The Statewide Patient Load Balancing Work of Washington State's Medical Operations Coordination Center.

Objectives: Load balancing of constrained healthcare resources has become a critical aspect of assuring access to care during periods of pandemic related surge. These impacts include patient surges, staffing shortages, and limited access to specialty resources. This research focuses on the creation and work of a novel statewide coordination center, the Washington Medical Coordination Center (WMCC), whose primary goal is the load balancing of patients across the healthcare continuum of Washington State.

Fragility of statistically significant findings from randomized clinical trials of surgical treatment of humeral shaft fractures: A systematic review.

Background: Despite recent meta-analyses of randomized controlled trials (RCTs), there remains no consensus regarding the preferred surgical treatment for humeral shaft fractures. The fragility index (FI) is an emerging tool used to evaluate the robustness of RCTs by quantifying the number of participants in a study group that would need to switch outcomes in order to reverse the study conclusions.

Aim: To investigate the fragility index of randomized control trials assessing outcomes of operative fixation in proximal humerus fractures.

A Review of Public Health Emergency Preparedness and Response (PHEPR) Curricula in US CEPH-Accredited Schools and Programs of Public Health.

Objective: To assess the current state of graduate-level disaster-related curricula (i.e., Masters and Doctoral programs, degree concentrations, and graduate certificates) offered by the Council on Education for Public Health (CEPH)-accredited public health schools and programs in the US.

Bracing for the Storm: One Health Care System's Planning for the COVID-19 Surge.

Problem: University of Washington Medicine (UW Medicine), an academic health system in Washington State, was at the epicenter of the first outbreak of the COVID-19 pandemic in the United States. The extent of emergency activation needed to adequately respond to this global pandemic was not immediately known, as the evolving situation differed significantly from any past disaster response preparations in that there was potential for exponential growth of infection, unproven mitigation strategies, serious risk to health care workers, and inadequate supply chains for critical equipment.

Approach: The rapid transition of the UW Medicine system to account for projected COVID-19 and usual patient care, while balancing patient and staff safety and conservation of resources, represents an example of an adaptive disaster response.

Lessons learned from COVID-19 outbreak in a skilled nursing facility, Washington State.

Long-term care facilities have been identified as a local epicenter of disease among populations vulnerable to coronavirus disease 2019 (COVID-19). A skilled nursing facility in Washington State was the first major site of COVID-19 infections in the United States. Many lessons were learned during the events surrounding this outbreak, including how to develop, and the importance of, a coordinated response between emergency medical services and local area hospitals.

Western Washington State COVID-19 Experience: Keys to Flattening the Curve and Effective Health System Response.

Background: Washington State experienced the first major outbreak of COVID-19 in the US and despite a significant number of cases, has seen a relatively low death rate per million population compared with other states with major outbreaks, and has seen a substantial decrease in the projections for healthcare use, that is, "flattening the curve." This consensus report seeks to identify the key factors contributing to the effective health system disaster response in western WA.

Methods: A multidisciplinary, expert panel including individuals and organizations who were integral to managing the public health and emergency healthcare system response were engaged in a consensus process to identify the key themes and lessons learned and develop recommendations for ongoing management of the COVID-19 pandemic.

Washington State Disaster Risk and Preparedness: A Primer for Health Care Providers.

Disaster in Washington State (USA) is inevitable. It is incumbent on health care providers to understand the practice environment as it will be affected by disasters. This means understanding the basic concepts of emergency management, local to national emergency response structure, and the risks and vulnerabilities of the region where one works.

Disaster Planning for Homeless Populations: Analysis and Recommendations for Communities.

Homelessness is a growing problem, with perhaps greater than a 150 million homeless people globally. The global community has prioritized the problem, as eradicating homelessness is one of the United Nation's sustainability goals of 2030. Homelessness is a variable entity with individual, population, cultural, and regional characteristics complicating emergency preparedness.

Early Identification of Central Retinal Artery Occlusion Using Point-of-care Ultrasound.

A 69-year-old woman with a history of untreated hypertension presented with acute-onset monocular vision loss. Initial workup was delayed due to lack of immediate specialty consultation and dilated funduscopic exam. Point-of-care ultrasound in the emergency department identified a small hyperechoic structure within the distal area of the central retinal artery; in conjunction with specialty ophthalmologic evaluation in a tertiary care center, the diagnosis of central retinal artery occlusion was made.

Using a novel technology for disaster staff notification.

Notification of backup staff and determining their ability to augment frontline staff is a major component of any disaster plan. However, the communication and organization of this effort has many challenges. These include communication system overload, the disaster setting, disrupted transportation, and staffing impacts on normal operations.

Using a novel technology for disaster staff notification.

Notification of backup staff and determining their ability to augment frontline staff is a major component of any disaster plan. However, the communication and organization of this effort has many challenges. These include communication system overload, the disaster setting, disrupted transportation, and staffing impacts on normal operations.

Ventricular tachycardia and prolonged QT interval presenting as seizure-like activity.

Seizures can be difficult to distinguish from other causes of transient cerebral hypoxia in the emergency department. We present a case of seizure activity in a woman in whom EKG led to a diagnosis of intermittent monomorphic and polymorphic ventricular tachycardia (torsades de pointes), highlighting the need for careful consideration of alternative causes of seizures, even in patients with known epilepsy.

Emergency Medicine Resident Rotations Abroad: Current Status and Next Steps.

Introduction: International rotations for residents are increasingly popular, but there is a dearth of evidence to demonstrate that these rotations are safe and that residents have appropriate training and support to conduct them.

Methods: A survey was sent to all U.S.

Establishing a trauma registry in Bhutan: needs and process.

Background: Globally, trauma represents a growing and significant burden of disease. Many health systems have limited metrics with which to guide development and appropriately inform policy and management decisions with regard to trauma related health care delivery.

Findings: This paper outlines the establishment of need for improved trauma related metrics in the country of Bhutan and the process of development of a trauma registry at Jigme Dorji Wangchuck National Referral Hospital to meet that need.