Early identification of life-threatening soft-tissue infection using dynamic fluorescence imaging: first-in-kind clinical study of first-pass kinetics.

Necrotizing soft-tissue infections (NSTIs) are aggressive and deadly. Immediate surgical debridement is standard-of-care, but patients often present with non-specific symptoms, thereby delaying treatment. Because NSTIs cause microvascular thrombosis, we hypothesized that perfusion imaging using indocyanine green (ICG) would show diminished fluorescence signal in NSTI-affected tissues, particularly compared to non-necrotizing, superficial infections.

Web-based morbidity and mortality conferencing: a model for rural medical education.

Transfer of patients from rural emergency departments to tertiary centers can improve outcomes. The transfer process is complex and often ad hoc, inefficient, duplicative, and frustrating to both patients and providers. Suboptimal transfer undermines quality of care, raises costs, and delays services.

Computer Face Scale for measuring pediatric pain and mood.

Unlabelled: This investigation determined the psychometric properties and acceptability of an animated face scale presented on a hand-held computer as a means to measure pediatric pain and mood. In study 1, 79 hospitalized, pediatric patients indicated their levels of pain by adjusting the expression of an animated cartoon face. The first objective was to determine feasibility, concurrent validity, and acceptability of the method.

The lack of an adult seat belt law in New Hampshire: live free and die?

New Hampshire (NH) is the only state with no adult seat belt law. The lack of a restraint law may stem from a reluctance to infringe on individual freedoms. Dartmouth-Hitchcock Medical Center (DHMC) is located in NH, only 4 miles from the Vermont (VT) border.

Evaluation of a fast track unit: alignment of resources and demand results in improved satisfaction and decreased length of stay for emergency department patients.

Background: Emergency departments (EDs) are struggling with overcrowding. The Institute for Healthcare Improvement recently concluded that reducing delays is critical to improving all aspects of emergency care. To reduce cycle times and improve patient flow, we developed a separate stream of care focused on low-acuity patients in our academic ED.