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style="font-size: 20px" translate="no">done</span>Following</button></div></div><div class="user-stats-container"><a><div class="stat-container js-profile-followers"><p class="label">Followers</p><p class="data">46</p></div></a><a><div class="stat-container js-profile-followees" data-broccoli-component="user-info.followees-count" data-click-track="profile-expand-user-info-following"><p class="label">Following</p><p class="data">21</p></div></a><a><div class="stat-container js-profile-coauthors" data-broccoli-component="user-info.coauthors-count" data-click-track="profile-expand-user-info-coauthors"><p class="label">Co-authors</p><p class="data">21</p></div></a><div class="js-mentions-count-container" style="display: none;"><a href="/DavidMilzman/mentions"><div class="stat-container"><p class="label">Mentions</p><p class="data"></p></div></a></div><span><div class="stat-container"><p class="label"><span class="js-profile-total-view-text">Public Views</span></p><p class="data"><span class="js-profile-view-count"></span></p></div></span></div><div class="suggested-academics-container"><div class="suggested-academics--header"><p class="ds2-5-body-md-bold">Related Authors</p></div><ul class="suggested-user-card-list"><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a href="https://fortisescorts.academia.edu/VivekanandJha"><img class="profile-avatar u-positionAbsolute" alt="Vivekanand Jha" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/16904/5686/5505/s200_vivekanand.jha.jpg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://fortisescorts.academia.edu/VivekanandJha">Vivekanand Jha</a><p class="suggested-user-card__user-info__subheader 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ds2-5-body-xs">University of medicine Zagreb</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a href="https://bu.academia.edu/EdwardBernstein"><img class="profile-avatar u-positionAbsolute" alt="Edward Bernstein" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/37843435/18737213/18698471/s200_edward.bernstein.jpg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://bu.academia.edu/EdwardBernstein">Edward Bernstein</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">Boston University</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a 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class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://spanalumni.academia.edu/FelixAnkel">Felix Ankel</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">University of Minnesota - Twin Cities</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a href="https://rkus-ott.academia.edu/AndrewBottomley"><img class="profile-avatar u-positionAbsolute" alt="Andrew Bottomley" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/39004550/16161314/16601733/s200_andrew.bottomley.jpg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://rkus-ott.academia.edu/AndrewBottomley">Andrew Bottomley</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">None (Private)</p></div></div></ul></div><div class="ri-section"><div class="ri-section-header"><span>Interests</span></div><div class="ri-tags-container"><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="37670283" href="https://www.academia.edu/Documents/in/Adolescent"><div id="js-react-on-rails-context" style="display:none" data-rails-context="{"inMailer":false,"i18nLocale":"en","i18nDefaultLocale":"en","href":"https://georgetown.academia.edu/DavidMilzman","location":"/DavidMilzman","scheme":"https","host":"georgetown.academia.edu","port":null,"pathname":"/DavidMilzman","search":null,"httpAcceptLanguage":null,"serverSide":false}"></div> <div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Adolescent"]}" data-trace="false" data-dom-id="Pill-react-component-6fc9784c-e82d-470c-b5fe-8f1122614bcb"></div> <div id="Pill-react-component-6fc9784c-e82d-470c-b5fe-8f1122614bcb"></div> </a><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="37670283" href="https://www.academia.edu/Documents/in/Emergency_Medicine"><div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Emergency Medicine"]}" data-trace="false" data-dom-id="Pill-react-component-da5f783b-3617-4870-a6f6-2778469b7521"></div> <div id="Pill-react-component-da5f783b-3617-4870-a6f6-2778469b7521"></div> </a><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="37670283" href="https://www.academia.edu/Documents/in/Clinical_Sciences"><div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Clinical Sciences"]}" data-trace="false" data-dom-id="Pill-react-component-bf04d465-4091-4b6c-b780-57bed27dd3aa"></div> <div id="Pill-react-component-bf04d465-4091-4b6c-b780-57bed27dd3aa"></div> </a><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="37670283" href="https://www.academia.edu/Documents/in/Medicine"><div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Medicine"]}" data-trace="false" data-dom-id="Pill-react-component-5845c85f-f474-4a73-8171-a4b755984067"></div> <div id="Pill-react-component-5845c85f-f474-4a73-8171-a4b755984067"></div> </a></div></div></div></div><div class="right-panel-container"><div class="user-content-wrapper"><div class="uploads-container" id="social-redesign-work-container"><div class="upload-header"><h2 class="ds2-5-heading-sans-serif-xs">Uploads</h2></div><div class="documents-container backbone-social-profile-documents" style="width: 100%;"><div class="u-taCenter"></div><div class="profile--tab_content_container js-tab-pane tab-pane active" id="all"><div class="profile--tab_heading_container js-section-heading" data-section="Papers" id="Papers"><h3 class="profile--tab_heading_container">Papers by David Milzman</h3></div><div class="js-work-strip profile--work_container" data-work-id="91815274"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/91815274/The_Prevalence_of_Quality_Issues_and_Adverse_Outcomes_among_72_Hour_Return_Admissions_in_the_Emergency_Department"><img alt="Research paper thumbnail of The Prevalence of Quality Issues and Adverse Outcomes among 72-Hour Return Admissions in the Emergency Department" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/91815274/The_Prevalence_of_Quality_Issues_and_Adverse_Outcomes_among_72_Hour_Return_Admissions_in_the_Emergency_Department">The Prevalence of Quality Issues and Adverse Outcomes among 72-Hour Return Admissions in the Emergency Department</a></div><div class="wp-workCard_item"><span>The Journal of Emergency Medicine</span><span>, 2013</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Records of patients discharged from the Emergency Department (ED) who return within 72 h and are ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Records of patients discharged from the Emergency Department (ED) who return within 72 h and are admitted are often reviewed for potential quality issues. We explored 72-h return admissions and determined the prevalence and predictors for substandard management on the initial visit or any adverse outcome. Retrospective review of quality assurance data from 72-h return admissions in three hospitals from 2006-2010 was performed. Any substandard quality on the first visit or change in outcome on the return admission was considered &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;low…</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815274"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815274"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815274; 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</script> <div class="js-work-strip profile--work_container" data-work-id="91815273"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/91815273/Emergency_Department_Variation_in_Utilization_and_Diagnostic_Yield_of_Advanced_Radiography_in_Diagnosis_of_Pulmonary_Embolus"><img alt="Research paper thumbnail of Emergency Department Variation in Utilization and Diagnostic Yield of Advanced Radiography in Diagnosis of Pulmonary Embolus" class="work-thumbnail" src="https://attachments.academia-assets.com/94995088/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/91815273/Emergency_Department_Variation_in_Utilization_and_Diagnostic_Yield_of_Advanced_Radiography_in_Diagnosis_of_Pulmonary_Embolus">Emergency Department Variation in Utilization and Diagnostic Yield of Advanced Radiography in Diagnosis of Pulmonary Embolus</a></div><div class="wp-workCard_item"><span>The Journal of Emergency Medicine</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: There is growing pressure to measure and reduce unnecessary imaging in the emergency ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: There is growing pressure to measure and reduce unnecessary imaging in the emergency department. Objective: We study provider and hospital variation in utilization and diagnostic yield for advanced radiography in diagnosis of pulmonary embolism (PE) and to assess patient-and provider-level factors associated with diagnostic yield. Methods: Retrospective chart review of all adult patients presenting to four hospitals from January 2006 through December 2009 who had a computed tomography or ventilation/perfusion scan to evaluate for PE. Demographic data on the providers ordering the scans were collected. Diagnostic yield (positive scans/total scans ordered) was calculated at the hospital and provider level. The study was not designed to assess appropriateness of imaging. Results: There was significant variation in utilization and diagnostic yield at the hospital level (chi-squared, p < 0.05). Diagnostic yield ranged from 4.2% to 8.2%; after adjusting for patient-and provider-level factors; the two hospitals with an emergency medicine residency training program had higher diagnostic yields (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.6-2.5 and OR 1.9, 95% CI 1.5-2.4). There was no significant variation in diagnostic yield among the 90 providers after adjusting for patient, hospital, and provider characteristics. Providers with < 10 years of experience had lower odds of diagnosing a PE than more experienced graduates (OR 0.8, 95% CI 0.6-0.9). Conclusions: Although we found significant variation in utilization of advanced radiography for PE and diagnostic yield at the hospital level, there was no significant variation at the provider level after adjusting for patient-, hospital-, and provider-level factors.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="b148bde265684c46ba0505f6619ed037" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":94995088,"asset_id":91815273,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/94995088/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815273"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815273"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815273; 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dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "b148bde265684c46ba0505f6619ed037" } } $('.js-work-strip[data-work-id=91815273]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":91815273,"title":"Emergency Department Variation in Utilization and Diagnostic Yield of Advanced Radiography in Diagnosis of Pulmonary Embolus","internal_url":"https://www.academia.edu/91815273/Emergency_Department_Variation_in_Utilization_and_Diagnostic_Yield_of_Advanced_Radiography_in_Diagnosis_of_Pulmonary_Embolus","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[{"id":94995088,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/94995088/thumbnails/1.jpg","file_name":"j.jemermed.2013.12.00220221129-1-kgrde2.pdf","download_url":"https://www.academia.edu/attachments/94995088/download_file","bulk_download_file_name":"Emergency_Department_Variation_in_Utiliz.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/94995088/j.jemermed.2013.12.00220221129-1-kgrde2-libre.pdf?1669687588=\u0026response-content-disposition=attachment%3B+filename%3DEmergency_Department_Variation_in_Utiliz.pdf\u0026Expires=1739804345\u0026Signature=WDuiyL2BCgiguzTuXofqfX155ruPAjaM38jUWxTBEaZF0FA0BJcSbK8Wb8O-jXyNRepcQDtbQQ38SjxV4HMdva0-drhDS7ZsPKRA0IlwJpb6Syc8V6ClrITPl5vYikG-ViyV9Bd4mt48~Ya7UeRHgpWGzGphvwqMnc4~USyP3greEER521nLXipfErg0YJOz12~2ytbIilaAOF8xDir62RZPGQVPHYK~sraVtBnhpGq3NeDtG3vuWMLoNtPSLzhOSDWyXjkLsQLX0PI8~8Tn9MezwlppPAtwaznkZpcx6NzCKmLUajd6-KwAbjt4GSkAtWPTU4y7a7aK3xIMRAZbSg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="91815271"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/91815271/A_review_of_costing_methodologies_in_critical_care_studies"><img alt="Research paper thumbnail of A review of costing methodologies in critical care studies" class="work-thumbnail" src="https://attachments.academia-assets.com/94995085/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/91815271/A_review_of_costing_methodologies_in_critical_care_studies">A review of costing methodologies in critical care studies</a></div><div class="wp-workCard_item"><span>Journal of Critical Care</span><span>, 2002</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Clinical decision making in critical care has traditionally been based on clinical outcome measur...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Clinical decision making in critical care has traditionally been based on clinical outcome measures such as mortality and morbidity. Over the past few decades, however, increasing competition in the health care marketplace has made it necessary to consider costs when making clinical and managerial decisions in critical care. Sophisticated costing methodologies have been developed to aid this decision-making process. We performed a narrative review of published costing studies in critical care during the past 6 years. A total of 282 articles were found, of which 68 met our search criteria. They involved a mean of 508 patients (range, 20-13,907). A total of 92.6% of the studies (63 of 68) used traditional cost analysis, whereas the remaining 7.4% (5 of 68) used cost-effectiveness analysis. None (0 of 68) used cost-benefit analysis or cost-utility analysis. A total of 36.7% (25 of 68) used hospital charges as a surrogate for actual costs. Of the 43 articles that actually counted costs, 37.2% (16 of 43) counted physician costs, 27.9% (12 of 43) counted facility costs, 34.9% (15 of 43) counted nursing costs, 9.3% (4 of 43) counted societal costs, and 90.7% (39 of 43) counted laboratory, equipment, and pharmacy costs. Our conclusion is that despite considerable progress in costing methodologies, critical care studies have not adequately implemented these techniques. Given the importance of financial implications in medicine, it would be prudent for critical care studies to use these more advanced techniques.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="094ef5abed5f8d3aae376fde8adca064" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":94995085,"asset_id":91815271,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/94995085/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815271"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815271"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815271; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="91815270"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/91815270/313_Impact_of_Acute_Care_Surgery_Service_on_Timing_of_Operation_and_Outcome_for_Emergency_Department_Diagnosis_of_Appendicitis"><img alt="Research paper thumbnail of 313: Impact of Acute Care Surgery Service on Timing of Operation and Outcome for Emergency Department Diagnosis of Appendicitis" class="work-thumbnail" src="https://attachments.academia-assets.com/94995084/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/91815270/313_Impact_of_Acute_Care_Surgery_Service_on_Timing_of_Operation_and_Outcome_for_Emergency_Department_Diagnosis_of_Appendicitis">313: Impact of Acute Care Surgery Service on Timing of Operation and Outcome for Emergency Department Diagnosis of Appendicitis</a></div><div class="wp-workCard_item"><span>Annals of Emergency Medicine</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Conclusion: In this external validation study, the 3-point out-of-hospital Simplified Motor Score...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Conclusion: In this external validation study, the 3-point out-of-hospital Simplified Motor Score demonstrated similar performance when compared to the 15-point out-of-hospital GCS score in the prediction of 4 clinically important traumatic brain injury outcomes.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="8f57c9aa0b7632c2a51e430e7d361964" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":94995084,"asset_id":91815270,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/94995084/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815270"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815270"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815270; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=91815270]").text(description); $(".js-view-count[data-work-id=91815270]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 91815270; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='91815270']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="91815269"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/91815269/Physiologic_affects_of_altitude_on_recreational_climbers"><img alt="Research paper thumbnail of Physiologic affects of altitude on recreational climbers" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/91815269/Physiologic_affects_of_altitude_on_recreational_climbers">Physiologic affects of altitude on recreational climbers</a></div><div class="wp-workCard_item"><span>The American Journal of Emergency Medicine</span><span>, 2009</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Previous analyses of physiologic parameter changes during ascent to altitude have incorporated sm...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Previous analyses of physiologic parameter changes during ascent to altitude have incorporated small numbers of well-trained climbers. The effects of altitude illness are more likely to occur and may come to medical attention more frequently in unacclimatized recreational individuals. We sought to evaluate acute changes in physiologic parameters during ascent to high altitude (14,100 ft) in recreational climbers. We performed a prospective naturalistic study of 221 recreational climbers at Mount Shasta (peak altitude of 14,162 ft). Baseline vital signs were recorded at 3500 ft (blood pressure, heart rate, respiratory rate, pulse oximetry, and peak flow). Subsequent measurements were obtained at 6700 ft, 10,400 ft, and at the summit. Mean vital signs and the amount they changed with altitude were estimated using mixed linear models. One hundred twenty-five climbers (56.6%) reached the summit. Heart rate increased and pulse oximetry decreased with ascent (mean, 71.9, 79, 97, and 102.4 beats/min and 96.9%, 93.9%, 88.8%, and 80.8%, respectively), with estimates at each altitude differing statistically at P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001. Mean systolic and diastolic blood pressures varied significantly by altitude (not measured at summit), but the changes were not monotonic. Peak flow progressively declined with ascent, but the difference between 6700 and 10,400 was not statistically significant. Respiratory rate did not change significantly. Acute compensation for altitude-induced hypoxia involves numerous physiologic changes; this is supported by our data that demonstrate significant changes in blood pressure and stepwise changes in pulse oximetry, peak flow, and heart rate. Consideration of these changes can be incorporated in future studies of the affect of altitude on recreational climbers.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815269"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815269"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815269; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=91815269]").text(description); 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dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=91815269]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":91815269,"title":"Physiologic affects of altitude on recreational climbers","internal_url":"https://www.academia.edu/91815269/Physiologic_affects_of_altitude_on_recreational_climbers","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="91815259"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/91815259/Absolute_Lymphocyte_Count_in_the_Emergency_Department_Predicts_a_Low_CD4_Count_in_Admitted_HIV_positive_Patients"><img alt="Research paper thumbnail of Absolute Lymphocyte Count in the Emergency Department Predicts a Low CD4 Count in Admitted HIV-positive Patients" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/91815259/Absolute_Lymphocyte_Count_in_the_Emergency_Department_Predicts_a_Low_CD4_Count_in_Admitted_HIV_positive_Patients">Absolute Lymphocyte Count in the Emergency Department Predicts a Low CD4 Count in Admitted HIV-positive Patients</a></div><div class="wp-workCard_item"><span>Academic Emergency Medicine</span><span>, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">This study sought to determine if the automated absolute lymphocyte count (ALC) predicts a &amp;a...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">This study sought to determine if the automated absolute lymphocyte count (ALC) predicts a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;low&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;200 × 10(6) cells/μL) CD4 count in patients with known human immunodeficiency virus (HIV+) who are admitted to the hospital from the emergency department (ED). This retrospective cohort study over an 8-year period was performed in a single, urban academic tertiary care hospital with over 85,000 annual ED visits. Included were patients who were known to be HIV+ and admitted from the ED, who had an ALC measured in the ED and a CD4 count measured within 24 hours of admission. Back-translated means and confidence intervals (CIs) were used to describe CD4 and ALC levels. The primary outcome was to determine the utility of an ALC threshold for predicting a CD4 count of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;200 × 10(6) cells/μL by assessing the strength of association between log-transformed ALC and CD4 counts using a Pearson correlation coefficient. In addition, area under the receiver operator curve (AUC) and a decision plot analysis were used to calculate the sensitivity, specificity, and the positive and negative likelihood ratios to identify prespecified optimal clinical thresholds of a likelihood ratio of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.1 and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;10. A total of 866 patients (mean age 42 years, 40% female) met inclusion criteria. The transformed means (95% CIs) for CD4 and ALC were 34 (31-38) and 654 (618-691), respectively. There was a significant relationship between the two measures, r = 0.74 (95% CI = 0.71 to 0.77, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The AUC was 0.92 (95% CI = 0.90 to 0.94, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). An ALC of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;1700 × 10(6) cells/μL had a sensitivity of 95% (95% CI = 93% to 96%), specificity of 52% (95% CI = 43% to 62%), and negative likelihood ratio of 0.09 (95% CI = 0.05 to 0.2) for a CD4 count of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;200 × 10(6) cells/μL. An…</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815259"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815259"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815259; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=91815259]").text(description); $(".js-view-count[data-work-id=91815259]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 91815259; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='91815259']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=91815259]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":91815259,"title":"Absolute Lymphocyte Count in the Emergency Department Predicts a Low CD4 Count in Admitted HIV-positive Patients","internal_url":"https://www.academia.edu/91815259/Absolute_Lymphocyte_Count_in_the_Emergency_Department_Predicts_a_Low_CD4_Count_in_Admitted_HIV_positive_Patients","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="87961796"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/87961796/The_impact_of_mosh_pits_on_medical_incidents_at_mass_gatherings"><img alt="Research paper thumbnail of The impact of “mosh pits” on medical incidents at mass gatherings" class="work-thumbnail" src="https://attachments.academia-assets.com/92043359/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/87961796/The_impact_of_mosh_pits_on_medical_incidents_at_mass_gatherings">The impact of “mosh pits” on medical incidents at mass gatherings</a></div><div class="wp-workCard_item"><span>Annals of Emergency Medicine</span><span>, 1999</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">insertion attempts by paramedics, of which 30 (81,1%) were successful. Mean insertion time for su...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">insertion attempts by paramedics, of which 30 (81,1%) were successful. Mean insertion time for successful attempts was 64.36_+2.1 seconds, and the mean recorded gravity flow rate was 23.0_+9.8 mL/min. One infnsion achieved a rate of 100 mL/h with a pressure bag. Common resuscitation drugs, including epinephrine, atropine, fidocaine, bretylium, and 25% dextrose solution were successfully infused. Complications seen in successfully inserted devices included minor leakage of fluid at site (5), kinking of the infusion tubing (2), difficulty with device removal (3), and poor adhesion of the target/stabilization patch (5). Information on failed attempts is included in the Table. Conclusion: Vascuiar access was achieved in 81.1% of patients with adequate flow rates to serve as a primary line for drug and fluid infusion in cardiac arrest. The FAST-1 device may be a useful alternative means of achieving rapid intravenous access when difficulty is encountered m obtaining timely peripheral access in the prehospital setting. Table, abstract 251. Unsuccessful insertion attempts Patient Comments 12 21 23 27 32 440 Ib; device deployed into presternal soft tissue 220 Ib; device did not deploy, infusion tubing in presternal soft tissue (probable operator error) 200 Lb; insertion attempted at "bad angle" deployed into presternaI soft tissue (operator error) 100 Ib; device did not deploy, "poor placement of patch," "never hit bone" 110 Ib; device did not deploy "Normal body fat"; device deployed but unable to infuse with syringe pressure; no infiltration 120 Ib; needles bent during insertion, noted "r/4-in stepoff in sternum" under insertion site. 52 Automated External Defibrillators Can Appropriately Recognize Ventricular Fibrillation in High Electromagnetic Fields Stolzenberg BT, Kupas DF, Sole DP, Wieczorek BJ/Geisinger Medical Center, Danville, PA Study objectives: Automated external defibrillators (AEDs) are increasingly available in industrial settings, but many industries have high electromagnetic fields (EMF), which can interfere with the function of electronic devices. This study evaluates the performance of several AEDs when exposed to high EMF. Methods: Three commercially available AEDs were evaluated in the setting of a public utility coal-fired electrical generation plant. Each AED was placed in 3 areas of high EMF ranging from 310 to 1,600 mG. A signal generator, used to simulate various cardiac rhythms, was connected to the AEDs. Rhythms simulated were ventricular fibrillation, asystole, and normal sinus rhythm. Each of the AED's interpretations of various rhythms were evaluated in the different EMP settings. Results: Rhythms of ventricular fibrillation, asystole, and normal sinus rhythm were correctly recognized by each AED in each of the 3 areas of high EMF. Each AED appropriately recommended defibrillation when presented with ventricular fibrillation No misinterpretations or inappropriate defibrillations were observed. Conclusion: EMF generated by an electrical power plant did not interfere with 3 commercial AEDs' abilities to correctly interpret simulated rhythms and recommend appropriate defibrillation.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="c9d2d581c4c07283591396a5ef2eaa39" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":92043359,"asset_id":87961796,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/92043359/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="87961796"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="87961796"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 87961796; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="82351004"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/82351004/Hyperbaric_Medicine_for_Outpatient_Wound_Care"><img alt="Research paper thumbnail of Hyperbaric Medicine for Outpatient Wound Care" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/82351004/Hyperbaric_Medicine_for_Outpatient_Wound_Care">Hyperbaric Medicine for Outpatient Wound Care</a></div><div class="wp-workCard_item"><span>Emergency Medicine Clinics of North America</span><span>, 1992</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">After proper cleansing, debridement, and appropriate antibiotic and closure decisions, some wound...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">After proper cleansing, debridement, and appropriate antibiotic and closure decisions, some wounds will fail to heal properly or may develop serious complications. Hyperbaric oxygen therapy offers a relatively safe noninvasive method of improving wound healing by enhancing tissue oxygenation and decreasing edema formation. Recommendation for the use of hyperbaric oxygen therapy in outpatient wound care is reviewed and the rationale behind the benefits is discussed.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="82351004"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="82351004"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 82351004; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=82351004]").text(description); $(".js-view-count[data-work-id=82351004]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 82351004; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='82351004']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=82351004]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":82351004,"title":"Hyperbaric Medicine for Outpatient Wound Care","internal_url":"https://www.academia.edu/82351004/Hyperbaric_Medicine_for_Outpatient_Wound_Care","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843424"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843424/Complications_of_intraosseous_infusion_Reply"><img alt="Research paper thumbnail of Complications of intraosseous infusion. Reply" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843424/Complications_of_intraosseous_infusion_Reply">Complications of intraosseous infusion. Reply</a></div><div class="wp-workCard_item"><span>Annals of Emergency Medicine</span><span>, 1990</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843424"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843424"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843424; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843424]").text(description); $(".js-view-count[data-work-id=69843424]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843424; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843424']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843424]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843424,"title":"Complications of intraosseous infusion. 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</script> <div class="js-work-strip profile--work_container" data-work-id="69843420"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843420/Utility_of_Ottawa_Ankle_Rules_in_an_Aging_Population_Evidence_for_Addition_of_an_Age_Criterion"><img alt="Research paper thumbnail of Utility of Ottawa Ankle Rules in an Aging Population: Evidence for Addition of an Age Criterion" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843420/Utility_of_Ottawa_Ankle_Rules_in_an_Aging_Population_Evidence_for_Addition_of_an_Age_Criterion">Utility of Ottawa Ankle Rules in an Aging Population: Evidence for Addition of an Age Criterion</a></div><div class="wp-workCard_item"><span>The Journal of Foot and Ankle Surgery</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">The Ottawa ankle rules (OAR) indicate that any patient with the inability to ambulate up to four ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">The Ottawa ankle rules (OAR) indicate that any patient with the inability to ambulate up to four steps or with tenderness at either malleoli should receive diagnostic imaging for an acute ankle injury. Current trends indicate that health care providers tend to order more images in practice than necessary according to OAR. The purpose of this study is to analyze OAR in geriatric versus nongeriatric patients. Secondarily, we hope to refine these guidelines for ankle imaging in the hopes that health care providers will be comfortable in adhering to these guidelines more strictly. A retrospective chart review was conducted of 491 adult patients with an average (± standard deviation) age of 54.4 ± 21.6 years (range 18 to 96). Applying the current OAR resulted in a sensitivity of 98.2% and a specificity of 58.6% in this entire cohort. The calculated sensitivities were comparable between the nongeriatric and geriatric cohorts, at 98.60% and 97.99%, respectively. The specificities varied between the nongeriatric and geriatric cohorts, at 60.13% and 33.33%. We propose new guidelines that would mandate imaging studies for any patient ≥65 years of age presenting to the emergency department with ankle pain. When applying these proposed guidelines, the sensitivity of the entire study population was found to be improved to 99.0%, whereas the specificity dropped to 56.7%. The slight decrease in specificity was deemed acceptable because these guidelines are meant to be used as a screening tool and because the risk of OAR not correctly identifying ankle fracture (2% of geriatric fractures) was completely mitigated in the geriatric population.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843420"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843420"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843420; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); 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window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843418]").text(description); $(".js-view-count[data-work-id=69843418]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843418; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843418']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843418]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843418,"title":"Helmet Design And Hits To The Head","internal_url":"https://www.academia.edu/69843418/Helmet_Design_And_Hits_To_The_Head","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843417"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843417/74_Mean_HEART_Scores_for_Admitted_Chest_Pain_Patients_are_Higher_in_More_Experienced_Providers"><img alt="Research paper thumbnail of 74 Mean HEART Scores for Admitted Chest Pain Patients are Higher in More Experienced Providers" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843417/74_Mean_HEART_Scores_for_Admitted_Chest_Pain_Patients_are_Higher_in_More_Experienced_Providers">74 Mean HEART Scores for Admitted Chest Pain Patients are Higher in More Experienced Providers</a></div><div class="wp-workCard_item"><span>Annals of Emergency Medicine</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843417"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843417"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843417; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843417]").text(description); $(".js-view-count[data-work-id=69843417]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843417; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843417']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843417]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843417,"title":"74 Mean HEART Scores for Admitted Chest Pain Patients are Higher in More Experienced Providers","internal_url":"https://www.academia.edu/69843417/74_Mean_HEART_Scores_for_Admitted_Chest_Pain_Patients_are_Higher_in_More_Experienced_Providers","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843416"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843416/Dynamic_motor_tracking_is_sensitive_to_subacute_mTBI"><img alt="Research paper thumbnail of Dynamic motor tracking is sensitive to subacute mTBI" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843416/Dynamic_motor_tracking_is_sensitive_to_subacute_mTBI">Dynamic motor tracking is sensitive to subacute mTBI</a></div><div class="wp-workCard_item"><span>Experimental brain research</span><span>, Nov 8, 2016</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Effective screening for mild traumatic brain injury (mTBI) is critical to accurate diagnosis, int...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Effective screening for mild traumatic brain injury (mTBI) is critical to accurate diagnosis, intervention, and improving outcomes. However, detecting mTBI using conventional clinical techniques is difficult, time intensive, and subject to observer bias. We examine the use of a simple visuomotor tracking task as a screening tool for mTBI. Thirty participants, 16 with clinically diagnosed mTBI (mean time since injury: 36.4 ± 20.9 days (95 % confidence interval); median = 20 days) were asked to squeeze a hand dynamometer and vary their grip force to match a visual, variable target force for 3 min. We found that controls outperformed individuals with mTBI; participants with mTBI moved with increased variability, as quantified by the standard deviation of the tracking error. We modeled participants&#39; feedback response-how participants changed their grip force in response to errors in position and velocity-and used model parameters to classify mTBI with a sensitivity of 87 % and a spe...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843416"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843416"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843416; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843416]").text(description); $(".js-view-count[data-work-id=69843416]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843416; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843416']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843416]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843416,"title":"Dynamic motor tracking is sensitive to subacute mTBI","internal_url":"https://www.academia.edu/69843416/Dynamic_motor_tracking_is_sensitive_to_subacute_mTBI","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843415"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843415/M_J_Wagner_and_S_Promes_Last_Minute_Emergency_Medicine_McGraw_Hill_Professional_2007_588_pages_45_ISBN_0071459626"><img alt="Research paper thumbnail of M.J. Wagner and S. Promes, Last Minute Emergency Medicine , McGraw-Hill Professional (2007) 588 pages, $45, ISBN 0071459626" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843415/M_J_Wagner_and_S_Promes_Last_Minute_Emergency_Medicine_McGraw_Hill_Professional_2007_588_pages_45_ISBN_0071459626">M.J. Wagner and S. Promes, Last Minute Emergency Medicine , McGraw-Hill Professional (2007) 588 pages, $45, ISBN 0071459626</a></div><div class="wp-workCard_item"><span>Ann Emerg Med</span><span>, 2009</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843415"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843415"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843415; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843415]").text(description); $(".js-view-count[data-work-id=69843415]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843415; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843415']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843415]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843415,"title":"M.J. Wagner and S. Promes, Last Minute Emergency Medicine , McGraw-Hill Professional (2007) 588 pages, $45, ISBN 0071459626","internal_url":"https://www.academia.edu/69843415/M_J_Wagner_and_S_Promes_Last_Minute_Emergency_Medicine_McGraw_Hill_Professional_2007_588_pages_45_ISBN_0071459626","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843414"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/69843414/Prehospital_Survivors_of_Falls_Height_and_Orthopedic_Injuries_Fail_to_Improve_Triage_or_Predict_Outcome"><img alt="Research paper thumbnail of Prehospital Survivors of Falls: Height and Orthopedic Injuries Fail to Improve Triage or Predict Outcome" class="work-thumbnail" src="https://attachments.academia-assets.com/79785971/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/69843414/Prehospital_Survivors_of_Falls_Height_and_Orthopedic_Injuries_Fail_to_Improve_Triage_or_Predict_Outcome">Prehospital Survivors of Falls: Height and Orthopedic Injuries Fail to Improve Triage or Predict Outcome</a></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Hypothesis: Injuries sustained from vertical trauma are predominantly orthopedic and have been as...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Hypothesis: Injuries sustained from vertical trauma are predominantly orthopedic and have been associated directly with the height of the fall. For prehospital survivors of falls, their physiologic stability and non-orthopedic injuries may be independent of the actual vertical fall distance. Methods: The records of 226 consecutive, adult trauma patients sustaining falls from a height >6 feet and admitted to a Level-1 Trauma Center during 1990 were reviewed. Pearson Correlation Coefficients (R) were used to determine if the height correlated with injury and outcome. Results: 217 victims fell a mean 22.1111.0 feet. Ninety-four percent of the patients were male, with a mean age of 36.1 years, mean Injury Severity Score (ISS) of 14, and a mean admission Glasgow Coma Score (GCS) of 14. Fracture distribution included 13% lower extremity (LEX), 22% upper extremity, and 25% spinal column with 7% associated cord injuries (CLCD). Mean values were: Systolic Blood Pressure (SBP) of 147+23 mmHg, Base Deficit (BD) of-2.4 mg/L, Lengdi of Stay (LOS) 11.7 days, and a mortality rate (MORT) of 3.1%. No significant correlation between fall distance and SBP (R =-.120), BD (R =-.014), GCS (R =-.114), LOS (R = .088) and MORT (R = .017) was found. Only height and ISS (R = .275), LEX (R = .305) were significant (p <.O5) Conclusions: In survivors of falls, non-fracture injuries, physiologic presentation, and outcome (LOS, MORT) are not associated with the height of fall. In transport and resuscitation decisions, trauma triage for fall victims must account for other than height and obvious fracture injuries.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="eda6ebec54025bbb335f30c876e64149" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":79785971,"asset_id":69843414,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/79785971/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843414"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843414"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843414; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843414]").text(description); $(".js-view-count[data-work-id=69843414]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843414; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843414']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843413"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/69843413/257_Blood_Lactate_An_Improved_Marker_of_Injury_Severity_and_Outcome_in_the_Triage_of_Multiple_Patients_Following_Traumatic_Injury"><img alt="Research paper thumbnail of 257 Blood Lactate: An Improved Marker of Injury Severity and Outcome in the Triage of Multiple Patients Following Traumatic Injury" class="work-thumbnail" src="https://attachments.academia-assets.com/79785972/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/69843413/257_Blood_Lactate_An_Improved_Marker_of_Injury_Severity_and_Outcome_in_the_Triage_of_Multiple_Patients_Following_Traumatic_Injury">257 Blood Lactate: An Improved Marker of Injury Severity and Outcome in the Triage of Multiple Patients Following Traumatic Injury</a></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In study #1, after circulatory arrest of one-hour in deep Hth (15°C), recovery was complete, even...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In study #1, after circulatory arrest of one-hour in deep Hth (15°C), recovery was complete, even with histologically almost normal brains. In study #2, after arrest of two hours in profound Hth (+10°C), functional and morphologic cerebral recovery were better than after two hours arrest with deep Hth (15°C). In study #3, adding washout with an organ preservation solution did not improve outcome further. Results were not worse in study #4, with avoidance of systemic heparinization (by heparin-bonded CPB circuit); nor in study #5, in which hemodilution was only to Hct 15%, not 5% as before. Conclusions: Clinical trials in selected cases of resuscitative surgery under CPB-induced profound hypothermic arrest of one hour are justified.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="178da25a418f69a7182c6042f79ef8ae" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":79785972,"asset_id":69843413,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/79785972/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843413"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843413"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843413; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843412"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843412/An_Introduction_to_Resuscitating_the_Ages"><img alt="Research paper thumbnail of An Introduction to Resuscitating the Ages" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843412/An_Introduction_to_Resuscitating_the_Ages">An Introduction to Resuscitating the Ages</a></div><div class="wp-workCard_item"><span>Emergency Medicine Clinics of North America</span><span>, 1996</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">corrective interventions. To individualize a patient&#39;s resuscitation, the emergency physician...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">corrective interventions. To individualize a patient&#39;s resuscitation, the emergency physician must be aware of certain specific host factors and must adjust therapy appropriately? Aside from gender (with few specific differences other than obvious genitourinary differences and the presence or lack of a womb, and risk factors for certain disease), age, specifically the extremes (pediatric and geriatric), is the most readily noticed and most important factor affecting overall outcome determination. An emergency physician should recognize the importance of specifically directing therapy mindful of the intricacies that pediatrics or gerontology entail. There can be no misunderstanding, though, that airway, breathing, and circulation are the basics, but optimizing oxygen delivery and resuscitating hypoperfusion must now be addressed. Emergency medicine is founded on the belief that residency training prepares one to resuscitate any and all patients and initiate disease-specific treatment. In this issue, the article, &quot;Resuscitating the Pediatric Patient,&quot; authored by Wright and Patterson, provides an overview of the issues in emergency pediatric resuscitation and then focuses on important lifesaving interventions. As these authors point out, understanding basic principles of pediatrics and maintaining a small armamentaria of procedures allows one to successfully treat most patients. The use of such devices as a Breslow tape can replace the problem of fumbling for proper age-appropriate equipment for critical interventions when needed.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843412"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843412"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843412; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843412]").text(description); $(".js-view-count[data-work-id=69843412]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843412; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843412']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843412]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843412,"title":"An Introduction to Resuscitating the Ages","internal_url":"https://www.academia.edu/69843412/An_Introduction_to_Resuscitating_the_Ages","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> </div><div class="profile--tab_content_container js-tab-pane tab-pane" data-section-id="3929559" id="papers"><div class="js-work-strip profile--work_container" data-work-id="91815274"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/91815274/The_Prevalence_of_Quality_Issues_and_Adverse_Outcomes_among_72_Hour_Return_Admissions_in_the_Emergency_Department"><img alt="Research paper thumbnail of The Prevalence of Quality Issues and Adverse Outcomes among 72-Hour Return Admissions in the Emergency Department" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/91815274/The_Prevalence_of_Quality_Issues_and_Adverse_Outcomes_among_72_Hour_Return_Admissions_in_the_Emergency_Department">The Prevalence of Quality Issues and Adverse Outcomes among 72-Hour Return Admissions in the Emergency Department</a></div><div class="wp-workCard_item"><span>The Journal of Emergency Medicine</span><span>, 2013</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Records of patients discharged from the Emergency Department (ED) who return within 72 h and are ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Records of patients discharged from the Emergency Department (ED) who return within 72 h and are admitted are often reviewed for potential quality issues. We explored 72-h return admissions and determined the prevalence and predictors for substandard management on the initial visit or any adverse outcome. Retrospective review of quality assurance data from 72-h return admissions in three hospitals from 2006-2010 was performed. Any substandard quality on the first visit or change in outcome on the return admission was considered &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;low…</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815274"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815274"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815274; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=91815274]").text(description); $(".js-view-count[data-work-id=91815274]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 91815274; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='91815274']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=91815274]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":91815274,"title":"The Prevalence of Quality Issues and Adverse Outcomes among 72-Hour Return Admissions in the Emergency Department","internal_url":"https://www.academia.edu/91815274/The_Prevalence_of_Quality_Issues_and_Adverse_Outcomes_among_72_Hour_Return_Admissions_in_the_Emergency_Department","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="91815273"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/91815273/Emergency_Department_Variation_in_Utilization_and_Diagnostic_Yield_of_Advanced_Radiography_in_Diagnosis_of_Pulmonary_Embolus"><img alt="Research paper thumbnail of Emergency Department Variation in Utilization and Diagnostic Yield of Advanced Radiography in Diagnosis of Pulmonary Embolus" class="work-thumbnail" src="https://attachments.academia-assets.com/94995088/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/91815273/Emergency_Department_Variation_in_Utilization_and_Diagnostic_Yield_of_Advanced_Radiography_in_Diagnosis_of_Pulmonary_Embolus">Emergency Department Variation in Utilization and Diagnostic Yield of Advanced Radiography in Diagnosis of Pulmonary Embolus</a></div><div class="wp-workCard_item"><span>The Journal of Emergency Medicine</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: There is growing pressure to measure and reduce unnecessary imaging in the emergency ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: There is growing pressure to measure and reduce unnecessary imaging in the emergency department. Objective: We study provider and hospital variation in utilization and diagnostic yield for advanced radiography in diagnosis of pulmonary embolism (PE) and to assess patient-and provider-level factors associated with diagnostic yield. Methods: Retrospective chart review of all adult patients presenting to four hospitals from January 2006 through December 2009 who had a computed tomography or ventilation/perfusion scan to evaluate for PE. Demographic data on the providers ordering the scans were collected. Diagnostic yield (positive scans/total scans ordered) was calculated at the hospital and provider level. The study was not designed to assess appropriateness of imaging. Results: There was significant variation in utilization and diagnostic yield at the hospital level (chi-squared, p < 0.05). Diagnostic yield ranged from 4.2% to 8.2%; after adjusting for patient-and provider-level factors; the two hospitals with an emergency medicine residency training program had higher diagnostic yields (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.6-2.5 and OR 1.9, 95% CI 1.5-2.4). There was no significant variation in diagnostic yield among the 90 providers after adjusting for patient, hospital, and provider characteristics. Providers with < 10 years of experience had lower odds of diagnosing a PE than more experienced graduates (OR 0.8, 95% CI 0.6-0.9). Conclusions: Although we found significant variation in utilization of advanced radiography for PE and diagnostic yield at the hospital level, there was no significant variation at the provider level after adjusting for patient-, hospital-, and provider-level factors.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="b148bde265684c46ba0505f6619ed037" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":94995088,"asset_id":91815273,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/94995088/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815273"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815273"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815273; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=91815273]").text(description); $(".js-view-count[data-work-id=91815273]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 91815273; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='91815273']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "b148bde265684c46ba0505f6619ed037" } } $('.js-work-strip[data-work-id=91815273]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":91815273,"title":"Emergency Department Variation in Utilization and Diagnostic Yield of Advanced Radiography in Diagnosis of Pulmonary Embolus","internal_url":"https://www.academia.edu/91815273/Emergency_Department_Variation_in_Utilization_and_Diagnostic_Yield_of_Advanced_Radiography_in_Diagnosis_of_Pulmonary_Embolus","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[{"id":94995088,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/94995088/thumbnails/1.jpg","file_name":"j.jemermed.2013.12.00220221129-1-kgrde2.pdf","download_url":"https://www.academia.edu/attachments/94995088/download_file","bulk_download_file_name":"Emergency_Department_Variation_in_Utiliz.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/94995088/j.jemermed.2013.12.00220221129-1-kgrde2-libre.pdf?1669687588=\u0026response-content-disposition=attachment%3B+filename%3DEmergency_Department_Variation_in_Utiliz.pdf\u0026Expires=1739804345\u0026Signature=WDuiyL2BCgiguzTuXofqfX155ruPAjaM38jUWxTBEaZF0FA0BJcSbK8Wb8O-jXyNRepcQDtbQQ38SjxV4HMdva0-drhDS7ZsPKRA0IlwJpb6Syc8V6ClrITPl5vYikG-ViyV9Bd4mt48~Ya7UeRHgpWGzGphvwqMnc4~USyP3greEER521nLXipfErg0YJOz12~2ytbIilaAOF8xDir62RZPGQVPHYK~sraVtBnhpGq3NeDtG3vuWMLoNtPSLzhOSDWyXjkLsQLX0PI8~8Tn9MezwlppPAtwaznkZpcx6NzCKmLUajd6-KwAbjt4GSkAtWPTU4y7a7aK3xIMRAZbSg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="91815271"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/91815271/A_review_of_costing_methodologies_in_critical_care_studies"><img alt="Research paper thumbnail of A review of costing methodologies in critical care studies" class="work-thumbnail" src="https://attachments.academia-assets.com/94995085/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/91815271/A_review_of_costing_methodologies_in_critical_care_studies">A review of costing methodologies in critical care studies</a></div><div class="wp-workCard_item"><span>Journal of Critical Care</span><span>, 2002</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Clinical decision making in critical care has traditionally been based on clinical outcome measur...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Clinical decision making in critical care has traditionally been based on clinical outcome measures such as mortality and morbidity. Over the past few decades, however, increasing competition in the health care marketplace has made it necessary to consider costs when making clinical and managerial decisions in critical care. Sophisticated costing methodologies have been developed to aid this decision-making process. We performed a narrative review of published costing studies in critical care during the past 6 years. A total of 282 articles were found, of which 68 met our search criteria. They involved a mean of 508 patients (range, 20-13,907). A total of 92.6% of the studies (63 of 68) used traditional cost analysis, whereas the remaining 7.4% (5 of 68) used cost-effectiveness analysis. None (0 of 68) used cost-benefit analysis or cost-utility analysis. A total of 36.7% (25 of 68) used hospital charges as a surrogate for actual costs. Of the 43 articles that actually counted costs, 37.2% (16 of 43) counted physician costs, 27.9% (12 of 43) counted facility costs, 34.9% (15 of 43) counted nursing costs, 9.3% (4 of 43) counted societal costs, and 90.7% (39 of 43) counted laboratory, equipment, and pharmacy costs. Our conclusion is that despite considerable progress in costing methodologies, critical care studies have not adequately implemented these techniques. Given the importance of financial implications in medicine, it would be prudent for critical care studies to use these more advanced techniques.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="094ef5abed5f8d3aae376fde8adca064" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":94995085,"asset_id":91815271,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/94995085/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815271"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815271"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815271; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="91815270"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/91815270/313_Impact_of_Acute_Care_Surgery_Service_on_Timing_of_Operation_and_Outcome_for_Emergency_Department_Diagnosis_of_Appendicitis"><img alt="Research paper thumbnail of 313: Impact of Acute Care Surgery Service on Timing of Operation and Outcome for Emergency Department Diagnosis of Appendicitis" class="work-thumbnail" src="https://attachments.academia-assets.com/94995084/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/91815270/313_Impact_of_Acute_Care_Surgery_Service_on_Timing_of_Operation_and_Outcome_for_Emergency_Department_Diagnosis_of_Appendicitis">313: Impact of Acute Care Surgery Service on Timing of Operation and Outcome for Emergency Department Diagnosis of Appendicitis</a></div><div class="wp-workCard_item"><span>Annals of Emergency Medicine</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Conclusion: In this external validation study, the 3-point out-of-hospital Simplified Motor Score...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Conclusion: In this external validation study, the 3-point out-of-hospital Simplified Motor Score demonstrated similar performance when compared to the 15-point out-of-hospital GCS score in the prediction of 4 clinically important traumatic brain injury outcomes.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="8f57c9aa0b7632c2a51e430e7d361964" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":94995084,"asset_id":91815270,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/94995084/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815270"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815270"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815270; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=91815270]").text(description); $(".js-view-count[data-work-id=91815270]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 91815270; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='91815270']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="91815269"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/91815269/Physiologic_affects_of_altitude_on_recreational_climbers"><img alt="Research paper thumbnail of Physiologic affects of altitude on recreational climbers" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/91815269/Physiologic_affects_of_altitude_on_recreational_climbers">Physiologic affects of altitude on recreational climbers</a></div><div class="wp-workCard_item"><span>The American Journal of Emergency Medicine</span><span>, 2009</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Previous analyses of physiologic parameter changes during ascent to altitude have incorporated sm...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Previous analyses of physiologic parameter changes during ascent to altitude have incorporated small numbers of well-trained climbers. The effects of altitude illness are more likely to occur and may come to medical attention more frequently in unacclimatized recreational individuals. We sought to evaluate acute changes in physiologic parameters during ascent to high altitude (14,100 ft) in recreational climbers. We performed a prospective naturalistic study of 221 recreational climbers at Mount Shasta (peak altitude of 14,162 ft). Baseline vital signs were recorded at 3500 ft (blood pressure, heart rate, respiratory rate, pulse oximetry, and peak flow). Subsequent measurements were obtained at 6700 ft, 10,400 ft, and at the summit. Mean vital signs and the amount they changed with altitude were estimated using mixed linear models. One hundred twenty-five climbers (56.6%) reached the summit. Heart rate increased and pulse oximetry decreased with ascent (mean, 71.9, 79, 97, and 102.4 beats/min and 96.9%, 93.9%, 88.8%, and 80.8%, respectively), with estimates at each altitude differing statistically at P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001. Mean systolic and diastolic blood pressures varied significantly by altitude (not measured at summit), but the changes were not monotonic. Peak flow progressively declined with ascent, but the difference between 6700 and 10,400 was not statistically significant. Respiratory rate did not change significantly. Acute compensation for altitude-induced hypoxia involves numerous physiologic changes; this is supported by our data that demonstrate significant changes in blood pressure and stepwise changes in pulse oximetry, peak flow, and heart rate. Consideration of these changes can be incorporated in future studies of the affect of altitude on recreational climbers.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815269"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815269"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815269; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=91815269]").text(description); 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dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=91815269]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":91815269,"title":"Physiologic affects of altitude on recreational climbers","internal_url":"https://www.academia.edu/91815269/Physiologic_affects_of_altitude_on_recreational_climbers","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="91815259"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/91815259/Absolute_Lymphocyte_Count_in_the_Emergency_Department_Predicts_a_Low_CD4_Count_in_Admitted_HIV_positive_Patients"><img alt="Research paper thumbnail of Absolute Lymphocyte Count in the Emergency Department Predicts a Low CD4 Count in Admitted HIV-positive Patients" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/91815259/Absolute_Lymphocyte_Count_in_the_Emergency_Department_Predicts_a_Low_CD4_Count_in_Admitted_HIV_positive_Patients">Absolute Lymphocyte Count in the Emergency Department Predicts a Low CD4 Count in Admitted HIV-positive Patients</a></div><div class="wp-workCard_item"><span>Academic Emergency Medicine</span><span>, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">This study sought to determine if the automated absolute lymphocyte count (ALC) predicts a &amp;a...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">This study sought to determine if the automated absolute lymphocyte count (ALC) predicts a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;low&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;200 × 10(6) cells/μL) CD4 count in patients with known human immunodeficiency virus (HIV+) who are admitted to the hospital from the emergency department (ED). This retrospective cohort study over an 8-year period was performed in a single, urban academic tertiary care hospital with over 85,000 annual ED visits. Included were patients who were known to be HIV+ and admitted from the ED, who had an ALC measured in the ED and a CD4 count measured within 24 hours of admission. Back-translated means and confidence intervals (CIs) were used to describe CD4 and ALC levels. The primary outcome was to determine the utility of an ALC threshold for predicting a CD4 count of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;200 × 10(6) cells/μL by assessing the strength of association between log-transformed ALC and CD4 counts using a Pearson correlation coefficient. In addition, area under the receiver operator curve (AUC) and a decision plot analysis were used to calculate the sensitivity, specificity, and the positive and negative likelihood ratios to identify prespecified optimal clinical thresholds of a likelihood ratio of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.1 and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;10. A total of 866 patients (mean age 42 years, 40% female) met inclusion criteria. The transformed means (95% CIs) for CD4 and ALC were 34 (31-38) and 654 (618-691), respectively. There was a significant relationship between the two measures, r = 0.74 (95% CI = 0.71 to 0.77, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). The AUC was 0.92 (95% CI = 0.90 to 0.94, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). An ALC of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;1700 × 10(6) cells/μL had a sensitivity of 95% (95% CI = 93% to 96%), specificity of 52% (95% CI = 43% to 62%), and negative likelihood ratio of 0.09 (95% CI = 0.05 to 0.2) for a CD4 count of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;200 × 10(6) cells/μL. An…</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="91815259"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="91815259"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 91815259; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=91815259]").text(description); $(".js-view-count[data-work-id=91815259]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 91815259; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='91815259']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=91815259]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":91815259,"title":"Absolute Lymphocyte Count in the Emergency Department Predicts a Low CD4 Count in Admitted HIV-positive Patients","internal_url":"https://www.academia.edu/91815259/Absolute_Lymphocyte_Count_in_the_Emergency_Department_Predicts_a_Low_CD4_Count_in_Admitted_HIV_positive_Patients","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="87961796"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/87961796/The_impact_of_mosh_pits_on_medical_incidents_at_mass_gatherings"><img alt="Research paper thumbnail of The impact of “mosh pits” on medical incidents at mass gatherings" class="work-thumbnail" src="https://attachments.academia-assets.com/92043359/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/87961796/The_impact_of_mosh_pits_on_medical_incidents_at_mass_gatherings">The impact of “mosh pits” on medical incidents at mass gatherings</a></div><div class="wp-workCard_item"><span>Annals of Emergency Medicine</span><span>, 1999</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">insertion attempts by paramedics, of which 30 (81,1%) were successful. Mean insertion time for su...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">insertion attempts by paramedics, of which 30 (81,1%) were successful. Mean insertion time for successful attempts was 64.36_+2.1 seconds, and the mean recorded gravity flow rate was 23.0_+9.8 mL/min. One infnsion achieved a rate of 100 mL/h with a pressure bag. Common resuscitation drugs, including epinephrine, atropine, fidocaine, bretylium, and 25% dextrose solution were successfully infused. Complications seen in successfully inserted devices included minor leakage of fluid at site (5), kinking of the infusion tubing (2), difficulty with device removal (3), and poor adhesion of the target/stabilization patch (5). Information on failed attempts is included in the Table. Conclusion: Vascuiar access was achieved in 81.1% of patients with adequate flow rates to serve as a primary line for drug and fluid infusion in cardiac arrest. The FAST-1 device may be a useful alternative means of achieving rapid intravenous access when difficulty is encountered m obtaining timely peripheral access in the prehospital setting. Table, abstract 251. Unsuccessful insertion attempts Patient Comments 12 21 23 27 32 440 Ib; device deployed into presternal soft tissue 220 Ib; device did not deploy, infusion tubing in presternal soft tissue (probable operator error) 200 Lb; insertion attempted at "bad angle" deployed into presternaI soft tissue (operator error) 100 Ib; device did not deploy, "poor placement of patch," "never hit bone" 110 Ib; device did not deploy "Normal body fat"; device deployed but unable to infuse with syringe pressure; no infiltration 120 Ib; needles bent during insertion, noted "r/4-in stepoff in sternum" under insertion site. 52 Automated External Defibrillators Can Appropriately Recognize Ventricular Fibrillation in High Electromagnetic Fields Stolzenberg BT, Kupas DF, Sole DP, Wieczorek BJ/Geisinger Medical Center, Danville, PA Study objectives: Automated external defibrillators (AEDs) are increasingly available in industrial settings, but many industries have high electromagnetic fields (EMF), which can interfere with the function of electronic devices. This study evaluates the performance of several AEDs when exposed to high EMF. Methods: Three commercially available AEDs were evaluated in the setting of a public utility coal-fired electrical generation plant. Each AED was placed in 3 areas of high EMF ranging from 310 to 1,600 mG. A signal generator, used to simulate various cardiac rhythms, was connected to the AEDs. Rhythms simulated were ventricular fibrillation, asystole, and normal sinus rhythm. Each of the AED's interpretations of various rhythms were evaluated in the different EMP settings. Results: Rhythms of ventricular fibrillation, asystole, and normal sinus rhythm were correctly recognized by each AED in each of the 3 areas of high EMF. Each AED appropriately recommended defibrillation when presented with ventricular fibrillation No misinterpretations or inappropriate defibrillations were observed. Conclusion: EMF generated by an electrical power plant did not interfere with 3 commercial AEDs' abilities to correctly interpret simulated rhythms and recommend appropriate defibrillation.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="c9d2d581c4c07283591396a5ef2eaa39" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":92043359,"asset_id":87961796,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/92043359/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="87961796"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="87961796"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 87961796; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="82351004"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/82351004/Hyperbaric_Medicine_for_Outpatient_Wound_Care"><img alt="Research paper thumbnail of Hyperbaric Medicine for Outpatient Wound Care" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/82351004/Hyperbaric_Medicine_for_Outpatient_Wound_Care">Hyperbaric Medicine for Outpatient Wound Care</a></div><div class="wp-workCard_item"><span>Emergency Medicine Clinics of North America</span><span>, 1992</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">After proper cleansing, debridement, and appropriate antibiotic and closure decisions, some wound...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">After proper cleansing, debridement, and appropriate antibiotic and closure decisions, some wounds will fail to heal properly or may develop serious complications. Hyperbaric oxygen therapy offers a relatively safe noninvasive method of improving wound healing by enhancing tissue oxygenation and decreasing edema formation. Recommendation for the use of hyperbaric oxygen therapy in outpatient wound care is reviewed and the rationale behind the benefits is discussed.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="82351004"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="82351004"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 82351004; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=82351004]").text(description); $(".js-view-count[data-work-id=82351004]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 82351004; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='82351004']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=82351004]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":82351004,"title":"Hyperbaric Medicine for Outpatient Wound Care","internal_url":"https://www.academia.edu/82351004/Hyperbaric_Medicine_for_Outpatient_Wound_Care","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843424"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843424/Complications_of_intraosseous_infusion_Reply"><img alt="Research paper thumbnail of Complications of intraosseous infusion. Reply" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843424/Complications_of_intraosseous_infusion_Reply">Complications of intraosseous infusion. Reply</a></div><div class="wp-workCard_item"><span>Annals of Emergency Medicine</span><span>, 1990</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843424"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843424"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843424; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843424]").text(description); $(".js-view-count[data-work-id=69843424]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843424; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843424']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843424]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843424,"title":"Complications of intraosseous infusion. 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window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843421]").text(description); $(".js-view-count[data-work-id=69843421]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843421; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843421']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); 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</script> <div class="js-work-strip profile--work_container" data-work-id="69843420"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843420/Utility_of_Ottawa_Ankle_Rules_in_an_Aging_Population_Evidence_for_Addition_of_an_Age_Criterion"><img alt="Research paper thumbnail of Utility of Ottawa Ankle Rules in an Aging Population: Evidence for Addition of an Age Criterion" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843420/Utility_of_Ottawa_Ankle_Rules_in_an_Aging_Population_Evidence_for_Addition_of_an_Age_Criterion">Utility of Ottawa Ankle Rules in an Aging Population: Evidence for Addition of an Age Criterion</a></div><div class="wp-workCard_item"><span>The Journal of Foot and Ankle Surgery</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">The Ottawa ankle rules (OAR) indicate that any patient with the inability to ambulate up to four ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">The Ottawa ankle rules (OAR) indicate that any patient with the inability to ambulate up to four steps or with tenderness at either malleoli should receive diagnostic imaging for an acute ankle injury. Current trends indicate that health care providers tend to order more images in practice than necessary according to OAR. The purpose of this study is to analyze OAR in geriatric versus nongeriatric patients. Secondarily, we hope to refine these guidelines for ankle imaging in the hopes that health care providers will be comfortable in adhering to these guidelines more strictly. A retrospective chart review was conducted of 491 adult patients with an average (± standard deviation) age of 54.4 ± 21.6 years (range 18 to 96). Applying the current OAR resulted in a sensitivity of 98.2% and a specificity of 58.6% in this entire cohort. The calculated sensitivities were comparable between the nongeriatric and geriatric cohorts, at 98.60% and 97.99%, respectively. The specificities varied between the nongeriatric and geriatric cohorts, at 60.13% and 33.33%. We propose new guidelines that would mandate imaging studies for any patient ≥65 years of age presenting to the emergency department with ankle pain. When applying these proposed guidelines, the sensitivity of the entire study population was found to be improved to 99.0%, whereas the specificity dropped to 56.7%. The slight decrease in specificity was deemed acceptable because these guidelines are meant to be used as a screening tool and because the risk of OAR not correctly identifying ankle fracture (2% of geriatric fractures) was completely mitigated in the geriatric population.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843420"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843420"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843420; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); 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window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843418]").text(description); $(".js-view-count[data-work-id=69843418]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843418; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843418']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843418]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843418,"title":"Helmet Design And Hits To The Head","internal_url":"https://www.academia.edu/69843418/Helmet_Design_And_Hits_To_The_Head","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843417"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843417/74_Mean_HEART_Scores_for_Admitted_Chest_Pain_Patients_are_Higher_in_More_Experienced_Providers"><img alt="Research paper thumbnail of 74 Mean HEART Scores for Admitted Chest Pain Patients are Higher in More Experienced Providers" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843417/74_Mean_HEART_Scores_for_Admitted_Chest_Pain_Patients_are_Higher_in_More_Experienced_Providers">74 Mean HEART Scores for Admitted Chest Pain Patients are Higher in More Experienced Providers</a></div><div class="wp-workCard_item"><span>Annals of Emergency Medicine</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843417"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843417"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843417; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843417]").text(description); $(".js-view-count[data-work-id=69843417]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843417; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843417']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843417]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843417,"title":"74 Mean HEART Scores for Admitted Chest Pain Patients are Higher in More Experienced Providers","internal_url":"https://www.academia.edu/69843417/74_Mean_HEART_Scores_for_Admitted_Chest_Pain_Patients_are_Higher_in_More_Experienced_Providers","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843416"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843416/Dynamic_motor_tracking_is_sensitive_to_subacute_mTBI"><img alt="Research paper thumbnail of Dynamic motor tracking is sensitive to subacute mTBI" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843416/Dynamic_motor_tracking_is_sensitive_to_subacute_mTBI">Dynamic motor tracking is sensitive to subacute mTBI</a></div><div class="wp-workCard_item"><span>Experimental brain research</span><span>, Nov 8, 2016</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Effective screening for mild traumatic brain injury (mTBI) is critical to accurate diagnosis, int...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Effective screening for mild traumatic brain injury (mTBI) is critical to accurate diagnosis, intervention, and improving outcomes. However, detecting mTBI using conventional clinical techniques is difficult, time intensive, and subject to observer bias. We examine the use of a simple visuomotor tracking task as a screening tool for mTBI. Thirty participants, 16 with clinically diagnosed mTBI (mean time since injury: 36.4 ± 20.9 days (95 % confidence interval); median = 20 days) were asked to squeeze a hand dynamometer and vary their grip force to match a visual, variable target force for 3 min. We found that controls outperformed individuals with mTBI; participants with mTBI moved with increased variability, as quantified by the standard deviation of the tracking error. We modeled participants&#39; feedback response-how participants changed their grip force in response to errors in position and velocity-and used model parameters to classify mTBI with a sensitivity of 87 % and a spe...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843416"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843416"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843416; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843416]").text(description); $(".js-view-count[data-work-id=69843416]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843416; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843416']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843416]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843416,"title":"Dynamic motor tracking is sensitive to subacute mTBI","internal_url":"https://www.academia.edu/69843416/Dynamic_motor_tracking_is_sensitive_to_subacute_mTBI","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843415"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843415/M_J_Wagner_and_S_Promes_Last_Minute_Emergency_Medicine_McGraw_Hill_Professional_2007_588_pages_45_ISBN_0071459626"><img alt="Research paper thumbnail of M.J. Wagner and S. Promes, Last Minute Emergency Medicine , McGraw-Hill Professional (2007) 588 pages, $45, ISBN 0071459626" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843415/M_J_Wagner_and_S_Promes_Last_Minute_Emergency_Medicine_McGraw_Hill_Professional_2007_588_pages_45_ISBN_0071459626">M.J. Wagner and S. Promes, Last Minute Emergency Medicine , McGraw-Hill Professional (2007) 588 pages, $45, ISBN 0071459626</a></div><div class="wp-workCard_item"><span>Ann Emerg Med</span><span>, 2009</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843415"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843415"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843415; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843415]").text(description); $(".js-view-count[data-work-id=69843415]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843415; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843415']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=69843415]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":69843415,"title":"M.J. Wagner and S. Promes, Last Minute Emergency Medicine , McGraw-Hill Professional (2007) 588 pages, $45, ISBN 0071459626","internal_url":"https://www.academia.edu/69843415/M_J_Wagner_and_S_Promes_Last_Minute_Emergency_Medicine_McGraw_Hill_Professional_2007_588_pages_45_ISBN_0071459626","owner_id":37670283,"coauthors_can_edit":true,"owner":{"id":37670283,"first_name":"David","middle_initials":null,"last_name":"Milzman","page_name":"DavidMilzman","domain_name":"georgetown","created_at":"2015-11-04T14:56:56.227-08:00","display_name":"David Milzman","url":"https://georgetown.academia.edu/DavidMilzman"},"attachments":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843414"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/69843414/Prehospital_Survivors_of_Falls_Height_and_Orthopedic_Injuries_Fail_to_Improve_Triage_or_Predict_Outcome"><img alt="Research paper thumbnail of Prehospital Survivors of Falls: Height and Orthopedic Injuries Fail to Improve Triage or Predict Outcome" class="work-thumbnail" src="https://attachments.academia-assets.com/79785971/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/69843414/Prehospital_Survivors_of_Falls_Height_and_Orthopedic_Injuries_Fail_to_Improve_Triage_or_Predict_Outcome">Prehospital Survivors of Falls: Height and Orthopedic Injuries Fail to Improve Triage or Predict Outcome</a></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Hypothesis: Injuries sustained from vertical trauma are predominantly orthopedic and have been as...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Hypothesis: Injuries sustained from vertical trauma are predominantly orthopedic and have been associated directly with the height of the fall. For prehospital survivors of falls, their physiologic stability and non-orthopedic injuries may be independent of the actual vertical fall distance. Methods: The records of 226 consecutive, adult trauma patients sustaining falls from a height >6 feet and admitted to a Level-1 Trauma Center during 1990 were reviewed. Pearson Correlation Coefficients (R) were used to determine if the height correlated with injury and outcome. Results: 217 victims fell a mean 22.1111.0 feet. Ninety-four percent of the patients were male, with a mean age of 36.1 years, mean Injury Severity Score (ISS) of 14, and a mean admission Glasgow Coma Score (GCS) of 14. Fracture distribution included 13% lower extremity (LEX), 22% upper extremity, and 25% spinal column with 7% associated cord injuries (CLCD). Mean values were: Systolic Blood Pressure (SBP) of 147+23 mmHg, Base Deficit (BD) of-2.4 mg/L, Lengdi of Stay (LOS) 11.7 days, and a mortality rate (MORT) of 3.1%. No significant correlation between fall distance and SBP (R =-.120), BD (R =-.014), GCS (R =-.114), LOS (R = .088) and MORT (R = .017) was found. Only height and ISS (R = .275), LEX (R = .305) were significant (p <.O5) Conclusions: In survivors of falls, non-fracture injuries, physiologic presentation, and outcome (LOS, MORT) are not associated with the height of fall. In transport and resuscitation decisions, trauma triage for fall victims must account for other than height and obvious fracture injuries.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="eda6ebec54025bbb335f30c876e64149" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":79785971,"asset_id":69843414,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/79785971/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843414"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843414"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843414; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=69843414]").text(description); $(".js-view-count[data-work-id=69843414]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 69843414; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='69843414']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843413"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/69843413/257_Blood_Lactate_An_Improved_Marker_of_Injury_Severity_and_Outcome_in_the_Triage_of_Multiple_Patients_Following_Traumatic_Injury"><img alt="Research paper thumbnail of 257 Blood Lactate: An Improved Marker of Injury Severity and Outcome in the Triage of Multiple Patients Following Traumatic Injury" class="work-thumbnail" src="https://attachments.academia-assets.com/79785972/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/69843413/257_Blood_Lactate_An_Improved_Marker_of_Injury_Severity_and_Outcome_in_the_Triage_of_Multiple_Patients_Following_Traumatic_Injury">257 Blood Lactate: An Improved Marker of Injury Severity and Outcome in the Triage of Multiple Patients Following Traumatic Injury</a></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In study #1, after circulatory arrest of one-hour in deep Hth (15°C), recovery was complete, even...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In study #1, after circulatory arrest of one-hour in deep Hth (15°C), recovery was complete, even with histologically almost normal brains. In study #2, after arrest of two hours in profound Hth (+10°C), functional and morphologic cerebral recovery were better than after two hours arrest with deep Hth (15°C). In study #3, adding washout with an organ preservation solution did not improve outcome further. Results were not worse in study #4, with avoidance of systemic heparinization (by heparin-bonded CPB circuit); nor in study #5, in which hemodilution was only to Hct 15%, not 5% as before. Conclusions: Clinical trials in selected cases of resuscitative surgery under CPB-induced profound hypothermic arrest of one hour are justified.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="178da25a418f69a7182c6042f79ef8ae" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":79785972,"asset_id":69843413,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/79785972/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843413"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843413"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843413; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="69843412"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/69843412/An_Introduction_to_Resuscitating_the_Ages"><img alt="Research paper thumbnail of An Introduction to Resuscitating the Ages" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/69843412/An_Introduction_to_Resuscitating_the_Ages">An Introduction to Resuscitating the Ages</a></div><div class="wp-workCard_item"><span>Emergency Medicine Clinics of North America</span><span>, 1996</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">corrective interventions. To individualize a patient&#39;s resuscitation, the emergency physician...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">corrective interventions. To individualize a patient&#39;s resuscitation, the emergency physician must be aware of certain specific host factors and must adjust therapy appropriately? Aside from gender (with few specific differences other than obvious genitourinary differences and the presence or lack of a womb, and risk factors for certain disease), age, specifically the extremes (pediatric and geriatric), is the most readily noticed and most important factor affecting overall outcome determination. An emergency physician should recognize the importance of specifically directing therapy mindful of the intricacies that pediatrics or gerontology entail. There can be no misunderstanding, though, that airway, breathing, and circulation are the basics, but optimizing oxygen delivery and resuscitating hypoperfusion must now be addressed. Emergency medicine is founded on the belief that residency training prepares one to resuscitate any and all patients and initiate disease-specific treatment. In this issue, the article, &quot;Resuscitating the Pediatric Patient,&quot; authored by Wright and Patterson, provides an overview of the issues in emergency pediatric resuscitation and then focuses on important lifesaving interventions. As these authors point out, understanding basic principles of pediatrics and maintaining a small armamentaria of procedures allows one to successfully treat most patients. The use of such devices as a Breslow tape can replace the problem of fumbling for proper age-appropriate equipment for critical interventions when needed.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="69843412"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="69843412"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 69843412; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); 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