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This article describes the development of a prototype dry decontamination system (DryCon) for use in the event of a contamination incident involving a particulate contaminant. Disrobing and showering is currently recommended almost exclusively in mass decontamination, although it may not be feasible when water is scarce, in cold weather environments, or when there may be compliance issues with the requirement to disrobe, ie, unwillingness to disrobe. During disrobing, dust particles could also re-aerosolize, leading to inhalation of contaminants.

The DryCon prototype uses air jets for dry decontamination. selleckchem The system is portable and can run on building-supplied 220-V power or generator power. Multiple contaminated persons can be treated rapidly, one after the other, using this system.

We tested DryCon in a controlled environment, using a manikin and three different types of fabric squares to investigate its effectiveness, with a decontamination time of 60 seconds.

At the higher airflow tested, ie, 90 pe promise of the DryCon system for use where water is not available, as a first step prior to wet decontamination, or in an industrial setting for post-work-shift decontamination. Further lab and field research will be necessary to prove the effectiveness of this technique in real-world applications and to determine if respiratory protection or other personal protective equipment (PPE) is needed during use of the DryCon system.

The mental health issues of personnel dealing with the deceased at times of disasters is a problem and techniques are needed that allow for real-time, easy-to-use stress checks. We have studied techniques for measuring mental state using voice analysis which has the benefit of being non-invasive, easy-to-use, and can be performed in real-time. For this study, we used voice measurement to determine the stress experienced during body identification training workshops for dentists. We studied whether or not stress levels were affected by having previous experience with body identification either in actual disaster settings or during training.

Since participants training using actual dead bodies in particular are expected to suffer higher stress exposure, we also assessed their mental state pre- and post-training using actual dead bodies.

The results confirmed marked differences in the mental state between before and after training in participants without any actual experience, between participants who engaged in training using manikins before actual dead bodies and participants who did not.

These results suggest that, in body identification training, the level of stress when coming into contact with dead bodies varies depending on participants' experience and the training sequence. Moreover, it is believed that voice-based stress assessment can be conducted in the limited time during training sessions and that it can be usefully implemented in actual disaster response settings.

These results suggest that, in body identification training, the level of stress when coming into contact with dead bodies varies depending on participants' experience and the training sequence. Moreover, it is believed that voice-based stress assessment can be conducted in the limited time during training sessions and that it can be usefully implemented in actual disaster response settings.

As the incidence of active shooters increase, local emergency response has also changed. South Metro Fire Rescue coordinated a series of hyper-realistic active shooter simulation drills involving multiple agencies.

"The Next Nine Minutes" was one of the largest active shooter drills performed to date with 904 personnel that were trained in 18 mass casualty active shooter drills. Evaluation was from point of injury to and including care in the operating room (OR), and evaluation of real-time system logistics.

A total of 126 patients in Cut Suits® received a total of 479 procedures such as needle decompressions, cricothyrotomies, tourniquets, wound packs, and chest tubes. Central to this exercise, law enforcement (LE) established a warm zone from the initial shooting. EMS was able to move into the facility, locate casualties, extract the first victim, move them to a casualty collection point (CCP), and transport them to safety within 12 minutes.

Strengths and weaknesses were identified in prehospital anlorado Shooting. This in situ immersion training should be practiced as a whole system.The outbreak of coronavirus disease (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) in 2019-2020 had a substantial impact on the healthcare resources of the world community. An organized regional response was essential to saving lives, preserving and distributing health care resources, and coordinating health care efforts. This brief report describes how a long-established regional trauma organization (RTO) provided that coordination in Central, Southeast, and Southeast Central Ohio during the COVID-19 pandemic.

To compare concomitant benzodiazepine (BZDs) use among chronic pain patients adherent to extended-release tapentadol (TapER) or oxycodone (OxnER) and estimate the number of lives potentially saved by switching pa-tients to the less BZD coprescribed treatment.

Retrospective database study.

Patients were identified using the IBM MarketScan® Commercial Database. The opioid overdose death esti-mates were obtained from the US national mortality register and were used to estimate the number of lives potentially saved by switching patients to the opioid treatment with lower rates of BZD coprescribing.

The authors identified 30,213 chronic pain patients between October 2012 and March 2016. Af-ter propensity score matching, N = 2,355 and N = 6,761 patients were adherent (proportion of days covered ≥80 percent) to TapER and OxnER, respectively.

TapER versus OxnER, during the 180-day treatment.

Proportions of BZD coprescribing, BZD dosing patterns in matched patients, and the esti-mated number of lives potenanted to explore rates and consequences of BZD coprescribing among opioids.

To describe current trends in filled opioid prescriptions for Medicaid-enrolled children, adolescents and young adults (AYAs) from 2012 to 2016, and to identify patient characteristics and clinical settings associated with a higher probability of filled opioid prescriptions.

Retrospective cohort study of children and young adults enrolled in Medicaid from 2012 to 2016.

10-12 states participating in the Medicaid Marketscan claims database.

Medicaid-enrolled children and young adults (0-21 years old).

Healthcare encounter(s) that could result in a new opioid prescription.

"Opioid visits," defined as healthcare encounters associated with a new opioid prescription filled within 7 days. Each opioid visit was assigned to the clinical provider most likely to have prescribed an opioid.

There were 113,068,027 visits among 4,427,838 Medicaid-enrollees and 1 percent (n = 1,130,006) of these were considered an opioid visit. Adjusted probabilities decreased from 1.2 percent to 0.8 percent from 2012 to 2016. m 2012 to 2016. Among opioids filled, combination opioids and those with pedi-atric safety warnings remain commonly prescribed. Further research is critical to better understand drivers of prescribing practices and clinical indications for appropriate opioid use to inform improvements in pain management guidelines in this population.

Over 80 percent of surgery patients experience acute post-operative pain and less than half feel their pain is adequately controlled. Patients receiving chronic opioids, including methadone, are at the highest risk of inadequate pain control. Guidelines do not provide specific recommendations for analgesia management in this population. The purpose of this study was to evaluate the association between post-operative methadone use and respiratory depression.

This study was a single center, retrospective, cohort study of adult patients.

Patients included were admitted to a single academic medical center from July 2016 to September 2018.

Medical records of adult inpatients with an operative procedure who received perioperative methadone were reviewed.

Preoperative methadone use was evaluated for all patients. Post-operative methadone dosing was compared to preoperative methadone dosing. Post-operative respiratory depression was evaluated. Logistic regression was performed to identify risk factors for respiratory depression.

Two hundred ninety-eight patients were included in the study. Patients were divided into groups based on pre-operative methadone use. Over 90 percent of patients were on preoperative methadone. There were no significant differences in baseline characteristics between groups. In the initial seven post-operative days, 14.8 percent of patients had documented respiratory depression. Respiratory depression was more common among patients who were newly initiated on methadone post-operatively. Factors associated with respiratory depression included male sex, increased age, and new post-operative methadone initiation.

Most patients who were administered post-operative methadone were on preoperative methadone. New post-operative methadone initiation was a risk factor for respiratory depression.

Most patients who were administered post-operative methadone were on preoperative methadone. New post-operative methadone initiation was a risk factor for respiratory depression.

To determine the incidence and factors associated with long-term -opioid use in trauma patients who were previously opioid-naïve.

A retrospective cohort study.

Level I Trauma Center.

Patients admitted to the study institution between January and October 2016 following traumatic injury. Trauma patients were linked with data from the state's Controlled Substance Monitoring Program (CSMP) database regarding controlled substance use.

Long-term use (LTU) of opioid medications following hospital discharge. Long-term use was defined as 4 weeks and above based on the Centers for Disease Control and Prevention's recommendation that opioid therapy should not be continued for > 4 weeks without a clinician evaluating the risk versus benefits of continued therapy.

The incidence of LTU in previously naïve patients was 46 percent. Pre-existing psychiatric illness (OR = 4.764, 95 percent CI = 1.592-14.260, p = 0.005) and prior controlled substance use (OR = 4.155, 95 percent CI = 1.903-9.072) were determined to be predictors for LTU. Patients with psychiatric comorbid conditions were almost five times more likely to be in the LTU group. Those with prior controlled substance use history were four times more likely to be in the LTU group.

These findings provide initial insight concerning the LTU of opioids in previously naïve patients. Application of these data may facilitate early identification of patients at risk for LTU following traumatic injury and serve to influence prescribing practices in these at-risk individuals.

These findings provide initial insight concerning the LTU of opioids in previously naïve patients. Application of these data may facilitate early identification of patients at risk for LTU following traumatic injury and serve to influence prescribing practices in these at-risk individuals.