Objectives : The primary objective of this case report is to review the clinical presentation, diagnostic methods, treatment, and outcomes associated with cavernous hemangioma of the urinary bladder. We aim to enhance awareness among healthcare professionals regarding this rare entity and improve management strategies for similar cases.

Introduction : Cavernous hemangioma of the urinary bladder is a rare vascular tumor that arises from the proliferation of blood vessels. While it can occur in various anatomical locations, its incidence in the bladder is particularly low, accounting for approximately 0.6% of urinary bladder tumors, with painless hematuria being the most common presenting symptom. The most frequent locations in the bladder are the base, posterior wall, and trigone. This condition presents diagnostic challenges due to its nonspecific symptoms, which often overlap with more common urological disorders. Cavernous hemangiomas are typically found in organs such as the liver, skin, or brain, where they are usually asymptomatic unless their size or location causes symptoms. Complete surgical excision is generally curative. Methods : A comprehensive literature review was conducted, focusing on case reports and studies published in peer-reviewed journals. The review iden

tified several cases of cavernous hemangioma, most commonly presenting with hematuria, urinary frequency, and pelvic pain. Imaging modalities such as ultrasound and CT scans revealed heterogeneous masses, often leading to differential diagnoses. Surgical excision emerged as the predominant treatment method.

Results : Most patients experienced favorable outcomes with no recurrence during follow-up.

Conclusion : Cavernous hemangioma of the urinary bladder, although rare, should be considered in the differential diagnosis of bladder masses, particularly in patients presenting with unexplained hematuria. Early diagnosis and appropriate surgical intervention lead to excellent long-term outcomes. Increased awareness and further research are essential to refine management protocols and improve patient care.

Background: The American Heart Association (AHA) put forth a set of guidelines for universal standard of care for patients who experience an in-hospital resuscitation event or receive post-cardiac arrest care following an in-hospital or out-of-hospital event. While some studies have suggested that Medical Emergency Response Teams (MERTs) help reduce mortality from unexpected cardiac arrest [1] and reduce the number of unexpected ICU admissions [2], there remains a paucity of data on the impact of formalized training of MERTs on adherence to the recommended AHA guidelines, as well as the impact of quality simulation training in implementing effective MERT training.

Methods: We performed a retrospective cohort analysis of cardiopulmonary and cardiac arrest codes called at ORMC before and after the implementation of the MERT program. We looked at code metrics according to the AHA guidelines one year before the implementation of High Fidelity Mannequin training and one year after its implementation. This data was separated into Group A, pre-MERT training, and Group B, post-MERT training. We analyzed time to chest compressions, time to first dose of epinephrine, and type of rhythm during the actual code, as well as adherence to post resuscitation guideline metrics such as oxygen titration, maintaining normothermia and normal blood pressure.

Results: Statistically significant differences between groups were found in comparing time to delivery of first shock for Ventricular Fibrillation (VF) or Pulseless Ventricular Tachycardia (pVT). No statistical significance was discovered in time to epinephrine, time to first compressions, or post-resuscitation guidelines.

Conclusions: MERT training can assist in better meeting AHA metrics. Use of HFM is a valuable investment for that training in that it can mitigate gaps in assessment, improve clinical outcomes and decreases patient mortality.