscales. The individual responses provided by these frontline workers may highlight critical solutions that may be generalized to other healthcare jobs in order to prevent future occupational burnout.

Nutrition in the Neoadjuvant Gastric Cancer Patient, is early administration appropriate?

Patrick Stringfellow, DMSc CCPA CD — 2021-10-12

ABSTRACT

Purpose: Gastric cancer is one of the world's leading cancers. Despite the availability of testing, patients often present with advanced (stage III or stage IV) gastric cancer. These patients are always in a state of malnutrition and will be sarcopenic secondary to pain, loss of appetite, nausea, vomiting and dysphagia. Treatment for this cancer includes radical surgery, sometimes chemotherapy and rarely radiotherapy. It is already well documented that nutrition is critical to patient outcomes during chemotherapy, surgery and healing; because of this, many measures are already in place to improve nutrition in these patients. This literature review will look directly at the use of enteral feeding (EN) of gastric cancer patients prior to or in conjunction with neoadjuvant chemotherapy (NACT).

Methods: Research was focused on the keywords: nutrition, gastric cancer, enteral feeding and neoadjuvant nutrition. Several electronic journals were reviewed, National Center for Biotechnology Information (NCBI), PubMed, QxMD Read, Science Direct, as well, a search was conducted through Alberta Health Services Knowledge Resource Service (KRS).

Results: The combined information within each of the articles reviewed all recognized that early nutrition supplementation had positive impacts on maintaining albumin levels, an increase in the patient's immunity, improved healing and shortened length of hospital stay.

Conclusion: All patients receive nutrition throughout their hospital stay; research indicates that the earlier nutrition is given to a patient, the better the overall outcomes of chemotherapy, surgery, shortened length of stay, and quality of life.

Keywords: nutrition, gastric cancer, enteral feeding and neoadjuvant nutrition.