Self-administered versus clinician-performed BinaxNOW COVID rapid test: a comparison of accuracy.

We conducted a single-center study at a free community testing site in Baltimore City to assess the accuracy of self-performed rapid antigen tests (RATs) for COVID-19. Self-administered BinaxNOW RATs were compared with clinician-performed RATs and against a reference lab molecular testing as the gold standard. Of the 953 participants, 14.

Feasibility of and Experience With Free State-Funded Telehealth-Based Patient Self-referral for COVID-19 Monoclonal Antibody Therapy.

Background: Monoclonal antibody (mAb) treatment for coronavirus disease 2019 (COVID-19) has been underutilized due to logistical challenges, lack of access, and variable treatment awareness among patients and health-care professionals. The use of telehealth during the pandemic provides an opportunity to increase access to COVID-19 care.

Methods: This is a single-center descriptive study of telehealth-based patient self-referral for mAb therapy between March 1, 2021, and October 31, 2021, at Baltimore Convention Center Field Hospital (BCCFH).

Baltimore City Health Department's Use of Public-Private Partnerships to Create a Continuum of COVID-19 Services for Special Populations.

The Baltimore City Health Department (BCHD) has developed a COVID-19 continuum of services to protect special populations at high risk of COVID-19 made possible through inter-agency and public-private partnerships. We present descriptions of each element along with descriptive data. Lessons are discussed to inform future public health frameworks.

High Sensitivity and NPV for BinaxNOW Rapid Antigen Test in Children at a Mass Testing Site during Prevalent Delta Variant Period.

SARS-CoV-2 continues to develop new, increasingly infectious variants including delta and omicron. We evaluated the efficacy of the Abbott BinaxNOW Rapid Antigen Test against Reverse Transcription PCR (RT-PCR) in 1,054 pediatric participants presenting to a high-volume Coronavirus Disease 2019 (COVID-19) testing site while the delta variant was predominant. Both tests utilized anterior nares swabs.

Implementation of Baltimore City's COVID-19 Isolation Hotel.

In May 2020, Baltimore City, Maryland, implemented the Lord Baltimore Triage, Respite, and Isolation Center (LBTC), a multiagency COVID-19 isolation and quarantine site tailored for people experiencing homelessness. In the first year, 2020 individuals were served, 78% completed isolation at LBTC, and 6% were transferred to a hospital. Successful isolation can mitigate outbreaks in shelters and residential recovery programs, and planning for sustainable isolation services integrated within these settings is critical as the COVID-19 pandemic continues.

Implementation and Accuracy of BinaxNOW Rapid Antigen COVID-19 Test in Asymptomatic and Symptomatic Populations in a High-Volume Self-Referred Testing Site.

Rapid antigen tests are simple to perform and provide results within 15 min. We describe our implementation and assess performance of the BinaxNOW COVID-19 Antigen Test (Abbott Laboratories) in 6,099 adults at a self-referred walk-up testing site. Participants were grouped by self-reported COVID-19 exposure and symptom status.

Infection Prevention Considerations for a Multi-Mission Convention Center Field Hospital in Baltimore, Maryland, During the COVID-19 Pandemic.

The state of Maryland identified its first case of coronavirus disease 2019 (COVID-19) on March 5, 2020. The Baltimore Convention Center (BCCFH) quickly became a selected location to set up a 250-bed inpatient field hospital and alternate care site. In contrast to other field hospitals throughout the United States, the BCCFH remained open throughout the pandemic and took on additional COVID-19 missions, including community severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostic testing, monoclonal antibody infusions for COVID-19 outpatients, and community COVID-19 vaccinations.

The Use of Intraosseous Fluid Resuscitation in a Pediatric Patient with Ebola Virus Disease.

Background: Vomiting, diarrhea, and severe dehydration are common manifestations of Ebola virus disease (EVD), leading to its high mortality. Mortality is especially high in patients older than 45 years, younger than 5 years, and in pregnant women and their fetuses. The majority of patients with EVD are not able to tolerate the quantities of oral hydration solutions necessary to rehydrate properly.

Orthopaedic Surgery Under National Health Reform: An Analysis of Power, Process, Adaptation, and Leadership: AOA Critical Issues.

Morrison argued that demography, economy, and technology drive the evolution of industries from a formative first-generation state ("First Curve") to a radically different way of doing things ("Second Curve") that is marked by new skills, strategies, and partners. The current health-reform movement in the United States reflects these three key evolutionary trends: surging medical needs of an aging population, dramatic expansion of Medicare spending, and care delivery systems optimized through powerful information technology. Successful transition from a formative first-generation state (First Curve) to a radically different way of doing things (Second Curve) will require new skills, strategies, and partners.

Overcoming resistance to implementation of integrated care pathways in orthopaedics.

The future of orthopaedic surgery will be shaped by unprecedented demographic and economic challenges, necessitating movement to so-called "second curve" innovations in the delivery of care. Implementation of integrated care pathways (ICPs) may be one solution to imminent cost and access pressures facing orthopaedic patients in this era of health-care accountability and reform. ICPs can lower costs and the duration of hospital stay while facilitating better outcomes through enhanced interspecialty communication.

Application of statistical process control to physician-specific emergency department patient satisfaction scores: a novel use of the funnel plot.

Objectives: Emergency department (ED) patient satisfaction remains a high priority for many hospitals. Patient surveys are a common tool for measuring patient satisfaction, and process improvement efforts are aimed at improving patient satisfaction scores. In some institutions, patient satisfaction scores can be calculated for each emergency physician (EP).

Finally "deliberate by design": milestones in the delivery of health care for U.S. military family members.

The development of medical care for U.S. military families and retirees was serendipitous, a fortunate accident.

Posttussive emesis as a symptom of asthma in children.

Background: Emesis can be triggered by cough in children, and cough is a common symptom of asthma.

Objective: To explore the association between posttussive emesis and asthma in the pediatric population.

Methods: A questionnaire was distributed to parents of children between the ages of 2 and 17 years in the pediatric and allergy-immunology clinics at our institution from August 16 through November 3, 2008.

Clinical response to unintentionally rapid infusion of drotrecogin alfa (activated).

Purpose: The case of a patient with severe sepsis who received a bolus dose of 184 microg/kg of drotrecogin alfa (activated) over one hour is reported.

Summary: An 84-year-old woman who had undergone right total knee replacement was admitted to the hospital from a rehabilitation facility with an initial diagnosis of mental status changes and a suspected urinary tract infection. Examination of the patient's incision from her recent knee surgery revealed a discharge, and a culture was obtained.

Decreased mortality associated with prompt Gram staining of blood cultures.

Gram stains of positive blood cultures are the most important factor influencing appropriate therapy. The sooner appropriate therapy is initiated, the better. Therefore, it is reasonable to expect that the sooner Gram stains are performed, the better.

Increased mortality rates of young children with traumatic injuries at a US army combat support hospital in Baghdad, Iraq, 2004.

Objective: The objective of this study was to determine whether age
Methods: A retrospective chart review was conducted of 1132 noncoalition trauma patients who were admitted to a combat support hospital between December 2003 and December 2004. Data on age, severity of injury indices, and in-hospital mortality rates were analyzed.

Pediatric care as part of the US Army medical mission in the global war on terrorism in Afghanistan and Iraq, December 2001 to December 2004.

Objective: Our objective in this report was to describe the epidemiologic features of and workload associated with pediatric admissions to 12 US Army military hospitals deployed to Iraq and Afghanistan.

Methods: The Patient Administration Systems and Biostatistics Activity database was queried for all local national patients <18 years of age who were admitted to deployed Army hospitals in Afghanistan and Iraq between December 2001 and December 2004.

Results: Pediatric admissions during the study period were 1012 (4.

Internet-based home monitoring and education of children with asthma is comparable to ideal office-based care: results of a 1-year asthma in-home monitoring trial.

Objective: The goal was to determine whether home asthma telemonitoring with store-and-forward technology improved outcomes, compared with in-person, office-based visits.

Methods: A total of 120 patients, 6 to 17 years of age, with persistent asthma were assigned randomly to the office-based or virtual group. The 2 groups followed the same ambulatory clinical pathway for 12 months.