Outbreak Protection and the Importance of Paid Sick Leave.

From the Field is a semi-regular column that explores what it means to be a local health professional on the front lines of an emergency. Typically, National Association of County and City Health Officials (NACCHO) members share their stories of preparing for and responding to disasters, epidemics, and other major health issues. Through exploring the analysis of the challenges faced and the solutions developed, readers can learn how these public health champions keep their communities safe even in extreme situations.

Improved patient survival using a modified resuscitation protocol for out-of-hospital cardiac arrest.

Background: Cardiac arrest continues to have poor survival in the United States. Recent studies have questioned current practice in resuscitation. Our emergency medical services system made significant changes to the adult cardiac arrest resuscitation protocol, including minimizing chest compression interruptions, increasing the ratio of compressions to ventilation, deemphasizing or delaying intubation, and advocating chest compressions before initial countershock.

Fetal mortality: timing of racial disparities.

Whether or not racial disparities exist in fetal mortality rate (FMR) statistics depends upon the methodology used to calculate the rates. While there appears to be consensus that there is a black-white disparity in late gestation (> or = 28 weeks), the issue is unclear for early gestation (20-27 weeks). To clarify this issue, we assessed disparities in FMR for singleton fetal deaths and live births between non-Hispanic blacks and non-Hispanic whites in three counties of Missouri using gestational age- and weight-specific analyses.

Perinatal periods of risk analysis of infant mortality in Jackson County, Missouri.

The perinatal periods of risk (PPOR) methodology provides an easy-to-use analytical approach to infant mortality that helps focus community initiatives for improving maternal and infant health. Because few analyses have been published, many public health practitioners may be unfamiliar with PPOR. This article demonstrates the application of PPOR analysis using infant mortality in Jackson County, Missouri.

Influenza, local public health practice, and the necessary paradigm shift.

The National Association of County and City Health Officials (NACCHO) is the national organization representing local health departments. NACCHO supports efforts that protect and improve the health of all people and all communities by promoting national policy, developing resources and programs, seeking health equity, and supporting effective local public health practice and systems.

Emergency department visits and hospitalizations resulting from dog bites, Kansas City, MO, 1998-2002.

Dog bites are the second most costly public health problem in the United States with half of all Americans being bitten in their lifetime. Approximately 17 to 18 percent of dog bite injuries receive medical attention. Between 1998 and 2002, Kansas City, Missouri, residents made 3,467 emergency department visits for dog bite trauma and 96 individuals were hospitalized.

When bioterrorism strikes: communication issues for the local health department.

Public health preparedness is a multifaceted planning process that becomes grounded in a response plan and in effective communications, internal and external. This article describes an incident when the presence of anthrax spores was detected in a postal facility within Kansas City, Missouri, and discusses the communications issues faced by the Kansas City Health Department (KCHD). This incident provided the KCHD the first opportunity to operationalize its Incident Management System-based response plan.

Multijurisdictional approach to biosurveillance, Kansas City.

An electronic reporting system for a network of 22 laboratories was implemented in Kansas City, Missouri, with an independent organization acting as a data clearinghouse between the reporting laboratories and public health departments. The system ran in tandem with conventional reporting methods. Laboratory test orders and results were aggregated and mapped to a common nomenclature.