An Observational Study of Patient Characteristics and Environmental Risk Factors of Stingray Envenomations in San Diego, California.

INTRODUCTION: Current literature on stingray envenomations focuses on the incidence, presentation, and complications of these injuries, with some studies providing such data for specific geographic locations. This is the first study to evaluate the influence of environmental factors and human characteristics on stingray envenomation patterns in San Diego, California. METHODS: Incident reports of injuries documented by the San Diego Fire-Rescue Department/Lifeguard Division (SDFR-LG) during 2017 were analyzed. Water temperature and tide height were populated based on date and time. Data was analyzed for associations between stingray injuries incidence and tide height, water temperature, time, month, age and sex of the injured person, and whether they were local. RESULTS: 1722 stingray injuries were reported to the SDFR-LG in 2017. Stingray injuries were associated with water temperature (p < 0.001), more frequently occurring between 18.8 °C and 19.5 °C. Most envenomations occurred at tide heights between 1.7 ft and 3.1 ft. Most victims were aged 20-29, and there were more males than females injured. Beaches separated from the greater ocean or with a reef bottom had a lower incidence. Stingray injuries were more frequent during summer months. More stingray envenomations were documented for out-of-town beachgoers. CONCLUSIONS: Beachgoers with certain characteristics had more reported stingray envenomations than others. Males, nonlocal beachgoers, and individuals in their twenties had more injuries than their counterparts. Stingray injuries were more common at water temperatures between 18.8 and 19.5 °C. These findings may lead to future research on the prevention of stingray injuries.

Hyperbaric medicine simulation education curriculum: CNS toxicity during Treatment Table 6 and intubated ICU patient with mucous plugging.

INTRODUCTION/BACKGROUND: The incidence of complications and number of critically ill patients in hyperbaric medicine is relatively low [1]. This poses a challenge to those tasked with educating trainees as well as maintaining the skills of staff. Hyperbaric medicine fellows may not be exposed to critical patient scenarios or complications of hyperbaric medicine during a one-year fellowship. Additional staff may be unfamiliar with these situations as well. The purpose of hyperbaric simulation curriculum is to train health care providers for rare situations. To our knowledge, this hyperbaric simulation curriculum is the first published use of simulation education in the specialty of undersea and hyperbaric medicine. MATERIALS AND METHODS: Two simulation cases have been developed that involve a patient with oxygen toxicity during hyperbaric treatment as well as an ICU patient with mucous plugging. RESULTS: Medical training simulations are an effective method of teaching content and training multiple roles in Undersea and Hyperbaric Medicine. SUMMARY/CONCLUSIONS: A hyperbaric simulation curriculum is an achievable educational initiative that is able to train multiple team members simultaneously in situations that they may not encounter on a regular basis. We believe that this could be easily exported to otherinstitutions for further education.