Use of ascending aortic access for imaging and wire rail access for endograft delivery in complex aortic arch anatomy.

In cases of complex aortic arch anatomy, it can be difficult to obtain wire access into the ascending aorta for deployment of a thoracic endograft (thoracic endovascular aortic repair [TEVAR]) using a transfemoral approach. This can result from tortuosity or patulous aneurysmal areas, making platform stability difficult. We report the case of a young adult man with a large proximal left subclavian aneurysm that made zone 0 TEVAR placement very difficult with transfemoral access alone.

Train-the-trainer: Pilot trial for ebola virus disease simulation training.

Background: Highly infectious but rare diseases require rapid dissemination of safety critical skills to health-care workers (HCWs). Simulation is an effective method of education; however, it requires competent instructors. We evaluated the efficacy of an internet-delivered train-the-trainer course to prepare HCWs to care for patients with Ebola virus disease (EVD).

Analysis of Mild Traumatic Brain Injury Outpatient Follow-Up.

Background: Mild traumatic brain injury (mTBI) remains a prevalent public health concern. Implementation of an mTBI guideline encouraged screening all patients at risk for mTBI, followed by outpatient follow-up in a "concussion clinic." This resulted in an increase in inpatient concussion evaluations, followed by high-volume referral to the concussion clinic.

Simulation Training Incorporating a Pulsatile Carotid Endarterectomy Model Results in Increased Procedure-Specific Knowledge, Confidence, and Comfort in Post-graduate Trainees.

Objectives: Surgical simulation has been used to facilitate the acquisition of vascular surgery skills. However, high cost and limited availability may restrict the use of this educational resource. We report how instruction using a low-cost, pulsatile, carotid endarterectomy (CEA) benchtop surgical simulation model can be used to enhance learners' procedure-specific knowledge, comfort, and confidence in performing the steps of a CEA procedure DESIGN: A single instructor engaged each participant in a one-on-one instructional session during which the instructor demonstrated, and then the participants performed, the steps of a CEA.

Analysis of an American College of Surgeons Committee on Trauma (ACS-COT) Approved Pilot Project: Increasing Provider Communication During Interhospital Transfer.

The American College of Surgeons Committee on Trauma requires physician-to-physician communication prior to interhospital transfer. This requirement can be difficult to achieve in high-volume trauma centers. This pilot project utilizes trauma advanced practice providers (APPs) as the primary communicator, in lieu of the trauma surgeon, prior to interhospital transfer.

Development of a pulsatile, tissue-based, versatile vascular surgery simulation laboratory for resident training.

Simulation in surgery is becoming an important component of surgical education. Training on bench top models has been demonstrated to improve technical skills. The objective of our project was to create a vascular surgery simulation model.

Analysis of Patient Follow-Up at a Level I Trauma Center in Ohio.

Trauma patients report being unprepared for hospital discharge. The purpose of this study was to identify follow-up compliance rates at our trauma clinic and identify factors associated with trauma patients' adherence to follow-up appointment. We recruited patients 15 years and older who were discharged from the trauma service between December 2014 and August 2015.

Pretrauma Functional Independence Measure Score Predicts Survival in Geriatric Trauma.

The Functional Independence Measure (FIM) is used by rehabilitation professionals to access disability. The FIM score combines both motor and cognitive parameters to assess a patient's level of required assistance in performing activities of daily living (ADL). The geriatric trauma patient is becoming an increasingly important cohort for trauma services.

Hospital incident command: First responders or receiving centers?

Objectives: (1) Propose a conceptual model of an alternative hospital incident management system (HIMS) that integrates concepts used by emergency operations centers (EOCs). (2) Compare HIMS to the standard hospital incident command system (HICS) model.

Design: A quasi-experimental study was performed.

Draft Genome Sequences of Three Flavobacterium psychrophilum Strains Isolated from Coldwater Disease Outbreaks at Three Production Hatcheries.

We report here the genome sequences of three Flavobacterium psychrophilum strains causing a bacterial coldwater disease (BCWD) outbreak, isolated from infected rainbow trout from hatcheries in Montana and South Dakota. The availability of these virulent outbreak-causing strain genome sequences will help further understand the pathogenesis of BCWD.

You cannot go home: routine concussion evaluation is not enough.

Traditional care of mild traumatic brain injury (MTBI) is to discharge patients from the emergency department (ED) if they have a Glasgow Coma Score (GCS) of 15 and a normal head computed tomography (CT) scan. However, this does not address short-term neurocognitive deficits. Our hypothesis is that a notable percentage of patients will need outpatient neurocognitive therapy despite a reassuring initial presentation.

Evidence-based patient handling: systematic review.

Background: This article summarises the findings of an international systematic review of patient handling. More than 880 papers were read, critically appraised and allocated a quality rating score. The evidence supports the provision of a minimal set of equipment for moving and handling patients, and multifactor intervention strategies based on risk assessment rather than those predominantly based on technique training.