ABSTRACT
STUDY OBJECTIVE: The COVID-19 pandemic has resulted in widespread shortages of personal protective equipment, including N95 respirators. Although basic surgical facemasks are more commonly available, their efficacy is limited due primarily to their poor face seal. This pilot study examined the impact of a rubber band mask brace on a basic surgical mask, as determined by quantitative fit testing. METHODS: Subjects wearing a basic surgical facemask and the rubber band mask brace underwent quantitative fit testing using machinery designed to certify N95 mask fit. Subjects were tested with the brace anchored behind their ears, with a paperclip behind the head, and on the side knobs of their face shields. The primary outcome measure was whether the subject passed the quantitative fit test at or above the Occupational Safety and Health Administration (OSHA)-verified standard for N95 masks. RESULTS: Subjects (n = 11) were 54.5% female, with a median height of 70 inches (interquartile range [IQR] = 68-74), weight of 170 pounds (IQR = 145-215), and body mass index (BMI) of 24.6 (IQR = 22.2-27.2), and encompassing 5 distinct N95 mask fit types. We found that 45%, 100%, and 100% of subjects passed the quantitative fit test when the brace was anchored behind the ears, with a paperclip and on a face shield, respectively. CONCLUSION: Of the 11 subjects included in the analysis, across a range of body habitus and N95 mask fit types, all passed the quantitative fit test when the mask brace was anchored on either face shield or with a paperclip. This data suggests that although the brace does not create an N95 equivalent in terms of filtration, it would offer improved protection from airborne viruses when worn with a basic surgical mask.
ABSTRACT
A review of the uses and evidence for the Canadian C-spine rule, which can be used to clinically clear cervical spine fracture without imaging.
ABSTRACT
A review of the uses and evidence for the NEXUS criteria for C-spine imaging, which are used to clear patients from cervical spine fracture clinically, without imaging.
ABSTRACT
A review of the uses and evidence for the modified Rankin Scale, which measures the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability.
ABSTRACT
A review of the uses and evidence for the National Institutes of Health Scale/Score, which is used to quantify stroke severity.
ABSTRACT
A review of the uses and evidence for the Alberta Stroke Program Early CT Score, which determines middle cerebral artery stroke severity using available computed tomography data.
ABSTRACT
The ASPECTS determines middle cerebral artery stroke severity using available computed tomography data.
Subject(s)
Middle Cerebral Artery/diagnostic imaging , Severity of Illness Index , Stroke/diagnostic imaging , Tomography, X-Ray Computed , Age Factors , Brain Ischemia/diagnostic imaging , Brain Ischemia/mortality , Cerebral Hemorrhage/diagnostic imaging , Cerebral Hemorrhage/mortality , Humans , Intracranial Aneurysm/drug therapy , Intracranial Aneurysm/mortality , Neurologic Examination , Stroke/mortality , Vestibular Diseases/diagnostic imaging , Vestibular Diseases/mortalityABSTRACT
The NIH Scale/Score is used to quantify stroke severity.
Subject(s)
Ischemic Stroke/physiopathology , Severity of Illness Index , Diagnostic Techniques, Neurological , Humans , Ischemic Stroke/mortality , National Institutes of Health (U.S.) , Neuropsychological Tests , Predictive Value of Tests , United States/epidemiologyABSTRACT
This clinical policy from the American College of Emergency Physicians addresses key issues in opioid management in adult patients presenting to the emergency department. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) In adult patients experiencing opioid withdrawal, is emergency department-administered buprenorphine as effective for the management of opioid withdrawal compared with alternative management strategies? (2) In adult patients experiencing an acute painful condition, do the benefits of prescribing a short course of opioids on discharge from the emergency department outweigh the potential harms? (3) In adult patients with an acute exacerbation of noncancer chronic pain, do the benefits of prescribing a short course of opioids on discharge from the emergency department outweigh the potential harms? (4) In adult patients with an acute episode of pain being discharged from the emergency department, do the harms of a short concomitant course of opioids and muscle relaxants/sedative-hypnotics outweigh the benefits? Evidence was graded and recommendations were made based on the strength of the available data.
Subject(s)
Analgesics, Opioid/administration & dosage , Emergency Medicine/standards , Emergency Service, Hospital/standards , Practice Patterns, Physicians'/standards , Humans , Practice Guidelines as Topic , Societies, Medical , United StatesABSTRACT
The NEXUS criteria for C-spine imaging clear patients from cervical spine fracture clinically, without imaging.
Subject(s)
Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/injuries , Decision Making , Spinal Injuries/diagnostic imaging , Emergency Service, Hospital , Humans , Neoplasms, Radiation-Induced/etiology , Neoplasms, Radiation-Induced/prevention & control , Radiation Exposure , Risk AssessmentABSTRACT
The Canadian C-spine rule clinically clears cervical spine fracture without imaging.
Subject(s)
Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/injuries , Decision Support Techniques , Neck Injuries/diagnostic imaging , Wounds, Nonpenetrating/diagnostic imaging , Canada , Emergency Service, Hospital , Humans , Sensitivity and SpecificityABSTRACT
The Canadian CT Head Rule was developed to help physicians determine which patients with minor head injury need head CT imaging.
Subject(s)
Craniocerebral Trauma/diagnostic imaging , Decision Support Techniques , Emergency Service, Hospital , Tomography, X-Ray Computed , Canada , HumansABSTRACT
The NIHSS is used to quantify the severity of ischemic stroke.
Subject(s)
Stroke/classification , Humans , National Institutes of Health (U.S.)/organization & administration , National Institutes of Health (U.S.)/trends , Severity of Illness Index , Stroke/therapy , United StatesABSTRACT
The modified Rankin Scale (mRS) for neurologic disability measures the degree of disability or dependence in the daily activities of people who have suffered a stroke.
Subject(s)
Disability Evaluation , Nervous System Diseases/classification , Research Design/trends , Humans , Severity of Illness IndexABSTRACT
The Alberta Stroke Program Early CT Score (ASPECTS) assesses the severity of middle cerebral artery stroke using available computed tomography data.
Subject(s)
Middle Cerebral Artery/abnormalities , Stroke/classification , Tomography, X-Ray Computed/methods , Humans , Middle Cerebral Artery/diagnostic imaging , Neurological Rehabilitation , Research Design , Stroke/diagnosis , Tomography, X-Ray Computed/trendsABSTRACT
The American College of Emergency Physicians (ACEP) organized a multidisciplinary effort to create a clinical practice guideline specific to unscheduled, time-sensitive procedural sedation, which differs in important ways from scheduled, elective procedural sedation. The purpose of this guideline is to serve as a resource for practitioners who perform unscheduled procedural sedation regardless of location or patient age. This document outlines the underlying background and rationale, and issues relating to staffing, practice, and quality improvement.
