SARS-CoV-2 control on a large urban college campus without mass testing.

Objective: A small percentage of universities and colleges conducted mass SARS-CoV-2 testing. However, universal testing is resource-intensive, strains national testing capacity, and false negative tests can encourage unsafe behaviors.

Participants: A large urban university campus.

Population-based hospitalization burden estimates for respiratory viruses, 2015-2019.

Background: Acute respiratory infections (ARIs) result in millions of illnesses and hundreds of thousands of hospitalizations annually in the United States. The responsible viruses include influenza, parainfluenza, human metapneumovirus, coronaviruses, respiratory syncytial virus (RSV), and human rhinoviruses. This study estimated the population-based hospitalization burden of those respiratory viruses (RVs) over 4 years, from July 1, 2015 to June 30, 2019, among adults ≥18 years of age for Allegheny County (Pittsburgh), Pennsylvania.

Emergency Department Communication in Persons Living With Dementia and Care Partners: A Scoping Review.

Objectives: To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research.

Design: Systematic scoping review.

Settings And Participants: PLWD and their care partners in the ED setting.

Performance of SARS-CoV-2 antigen testing in symptomatic and asymptomatic adults: a single-center evaluation.

Background: Antigen testing offers rapid and inexpensive testing for SARS-CoV-2 but concerns regarding performance, especially sensitivity, remain. Limited data exists for use of antigen testing in asymptomatic patients; thus, performance and reliability of antigen testing remains unclear.

Methods: 148 symptomatic and 144 asymptomatic adults were included.

Care transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement.

Objectives: Individual-level social needs have been shown to substantially impact emergency department (ED) care transitions of older adults. The Geriatric Emergency care Applied Research (GEAR) Network aimed to identify care transition interventions, particularly addressing social needs, and prioritize future research questions.

Methods: GEAR engaged 49 interdisciplinary stakeholders, derived clinical questions, and conducted searches of electronic databases to identify ED discharge care transition interventions in older adult populations.

Respiratory Viral Infections and Infection Prevention Practices Among Women With Acute Respiratory Illness During Delivery Hospitalizations During the 2019-2020 Influenza Season.

Background: We conducted a cross-sectional study of pregnant women with acute respiratory illness during delivery hospitalizations during influenza season to describe clinical testing for respiratory viruses and infection prevention practices.

Methods: Women had nasal swabs tested for influenza and other respiratory viruses. Among 91 enrolled women, 22 (24%) had clinical testing for influenza.

Influenza vaccine effectiveness among outpatients in the US Influenza Vaccine Effectiveness Network by study site 2011-2016.

Background: Influenza vaccination is recommended for all US residents aged ≥6 months. Vaccine effectiveness (VE) varies by age, circulating influenza strains, and the presence of high-risk medical conditions. We examined site-specific VE in the US Influenza VE Network, which evaluates annual influenza VE at ambulatory clinics in geographically diverse sites.

Cardiovascular Effects of Compression Garments During Uncompensable Heat Stress.

Bautz, J, Hostler, D, Khorana, P, and Suyama, J. Cardiovascular effects of compression garments during uncompensable heat stress. J Strength Cond Res 35(4): 1058-1065, 2021-This study examined the potential hemodynamic benefits of wearing lower extremity compression garments (CGs) beneath thermal protective clothing (TPC) worn by wildland firefighters, while exercising in a heated environment.

Delirium and Dementia.

Approximately 35% to 37% of older emergency department (ED) patients will have delirium or dementia, which can negatively affect safe and appropriate clinical care. This article describes the epidemiology of delirium and dementia in the ED and how it affects clinical care and patient outcomes. Screening for delirium and dementia in the context of the busy ED environment, as well as their diagnostic evaluation and management, is discussed.

Scene Safety and Force Protection in the Era of Ultra-Potent Opioids.

Ultra-potent opioids (fentanyl, carfentanil) are now widely available and fueling an epidemic of overdose. First responders are increasingly exposed to these potent narcotics necessitating guidance for scene safety and force protection from medical directors. Reports in lay media have sensationalized accounts of exposure and harm that may lead providers to fear providing care to patients suspected of opioid overdose.

Delayed Detection of Spontaneous Bilateral Tubal Ectopic Pregnancies After Methotrexate Treatment.

Background: Bilateral tubal ectopic pregnancies are a rare subset of ectopic pregnancy that can pose a diagnostic dilemma for clinicians. There is no distinct clinical presentation for bilateral tubal ectopic pregnancies, although they are typically associated with assistive reproductive techniques. In addition, there is no single diagnostic feature to help clinicians delineate bilateral tubal ectopic pregnancies from other types of ectopic pregnancy prior to passing the discriminatory zone (such as heterotopic pregnancy or twin ectopic [two gestational sacs in one tube]).

Cardiorespiratory Fitness Is Associated with Gait Changes among Firefighters after a Live Burn Training Evolution.

Background: Recommendations have been proposed for minimum aerobic fitness among firefighters but it is unclear if those criteria relate to performance on the fireground. Less fit individuals fatigue more quickly than fit individuals when working at comparable intensity and may have gait changes, increasing risk of falls. We evaluated the effect of fatigue during a live burn evolution on gait parameters and functional balance comparing them to aerobic fitness levels.

Pilot Study Examining the Effects of Atropine on Performance during Uncompensable Heat Stress.

Unlabelled: In many operational scenarios, hypohydration can be corrected with oral rehydration following the work interval. Although rare, there are potential situations that require extended intervals of uncompensable heat stress exposure while working in personal protective equipment (PPE). Under these conditions, retention of body water may be valuable to preserve work capacity and reduce cardiovascular strain.

A Mobile Alert System for Preparing the Delivery of Radiation Mitigators.

Background/aim: A mobile system allowing hospital medical personnel to prepare for the administration of radiation mitigators prior to receiving casualties is desirable.

Materials And Methods: We evaluated a portable spectroscopic personal radiation detector for use as an ambulance-based unit for early detection and identification of gamma radiation. We tested the sensitivity, time-to-identification, and radionuclide identification accuracy rates, change in detector response to vehicle operation, interference from cardiac equipment, and internal versus external radiation source location.

Exertional heat illness: emerging concepts and advances in prehospital care.

Exertional heat illness is a classification of disease with clinical presentations that are not always diagnosed easily. Exertional heat stroke is a significant cause of death in competitive sports, and the increasing popularity of marathons races and ultra-endurance competitions will make treating many heat illnesses more common for Emergency Medical Services (EMS) providers. Although evidence is available primarily from case series and healthy volunteer studies, the consensus for treating exertional heat illness, coupled with altered mental status, is whole body rapid cooling.

The effects of ice slurry ingestion before exertion in Wildland firefighting gear.

Purpose: To investigate the effect of ice slurry ingestion precooling on body core temperature (Tc) during exertion in wildland firefighting garments in uncompensable heat stress.

Methods: On two separate trials, 10 males ingested 7.5 g·kg(-1) of either an ice slurry (0.

A randomized controlled trial of aspirin and exertional heat stress activation of platelets in firefighters during exertion in thermal protective clothing.

Purpose: Platelet aggregation is enhanced in firefighters following short bouts of work in thermal protective clothing (TPC). We sought to determine if aspirin therapy before and/or following exertion in TPC prevents platelet activation.

Methods: In a double-blind, placebo-controlled study, 102 firefighters were randomized to receive daily therapy (81 mg aspirin or placebo) for 14 days before and a single dose (325 mg aspirin or placebo) following exercise in TPC resulting in four potential assignments: aspirin before and after exercise (AA), placebo before and after exercise (PP), aspirin before and placebo after exercise (AP), and placebo before and aspirin after exercise (PA).

Effectiveness of three just-in-time training modalities for N-95 mask fit testing.

Objective: To compare and contrast three different training modalities for fit testing N-95 respirator face masks.

Design: Block randomized interventional study.

Setting: Urban university.

What does it cost to prevent on-duty firefighter cardiac events? A content valid method for calculating costs.

Cardiac arrest is a leading cause of mortality among firefighters. We sought to develop a valid method for determining the costs of a workplace prevention program for firefighters. In 2012, we developed a draft framework using human resource accounting and in-depth interviews with experts in the firefighting and insurance industries.

Validation of the OMNI Scale of Thermal Sensations.

Concurrent and construct validation of the OMNI Scale of Thermal Sensations was examined in a sample of 16 adult men and 5 adult women. Concurrent validity was established by regressing OMNI ratings of thermal sensation against core and skin temperatures obtained during treadmill walking while wearing firefighter thermal-protective clothing in temperatures between 33 and 35 degrees C. Construct validity was established by regressing the OMNI scale against a construct-specific visual analogue scale.

Interceptor and Phantom Trials of EDNS at UPMC.

University of Pittsburgh Medical Center (UPMC) installed an Emergency Department Notification System (EDNS) in one of its hospitals. The system, manufactured by Thermo Fisher Scientific (Thermo Fisher Scientific, Inc., 81 Wyman Street, Waltham, MA 02454), consists of four NaI(Tl) scintillation detectors, a 2.

The effect of prolonged light intensity exercise in the heat on executive function.

Objective: When people are involved in outdoor activities, it is important to be able to assess a situation and make rational decisions. The goal of this study is to determine the effects of 90 minutes of light-intensity exercise in a hot environment on executive functioning capabilities of healthy individuals.

Methods: In this prospective laboratory study, 40 healthy male and female subjects 18 to 45 years of age performed treadmill exercise while wearing athletic clothing and a backpack in either a hot or temperate environment.

Association of over-the-counter pharmaceutical sales with influenza-like-illnesses to patient volume in an urgent care setting.

We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.

Mitigation and prevention of exertional heat stress in firefighters: a review of cooling strategies for structural firefighting and hazardous materials responders.

Most duties performed by firefighters require the use of personal protective equipment, which inhibits normal thermoregulation during exertion, creating an uncompensable heat stress. Structured rest periods are required to correct the effects of uncompensable heat stress and ensure that firefighter safety is maintained and that operations can be continued until their conclusion. While considerable work has been done to optimize firefighter cooling during fireground operations, there is little consensus on when or how cooling should be deployed.

The relationship between physical activity and thermal protective clothing on functional balance in firefighters.

We investigated the relationship between baseline physical training and the use of firefighting thermal protective clothing (TPC) with breathing apparatus on functional balance. Twenty-three male firefighters performed a functional balance test under four gear/clothing conditions. Participants were divided into groups by physical training status, and task performance was analyzed.