Analyzing unmanned aerial vehicle (drone) attacks; a disaster medicine perspective.

Introduction: Unmanned aerial vehicles (UAVs), more commonly known as drones, have rapidly become more diverse in capabilities and utilization through technology advancements and affordability. While drones have had significant positive impact on healthcare and consumer delivery particularly in remote and austere environments, Violent Non-State Actors (VNSAs) have increasingly used drones as weapons in planning and executing terrorist attacks resulting in significant morbidity and mortality. We aim to analyze drone-related attacks globally against civilians and critical infrastructure for more effective hospital and prehospital care preparedness.

Trends and Characteristics of Terrorist Attacks Against Nightclub Venues Over 5 Decades.

Introduction: Nightclubs are entertainment and hospitality venues historically vulnerable to terrorist attacks. This study identified and characterized terrorist attacks targeting nightclubs and discotheques documented in the Global Terrorism Database (GTD) over a 50-y period.

Methods: A search of the Global Terrorism Database (GTD) was conducted from 1970 to 2019.

Discrepancies between Retrospective Review of "Real-Time" Electronic Health Record Documentation and Prospective Observer Documentation of In-Hospital Cardiac Arrest Quality Metrics in an Academic Cardiac Intensive Care Unit.

Background: Every year, approximately 200,000 patients will experience in-hospital cardiac arrest (IHCA) in the United States. Survival has been shown to be greatest with the prompt initiation of CPR and early interventions, leading to the development of time-based quality measures. It is uncertain how documentation practices affect reports of compliance with time-based quality measures in IHCA.

Terrorist attacks against women's healthcare facilities 1970-2018.

Introduction: Targeted acts of violence against women's healthcare facilities and healthcare providers are a continued threat to the safety and well-being of those seeking reproductive care as well as those who provide it around the world.

Study Objectives: This study aims to review and analyze terrorist attacks against facilities and providers who offer women's healthcare services globally.

Methods: A thorough analysis of data coming from the Global Terrorism Database (GTD) was performed.

Association Between Primary Care Availability and Emergency Medical Services Utilization.

Background: Emergency medical services (EMS) contribute to the vital role of providing health care to an individual by delivering time-sensitive, episodic treatment to patients with acute illnesses. Understanding which factors impact EMS utilization can help guide policies and allocate resources more effectively. Increasing primary care access has often been touted to decrease unnecessary emergency care utilization.

Terrorist Attacks against Sports Venues: Emerging Trends and Characteristics Spanning 50 Years.

Introduction: Sports venues foster community and support local economies. Due to their capacity to host hundreds to thousands of spectators, sports venues are vulnerable to becoming targets of terrorism. Types of venues targeted, regional trends, and methods of attack employed world-wide have not been well-described.

Terrorist Attacks Against Firefighters, 1970-2019.

Firefighters are a critical component of the emergency response system and therefore a potential target for organizations seeking to disrupt this system. Terrorist organizations may deliberately attack firefighters to both increase the devastation of an attack and impair the affected community's ability to respond to an attack. We performed a focused search of the Global Terrorism Database to identify terrorist attacks against firefighters worldwide.

Terrorist attacks against emergency departments.

Introduction: Emergency departments (EDs) play an integral role in a community's response to disaster. Terrorist attacks targeting EDs have the potential to disrupt the emergency response apparatus. Understanding prior attacks against EDs can yield important lessons to mitigate the impact of future violence.

Strengthening Emergency Department Resiliency - Resident Deployment Considerations during a Mass-Casualty Incident.

In the event of a mass-casualty incident (MCI), hospital emergency departments (EDs) may be called upon to provide care to a large number of critically ill patients. As EDs plan for MCIs, determining how to best allocate staff members can play a significant role in the success or failure of a response. In academic EDs, a group that is often overlooked during MCI planning is the resident physicians.

Terrorist Attacks Against Performing Arts Venues: Global Trends and Characteristics Spanning 50 Years.

Introduction: In fostering community and culture through entertainment in shared spaces, performing arts venues have also become targets of terrorism. A greater understanding of these attacks is needed to assess the risk posed to different types of venues, to inform medical disaster preparedness, to anticipate injury patterns, and to reduce preventable deaths.

Methods: A search of the Global Terrorism Database (GTD) was conducted from the year 1970 through 2019.

Changes in EMS utilization in the state of Maryland during the first 6 months of the COVID-19 pandemic.

Introduction And Objectives: Emergency medical services (EMS) is an invaluable healthcare resource, providing life-saving care in the prehospital setting. During the COVID-19 pandemic, there have been concerns that healthcare resources, including EMS, would be overwhelmed by the potential surge in critically ill patients. This study seeks to determine the impact of the COVID-19 pandemic on EMS utilization in the state of Maryland.

Emergency department active shooter training: A survey of current practices in 2020.

Background: Shooting events in hospitals are increasing in frequency, with the emergency department (ED) being the most common site of such events. EDs must be prepared for shooting events, but current practices surrounding active shooter preparation are unknown.

Objective: To determine what active shooter training emergency medicine physicians are receiving.

The Rising Threat of Terrorist Attacks Against Hospitals.

Introduction: Hospitals are vulnerable to terrorist attacks, as they must remain easily accessible to the general public. Hospitals are also occupied with both staff and patients 24 hours a day, 365 days a year, meaning that any attack is almost guaranteed to inflict a multitude of casualties. In addition to the immediate effects of attacking a hospital, there are also uniquely devastating second- and third-order effects when hospitals are attacked.

Emergency medical services operations during civil unrest: Best practices from lessons learned.

During periods of civil unrest, emergency medical services (EMSs) clinicians will be called upon to provide care to those impacted, including those who are actively instigating violence. Working during periods of civil unrest poses significant operational and security challenges to EMS leadership and clinicians. This review provides best practices for EMS operating during periods of civil unrest through analysis of after action reports from Baltimore, Maryland; Charlottesville, North Carolina; Minneapolis, Minnesota; and Washington, DC.

Inner ear decompression sickness in a hyperbaric chamber inside tender: a case report.

Inner ear decompression sickness (IEDCS) is a rare diving complication that presents with vestibular dysfunction, cochlear dysfunction, or a combination of both. While scuba diving is a known cause, no cases have been reported in the occupational hyperbaric setting. We present the case of a 55-year-old man who developed IEDCS after working as a hyperbaric multiplace chamber inside tender.

Terrorist Attacks Against Vaccinators: A Review.

Vaccinators fulfill an important role in a nation's public health by reducing the burden of disease on the population. Understanding patterns of attack employed against vaccinators is important to determine how to protect them. We conducted a search of the Global Terrorism Database for terrorist attacks against vaccinators that occurred between the years 1970 and 2018.

Terrorist Attacks Against Healthcare Facilities: A Review.

Healthcare facilities play an essential role in response to terrorist attacks, but they also can be "soft targets" due to their accessibility and limited security. In this review, the authors used the Global Terrorism Database to conduct a search on terrorist attacks directed against hospitals and healthcare facilities between 1970 and 2018. Search terms included "healthcare," "doctor," "nurses," "vaccinators," "clinic," and "hospital," which resulted in 2,322 healthcare-related entries.

Difficulty Ventilating: A Case Report on Ventilation Considerations of an Intubated Asthmatic Undergoing Air Medical Critical Care Transport.

The air medical transport of intubated patients is a high-risk mission that requires preplanning before helicopter launch. This case describes a scenario in which the helicopter emergency medical services (HEMS) team was unable to ventilate a patient because of the mechanical limitations of the transport ventilator. The HEMS mission was ultimately aborted, and the patient had to be transported by a ground crew equipped with a hospital-based ventilator.

Terrorists Use of Ambulances for Terror Attacks: A Review.

Introduction: Using an ambulance as an attack modality offers many advantages to a terrorist organization. Ambulances can carry more explosives than most vehicles and can often bypass security. Yet, studies examining how terrorist organizations have incorporated ambulances into their attacks are lacking.

The Evolving Landscape of Acute Pain Management in the Era of the Opioid Crisis.

Purpose Of Review: The purpose of the study is to evaluate and analyze the role of both opioid and non-opioid analgesics in the emergency department (ED).

Recent Findings: Studies have shown that the implementation of opioid-prescribing policies in the ED has the potential to reduce the opioid addiction burden. Clinical studies point to inconsistencies in providers' approach to pain treatment.

Immediate Stress Echocardiography for Low-Risk Chest Pain Patients in the Emergency Department: A Prospective Observational Cohort Study.

Background: Evaluation and disposition of low-risk chest pain (CP) patients in the emergency department (ED) is time consuming and expensive. Low-risk CP often results in hospital admission to rule out myocardial infarction, which leads to additional costs and delays.

Objective: Our aim was to assess whether an immediate exercise stress echocardiogram (IESE) in the ED will allow safe, efficient, and cost-effective evaluation and discharge of patients with low-risk CP.

Emerging trends in antibiotic resistance: Implications for emergency medicine.

Background: Many bacteria are demonstrating increasing levels of resistance to commonly used antibiotics. While this has implications for the healthcare system as a whole, many patients infected with these resistant organisms will initially present to the emergency department (ED). The purpose of this review is to provide a summary of current trends in infections caused by the most clinically relevant resistant organisms encountered in emergency medicine.