Publications by authors named "Matthew Kiefer"

Development of personal and social skills in a classroom prevents later drug use and alcohol abuse, and influence-related risk factors. However, clinical trials on the potential impact of such programs from low- or middle-income countries remain limited. Lions Quest Skills for Adolescence (LQSFA), a school-based prevention intervention supporting life skills, was implemented in three South East European countries.

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Introduction: In hospital cardiac arrest (IHCA) affects 200,000 adults in the United States each year, and resuscitative efforts are often suboptimal. The objective of this study was to determine whether a program of "mock codes" improves group-level performance of IHCA skills. Our primary outcome of interest was change in CPR fraction, and the secondary outcomes of interest were time to first dose of epinephrine and time to first defibrillation.

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Introduction: Prehospital first responders historically have used an IV bolus of 50 mL of 50% dextrose solution (D50) for the treatment of hypoglycemia in the field. A local Emergency Medical Services (EMS) system recently approved a hypoglycemia treatment protocol of IV 10% dextrose solution (D10) due to occasional shortages and higher cost of D50. We use the experience of this EMS system to report the feasibility, safety, and efficacy of this approach.

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Introduction: Prehospital first responders historically have treated hypoglycemia in the field with an IV bolus of 50 mL of 50% dextrose solution (D50). The California Contra Costa County Emergency Medical Services (EMS) system recently adopted a protocol of IV 10% dextrose solution (D10), due to frequent shortages and relatively high cost of D50. The feasibility, safety, and efficacy of this approach are reported using the experience of this EMS system.

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Regional nerve blocks provide superior analgesia over opioid-based pain management regimens for traumatic injuries such as femur fractures. An ultrasound-guided regional nerve block is placed either as a single-shot injection or via a perineural catheter that is left in place. Although perineural catheters are commonplace in the perioperative setting, their use by emergency physicians (EPs) for emergency pain management in adults has not been previously described.

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Background: Subcutaneous emphysema is often a symptom of a serious pathologic condition but rarely requires direct treatment. Subcutaneous emphysema itself occasionally may interfere with effective cardiopulmonary resuscitation and require direct intervention.

Objective: The aim of this article is to present a case of subcutaneous emphysema during cardiac arrest and to describe a therapeutic technique that we call the "gills" procedure, as well as the background and rationale for this and other similar techniques.

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Background: Unresectable intrahepatic cholangiocarcinoma has a poor prognosis, with a median survival of 5 to 8 months without treatment. Response and survival after chemoembolization were evaluated.

Methods: Lobar or segmental chemoembolization with cisplatinum, doxorubicin, mitomycin-C, ethiodol, and polyvinyl alcohol particles was performed at monthly intervals for 1-4 sessions until the entire intrahepatic tumor burden was treated.

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Background: Unresectable colorectal liver metastases have a 1- and 2-year survival of 55% and 33% with current systemic therapies. The authors evaluated response and survival after transarterial chemoembolization.

Methods: Chemoembolization with cisplatin, doxorubicin, mitomycin C, ethiodized oil, and polyvinyl alcohol particles was performed at monthly intervals for 1 to 4 sessions.

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