National assessment of clinicians participating in stroke treatment decisions at strokenet regional coordinating centers: Clinicians Making Stroke Treatment Decisions.

Objectives: Since the introduction of thrombolytics, stroke teams evolved to improve thrombolytic care delivery. The impact of the advent of endovascular therapy on the composition of acute stroke teams is unknown.

Materials And Methods: A two-part pilot-tested survey was deployed to site-Principal Investigators (PIs) of the 27 StrokeNet Regional Coordinating Centers (RCCs) regarding institutional acute stroke teams.

Lifetime non-fatal overdose experiences among at-risk adolescents and young adults in the emergency department with past-year opioid use in the USA.

Background: Adolescents and young adults with risk factors for opioid misuse and opioid use disorder are at elevated risk for overdose. We examined prior non-fatal overdose experiences among at-risk adolescents/young adults to inform prevention efforts.

Methods: Adolescents/young adults (ages 16-30) in two US emergency departments self-reporting past year opioid misuse or opioid use plus a misuse risk factor completed a baseline survey as part of an ongoing randomised controlled trial.

Current summary of the evidence in drone-based emergency medical services care.

Interventions for many medical emergencies including cardiac arrests, strokes, drug overdoses, seizures, and trauma, are critically time-dependent, with faster intervention leading to improved patient outcomes. Consequently, a major focus of emergency medical services (EMS) systems and prehospital medicine has been improving the time until medical intervention in these time-sensitive emergencies, often by reducing the time required to deliver critical medical supplies to the scene of the emergency. Medical indications for using unmanned aerial vehicles, or drones, are rapidly expanding, including the delivery of time-sensitive medical supplies.

Effect of pulmonary embolism response team on advanced therapies administered: The University of Michigan experience.

Background: Pulmonary Embolism Response Teams (PERT) were employed at multiple institutions to bridge the gap between varied treatment options for acute PE and unclear evidence for optimal management. There is limited data regarding the impact of PERT on the use of advanced therapies and clinical outcomes.

Methods: We performed a retrospective single-center cohort study comparing patients that presented to the ED with an acute PE before and after the creation of PERT in June 2017 at our institution.

Beneficiaries' perspectives on improved oral health and its mediators after Medicaid expansion in Michigan: a mixed methods study.

Objective: To investigate self-reported improved oral health and its mediators, and job-related outcomes, of Medicaid expansion beneficiaries in Michigan.

Methods: This cross-sectional mixed-methods study of adult "Healthy Michigan Plan" (HMP) Medicaid expansion beneficiaries included qualitative interviews with a convenience sample of 67 beneficiaries enrolled for ≥6 months, a stratified random sample survey of 4,090 beneficiaries enrolled for ≥12 months; and Medicaid claims data. We examined unadjusted associations between demographic variables and awareness of dental coverage, self-reported dental care access, dental visits, and self-reported oral health; and between improved oral health and job seeking and job performance.

Prescription opioid misuse among adolescents and emerging adults in the United States: A scoping review.

The U.S. opioid epidemic is a critical public health problem.

Hemorrhagic blood failure: Oxygen debt, coagulopathy, and endothelial damage.

Our understanding of the events taking place within the blood following severe injury with hemorrhagic shock is quickly evolving. Traditional concepts have given way to a detailed and nuanced understanding of coagulopathy, bleeding, and shock at the cellular and biochemical levels. In doing so, the tremendous complexity of events taking place within the blood have been illuminated and present an additional challenge.

A method for developing biomechanical response corridors based on principal component analysis.

The standard method for specifying target responses for human surrogates, such as crash test dummies and human computational models, involves developing a corridor based on the distribution of a set of empirical mechanical responses. These responses are commonly normalized to account for the effects of subject body shape, size, and mass on impact response. Limitations of this method arise from the normalization techniques, which are based on the assumptions that human geometry linearly scales with size and in some cases, on simple mechanical models.

Herpes Zoster Overlying Recently Placed Central Venous Access Site: A Case Report.

Herpes zoster, commonly called shingles, is a disease that results from the reactivation of varicella zoster virus. Local trauma has been reported as a precipitant for reactivation, but this condition is rarely seen localized to a fresh surgical incision. We present the case of a patient who developed shingles overlying the incision site of a recently buried central venous access port, illustrating the need to consider this diagnosis as a unique imposter of localized infection or reaction at sites of recent procedural trauma.

Diversion of ADHD Stimulants and Victimization Among Adolescents.

Objective: To examine whether a recent prescription for stimulant medication is associated with peer victimization among youth with attention deficit/hyperactivity disorder (ADHD).

Methods: Data from 4,965 adolescents attending five public schools who completed an annual web survey over 4 years were used to examine recent stimulant medication prescription and self-reported frequent victimization.

Results: Adolescents with ADHD and recent stimulant prescription reported more victimization than those without ADHD, but similar to adolescents with ADHD and no recent prescription.

Response and Tolerance of Female and/or Elderly PMHS to Lateral Impact.

Eight whole fresh-frozen cadavers (6 female, 2 male) that were elderly and/or female were laterally impacted using UMTRI's dual-sled side-impact test facility. Cadavers were not excluded on the basis of old age or bone diseases that affect tolerance. A thinly padded, multi-segment impactor was used that independently measured force histories applied to the shoulder, thorax, abdomen, greater trochanter, iliac wing, and femur of each PMHS.

The Affordable Care Act and emergency care.

The Affordable Care Act (ACA) will have far-reaching effects on the way health care is designed and delivered. Several elements of the ACA will directly affect both demand for ED care and expectations for its role in providing coordinated care. Hospitals will need to employ strategies to reduce ED crowding as the ACA expands insurance coverage.

Comparing the effects of age, BMI and gender on severe injury (AIS 3+) in motor-vehicle crashes.

Background: The effects of age, body mass index (BMI) and gender on motor vehicle crash (MVC) injuries are not well understood and current prevention efforts do not effectively address variability in occupant characteristics.

Objectives: (1) Characterize the effects of age, BMI and gender on serious-to-fatal MVC injury. (2) Identify the crash modes and body regions where the effects of occupant characteristics on the numbers of occupants with injury is largest, and thereby aid in prioritizing the need for human surrogates that represent different types of occupant characteristics and adaptive restraint systems that consider these characteristics.

Skills and educational needs of accident and emergency nurses in Ghana: an initial needs analysis.

Background: The specialty of emergency medicine is highly reliant on a well-trained team of providers. Ghana has recently begun a specialist training program for physicians and the need to train specialist emergency nurses has been recognized. The first step to developing this training is to conduct a needs assessment.

Long-term air medical services system performance using APACHE-II and mortality benchmarking.

Objective: Air medical transport programs have been in existence for two decades. During this time, no outcome measures have been developed for these services. The authors examined severity scoring and mortality data from their air medical service to characterize its performance and to identify trends in acuity and mortality over a 15-year period.