Potential long-term disturbance associated with beach nourishment - insights and observations from Pea Island National Wildlife Refuge, Outer Banks, North Carolina.

The longer-term ecosystem impacts associated with a beach nourishment project conducted in 2014 were studied on an ocean beach on the Pea Island National Wildlife Refuge on North Carolina's Outer Banks. The unique nature of the project is tied to the study's duration, which spans nine years, and the venue, a national wildlife refuge where human-sourced confounding effects are minimal. Populations for five invertebrates: Emerita talpoida (the Atlantic Mole Crab), (the Coquina Clam), Scolelepis squamata, Ocypode quadrata (the Atlantic Ghost Crab), and indigenous Amphipods were monitored seasonally over nine-years that asymmetrically straddled the 2014 nourishment event.

Recovery and detection of botulinum neurotoxins from a nonporous surface.

We describe the adaptation of a sample recovery method for botulinum neurotoxins from stainless steel. Botulinum toxin was recovered from surfaces left to dry for up to 16 h and detected by either ELISA or EndoPep mass spectrometry methods. In addition, we demonstrate that this method can be used to evaluate the efficacy of surface decontamination procedures.

The emergency medical services safety champions.

The overarching mission of prehospital emergency medical services (EMS) is to deliver lifesaving care for people when their needs are greatest. Fulfilling this mission is challenged by threats to patient and provider safety. The EMS setting is a high-risk one because care is delivered rapidly in the out-of-hospital setting where resources of benefit to patients are limited.

Performance characteristics of a novel radioactive isotope detection and notification system designed for use in hospitals.

Recently, University of Pittsburgh Medical Center (UPMC) Cancer Centers has installed an Emergency Department Notification System (EDNS) in one of its hospitals. This system, manufactured by Thermo Fisher Scientific (Thermo Fisher Scientific, Inc., 81 Wyman Street, Waltham, MA 02454), was designed to discriminate non-medical radioactive isotopes from medical radioactive isotopes routinely used in nuclear medicine and radiation treatments.

Errors of omission in the treatment of prehospital chest pain patients.

Objective: Despite the widespread use of standard treatment protocols, there are few published data regarding paramedic protocol adherence. In this descriptive study, the authors sought to assess the frequency and nature of deviations from a standardized treatment protocol for the chief complaint of chest pain. They also sought to quantify any time delays in treatment of potential ischemic cardiac chest pain.

Factors associated with the use of pharmacologic agents to facilitate out-of-hospital endotracheal intubation.

Objective: To identify a set of clinical factors most strongly associated with the use of drug-facilitated intubation (DFI) in the out-of-hospital setting.

Method: The authors used data from a prospective, multicentered endotracheal intubation (ETI) observational cohort trial, including patients from 45 emergency medical services in Pennsylvania. Providers reported clinical, physiologic, and anatomic factors associated with each ETI effort.

Preliminary experience with a prospective, multi-centered evaluation of out-of-hospital endotracheal intubation.

Study Objective: Previous out-of-hospital airway management data are limited by small, single-site designs. We sought to evaluate the feasibility of performing a prospective, multi-centered evaluation of out-of-hospital endotracheal intubation (ETI) using a standardized data collection tool.

Methods: We designed a prospective multi-centered observational study involving 45 advanced life support (ALS) services from a mid-Atlantic state.

Multivariate predictors of failed prehospital endotracheal intubation.

Objectives: Conventionally trained out-of-hospital rescuers (such as paramedics) often fail to accomplish endotracheal intubation (ETI) in patients requiring invasive airway management. Previous studies have identified univariate variables associated with failed out-of-hospital ETI but have not examined the interaction between the numerous factors impacting ETI success. This study sought to use multivariate logistic regression to identify a set of factors associated with failed adult out-of-hospital ETI.

Comparison of times to intubate a simulated trauma patient in two positions.

Background: The nature of the trauma patient's injuries may compromise the airway and ultimately lead to death or neurological devastation. The same injuries complicate protecting the airway in these patients by preventing manipulation of the cervical spine for direct laryngoscopy. A recent study has shown that misplaced endotracheal tubes occur significantly more often in trauma patients than in medical patients.

Pneumococcal vaccination: an opportunity for emergency medical services.

This report examines the literature regarding pneumococcal disease and the current state of pneumococcal vaccination. Improvements in medical care have reduced the number of deaths from pneumococcal disease. However, vaccination is still the most effective measure.

Influenza immunizations provided by EMS agencies: the MEDICVAX Project.

Objective: Emergency medical services (EMS) agencies may be an underutilized resource for provision of preventive health services. This study sought to demonstrate the feasibility for EMS agencies to provide influenza immunizations.

Methods: This prospective, observational cohort study was conducted with urban, suburban, and rural EMS agencies that volunteered to participate.

Law Enforcement Agency Defibrillation (LEA-D): proceedings of the National Center for Early Defibrillation Police AED Issues Forum.

Why does LEA-D intervention seem to work in some systems but not others? Panelists agreed that some factors that delay rapid access to treatment, such as long travel distances in rural areas, may represent insurmountable barriers. Other factors, however, may be addressed more readily. These include: absence of a medical response culture, discomfort with the role of medical intervention, insecurity with the use of medical devices, a lack of proactive medical direction, infrequent refresher training, and dependence on EMS intervention.