A Worksheet to Quantify Social and Digital Media Content as Scholarly Products for Academic Promotion.

Problem: Social and digital media contributions are a timely way of adding to the public discourse, serve as an online footprint of public contributions that a faculty member has made on behalf of their institution, can increase community trust, and serve as a public commitment to diversity, equity, and inclusion (DEI) work. Thus, such contributions should be considered significant and meritorious in a promotion package.

Approach: A diverse group of 6 University of Pittsburgh School of Medicine academics from varying specialties, training pathways, and academic ranks was assembled to create a consensus worksheet for the inclusion of social and digital media contributions in a promotion package.

Community lessons to understand resuscitation excellence (culture): Association between emergency medical services (EMS) culture and outcome after out-of-hospital cardiac arrest.

Background: The large geographic variation in outcome after out-of-hospital cardiac arrest (OHCA) is not well explained by traditional patient and emergency medical services (EMS) characteristics. A 'culture of excellence' in resuscitation within an EMS is believed to be an important factor that influences quality of care and outcome in patients with OHCA. However, whether a culture of excellence is associated with improved survival after OHCA is not known.

Tree of Life Synagogue Shooting in Pittsburgh: Preparedness, Prehospital Care, and Lessons Learned.

On Saturday, October 27, 2018, a man with anti-Semitic motivations entered Tree of Life synagogue in the Squirrel Hill section of Pittsburgh, Pennsylvania; he had an AR-15 semi-automatic rifle and three handguns, opening fire upon worshippers. Eventually 11 civilians died at the scene and eight people sustained non-fatal injuries, including five police officers. Each person injured but alive at the scene received care at one of three local level-one trauma centers.

Spatial Methods to Enhance Public Health Surveillance and Resource Deployment in the Opioid Epidemic.

Objectives: To improve public health surveillance and response by using spatial optimization.

Methods: We identified cases of suspected nonfatal opioid overdose events in which naloxone was administered from April 2013 through December 2016 treated by the city of Pittsburgh, Pennsylvania, Bureau of Emergency Medical Services. We used spatial modeling to identify areas hardest hit to spatially optimize naloxone distribution among pharmacies in Pittsburgh.

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.

A comparative assessment of adverse event classification in the out-of-hospital setting.

Objectives: We sought to test reliability of two approaches to classify adverse events (AEs) associated with helicopter EMS (HEMS) transport.

Methods: The first approach for AE classification involved flight nurses and paramedics (RN/Medics) and mid-career emergency physicians (MC-EMPs) independently reviewing 50 randomly selected HEMS medical records. The second approach involved RN/Medics and MC-EMPs meeting as a group to openly discuss 20 additional medical records and reach consensus-based AE decision.

Characterization of electrocardiogram changes throughout a marathon.

Purpose: There are few data examining cardiovascular physiology throughout a marathon. This study was devised to characterize electrocardiographic activity continuously throughout a marathon.

Methods: Cardiac activity was recorded from 19 subjects wearing a Holter monitor during a marathon.

Recognition and treatment of exertional heat illness at a marathon race.

Exertional heat illness is rarely encountered by individual EMS providers but can be common in certain settings and events. The notion that significantly altered mental status must accompany elevated core temperature in heat illness may delay recognition and treatment. We report on a series of marathon and half-marathon runners who suffered exertional heat illness during a marathon race in relatively mild conditions.

Measuring adverse events in helicopter emergency medical services: establishing content validity.

Introduction: We sought to create a valid framework for detecting adverse events (AEs) in the high-risk setting of helicopter emergency medical services (HEMS).

Methods: We assembled a panel of 10 expert clinicians (n = 6 emergency medicine physicians and n = 4 prehospital nurses and flight paramedics) affiliated with a large multistate HEMS organization in the Northeast US. We used a modified Delphi technique to develop a framework for detecting AEs associated with the treatment of critically ill or injured patients.

Identification of adverse events in ground transport emergency medical services.

The purpose of this study was to develop a method to define and rate the severity of adverse events (AEs) in emergency medical services (EMS) safety research. They used a modified Delphi technique to develop a consensus definition of an AE. The consensus definition was as follows: "An adverse event in EMS is a harmful or potentially harmful event occurring during the continuum of EMS care that is potentially preventable and thus independent of the progression of the patient's condition.

Resident field response in an emergency medicine prehospital care rotation.

Background: Emergency medical services (EMS) is an important component of emergency medicine residency curricula. For over 20 years, residents at a university-affiliated program have staffed a physician response vehicle and responded to selected calls in an urban EMS system with online faculty backup.

Objectives: To describe the prehospital educational experience and patient care provided through this unique program and to assess residents' perceptions.

Management of prehospital seizure patients by paramedics.

Background: Seizure patients are frequently encountered in the prehospital environment and have the potential to need advanced interventions, though the utility of advanced life support (ALS) interventions in many of these patients has not been proven.

Objective: Our goals were to assess the management of prehospital seizure patients by paramedics in an urban EMS system with an existing ALS-based prehospital seizure protocol and to assess characteristics and short-term outcomes that may aid in addressing the utility of specific ALS interventions.

Methods: This was a retrospective study of 97 EMS cases with the chief complaint of seizure.

Coronary artery aneurysm formation after drug-eluting stent implantation.

Drug-eluting stents (DES) have had a profound impact on the practice of interventional cardiology. Important safety concerns regarding DES have been widely publicized and acknowledged. The primary emphasis has been placed on late stent thrombosis and the adverse sequela which result.

Symptomatic cerebral air embolism during neuro-angiographic procedures: incidence and problem avoidance.

Background: While clinically symptomatic cerebral air embolism secondary to neuro-angiographic procedures is rare, the incidence in a large series of procedures is unknown. Understanding this complication's frequency and etiology is critical if systems are to be instituted to reduce its incidence.

Methods: We prospectively reviewed 4,568 consecutive neuro-angiographic procedures performed between June 2000 and July 2005.

Increased chest compression to ventilation ratio improves delivery of CPR.

Objective: Chest compressions are interrupted during cardiopulmonary resuscitation (CPR) due to human error, for ventilation, for rhythm analysis and for rescue shocks. Earlier data suggest that the recommended 15:2 compression to ventilation (C:V) ratio results in frequent interruptions of compressions during CPR. We evaluated a protocol change from the recommended C:V ratio of 15:2-30:2 during CPR in our municipal emergency medical system.

Usefulness of vasopressin administered with epinephrine during out-of-hospital cardiac arrest.

Vasopressin administration has been suggested during cardiopulmonary resuscitation, and a previous clinical trial has suggested that vasopressin is most effective when administered with epinephrine. Adult subjects (n = 325) who received > or =1 dose of intravenous epinephrine during cardiopulmonary resuscitation for nontraumatic, out-of-hospital cardiac arrest were randomly assigned to receive 40 IU of vasopressin (n = 167) or placebo (n = 158) as soon as possible after the first dose of epinephrine. The rate of return of pulses was similar between the vasopressin and placebo groups (31% vs 30%), as was the presence of pulses at the emergency department (19% vs 23%).

Inter-rater reliability for witnessed collapse and presence of bystander CPR.

Objective: Witnessed collapse and bystander CPR are the variables most frequently associated with good outcome from out-of-hospital cardiac arrest (OOHCA). The reliability of abstracting witnessed collapse and bystander CPR from prehospital Emergency Medical Services (EMS) patient care records (PCRs) is not known. We sought to determine the inter-rater reliability for different methods of ascertaining and defining witnessed collapse and performance of bystander CPR.

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.