Prehospital Traction Splint Use in Midthigh Trauma Patients.

Context: Traction splint (TS) use during emergency medical system transport has been theorized to relieve pain, limit continued injury from loose bone fragments, and decrease potential bleeding space in the injured thigh.

Aims: This study aimed to evaluate the benefit of prehospital TS (PTS) application, using data from the trauma registry at a large Level 1 trauma center.

Methods: A retrospective review of patients from the NTRACS and Trauma One registry at an American College of Surgeons-verified Level 1 trauma center was conducted.

The Efficacy of Antivenin Latrodectus (Black Widow) Equine Immune F(ab') Versus Placebo in the Treatment of Latrodectism: A Randomized, Double-Blind, Placebo-Controlled, Clinical Trial.

Study Objective: The antivenom currently available for treatment of systemic black widow envenomation (latrodectism) is composed of equine whole immunoglobin. Although considered effective, it has been associated with anaphylaxis and 2 reported fatalities. We test the efficacy and safety of new equine antivenom composed of purified F(ab') antibody fragments.

Pre-hospital qSOFA as a predictor of sepsis and mortality.

Background: The quick sequential organ failure assessment score (qSOFA) has been proposed as a simple tool to identify patients with sepsis who are at risk for poor outcomes. Its utility in the pre-hospital setting has not been fully elucidated.

Methods: This is a retrospective observational study of adult patients arriving by ambulance in September 2016 to an academic emergency department in Fresno, California.

Emergency Medical Services and Remote Medical Oversight in Sequoia and Kings Canyon National Parks, 2011-2013.

Introduction: The University of California San Francisco Fresno Department of Emergency Medicine provides base hospital support for the Sequoia and Kings Canyon National Parks (SEKI) emergency medical services (EMS) system. This descriptive epidemiologic study reports reasons the park EMS system is used and interventions provided, detailing the nature of patient encounters, type and frequency of injuries and interventions, reasons for base hospital contact, and patient dispositions.

Methods: Patient charts for all EMS encounters in SEKI from 2011 to 2013 were included, and relevant data were extracted by a single reviewer.

Teaching Methods Utilized During Medical Resuscitations in an Academic Emergency Department.

Introduction: One important skill that an emergency medicine trainee must learn is the resuscitation of the critically ill patient. There is research describing clinical teaching strategies used in the emergency department (ED), but less is known about specific methods employed during actual medical resuscitations. Our objective was to identify and describe the teaching methods used during medical resuscitations.

Hot and Cold Drugs: National Park Service Medication Stability at the Extremes of Temperature.

Study Objective: National Park Service (NPS) Parkmedics provide medical care in austere environments. The objective of this study was to evaluate the stability of specific medications used by Parkmedics at extremes of temperatures likely to be faced in the field.

Methods: This is a bench research study conducted in the laboratory setting over a 4-week period.

Pressures of Wilderness Improvised Wound Irrigation Techniques: How Do They Compare?

Objective: Compare the pressures measured by improvised irrigation techniques to a commercial device and to prior reports.

Methods: Devices tested included a commercial 500-mL compressible plastic bottle with splash guard, a 10-mL syringe, a 10-mL syringe with a 14-ga angiocatheter (with needle removed), a 50-mL Sawyer syringe, a plastic bag punctured with a 14-ga needle, a plastic bottle with cap punctured by a 14-ga needle, a plastic bottle with sports top, and a bladder-style hydration system. Each device was leveled on a support, manually compressed, and aimed toward a piece of glass.

Pediatric Tape: Accuracy and Medication Delivery in the National Park Service.

Introduction: The objective is to evaluate the accuracy of medication dosing and the time to medication administration in the prehospital setting using a novel length-based pediatric emergency resuscitation tape.

Methods: This study was a two-period, two-treatment crossover trial using simulated pediatric patients in the prehospital setting. Each participant was presented with two emergent scenarios; participants were randomized to which case they encountered first, and to which case used the National Park Service (NPS) emergency medical services (EMS) length-based pediatric emergency resuscitation tape.

A lightning multiple casualty incident in Sequoia and Kings Canyon National Parks.

Multiple casualty incidents (MCIs) are uncommon in remote wilderness settings. This is a case report of a lightning strike on a Boy Scout troop hiking through Sequoia and Kings Canyon National Parks (SEKI), in which the lightning storm hindered rescue efforts. The purpose of this study was to review the response to a lightning-caused MCI in a wilderness setting, address lightning injury as it relates to field management, and discuss evacuation options in inclement weather incidents occurring in remote locations.

Lightning safety awareness of visitors in three California national parks.

Objective: To assess the level of lightning safety awareness among visitors at 3 national parks in the Sierra Nevada Mountains of California.

Methods: A 12-question, short answer convenience sample survey was administered to participants 18 years of age and over concerning popular trails and points of interest with known lightning activity. There were 6 identifying questions and 5 knowledge-based questions pertaining to lightning that were scored on a binary value of 0 or 1 for a total of 10 points for the survey instrument.

Inaccuracy of the global assessment score in the emergency medicine standard letter of recommendation.

Objectives: The standard letter of recommendation (SLOR) is used by most emergency medicine (EM) faculty to submit evaluations for medical students applying for EM residency programs. In the global assessment score (GAS) section, there is a crucial summative question that asks letter writers to estimate the applicant's rank order list (ROL) position in their own program. The primary aim of the study was to determine if these estimated global assessment tiers agreed with the actual ROL, using the criteria recommended by the Council of Emergency Medicine Residency Directors (CORD).

A comparison of GlideScope video laryngoscopy versus direct laryngoscopy intubation in the emergency department.

Objectives: The first-attempt success rate of intubation was compared using GlideScope video laryngoscopy and direct laryngoscopy in an emergency department (ED).

Methods: A prospective observational study was conducted of adult patients undergoing intubation in the ED of a Level 1 trauma center with an emergency medicine residency program. Patients were consecutively enrolled between August 2006 and February 2008.