Simulated Patient as a Learner: Medical Volunteers Gain Knowledge by Participating in a Wilderness Medicine Training Session.

Introduction: -A multifaceted approach to wilderness medicine education and training is necessary to provide a high-quality learning experience, often requiring innovative instructional techniques. Using volunteers to act as patients in medical education is a well-established practice that helps teach crucial skills. However, more is needed to know if there is potential knowledge acquisition through participation.

Impact of an Oregon health policy aimed at strengthening adolescent linkage to outpatient mental health care from the emergency department.

Background: Oregon introduced a state policy, HB 3090, on October 6, 2017, which increased requirements on emergency departments (EDs) to improve transitions to outpatient mental health care. The objective of this study was to examine the policy's impact among low-income adolescent patients who face severe barriers to follow-up.

Methods: This was a retrospective cohort study of visits by Medicaid enrollees ages 14-18 presenting to any Oregon ED for a mental health concern between January 1, 2016, and December 31, 2019.

Exploring the impact of surgeon-reported gender on palliative care utilization in geriatric trauma patients.

Introduction: Geriatric trauma research increasingly supports the use of Palliative Care (PC). We surveyed trauma surgeon for perspectives on PC usage. Significant gender differences were identified, necessitating post-hoc investigation.

Governance Considerations for Point-of-Care Ultrasound: a HIMSS-SIIM Enterprise Imaging Community Whitepaper in Collaboration with AIUM.

Point-of-care ultrasound (POCUS) has emerged as a standard of care across a variety of healthcare settings due to its ability to provide critical clinical information and as well as procedural guidance to clinicians directly at the bedside. Implementation of enterprise imaging (EI) strategies is needed such that POCUS images can be appropriately captured, indexed, managed, stored, distributed, viewed, and analyzed. Because of its unique workflow and educational requirements, reliance on traditional order-based workflow solutions may be insufficient.

Evaluating the use of sublingual sufentanil in patients with buprenorphine treatment who are undergoing ambulatory surgery: A Prospective Case Report.

Introduction: Opioid use disorder is a chronic illness with significant morbidity and mortality. Opioid agonists, like buprenorphine, are commonly used to prevent relapse. Recent changes in buprenorphine legislation are expected to increase prescription and guidelines recommend its continuation during the perioperative period for many patients.

Evaluating the Realism of a Task Trainer and the Impact on Residents' Confidence in Managing Massive Upper Gastrointestinal Bleeding Among Emergency Medicine Residents.

Objective Hemodynamically unstable upper gastrointestinal bleeding (UGIB) represents a life-threatening emergency that often lacks adequate high-fidelity training in the insertion of balloon tamponade devices. To address this gap, we developed an affordable task trainer that provides real-time feedback to enhance the training experience for emergency medicine residents. This study aims to evaluate the realism of the task trainer and its impact on residents' confidence in managing massive UGIB.

Naloxone administration and survival in overdoses involving opioids and stimulants: An analysis of law enforcement data from 63 Pennsylvania counties.

Background: In consideration of rising opioid-stimulant deaths in the United States, this study explored rates of naloxone administration and survival in suspected opioid overdoses with, versus without, stimulants co-involved.

Methods: The study analyzed 26,635 suspected opioid-involved overdoses recorded by law enforcement/first-responders in the Pennsylvania Overdose Information Network in 63 Pennsylvania counties, January 2018-July 2024. All measures, including suspected drug involvement, were based on first-responder assessment/report.

An innovative approach to the multidisciplinary treatment of uninsured breast cancer patients.

Purpose: A significant proportion of many populations remain uninsured. The aim of the study was to assess differences in breast cancer outcomes before and after the implementation of an innovative approach to the multidisciplinary treatment of uninsured breast cancer patients.

Methods: Retrospective review was performed of patients seen at a safety net hospital from January 2000 to December 2020.

Simplified treatment of chronic scalp wounds with exposed skull.

Background: Exposed cranial bone can present a considerable challenge to the reconstructive surgeon. Removal of the outer cortex of exposed skull bone has proven effective in the management of complex scalp wounds for which traditional reconstruction efforts were limited.

Objective: To demonstrate a simplified approach for management of scalp wounds with exposed skull.

Nonbacterial Thrombotic Endocarditis in a 78-Year-Old Female With Recurrent Acute Ischemic Stroke: A Case Report.

Nonbacterial thrombotic endocarditis (NBTE) is a rare but serious complication, particularly in patients with malignancies like acute myeloid leukemia (AML), where a hypercoagulable state increases the risk of embolic events. This case report describes a rare and complex presentation of marantic endocarditis in a 78-year-old female with relapsed AML. The uniqueness of this case lies in the intersection of a hypercoagulable state induced by AML and the resultant NBTE, leading to recurrent embolic strokes, despite oral anticoagulation.

Cost Analysis of Pure Hypochlorous Acid Preserved Wound Cleanser versus Mafenide for the Irrigation of Burn Wounds.

Over 40,000 patients in the United States (US) require hospitalization for burns annually. The treatment regimen can cost more than $6,000 a day and requires the use of numerous supplies to ensure the graft takes for successful wound healing. Irrigation of the wound is a critical step for burn treatment, yet little is known about the cost-effectiveness of different irrigation modalities.

The Discover In-Hospital Cardiac Arrest (Discover IHCA) Study: An Investigation of Hospital Practices After In-Hospital Cardiac Arrest.

Importance: In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the post-resuscitation period, and we do not know current post-IHCA practice patterns.

Naloxone Administration and Survival in Overdoses Involving Opioids and Stimulants: An Analysis of Law Enforcement Data from 63 Pennsylvania Counties.

Background: In consideration of rising opioid-stimulant deaths in the United States, this study explored rates of naloxone administration and survival in suspected opioid overdoses with, versus without, stimulants co-involved.

Methods: The study analyzed 26,635 suspected opioid-involved overdoses recorded by law enforcement/first-responders in the Pennsylvania Overdose Information Network in 63 Pennsylvania counties, January 2018-July 2024. All measures, including suspected drug involvement, were based on first-responder assessment/report.

Sexual and Reproductive Healthcare Needs of Refugee Women Exposed to Gender-Based Violence: The Case for Trauma-Informed Care in Resettlement Contexts.

This paper assesses literature regarding the sexual and reproductive healthcare (SRH) needs of resettled refugee women who experienced gender-based violence (GBV) and trauma-informed care (TIC) principles utilized among SRH service providers. A systematic search identified relevant studies published between 2000 and 2021; no articles found reflected both SRH and TIC principles among refugee women. The search was therefore separated into two aims: to review the literature about SRH needs for refugee women in resettlement countries who experienced GBV (Aim 1) and to examine the use of TIC principles in SRH care among women who experienced GBV (Aim 2).

The Use of Steroids to Treat Hypercalcemia Due to Granulomatous Disease From Disseminated Coccidioidomycosis.

The clinical course and treatment of hypercalcemia from a granulomatous disease in the setting of an infectious etiology, namely disseminated coccidioidomycosis, remains incompletely understood. The mechanism and treatment of hypercalcemia have been documented in most granulomatous disorders, with sarcoidosis being the most well-understood so far. We discuss a case of a patient with a recent diagnosis of disseminated coccidioidomycosis who presented with hypercalcemia despite adequate infection control.

The Role of Ultrasound in Pediatric Peritonsillar Infection: A Descriptive Analysis.

In this study, we describe the role of ultrasound in diagnosing pediatric peritonsillar abscesses (PTAs). A retrospective chart review was conducted on 54 children aged 4 to 17 years who had an ultrasound performed for suspected PTA. Based on ultrasound imaging, the patients were classified into 2 groups: PTA-positive (8, 14.

Outcomes After a Statewide Policy to Improve Evidence-Based Treatment of Back Pain Among Medicaid Enrollees in Oregon.

Background: A novel Oregon Medicaid policy guiding back pain management combined opioid restrictions with emphasis on non-opioid and non-pharmacologic therapies.

Objective: To examine the effect of the policy on prescribing, health outcomes, and health service utilization.

Design: Using Medicaid enrollment, medical and prescription claims, prescription drug monitoring program, and vital statistics files, we analyzed the policy's association with selected outcomes using interrupted time series models.

A Quantitative Review of Certified Burn Therapist's Involvement in the JBCR Publications and ABA Leadership.

The Burn Therapist Certification (BT-C) was introduced in 2018 to acknowledge occupational therapists (OT) and physical therapists (PT) with specialized knowledge, skill, and experience in the promotion of quality burn rehabilitation. Currently, BT-Cs make up 11.7% of therapists working in burn rehabilitation (n = 39/333).

Desert Medicine.

Deserts are defined by their arid nature, characterized by little rainfall, and often featuring vast stretches of sandy terrain with sparse vegetation. The resulting variations in temperature, humidity, and topography predispose patients to medical conditions that practitioners in both rural and urban deserts must recognize and manage. This article will equip medical practitioners with the essential knowledge and tools to navigate these complexities, including a description of specific environmental considerations and challenges encountered while providing care in these desert locations, common conditions associated with extreme heat and solar radiation, and animal encounters.