Rapid Mobilization of Medical Student Volunteers to Administer Vaccines During the COVID-19 Pandemic.

In December 2020, the first COVID-19 vaccines were approved for emergency use by the U.S. Food and Drug Administration, and vaccination efforts rapidly launched across the country. Concurrently, New York City experienced an increase in COVID-19 hospitalizations. This created an immediate need to inoculate frontline workers in a strained health system that lacked sufficient personnel to meet the demand. In response, New York State permitted medical students with appropriate clinical experience to administer vaccinations. Albert Einstein College of Medicine students rapidly stepped in to administer vaccines and serve as clinic navigators. Student leaders at Einstein collaborated with Montefiore Medical Center to rapidly implement a student vaccination initiative. Medical students underwent virtual and on-site training regarding COVID-19 vaccines and their administration. In January 2021, students began to staff vaccine clinics across the Bronx. By July 2021, 291 out of 830 eligible medical and Medical Scientist Training Program (MSTP) students (35.1%) had volunteered >2400 h. Of the 291 volunteers, 77 (26.5%) worked as vaccinators and administered approximately 2929 COVID-19 vaccines from January to May 2021. We demonstrate success using the concept of Entrustable Professional Activities (EPAs) in the context of training medical students in a specific clinical skill. Our framework resulted in the administration of approximately 2929 COVID-19 vaccines from January to May 2021. The authors believe that this framework can be implemented at peer institutions to alleviate the burden on hospital systems and outpatient clinics vaccinating their communities against COVID-19, or to meet future clinical needs.

Early Point-of-Care Testing at Triage Reduces Care Time in Stable Adult Emergency Department Patients.

BACKGROUND: Core laboratory testing may increase length of stay and delay care. OBJECTIVES: We compared length of emergency department (ED) care in patients receiving point-of-care testing (POCT) at triage vs. traditional core laboratory testing. METHODS: We conducted a prospective, case-controlled trial of adult patients with prespecified conditions requiring laboratory testing and had POCT performed by a nurse after triage for: a basic metabolic panel, troponin I, lactate, INR (i-STAT System), urinalysis (Beckman Coulter Icon), or urine pregnancy test. Study patients were matched with controls based on clinical condition, gender, age, and time to be seen. Groups were compared with Wilcoxon rank-sum or Fisher's exact tests. RESULTS: We matched 52 POCT study patients with 52 controls. Groups were similar in age, gender, clinical condition, time to be seen by a physician (3.3 h, 95% confidence interval [CI] 2.2-4.4, vs. 3.1 h, 95% CI 2.2-4.5 h, in POCT and control patients, respectively; p = 0.84), use of imaging, and disposition. Of 52 study patients, 3 (5.8%, 95% CI 2.0-15.9) were immediately transferred to the critical care area to be urgently seen by an emergency physician. POCT patients had a significantly shorter median (interquartile range [IQR]) ED care time than matched controls (7.6, 95% CI 5.1-9.5 vs. 8.5, 6.2-11.3 h, respectively; p = 0.015). Median [IQR] ED length of stay was similar in study patients and controls (9.6, 95% CI 7.9-14.5 vs. 12.5, 8.2-21.2 h, respectively; p = 0.15). CONCLUSIONS: Among stable adult patients presenting to the ED with one of the prespecified conditions, early POCT at triage, compared with traditional core laboratory testing after evaluation by an ED provider, reduced ED care time by approximately 1 h.

Prevalencia de Listeria monocytogenes en carnes y derivados de la industria porcícola colombiana / Prevalence of Listeria monocytogenes in pork-meat and other processed products from the Colombian swine industry

Objective. To determine the prevalence of L. monocytogenes in pork carcasses, meat cuts, and meat products (“chorizo”, sausage and ham). Materials and methods. Stratified sampling was implemented in meat-processed products. We analyzed 566 (37%) carcasses, 472 (31%) meat cuts, and 481, (32%) meat-processed products, distributed as follows: 169 (11%) sausage, 163 (11%) ham, and 149 (10%) “chorizo”, for a total of 1519 (100%) samples in a period of 18 months. The samples were processed using the ISO-17604, ISO-11290-1 and the USDA/FSIS (MLG-8.03) methods. Genus and species were confirmed by multiplex-PCR. Results. We obtained isolates of L. monocytogenes from 21 carcasses (10%), 160 (76%) from meat deboning, 10 (5%) from ham, 6 (3%) from “chorizo”, and 13 (6%) from sausage. The prevalence found was 3.7% and 33.9% in carcasses and meat deboning respectively. The prevalence in the meat-processed products was 4.03% in “chorizo”, 6.13% in ham and 7.69% in sausage. The overall prevalence of L. monocytogenes in the study was 13.82%. Conclusions. We found L. monocytogenes in different products analyzed, with particular interest in ham and sausage since both are consumed without previous heat treatment.