Academic Medicine & Surgery最新文献

{"title":"Rare case of pseudo-pneumoperitoneum as a triad of extensive subcutaneous emphysema and pneumomediastinum as a complication of non-invasive respiratory support","authors":"Luke Winter, Derrick Huang, J. L. Wilson","doi":"10.62186/001c.92428","DOIUrl":"https://doi.org/10.62186/001c.92428","url":null,"abstract":"Respiratory support through non-invasive ventilation and high-flow nasal cannula is frequently used in patients with acute respiratory failure as a way to maintain oxygenation without intubation. Although mostly well-tolerated, infrequent but increasingly recognized complications can occur, such as pneumothorax, pneumomediastinum, and subcutaneous emphysema. This likely occurs as a result of alveolar rupture from barotrauma related to ventilatory support and dissection of higher-pressure air along the pulmonary interstitium and into the anatomic cavities of the chest. We present a rare case of pseudo-pneumoperitoneum as a result of non-invasive respiratory support. This occurred as part of a triad of pneumomediastinum and extensive subcutaneous emphysema extending circumferentially around the abdomen and into the scrotum of a hypoxic patient with congestive heart failure and chronic obstructive pulmonary disease exacerbation with pneumonia requiring aggressive respiratory support.","PeriodicalId":516872,"journal":{"name":"Academic Medicine & Surgery","volume":"61 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140496870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conference Proceedings: Southeastern Regional Society of Academic Emergency Medicine Meeting, 2023","authors":"Mary McLean, Shayne Gue, Andy Little, L. Ganti","doi":"10.62186/001c.92096","DOIUrl":"https://doi.org/10.62186/001c.92096","url":null,"abstract":"The Society of Academic Emergency Medicine Southeastern Regional Meeting Research Forum featured a peer-reviewed line-up of emergency medicine research, innovations, and case reports in oral presentation format at the 2023 SAEM Southeastern Regional Meeting on July 8th, 2023, in Orlando, Florida. Dr. Wendy Coates, President-Elect for SAEM, gave the keynote address. Awards were given to winners in 3 categories: Faculty/Fellow, Resident, and Student.","PeriodicalId":516872,"journal":{"name":"Academic Medicine & Surgery","volume":"470 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140502370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The healing power of amniotic membrane extract eye drops. A 100 year old man saved from an Ocular Perforation.","authors":"Carlos F. Vargas Lopez, Jorge Pradas Chacon, Yolanda Palomino Ortiz","doi":"10.62186/001c.92290","DOIUrl":"https://doi.org/10.62186/001c.92290","url":null,"abstract":"","PeriodicalId":516872,"journal":{"name":"Academic Medicine & Surgery","volume":"7 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140505895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Polk COVID-19 and Flu Response clinical trial: COVID-19 antibody positivity higher in Black EMS workers","authors":"Paul Banerjee, Anjali Banerjee, Breanna Campion","doi":"10.62186/001c.92037","DOIUrl":"https://doi.org/10.62186/001c.92037","url":null,"abstract":"This study reports on a countywide assessment of COVID-19 positivity among emergency medical services workers. Participants completed a short survey of demographic factors and co-morbidities prior to obtaining COVID-19 and influenza testing to analyze the prevalence of these two respiratory viruses that EMS workers, being the first on the scene, are at special risk for, especially in the early days of the pandemic. A total of 7% had a positive COVID-19 antibody test. Although Black EMS personnel only comprised 9% of the cohort, they were significantly more likely to test positive for COVID-19 (P=0.0012). Black race remained a statistically significant predictor in a multivariate model that included the age, sex, BMI, number of hours of direct patient contact, whether the medic was symptomatic, presence of co-morbidities and whether or not the medic had received a flu shot prior (P=0.0008, 95% CI 0.0621-0.2354). This clinical trial (NCT04682132) ) was registered at clinicaltrials.gov, a resource provided by the U.S. National Library of Medicine.","PeriodicalId":516872,"journal":{"name":"Academic Medicine & Surgery","volume":"101 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140513231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Telemedicine Training into the Graduate Medical Education Curriculum","authors":"Nubaha Elahi, Keegan McNally, L. Ganti, D. Lebowitz, T. Macintosh, C. Plamoottil, William Gonzalez","doi":"10.62186/001c.91883","DOIUrl":"https://doi.org/10.62186/001c.91883","url":null,"abstract":"The primary objective of this study was to examine current emergency medicine resident knowledge of telemedicine, expose residents to standardized telemedicine patients virtually, and analyze the effectiveness of telemedicine training on completing a successful encounter. emergency medicine residents first underwent a virtual standardized telemedicine encounter using the ZoomTM telecommunications application without prior training in telemedicine. Standardized patients were then queried on resident success during this untrained encounter using a survey with aspects of a successful telemedicine encounter. The following session involved a lecture by a telemedicine physician. After this intervention, the residents underwent a repeat virtual encounter, with standardized patients responding to the same questions on the fundamental aspects of a successful interview. Residents also underwent a post-survey on their experiences with the training. Statistically significant differences were noted on aspects of the encounter related to obtaining informed consent (0% vs. 61%, p = 0.00012), asking about privacy in the patient’s environment (6% vs. 87%, p <0.00001), verifying name and/or date of birth (29% vs. 94%, p =0.00014), explaining the telehealth process and expectations to the patient (0% vs. 94%, p <0.00001). No statistical significance was seen with: resident introducing themselves (94% vs. 100%, p =.31732), asking focused questions about medical condition (100% vs. 100% p = 1), closing the encounter by explaining care plan (94% vs. 94%, p = 1). Overall, emergency medicine residents had significant improvement on aspects of an encounter with a standardized patient that were unique to telemedicine after undergoing training from an expert in the field. Similar training could easily be utilized across the country in emergency medicine residencies. This training could prove to be essential in the future because of the global health crisis of the COVID-19 pandemic, but also for rural emergency patient care and remote educational programs.","PeriodicalId":516872,"journal":{"name":"Academic Medicine &amp; Surgery","volume":"21 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140513892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Virtual Simulation to Teach EMS Personnel Respiratory Failure Management During the COVID-19 Pandemic","authors":"Ayanna Walker, Keegan McNally, L. Ganti, Nubaha Elahi, C. Van Dillen, Parth Patel, Ariel Vera","doi":"10.62186/001c.91500","DOIUrl":"https://doi.org/10.62186/001c.91500","url":null,"abstract":"This study presents a unique way to provide simulation education to paramedics during the Coronavirus pandemic, without some of the logistical concerns that accompany traditional in-person simulation. Our county EMS personnel were divided in groups of 3-6 for the virtual simulation conducted by a physician facilitator who was remotely broadcasted to the EMS team performing tasks on a mannequin. A post-simulation survey was conducted to determine how the simulation affected their comfort level with managing respiratory failure in both suspected COVID-19 and non-COVID-19 patients. The 42 EMS personnel responding to the survey felt an increased comfort level in managing respiratory failure in a suspected or known COVID-19 patient after the virtual simulation. There was an increase in “extremely comfortable” responses from 24% to 43% before and after the simulation, and a decrease in “somewhat uncomfortable” responses from 10% to 0%. Respondents had extensive prior EMS experience, with 95% stating 2+ years working in EMS, and 33% with more than 10 year’s experience. Only 12% of the responders stated they underwent simulation training once a month or more, with 64% stating “a few times per year”. 86% of the responders felt the video platform was easy to use. The most common technical difficulty involved audio problems. EMS personnel undergoing a virtual simulation and debrief in the management of respiratory failure in the setting of the COVID-19 pandemic felt more comfortable in their management of these patients after their sessions. The majority recommended continuing this type of training in the future.","PeriodicalId":516872,"journal":{"name":"Academic Medicine &amp; Surgery","volume":"125 1-3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140515128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}