Authors’ Response

To the Editor: Mr. Ho and Dr. Ware suggested advising an ill airline passenger regarding the Health Insurance Portability and Accountability Act of 19961 (HIPPA) protection of his or her health information “if circumstances permit” and/or with a surrogate “when feasible.” ” We agree with this recommendation; however, during...

On “Healthcare Professionals and In-Flight Medical Emergencies: Resources, Responsibilities, Goals, and Legalities as a Good Samaritan”

To the Editor: We read with interest the article by de Caprariis et al that appeared inthe January 2019 issue of the Southern Medical Journal.1 The authors provide anauthoritative review of matters of importance to healthcare professionals who respond to in-flight emergencies, including expected resources on board US commercial...

CME Article: Patients on Involuntary Hold Status in the Emergency Department

Objectives: Patients requiring involuntary holds are frequently seen in the emergency department (ED). Much of what is known comes from studies of patients at urban academic centers. Our aim was to describe the demographic and clinical characteristics of patients who were evaluated while on involuntary status at a suburban...

Trauma Providers’ Perceptions of Frailty Assessment: A Mixed-Methods Analysis of Knowledge, Attitudes, and Beliefs

Objectives: Quality improvement in geriatric trauma depends on timely identification of frailty, yet little is known about providers’ knowledge and beliefs about frailty assessment. This study sought to understand trauma providers’ understanding, beliefs, and practices for frailty assessment. Methods: We developed a 20-question survey using the Health Belief Model...

CME Article: Clinical Utility of Routine Chest X-Rays During the Initial Stabilization of Trauma Patients

Objectives: The Advanced Trauma Life Support (ATLS) course encourages the use of chest x-ray (CXR) to identify injuries that may change clinical management during the initial stage of trauma resuscitations. Several studies have failed to show benefit for the routine use of CXR without a clinical indication, however. We...

Healthcare Professionals and In-Flight Medical Emergencies: Resources, Responsibilities, Goals, and Legalities as a Good Samaritan

Common in-flight emergencies include syncope, respiratory symptoms, nausea/vomiting, cardiac symptoms, and seizures. Flight conditions, such as changes in air pressure and humidity, can exacerbate existing chronic medical conditions. In 2017, US airlines carried 849.3 million passengers. Undoubtedly, there were many requests for in-flight medical assistance. Whenever a medical event...

Adverse Events in the Efficacy of Crotalidae Polyvalent Immune Fab Antivenom vs Placebo in Recovery from Copperhead Snakebite Trial

Objective: To compare the incidence of hypersensitivity reactions following copperhead envenomation treated with Fab antivenom (FabAV) or placebo. Methods: Patients with copperhead snakebites received treatment and follow-up in a prospective, randomized, double-blind, placebo-controlled trial of FabAV or placebo. The treatment allocation ratio was 2:1 (FabAV:placebo). All of the included...

Commentary on “Prehospital Airway Management in Iraq and Afghanistan: A Descriptive Analysis”

In this issue of the Southern Medical Journal, Schauer and associates address the vitally important issue of airway management in combat casualty care.1 Using data from the Department of Defense Trauma Registry, the authors provide qualitative information on the “what, where, when, and how” of airway placement in wounded...

Prehospital Airway Management in Iraq and Afghanistan: A Descriptive Analysis

Objectives: Airway failures are the second leading cause of potentially preventable death on the battlefield. Improvements in airway management depend on identifying current challenges. We sought to build on previously reported data on prehospital, combat airway management. Methods: We used a series of emergency department procedure codes to identify...

Characteristics of Dog Bites in Arkansas

Objective: Dog bite injuries are encountered frequently in emergency departments and can cause significant morbidity. The objective of this study was to explore the associations between the multiple variables at play during these occurrences (eg, the patient’s age, the bite location, the bite severity, the dog’s relationship with the...

Bathing Habits in Emergency Department Patients with Cellulitis or Abscess Versus Controls

Objective: Cellulitis is a leading cause of emergency department (ED) visits, with more than 200 cases per 100,000 people per year. Although many risk factors have been identified, including edema, skin breakdown, and penetrance of the skin, there are few data available on whether personal hygiene habits (bathing and...

Differences Between Snakebites with Concomitant Use of Alcohol or Drugs and Single Snakebites

Objectives: Published reports have suggested that the concurrent use of alcohol or drugs occurs among some snakebite victims, but no national assessment of such data exists. Methods: We used data from US poison control centers collected during telephone calls in calendar years 2000–2013 to compare snake envenomations with concomitant...

Helmets Matter: Kentucky Motorcycle Crash Victims Seen at a Tennessee Trauma Center

Objectives: Motorcycle helmet laws vary by state, with Kentucky requiring helmets only for younger riders. We hypothesized that motorcyclists injured in Kentucky and seen at a Tennessee trauma center would be more likely to be unhelmeted, have more severe head injuries, and sustain more fatal injuries than those injured...

Association Between Perceived Discrimination and Emergency Department Use Among Safety-Net Patients in the Southwestern United States

Objectives: Patients’ perceptions of how they are treated in their interactions with the healthcare system represent important and valid measures of healthcare quality that may influence health utilization, outcomes, and costs. Perceived discrimination or the sense of being treated unfairly is an important patient perception known to adversely affect...

Developing a Mass Casualty Surge Capacity Protocol for Emergency Medical Services to Use for Patient Distribution

Objectives: Metropolitan areas must be prepared to manage large numbers of casualties related to a major incident. Most US cities do not have adequate trauma center capacity to manage large-scale mass casualty incidents (MCIs). Creating surge capacity requires the distribution of casualties to hospitals that are not designated as...

Cross-Sectional Study of the Relation of Health Literacy to Primary Language and Emergency Department Length of Stay

Objectives: The primary aim of this study was to determine whether emergency department (ED) length of stay (LOS) or primary language was related to the degree of health literacy of patients. Methods: Adult English-speaking and Spanish-speaking patients were recruited for the study. Participants completed the Newest Vital Sign (NVS)...

Assessing Disaster Preparedness Among Select Children’s Summer Camps in the United States and Canada

Objective: Children’s summer camps are at risk for multiple pediatric casualties during a disaster. The degree to which summer camps have instituted disaster preparedness is unknown. We assessed disaster preparedness among selected camps nationally for a range of disasters. Methods: We partnered with a national, web-based electronic health records...

Chester Step Test as a Reliable, Reproducible Method of Assessing Physical Fitness of Disaster Deployment Personnel

Field disaster response typically is strenuous, difficult work, both physically and mentally.1–3 Although hard evidence is lacking, it may be inferred that responders lacking appropriate physical fitness are at increased risk of injury or compromising safety operations during a...

Transfusion Practice in Trauma Resuscitation

Recognition of the acute coagulopathy of trauma and the limits of reconstituting whole blood with conventional blood components has led to a radical change in the way trauma patients with severe injuries are resuscitated. Massive transfusion protocols (MTP) have evolved toward the administration of conventional blood components in fixed...

Survey of Hospital Employees’ Personal Preparedness and Willingness to Work Following a Disaster

Objectives: Little is known about the personal readiness of hospital staff for disasters. As many as 30% of hospital staff say that they plan not to report for work during a large-scale disaster. We sought to understand the personal disaster preparedness for hospital staff. Methods: Surveys were distributed to...