Stop the Bleed: Effective Training in Need of Improvement.

Background: The "Stop the Bleed" (StB) campaign aims to educate laypersons on performing bleeding control techniques in any setting that requires hemorrhage control, such as motor vehicle crashes or mass casualty incidents. Participants undergo a didactic and practical session, the latter incorporating a mannequin. We hypothesized that participants would increase content knowledge after StB participation and that the training could be improved by a more life-like bleeding modification of the mannequin.

Trauma Response Nurse: Bringing Critical Care Experience and Continuity to Early Trauma Care.

Multitrauma patients can benefit significantly from specialized care. Prior to mid-2016, this hospital's trauma team did not include a surgical intensive care unit (SICU) nurse. As the value of bringing this expertise to the patient upon arrival was realized, the role of the trauma response nurse (TRN) was developed.

The Incidence of Complications Is Low Following Foot and Ankle Surgery for Which Peripheral Nerve Blocks Are Used for Postoperative Pain Management.

Background: The incidence of neurologic complications from foot and ankle surgery utilizing regional anesthesia is not well established.

Questions/purposes: The purpose of this study was to prospectively determine the incidence of neurologic and peripheral nerve block (PNB) site complications on a busy foot and ankle service that utilizes ankle blocks (ABs) and popliteal blocks (POPs).

Patients And Methods: This prospective observational study included patients undergoing foot and ankle surgery with ABs or POPs.

Post-Dural Puncture Headache is Uncommon in Young Ambulatory Surgery Patients.

Background: The incidence of post-dural puncture headache (PDPH) arising from spinal anesthesia in the general population is low. However, patients under 45 years have been shown to exhibit a higher incidence of PDPH, even with small needles.

Questions/purposes: This study aimed to estimate the incidence of PDPH from a 27G pencil-point needle in ambulatory surgery patients between the ages of 15-45 years and compare incidence of PDPH by age group, sex, and history of headache.

Identification and quantification of nuisance odors at a trash transfer station.

The objective of this study was to evaluate the effectiveness of a modified Odor Profile Method (OPM) at a trash transfer station (TTS). An updated Landfill Odor Wheel was used to define odor character and distinguish among odor sources. The Flavor Profile Analysis (FPA) intensity scale was used to rank the relative intensity of the various odor characters defined by the odor wheel and to understand how each odor profile changed off site.

Pregabalin and pain after total knee arthroplasty: a double-blind, randomized, placebo-controlled, multidose trial.

Background: Pregabalin may reduce postoperative pain and opioid use. Higher doses may be more effective, but may cause sedation and confusion. This prospective, randomized, blinded, placebo-controlled study tested the hypothesis that pregabalin reduces pain at 2 weeks after total knee arthroplasty, but increases drowsiness and confusion.

Comparison of two standard odor intensity evaluation methods for odor problems in air or water.

Government agencies responsible for ensuring healthful water and/or air quality are often faced with resolving public complaints of nuisance odors. Understanding variations in odor intensity may ultimately lead to the establishment and application by such agencies of quantitative limits for effective odorant control. An odor panel was trained in suprathreshold odor intensity evaluation using both the ASTM Method E544 (Butanol Method) and the APHA Method 2170 (Flavor Profile Analysis (FPA) Method).

Coagulopathy after a liver resection: is it over diagnosed and over treated?

Background: Prothrombin time-international normalized ratio (PT-INR) is widely utilized to guide plasma therapy and initiation of thromboprophylaxis after a hepatectomy. Thrombelastography (TEG) monitors shear elasticity, which is sensitive to cellular and plasma components in blood, allowing for functional assessment of the life of the clot. The objective of this study was to prospectively compare PT-INR and TEG in liver resection patients.

A field studies and modeling approach to develop organochlorine pesticide and PCB total maximum daily load calculations: case study for Echo Park Lake, Los Angeles, CA.

Echo Park Lake is a small lake in Los Angeles, CA listed on the USA Clean Water Act Section 303(d) list of impaired water bodies for elevated levels of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in fish tissue. A lake water and sediment sampling program was completed to support the development of total maximum daily loads (TMDL) to address the lake impairment. The field data indicated quantifiable levels of OCPs and PCBs in the sediments, but lake water data were all below detection levels.

Identification of subwatershed sources for chlorinated pesticides and polychlorinated biphenyls in the Ballona Creek watershed.

Santa Monica Bay forms part of the western border of the greater Los Angeles region. The Ballona Creek watershed is highly urbanized and past studies indicate that Ballona Creek is the largest source for most pollutants to Santa Monica Bay. This study evaluates the contribution of subwatersheds to PCB and chlorinated pesticide loading during wet weather flow.

Support needs of brain tumour patients and their carers: the place of a telephone service.

Although the survival rate for many cancers has improved over the past two decades this has not happened for most patients with a primary malignant brain tumour. Numbers of patients diagnosed with this condition each year are small, and as expertise is often very limited, information, advice, and support can be difficult for patients and carers to access. The role of the appropriately trained nurse in meeting these needs has been well researched and published literature supports the development of such roles.

Transplacental flecainide therapy for fetal supraventricular tachycardia in a twin pregnancy.

We present the case of a twin pregnancy in which 1 fetus developed hydrops secondary to supraventricular tachycardia at 30 weeks' gestation. Transplacental flecainide administration successfully treated the condition without evidence of maternal or fetal side-effects. The case raises ethical and possibly legal issues that present when 1 fetus in a twin pregnancy develops a condition the management of which could cause complications to the other twin and/or the mother.

Noninvasive positive pressure ventilation.

Preview In most cases of acute respiratory failure, mechanical ventilation and endotracheal intubation are the preferred treatment. However, a noninvasive approach is proving valuable in selected patients and has some advantages over standard mechanical ventilation. How are patients selected for this therapy? What are its risks and benefits? The authors discuss the usefulness and potential role of this important new technique.

Protection against lethal Sendai virus infection by in vivo priming of virus-specific cytotoxic T lymphocytes with a free synthetic peptide.

The only peptide of Sendai virus that is recognized by cytotoxic T lymphocytes (CTL) in B6 mice was found with (i) the use of recombinant vaccinia virus constructs containing separate genes of Sendai virus and (ii) a set of overlapping peptides completely spanning the identified nucleoprotein (NP) gene product. This immunodominant NP peptide is recognized by Sendai virus-specific CTL that are known to have therapeutic effects in vivo. By subcutaneous immunization, this peptide induced Sendai virus and NP peptide-specific CTL memory responses in vivo.