Variability of Prehospital Pain Management Protocols: A Review of Prehospital Care Protocols in the United States.

Purpose: We describe emergency medical services (EMS) protocols for pain management in the United States to elucidate systemic variability in protocols. We describe types of pain medications included in protocols, routes of administration, indications for use, standing orders for dosing, and use in pediatric patients.

Methods: We performed a review of all publicly accessible EMS protocols from the website http://www.

Prehospital transport and termination of resuscitation of cardiac arrest patients: A review of prehospital care protocols in the United States.

Background: The objective was to describe emergency medical services (EMS) protocol variability in transport expectations for out-of-hospital cardiac arrest (OHCA) patients and the involvement of online medical control for on-scene termination of resuscitation in the United States. Whether other aspects of OHCA care were mentioned, including the definition of a "pediatric" patient, and use of end-tidal carbon dioxide monitoring, mechanical chest compression devices (MCCDs), and extracorporeal membrane oxygenation (ECMO), were also described.

Methods And Results: Review of EMS protocols publicly accessible from https://www.

Resuscitation Quality Improvement® (RQI®) HeartCode Complete® program improves chest compression rate in real world out-of hospital cardiac arrest patients.

Background: The Resuscitation Quality Improvement® (RQI®) HeartCode Complete® program is designed to enhance cardiopulmonary resuscitation (CPR) training by using real-time feedback manikins. Our objective was to assess the quality of CPR, such as chest compression rate, depth, and fraction, performed on out-of-hospital cardiac arrest (OHCA) patients among paramedics trained with the RQI® program vs. paramedics who were not.

Cellulose Fibre Degradation in Cellulose/Steel Hybrid Geotextiles under Outdoor Weathering Conditions.

Risks from rockfall and land sliding can be controlled by high-tensile steel nets and meshes which stabilise critical areas. In many cases, a recultivation of the land is also desired. However, high-tensile steel meshes alone are not always sufficient, depending on the location and the inclination of the stabilised slope, to achieve rapid greening.

Factors Influencing Use of Personal Protective Equipment Among Emergency Medical Services Responders During the COVID-19 Pandemic: A Retrospective Chart Review.

Introduction: The use of personal protective equipment (PPE) is a salient component of reducing occupational risk in many fields. Emergency medical services (EMS) personnel use PPE to reduce risk of exposure and defend against various pathogens they come in contact with while providing patient care. Currently, the understanding of factors that predict the use of PPE by an EMS responder during a pandemic is limited.

Characteristics and Demographics of Patients Requiring Emergent Air Medical.

Background: As integrated health systems become more common, interfacility patient transfers will increase and air transport programs will be prioritized. Understanding characteristics of patients triaged to air medical transport will assist with resource allocation and needs assessment. The objective of this study was to investigate the demographics and clinical characteristics of patients that presented to the emergency department (ED) and subsequently required emergent air medical interfacility transport.

Utility of Emergency Medical Dispatch (EMD) Telephone Screening in Identifying COVID-19 Positive Patients.

: In response to the COVID-19 pandemic, Emergency Medical Services (EMS) systems have received guidelines as part of coordinated response efforts aimed at mitigating exposures and ensuring occupational wellbeing, including recommendations of Personal Protective Equipment (PPE) utilization, and modifications of Emergency Medical Dispatch (EMD) caller queries. The aim of the study was to estimate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of an EMD telephone screening process for the identification of hospital diagnosed COVID-19 positive patients. : A retrospective cohort study was conducted of adult EMS encounters presenting to hospitals within a large health system from March 16-June 30, 2020.

Evaluating a school-based science program that teaches the physiological effects of nicotine.

School-based drug prevention programs represent a widely endorsed public health goal, with an important aspect of knowledge-based curricula being education about the physiological effects of drugs. Nicotine is one of the world's most addictive substances and in this program we have used nicotine-induced mammalian-like behaviors in flatworms called planarians to successfully teach students (4th-12th grade; n = 1,616 students) about the physiological and addictive effects of nicotine. An initial study tested the change in knowledge about addictive substances in 6th-12th grade students after they completed a lab examining the effects of two concentrations of nicotine on the number of stereotypies (C-shaped spasms) planarians demonstrate in a 5-minute period of time.

Demographics and clinical patterns of burns requiring emergency hospitalization at a regional north-eastern us burn center.

Background: There are known demographic and clinical patterns related to burn injuries and care associated with national and global geography. Still, limited data sources exist to facilitate the study of trends in the regionalization of burn care.

Objectives: The current study aims to investigate the demographics and clinical characteristics of patients that presented to the Emergency Department (ED) and were subsequently admitted for treatment to the inpatient unit of a regional burn center.

The quick sequential organ failure assessment (qSOFA) identifies septic patients in the out-of-hospital setting.

Background: Recently a multispecialty, multinational task force convened to redefine the criteria for organ dysfunction, sepsis, severe sepsis, and septic shock. The study recommended the quick sequential organ failure assessment (qSOFA) score to identify sepsis patients. The qSOFA is felt to be the initial screen to prompt a more in-depth sepsis workup.

Cost analysis of strategies to reduce blood culture contamination in the emergency department: sterile collection kits and phlebotomy teams.

Objective: Blood culture collection practices that reduce contamination, such as sterile blood culture collection kits and phlebotomy teams, increase up-front costs for collecting cultures but may lead to net savings by eliminating downstream costs associated with contamination. The study objective was to compare overall hospital costs associated with 3 collection strategies: usual care, sterile kits, and phlebotomy teams.

Design: Cost analysis.

Reducing blood culture contamination in community hospital emergency departments: a multicenter evaluation of a quality improvement intervention.

Objectives: Blood culture contamination is a common and preventable problem in the emergency department (ED). In a previous single-center study, changing the process of ED blood culture collection from the traditional "clean," nonsterile procedure to a fully sterile procedure with standardized use of sterile gloves, large-volume chlorhexidine skin antisepsis, and fenestrated sterile drapes resulted in a substantial reduction in contamination. The objective of the current study was to evaluate the effectiveness of this sterile blood culture collection process for reducing blood culture contamination in two community hospital EDs.

Relation of platelet C4d with all-cause mortality and ischemic stroke in patients with systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease associated with significant morbidity, including premature cardiovascular disease, and mortality. Platelets bearing complement protein C4d (P-C4d) were initially determined to be specific for diagnosis of SLE and were later found to be associated with acute ischemic stroke in non-SLE patients. P-C4d may identify a subset of SLE patients with a worse clinical prognosis.

Conformational effect on energy transfer in single polythiophene chains.

Herein we describe the use of regioregular (rr-) and regiorandom (rra-) P3HT as models to study energy transfer in ordered and disordered single conjugated polymer chains. Single molecule fluorescence spectra and excitation/emission polarization measurements were compared with a Förster resonance energy transfer (FRET) model simulation. An increase in the mean single chain polarization anisotropy from excitation to emission was observed for both rr- and rra-P3HT.

Conformation and energy transfer in single conjugated polymers.

In contrast to the detailed understanding of inorganic materials, researchers lack a comprehensive view of how the properties of bulk organic materials arise from their individual components. For conjugated polymers to eventually serve as low cost semiconductor layers in electronic devices, researchers need to better understand their functionality. For organics, traditional materials science measurements tend to destroy the species of interest, especially at low concentrations.

Single-molecule spectroscopic study of dynamic nanoscale DNA bending behavior of HIV-1 nucleocapsid protein.

We have studied the conformational dynamics associated with the nanoscale DNA bending induced by human immunodeficiency virus type 1 (HIV-1) nucleocapsid (NC) protein using single-molecule Förster resonance energy transfer (SM-FRET). To gain molecular-level insights into how the HIV-1 NC locally distorts the structures of duplexed DNA segments, the dynamics, reversibility, and sequence specificity of the DNA bending behavior of NC have been systematically studied. We have performed SM-FRET measurements on a series of duplexed DNA segments with varying sequences, lengths, and local structures in the presence of the wide-type HIV-1 NC and NC mutants lacking either the basic N-terminal domain or the zinc fingers.

Mimicking conjugated polymer thin-film photophysics with a well-defined triblock copolymer in solution.

Conjugated polymers (CPs) are promising materials for use in electronic applications, such as low-cost, easily processed organic photovoltaic (OPV) devices. Improving OPV efficiencies is hindered by a lack of a fundamental understanding of the photophysics in CP-based thin films that is complicated by their heterogeneous nanoscale morphologies. Here, we report on a poly(3-hexylthiophene)-block-poly(tert-butyl acrylate)-block-poly(3-hexylthiophene) rod-coil-rod triblock copolymer.

Unmasking bulk exciton traps and interchain electronic interactions with single conjugated polymer aggregates.

For conjugated polymer materials, there is currently a major gap in understanding between the fundamental properties observed in single molecule measurements and the bulk electronic properties extracted from measurements of highly heterogeneous thin films. New materials and methodologies are needed to follow the evolution from single chain to bulk film properties as multiple chains begin to interact. In this work, we used a controlled solvent vapor annealing process to assemble single chains of phenylene-vinylene conjugated polymers into aggregates that can be individually spectroscopically interrogated.

Self-assembly of highly ordered conjugated polymer aggregates with long-range energy transfer.

Applications of conjugated polymers (CP) in organic electronic devices such as light-emitting diodes and solar cells depend critically on the nature of electronic energy transport in these materials. Single-molecule spectroscopy has revealed their fundamental properties with molecular detail, and recent reports suggest that energy transport in single CP chains can extend over extraordinarily long distances of up to 75 nm. An important question arises as to whether these characteristics are sustained when CP chains agglomerate into a neat solid.

Electronic energy transfer in highly aligned MEH-PPV single chains.

This paper describes the simultaneous measurement of excitation and emission anisotropy to visualize energy transfer in single chains of the prototypical conjugated polymer MEH-PPV, for samples with >70% of the single chains organized into extended, rod-like conformations. The uniformity and high degree of order of the single molecules in these experiments has allowed direct comparison of our experimental data to energy-transfer simulations in model polymer chains. Increases in average anisotropy from 0.

Hole localization in molecular crystals from hybrid density functional theory.

We use first-principles computational methods to examine hole trapping in organic molecular crystals. We present a computational scheme based on the tuning of the fraction of exact exchange in hybrid density functional theory to eliminate the many-electron self-interaction error. With small organic molecules, we show that this scheme gives accurate descriptions of ionization and dimer dissociation.

Electrogenerated chemiluminescence of conjugated polymer films from patterned electrodes.

A new phenomenon is presented in which electrogenerated chemiluminescence (ECL) is generated and propagates laterally as self-reinforcing waves as a result of the oxidation of a poly(9,9-dioctylfluorene-co-benzothiadiazole) thin film. In an ordered array of Au electrode posts that act as effective ECL nucleation sites, soliton-like waves were observed to expand from each site and annihilate upon collision with each other. Simulations of the ECL response supported the experimental observations that the ECL waves propagate at a constant speed.

Controlling chain conformation in conjugated polymers using defect inclusion strategies.

The Horner method was used to synthesize random copolymers of poly(2-methoxy-5-(2'-ethylhexyloxy)-p-phenylene vinylene) (MEH-PPV) that incorporated different backbone-directing monomers. Single-molecule polarization absorption studies of these new polymers demonstrate that defects that preserve the linear backbone of PPV-type polymers assume the highly anisotropic configurations found in defect-free MEH-PPV. Rigid defects that are bent lower the anisotropy of the single chain, and saturated defects that provide rotational freedom for the chain backbone allow for a wide variety of possible configurations.

Electrogenerated chemiluminescence of pure polymer films and polymer blends.

We recently reported the discovery of soliton-like electrogenerated chemiluminescence (ECL) waves from pure conjugated polymer films and gold-nanoparticles-doped polymer films. In addition to a more detailed study of these polymer systems by changing the film thickness and the distribution of local leaks, we also apply the ECL wave phenomenon to polymer blends of conjugated and nonconjugated polymers. Poly(9,9-dioctylfluorene-co-benzothiadiazole) (F8BT) is used as the active material that is oxidized and produces ECL with the presence of a co-reactant, tri-n-propylamine (TPA).