United States Federal Emergency Management Agency regional clustering by disaster exposure: a new paradigm for disaster response.

The Federal Emergency Management Agency (FEMA) divides the United States (US) into ten standard regions to promote local partnerships and priorities. These divisions, while longstanding, do not adequately address known hazard risk as reflected in past federal disaster declarations. From FEMA's inception in 1979 until 2020, the OpenFEMA dataset reports 4127 natural disaster incidents declared by 53 distinct state-level jurisdictions, listed by disaster location, type, and year.

Virtual Reality Training in Disaster Medicine: A Systematic Review of the Literature.

Disaster medicine (DM) training aims to recreate stressful, mass casualty scenarios faced by medical professionals in the field with high fidelity. Virtual (VR) and augmented reality (AR) are well suited to disaster training as it can provide a safe, socially distant simulation with a high degree of realism. The purpose of this literature review was to summarize the current use of VR or AR for simulation training of healthcare providers in DM education.

Half-a-Century of Terrorist Attacks: Weapons Selection, Casualty Outcomes, and Implications for Counter-Terrorism Medicine.

Background: High profile terrorist attacks in major capital cities have seemingly become a regular occurrence and the resultant mass-casualty events continue to challenge health care systems. Counter-Terrorism Medicine (CTM) addresses unique terrorism-related issues relating to the mitigation, preparedness, and response measures to asymmetric, multi-modality terrorist attacks. This study is an epidemiological examination of all terrorism-related events sustained from 1970-2019, analyzing historical weapon types used and the resulting fatal injuries (FI) and non-fatal injuries (NFI) sustained.

Emergency Physician Twitter Use in the COVID-19 Pandemic as a Potential Predictor of Impending Surge: Retrospective Observational Study.

Background: The early conversations on social media by emergency physicians offer a window into the ongoing response to the COVID-19 pandemic.

Objective: This retrospective observational study of emergency physician Twitter use details how the health care crisis has influenced emergency physician discourse online and how this discourse may have use as a harbinger of ensuing surge.

Methods: Followers of the three main emergency physician professional organizations were identified using Twitter's application programming interface.

Discharge in Pandemic: Suspected Covid-19 patients returning to the Emergency Department within 72 hours for admission.

Introduction: Coronavirus disease 2019 (Covid-19) has led to unprecedented healthcare demand. This study seeks to characterize Emergency Department (ED) discharges suspected of Covid-19 that are admitted within 72 h.

Methods: We abstracted all adult discharges with suspected Covid-19 from five New York City EDs between March 2nd and April 15th.

Crisis Standards of Care Implementation at the State Level in the United States.

Introduction: In 2009, the Institute of Medicine published guidelines for implementation of Crisis Standards of Care (CSC) at the state level in the United States (US). Based in part on the then concern for H1N1 pandemic, there was a recognized need for additional planning at the state level to maintain health system preparedness and conventional care standards when available resources become scarce. Despite the availability of this framework, in the years since and despite repeated large-scale domestic events, implementation remains mixed.

Clinical Outcomes and Immunologic Characteristics of Coronavirus Disease 2019 in People With Human Immunodeficiency Virus.

We performed a retrospective study of coronavirus disease 2019 (COVID-19) in people with human immunodeficiency virus (PWH). PWH with COVID-19 demonstrated severe lymphopenia and decreased CD4+ T cell counts. Levels of inflammatory markers, including C-reactive protein, fibrinogen, D-dimer, interleukin 6, interleukin 8, and tumor necrosis factor α were commonly elevated.

Stellate Ganglion Nerve Block by Point-of-Care Ultrasonography for Treatment of Refractory Infarction-Induced Ventricular Fibrillation.

Stellate ganglion blockade has been previously suggested as a treatment option for intractable ventricular arrhythmia; however, its use in emergency department management of pulseless arrest with shockable rhythm has not been described. We report the case of a 65-year-old man brought in by ambulance who complained of chest pain and received an out-of-hospital ECG suggestive of anterior-wall ST-segment elevation myocardial infarction. Shortly after arrival, the patient became unresponsive, with no palpable pulse, and was found to be in ventricular fibrillation.

Health literacy and medication awareness in outpatient neurology.

AS RESEARCHERS CONTINUE TO ILLUMINATE THE COMPLEXITIES OF NEUROLOGIC DISORDERS AND THEIR MANAGEMENT, THE CLINICIAN FACES AN EQUALLY INTENSIFYING BURDEN: how to communicate these advances effectively to patients. Health literacy (HL) refers to a person's ability to find, comprehend, and use basic information and resources in order to make appropriate decisions related to his or her health. We describe the first study of low HL prevalence using a validated measure in a cohort of adult neurology outpatients without dementia.