The impact of modern airport security protocols on patients with total shoulder replacements.

BACKGROUND: Advancements in airport screening measures in response to 9/11 have resulted in increased false alarm rates for patients with orthopedic and metal implants. With the implementation of millimeter-wave scanning technology, it is important to assess the changes in airport screening experiences of patients who underwent total shoulder arthroplasty (TSA). METHODS: Here, 197 patients with prior anatomic and reverse TSA completed between 2013 and 2020 responded to a questionnaire regarding their experiences with airport travel screening after their operation. Of these patients, 86 (44%) stated that they had traveled by plane, while 111 (56%) had not. The questionnaire addressed several measures including the number of domestic and international flights following the operation, number of false alarm screenings by the millimeter-wave scanner, patient body habitus, and presence of additional metal implants. RESULTS: A total of 53 patients (62%) responded "yes" to false screening alarms due to shoulder arthroplasty. The odds of a false screening alarm for patients with other metal implants was 5.87 times that of a false screening alarm for patients with no other metal implants (P<0.1). Of a reported 662 flights, 303 (45.8%) resulted in false screening alarms. Greater body mass index was not significantly lower in patients who experienced false screening alarms (P=0.30). CONCLUSIONS: Patients with anatomic and reverse TSA trigger false alarms with millimeter-wave scanners during airport screening at rates consistent with prior reports following 9/11. Patient education on the possibility of false alarms during airport screening is important until improvements in implant identification are made. Level of evidence: IV.

Medical Supervision of Illinois Public and Private High School Athletics.

BACKGROUND: High-school sports participation in the United States has increased over the years with a corresponding increase in the number of injuries. Leading medical and sports organizations nationwide advocate for an increase in proper medical supervision of athletes. OBJECTIVES: To analyze athletic medical coverage in Illinois high schools and compare differences between public and private Illinois high school. METHODS: A survey addressing various components of sports medical coverage was distributed in 2018 to all 810 Illinois High School Association (IHSA) high schools to be completed electronically. RESULTS: The response rate was 50% (407/810 schools). Of the responding schools, 14% were private high schools and 86% public high schools. An orthopedic surgeon, family doctor, pediatrician, or another type of physician were present on sidelines in 9.2% of private high schools and 8.5% of public high schools. Athletic trainers (ATs) were present on sidelines in 91% of private high schools and in 79% of public high schools. There was 68% of private high schools reporting coaches trained in CPR versus 85% in public high schools. Both private and public high schools had high rates of having written emergency action plans (89% vs 91%), AED on site (100% vs 99%), written concussion management protocols (96% vs 97%). CONCLUSION: Our study found similar rates of high school medical coverage as compared to national studies, with some significant differences found between private and public high schools. Most Illinois high schools had high rates of having written EAPs, concussion management protocols and AEDs on site. Overall, an increase of medical supervision and emergency preparedness is needed, which should come in the form of increasing AT and physician presence alongside community and school engagement for improved implementation of coverage.

Needlestick Occurrences and Reporting Among Residents in the Operative Setting.

OBJECTIVE: Needlesticks are common work-related injuries suffered by health care professionals. We sought to identify prevalence of needlestick/sharps injuries of residents working in the operating room and identify contributing factors and barriers to reporting/seeking treatment. METHODS: A 17-question survey on needlestick injuries was distributed to 168 residents in anesthesiology, surgery, and surgical subspecialties and the responses were analyzed for statistical significance of differences observed between departments. RESULTS: Of 138 respondents (82% response rate), 49% of residents had at least one needlestick injury during training. One quarter did not report their injuries to employee health or seek treatment, with the largest percentage from general surgery (53%). The primary reasons for not reporting injuries or seeking treatment included time away from patient care and lack of concern about the injury. More than half (64%) of the anesthesiology residents who reported an injury thought fatigue was a contributing factor. CONCLUSIONS: Half of residents sustained an injury and a quarter of injuries did not get reported, with the most valid reason being too much time away from patient care. Only anesthesiology residents commonly cited fatigue as a contributor to their needlestick/sharps injury. Understanding the program-specific needlestick/sharps injury incidence and prevalence, and the attitudes about reporting injuries and seeking treatment, is a first step toward prevention of injury for residents in training. ACGME Core Competencies: Medical Knowledge, Practice-based Learning and Improvement, Professionalism.