Assessment of community healthcare providers ability and willingness to respond to emergencies resulting from bioterrorist attacks

From Journal of Emergencies, Trauma and Shock:

Introduction: Previous findings have demonstrated that preparedness and planning within the public health system are inadequately developed to respond to an act of biological or chemical terrorism.

Methods:This investigation used Internet-based surveys to assess the level of preparedness (PL) and willingness to respond (WTR) to a bioterrorism attack, and identify factors that predict PL and WTR among Florida community healthcare providers. Invitations were sent to 22,800 healthcare providers in Florida, which resulted in 2,279 respondents.

Results: Respondents included physicians (n=604), nurses (n=1,152), and pharmacists (n=486). The results indicated that only 32% of Florida healthcare providers were competent and willing to respond to a bioterrorism attack, 82.7% of providers were willing to respond in their local community, and 53.6% within the State. Respondents were more competent in administrative skills than clinical knowledge (62.8% vs. 45%). Areas in which respondents had the highest competency were the initiation of treatment and recognition of their clinical and administrative roles. Areas in which respondents showed the lowest competency were the ability to identify cases and the ability to communicate risk to others. About 55% of the subjects had previous bioterrorism training and 31.5% had conducted emergency drills. Gender, race, previous training and drills, perceived threats of bioterrorism attack, perceived benefits of training and drills, and feeling prepared were all predictors of overall preparedness.

Conclusions: The findings suggest that only one-third of Florida community healthcare providers were prepared for a bioterrorism attack, which is an insufficient response rate to effectively respond to a bioterrorism incident.

The Use of Systemic Hypothermia for the Treatment of an Acute Cervical Spinal Cord Injury in a Professional Football Player

From Spine:

Objective. We will describe the injury and clinical course of an NFL Football player who sustained a complete spinal cord injury and was treated with conventional care in addition to modest systemic hypothermia.

Summary of Background Data. Systemically induced moderate hypothermia is a potentially neuroprotective intervention in acute spinal cord injury. However, case descriptions of human patients receiving systemic hypothermia after spinal cord injuries are lacking in the literature.

Methods. Here, we present the case of a National Football League player who sustained a complete (ASIA A) spinal cord injury from a C3/4 fracture dislocation. Moderate systemic hypothermia was instituted immediately after his injury, in addition to standard medical/surgical treatment, including, surgical decompression and intravenous methylprednisolone.

Results. The patient experienced significant and rapid neurologic improvement, and within weeks of his injury was walking with harness assistance. Since that time, the patient has continued to make significant progress in his rehabilitation (now ASIA D).

Conclusion. The extent to which this hypothermia contributed to his neurologic recovery is difficult to determine. It is hoped that this case will draw attention to the need for further preclinical and clinical studies to elucidate the role of hypothermia in acute spinal cord injury. Until these studies are completed, it is impossible to advocate for systemic hypothermia as a standard of care.

Woman charged after biting ER nurse, throwing vomit

From the Chicago Sun-Times:

A woman was charged after allegedly biting a nurse in the hand and throwing a vomit filled pan at an emergency room doctor at a Southwest Side hospital Monday night, police said.