Implementation of a workshop for mass casualty incident triage training using an immersive virtual reality simulation.

Objective: We offered a workshop at the 2023 annual meeting of the Society for Academic Emergency Medicine to teach the Sort-Assess-Lifesaving Interventions-Treatment/Transport (SALT) triage protocol for responding to mass casualty incidents (MCIs) using an immersive virtual reality (VR) simulator. Here, we report workshop outcomes.

Methods: After a 1-h didactic on the basics of triage protocols, workshop participants rotated through three skill stations at which learners learned how to use the VR headset and controllers, practiced applying SALT triage skills through a tabletop exercise, and then finally used our VR simulator for training responses to MCIs.

State Requirements for Medical Directors in the United States.

Background: The requirements for emergency medical services (EMS) medical directors are commonly defined by state rules and regulations without national standardization. The extent of variability in the requirements to be an EMS medical director in the US is unclear. The objective of this study is to describe the state requirements to function as an EMS medical director in the US.

A Different Type of Tension Headache: A Case Report of Traumatic Tension Pneumocephalus.

Unlabelled: Tension pneumocephalus is a rare neurosurgical emergency requiring cranial decompression to prevent permanent neurological injury, herniation, and death. In this report, we present a trauma patient struck by a knife in the forehead who presented with agitation and vomiting. Imaging ultimately revealed a minimally displaced frontal sinus fracture through both the anterior and posterior walls of the sinus.

Prehospital Stroke Assessment for Large Vessel Occlusions: A Systematic Review.

Background And Objective: Stroke is the leading cause of disability in the United States and new evidence shows interventional procedures provide better outcomes for large vessel occlusions (LVO). We performed a systematic review of the literature on prehospital stroke scales used to identify LVOs comparing the scales with analysis of the sensitivity, specificity, and predictive values. The goal was to determine if emergency medical services (EMS) are able to accurately identify LVO in the field.

Iron, inflammation and atherosclerosis risk in men vs. perimenopausal women.

Objective: Age at first atherosclerotic event is typically older for women vs. men; monthly iron loss has been postulated to contribute to this advantage. We investigated the relationship between an MRI-based arterial wall biomarker and the serum inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) in perimenopausal women vs.

Iron and noncontrast magnetic resonance T2* as a marker of intraplaque iron in human atherosclerosis.

Objective: Iron has been implicated in atherogenesis and plaque destabilization, whereas less is known about iron-related proteins in this disease. We compared ex vivo quantities with in vivo vessel wall T2*, which is a noncontrast magnetic resonance relaxation time that quantitatively shortens with increased tissue iron content. We also tested the hypothesis that patients with carotid atherosclerosis have abnormal T2* times vs controls that would help support a role for iron in human atherosclerosis.

Iron and atherosclerosis: nailing down a novel target with magnetic resonance.

Iron is an essential mineral in many proteins and enzymes in human physiology, with limited means of iron elimination to maintain iron balance. Iron accrual incurs various pathological mechanisms linked to cardiovascular disease. In atherosclerosis, iron catalyzes the creation of reactive oxygen free radicals that contribute to lipid modification, which is essential to atheroma formation.

Quantification of aortic stiffness using MR elastography and its comparison to MRI-based pulse wave velocity.

Purpose: To determine the correlation in abdominal aortic stiffness obtained using magnetic resonance elastography (MRE) (μ(MRE)) and MRI-based pulse wave velocity (PWV) shear stiffness (μ(PWV)) estimates in normal volunteers of varying age, and also to determine the correlation between μ(MRE) and μ(PWV).

Materials And Methods: In vivo aortic MRE and MRI were performed on 21 healthy volunteers with ages ranging from 18 to 65 years to obtain wave and velocity data along the long axis of the abdominal aorta. The MRE wave images were analyzed to obtain mean stiffness and the phase contrast images were analyzed to obtain PWV measurements and indirectly estimate stiffness values from the Moens-Korteweg equation.

Improved in vivo human carotid artery wall T₂ estimation.

T(2) quantification has been shown to noninvasively and accurately estimate tissue iron content in the liver and heart; applying this to thin-walled carotid arteries introduces a new challenge to the estimation process. With most imaging voxels in a vessel being along its boundaries, errors in parameter estimation may result from partial volume mixing and misregistration due to motion in addition to noise and other common error sources. To minimize these errors, we propose a novel technique to reliably estimate T(2) in thin regions of vessel wall.