Peter Pons - Academia.edu (original) (raw)

Papers by Peter Pons

Prehospital and Disaster Medicine, 1993

Background: Because of the direction of the tube bevel, the right naris is used initially when pe... more Background: Because of the direction of the tube bevel, the right naris is used initially when performing blind nasotracheal intubation. This is thought to result in a higher success rate and less epistaxis than when the left naris is utilized. Hypothesis: The efficacy of right-sided nasotracheal intubation (rNTI) is superior to left-sided nasotracheal intubation (1NTI). Design: A two phase, prospective study in which Phase I evaluated the success rate and incidence of epistaxis based on which naris was attempted in a consecutive population. Phase II randomized patients to rNTI or 1NTI following the decision to perform nasotracheal intubation and noted the success rate and incidence of epistaxis for the first naris attempted. Setting: An urban 9-1-1 system with 70 paramedics and a run volume of 44,000/year.

Annals of Emergency Medicine, 2004

A 52-year-old man presented to an emergency department (ED) in southern California after a spider... more A 52-year-old man presented to an emergency department (ED) in southern California after a spider bite to his left thumb. He had been working in his yard when he reported feeling a sharp sensation and looked down to see a patterned, brownish spider on his hand. He captured the spider and brought it to the ED in a plastic bucket. The patient's vital signs and physical examination results were unremarkable; the affected finger had no erythema, swelling, or notable bite mark. He reported only mild pain by the time of physician evaluation, approximately 2 hours after the bite. He declined opiate analgesics but was mostly concerned about identifying the spider species and determining whether antivenom therapy was indicated. The spider (Figures 1 and 2) had died either en route or during its capture, but was intact except for single leg dismemberment.

Prehospital Emergency Care, 2008

The information contained in these Guidelines, which reflects the current state of knowledge at t... more The information contained in these Guidelines, which reflects the current state of knowledge at the time of completion of the literature search (July 2006), is intended to provide accurate and authoritative information about the subject matter covered. Because there will be future developments in scientific information and technology, it is anticipated that there will be periodic review and updating of these Guidelines. These Guidelines are distributed with the understanding that the Brain Trauma Foundation, the National Highway Traffic Safety Administration, and the other organizations that have collaborated in the development of these Guidelines are not engaged in rendering professional medical services. If medical advice or assistance is required, the services of a competent physician should be sought. The recommendations contained in these Guidelines may not be appropriate for use in all circumstances. The decision to adopt a particular recommendation contained in these Guidelines must be based on the judgment of medical personnel, who take into consideration the facts and circumstances in each case, and on the available resources.

PubMed, Nov 6, 1991

OBJECTIVE--To determine the impact of the pneumatic antishock garment on survival in patients wit... more OBJECTIVE--To determine the impact of the pneumatic antishock garment on survival in patients with cardiac wounds. DESIGN--A retrospective review of a 6.5-year experience in a population of patients with gunshot or stab wounds to the heart (N = 70). SETTING--The city and county of Denver, Colo, where all patients were transported by paramedic ambulances to Denver General Hospital, an urban, level 1 trauma center. PATIENTS--All patients were analyzed, including those transported to the emergency department with no vital signs at the trauma scene. Only patients with definite penetrating cardiac injuries were included. METHODS--Paramedic trip sheets and emergency department, operating room, in-hospital, and autopsy records were reviewed. Demographic, clinical outcome, and treatment data were collected. A multiple logistic regression model was developed to determine which characteristics and treatment variables were independently predictive of patient outcome. The ability of each independent variable to predict outcome was determined by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS--Seventy patients (31 gunshot and 39 stab wounds) had a revised trauma score of 2.8 +/- 4.0 (mean +/- SD; range, 0-12; median, 0). Thirty-two (46%) had cardiac tamponade. Overall, 21 (30%) of the patients survived. In the logistic model, the presence of cardiac tamponade (OR, 9.1; 95% CI, 1.5 to 56.1) and a higher revised trauma score were associated with higher survival. Inflation of the pneumatic antishock garment was associated with sevenfold lower survival (adjusted OR, 0.14; 95% CI, 0.02 to 0.86); the effect was negative across all trauma score groups. Conclusion: --Survival in patients with penetrating cardiac wounds is highly associated with anatomic and physiologic factors, while application of the pneumatic antishock garment appears to be detrimental.

The Journal of emergency medicine, 1985

The Journal of emergency medicine, May 1, 2001

Wound botulism is a rare and potentially fatal disease. The use of black tar heroin has spawned a... more Wound botulism is a rare and potentially fatal disease. The use of black tar heroin has spawned an increase in the incidence of the disease, with the majority of cases occurring in California. The use of botulism antitoxin and surgical debridement are recommended to decrease hospital stay. For this to be effective, the diagnosis of wound botulism first must be considered, followed by an aggressive search for any area of infection that may be debrided. This case report demonstrates several factors to consider in patients presenting with symptoms of botulism poisoning: occurrence away from the Mexico border, no obvious abscess, and the need for prolonged ventilatory support. This case report documents a prolonged hospital stay, possibly caused by delay in administration of antitoxin in a patient with cellulitis that was not considered appropriate for debridement.

A major aspect of successful operation of an ACF is the preparation and use of an operations guid... more A major aspect of successful operation of an ACF is the preparation and use of an operations guide (referred to as a "concept of operations" or "ConOps"). Each implementation of an ACF is unique and dependent on the population served, the nature of the disaster, the duration of operation, and other factors. Thus, it is not possible to provide a "one-size-fits-all" operations guide; however, we have attempted to develop a template for such a document, which is provided below. This template should be altered during the planning phase to reflect local variables and the planned use of the ACF.

Emergency Medicine Clinics of North America, 1988

Great strides have been made in the prehospital and Emergency Department management of patients, ... more Great strides have been made in the prehospital and Emergency Department management of patients, yet the relief of pain and suffering is something that is often forgotten or, if not overlooked, provided in a suboptimal fashion. It is too easy not to feel the pain the patient has or that is is produced while one is seeking to help. The optimal analgesic should have rapid onset, short duration, few side effects, and no major adverse reactions. Nitrous oxide, known since 1776, is perhaps the drug that comes closest to meeting that ideal.

Covers all facets of emergency care and is aimed not only at the emergency department, but also a... more Covers all facets of emergency care and is aimed not only at the emergency department, but also at practitioners who deal with emergencies in their practices. The book discusses such topics as primary complaints, non-trauma illness, environmental emergencies, neonatal and childhood disorders, toxicological emergencies, obstetrics and gynaecology, trauma, behavioural emergencies, prehospital care and emergency medical services, and administrative emergency medicine.

Current Problems in Surgery

Journal of Special Operations Medicine

BACKGROUND Uncontrolled external hemorrhage is a common cause of preventable death. The Hartford ... more BACKGROUND Uncontrolled external hemorrhage is a common cause of preventable death. The Hartford Consensus recommendations presented the concept of a continuum of care, in which police officers should be considered an integral component of the emergency medical response to active shooter incidents. Recent publications have reported individual cases of tourniquet application by police officers. This report analyzed all documented cases of hemorrhage control using tourniquets applied by police officers in a single large metropolitan police department. METHODS A retrospective computerized search of all public safety communications center reports and police officer documentation for cases of tourniquet application was conducted by searching for the word "tourniquet." Each case was evaluated for indication and appropriateness using Stop The Bleed criteria for tourniquet placement. In addition, police response time was compared to emergency medical services (EMS) response time in an effort to determine if there was a time difference in response to the bleeding patient that could potentially impact patient outcomes. RESULTS Forty- three cases were identified over the 6-year period ending in December 2019. The majority of cases involved gunshot wounds and most were civilian victims. Injured police officers accounted for two cases (gunshot wound and dog bite). Review of the officers' narratives indicated that most applications appeared justified using the Stop The Bleed criteria (two cases were questionable if a tourniquet was necessary and one may have been placed in an incorrect location). On average, police arrived 4 minutes sooner than EMS did. CONCLUSION Several reports in the literature document the success of police officer application of tourniquets to control limb hemorrhage. Most of the reports involved a small number of case reports. This is the largest case series to date from a single urban police department.

Emergency Medicine Clinics of North America, 1994

The prehospital care of the pregnant patient is aimed at expeditious transport of the patient to ... more The prehospital care of the pregnant patient is aimed at expeditious transport of the patient to an appropriate facility combined with rapid intervention to stabilize the mother, including oxygen administration and fluid resuscitation. Optimal care of the fetus is dependent on appropriate management of the mother.

The Journal of Emergency Medicine, 1997

Les R&urn& 0 COMMUNICATION MkDECIN-MALADE AU MO-0 L'EFFICACITl? DU DROPriRIDOL INTRA-MENT DU CONG... more Les R&urn& 0 COMMUNICATION MkDECIN-MALADE AU MO-0 L'EFFICACITl? DU DROPriRIDOL INTRA-MENT DU CONGk DU DLh'ARTEMENT D'URGENCE. VEINEUX EN MILIEU PRti-HOSPITALIER. liocal Crane JA CL. Katliff AF. Wolfe RE. Branney SW. Rot EJ. Pans PT Une entrevue fut men& au tours du mois de mars 1994 aup& de 3 14 malades qui avaient &d trait& au dipartement d'urgence du Kern Medical Center B Bakersfield, Califomie et avaient rqu leur congC. Le questionnaire Ctait conqu pour Cvaluer la compr6hension du diagnostic, des ordonnances, des instructions suppl6mentaires et de la planification du suivi. On d&ermina Cgalement les perceptions personnelles du malade quant 2 la qualit de la communication qui, selon lui, 6tait la plus importante. Globalement, les malades identifikrent conectement 50% des instructions regues. On pro&da B une comparaison de la performance des malades anglophones par rapport aux hispanophones. Les r6sultats Ctaient significativement plus faibles pour toutes les questions chez les malades de langue espagnole. La plupart des malades (63, 8%) identifikrent le m&decin comme Ctant la source du plus grande nombre de renseignements.

ACEP's Paramedic Field Care is a core paramedic textbook that supports the EMT-Paramedic Nati... more ACEP's Paramedic Field Care is a core paramedic textbook that supports the EMT-Paramedic National Standard Curriculum, yet moves in a bold new direction. Its patient-presentation (complaint-based) approach encourages linkage of information gleaned from lectures and books to actual field care.

Emergency Medicine Clinics of North America, 1988

The esophageal obturator airway has been in use for the past 20 years. It is promoted as being ea... more The esophageal obturator airway has been in use for the past 20 years. It is promoted as being easy to use and can be rapidly inserted blindly; however, numerous complications have been noted. The device is reviewed in this article and compared to endotracheal intubation.

JAMA Network Open, 2020

IMPORTANCE Trauma is the leading cause of death for US individuals younger than 45 years, and unc... more IMPORTANCE Trauma is the leading cause of death for US individuals younger than 45 years, and uncontrolled hemorrhage is a major cause of trauma mortality. The US military's medical advancements in the field of prehospital hemorrhage control have reduced battlefield mortality by 44%. However, despite support from many national health care organizations, no integrated approach to research has been made regarding implementation, epidemiology, education, and logistics of prehospital hemorrhage control by layperson immediate responders in the civilian sector. OBJECTIVE To create a national research agenda to help guide future work for prehospital hemorrhage control by laypersons. EVIDENCE REVIEW The 2-day, in-person, National Stop the Bleed (STB) Research Consensus Conference was conducted on February 27 to 28, 2019, to identify and achieve consensus on research gaps. Participants included (1) subject matter experts, (2) professional society-designated leaders, (3) representatives from the federal government, and (4) representatives from private foundations. Before the conference, participants were provided a scoping review on layperson prehospital hemorrhage control. A 3-round modified Delphi consensus process was conducted to determine high-priority research questions. The top items, with median rating of 8 or more on a Likert scale of 1 to 9 points, were identified and became part of the national STB research agenda. FINDINGS Forty-five participants attended the conference. In round 1, participants submitted 487 research questions. After deduplication and sorting, 162 questions remained across 5 a prioridefined themes. Two subsequent rounds of rating generated consensus on 113 high-priority, 27 uncertain-priority, and 22 low-priority questions. The final prioritized research agenda included the top 24 questions, including 8 for epidemiology and effectiveness, 4 for materials, 9 for education, 2 for global health, and 1 for health policy. CONCLUSIONS AND RELEVANCE The National STB Research Consensus Conference identified and prioritized a national research agenda to support laypersons in reducing preventable deaths due to life-threatening hemorrhage. Investigators and funding agencies can use this agenda to guide their future work and funding priorities.

Prehospital Emergency Care, 2019

On March 13, 2019 the EMS Examination Committee of the American Board of Emergency Medicine (ABEM... more On March 13, 2019 the EMS Examination Committee of the American Board of Emergency Medicine (ABEM) approved modifications to the Core Content of EMS Medicine. The Core Content is used to define the subspecialty of EMS Medicine, provides the basis for questions to be used during written examinations, and leads to development of a certification examination blueprint. The Core Content defines the universe of knowledge for the treatment of prehospital patients that is necessary to practice EMS Medicine. It informs fellowship directors and candidates for certification of the full range of content that might appear on certification examinations.

Emergency Medicine Secrets, 2011

Prehospital and Disaster Medicine, 1993

Background: Because of the direction of the tube bevel, the right naris is used initially when pe... more Background: Because of the direction of the tube bevel, the right naris is used initially when performing blind nasotracheal intubation. This is thought to result in a higher success rate and less epistaxis than when the left naris is utilized. Hypothesis: The efficacy of right-sided nasotracheal intubation (rNTI) is superior to left-sided nasotracheal intubation (1NTI). Design: A two phase, prospective study in which Phase I evaluated the success rate and incidence of epistaxis based on which naris was attempted in a consecutive population. Phase II randomized patients to rNTI or 1NTI following the decision to perform nasotracheal intubation and noted the success rate and incidence of epistaxis for the first naris attempted. Setting: An urban 9-1-1 system with 70 paramedics and a run volume of 44,000/year.

Annals of Emergency Medicine, 2004

A 52-year-old man presented to an emergency department (ED) in southern California after a spider... more A 52-year-old man presented to an emergency department (ED) in southern California after a spider bite to his left thumb. He had been working in his yard when he reported feeling a sharp sensation and looked down to see a patterned, brownish spider on his hand. He captured the spider and brought it to the ED in a plastic bucket. The patient's vital signs and physical examination results were unremarkable; the affected finger had no erythema, swelling, or notable bite mark. He reported only mild pain by the time of physician evaluation, approximately 2 hours after the bite. He declined opiate analgesics but was mostly concerned about identifying the spider species and determining whether antivenom therapy was indicated. The spider (Figures 1 and 2) had died either en route or during its capture, but was intact except for single leg dismemberment.

Prehospital Emergency Care, 2008

The information contained in these Guidelines, which reflects the current state of knowledge at t... more The information contained in these Guidelines, which reflects the current state of knowledge at the time of completion of the literature search (July 2006), is intended to provide accurate and authoritative information about the subject matter covered. Because there will be future developments in scientific information and technology, it is anticipated that there will be periodic review and updating of these Guidelines. These Guidelines are distributed with the understanding that the Brain Trauma Foundation, the National Highway Traffic Safety Administration, and the other organizations that have collaborated in the development of these Guidelines are not engaged in rendering professional medical services. If medical advice or assistance is required, the services of a competent physician should be sought. The recommendations contained in these Guidelines may not be appropriate for use in all circumstances. The decision to adopt a particular recommendation contained in these Guidelines must be based on the judgment of medical personnel, who take into consideration the facts and circumstances in each case, and on the available resources.

PubMed, Nov 6, 1991

OBJECTIVE--To determine the impact of the pneumatic antishock garment on survival in patients wit... more OBJECTIVE--To determine the impact of the pneumatic antishock garment on survival in patients with cardiac wounds. DESIGN--A retrospective review of a 6.5-year experience in a population of patients with gunshot or stab wounds to the heart (N = 70). SETTING--The city and county of Denver, Colo, where all patients were transported by paramedic ambulances to Denver General Hospital, an urban, level 1 trauma center. PATIENTS--All patients were analyzed, including those transported to the emergency department with no vital signs at the trauma scene. Only patients with definite penetrating cardiac injuries were included. METHODS--Paramedic trip sheets and emergency department, operating room, in-hospital, and autopsy records were reviewed. Demographic, clinical outcome, and treatment data were collected. A multiple logistic regression model was developed to determine which characteristics and treatment variables were independently predictive of patient outcome. The ability of each independent variable to predict outcome was determined by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS--Seventy patients (31 gunshot and 39 stab wounds) had a revised trauma score of 2.8 +/- 4.0 (mean +/- SD; range, 0-12; median, 0). Thirty-two (46%) had cardiac tamponade. Overall, 21 (30%) of the patients survived. In the logistic model, the presence of cardiac tamponade (OR, 9.1; 95% CI, 1.5 to 56.1) and a higher revised trauma score were associated with higher survival. Inflation of the pneumatic antishock garment was associated with sevenfold lower survival (adjusted OR, 0.14; 95% CI, 0.02 to 0.86); the effect was negative across all trauma score groups. Conclusion: --Survival in patients with penetrating cardiac wounds is highly associated with anatomic and physiologic factors, while application of the pneumatic antishock garment appears to be detrimental.

The Journal of emergency medicine, 1985

The Journal of emergency medicine, May 1, 2001

Wound botulism is a rare and potentially fatal disease. The use of black tar heroin has spawned a... more Wound botulism is a rare and potentially fatal disease. The use of black tar heroin has spawned an increase in the incidence of the disease, with the majority of cases occurring in California. The use of botulism antitoxin and surgical debridement are recommended to decrease hospital stay. For this to be effective, the diagnosis of wound botulism first must be considered, followed by an aggressive search for any area of infection that may be debrided. This case report demonstrates several factors to consider in patients presenting with symptoms of botulism poisoning: occurrence away from the Mexico border, no obvious abscess, and the need for prolonged ventilatory support. This case report documents a prolonged hospital stay, possibly caused by delay in administration of antitoxin in a patient with cellulitis that was not considered appropriate for debridement.

A major aspect of successful operation of an ACF is the preparation and use of an operations guid... more A major aspect of successful operation of an ACF is the preparation and use of an operations guide (referred to as a "concept of operations" or "ConOps"). Each implementation of an ACF is unique and dependent on the population served, the nature of the disaster, the duration of operation, and other factors. Thus, it is not possible to provide a "one-size-fits-all" operations guide; however, we have attempted to develop a template for such a document, which is provided below. This template should be altered during the planning phase to reflect local variables and the planned use of the ACF.

Emergency Medicine Clinics of North America, 1988

Great strides have been made in the prehospital and Emergency Department management of patients, ... more Great strides have been made in the prehospital and Emergency Department management of patients, yet the relief of pain and suffering is something that is often forgotten or, if not overlooked, provided in a suboptimal fashion. It is too easy not to feel the pain the patient has or that is is produced while one is seeking to help. The optimal analgesic should have rapid onset, short duration, few side effects, and no major adverse reactions. Nitrous oxide, known since 1776, is perhaps the drug that comes closest to meeting that ideal.

Covers all facets of emergency care and is aimed not only at the emergency department, but also a... more Covers all facets of emergency care and is aimed not only at the emergency department, but also at practitioners who deal with emergencies in their practices. The book discusses such topics as primary complaints, non-trauma illness, environmental emergencies, neonatal and childhood disorders, toxicological emergencies, obstetrics and gynaecology, trauma, behavioural emergencies, prehospital care and emergency medical services, and administrative emergency medicine.

Current Problems in Surgery

Journal of Special Operations Medicine

BACKGROUND Uncontrolled external hemorrhage is a common cause of preventable death. The Hartford ... more BACKGROUND Uncontrolled external hemorrhage is a common cause of preventable death. The Hartford Consensus recommendations presented the concept of a continuum of care, in which police officers should be considered an integral component of the emergency medical response to active shooter incidents. Recent publications have reported individual cases of tourniquet application by police officers. This report analyzed all documented cases of hemorrhage control using tourniquets applied by police officers in a single large metropolitan police department. METHODS A retrospective computerized search of all public safety communications center reports and police officer documentation for cases of tourniquet application was conducted by searching for the word "tourniquet." Each case was evaluated for indication and appropriateness using Stop The Bleed criteria for tourniquet placement. In addition, police response time was compared to emergency medical services (EMS) response time in an effort to determine if there was a time difference in response to the bleeding patient that could potentially impact patient outcomes. RESULTS Forty- three cases were identified over the 6-year period ending in December 2019. The majority of cases involved gunshot wounds and most were civilian victims. Injured police officers accounted for two cases (gunshot wound and dog bite). Review of the officers' narratives indicated that most applications appeared justified using the Stop The Bleed criteria (two cases were questionable if a tourniquet was necessary and one may have been placed in an incorrect location). On average, police arrived 4 minutes sooner than EMS did. CONCLUSION Several reports in the literature document the success of police officer application of tourniquets to control limb hemorrhage. Most of the reports involved a small number of case reports. This is the largest case series to date from a single urban police department.

Emergency Medicine Clinics of North America, 1994

The prehospital care of the pregnant patient is aimed at expeditious transport of the patient to ... more The prehospital care of the pregnant patient is aimed at expeditious transport of the patient to an appropriate facility combined with rapid intervention to stabilize the mother, including oxygen administration and fluid resuscitation. Optimal care of the fetus is dependent on appropriate management of the mother.

The Journal of Emergency Medicine, 1997

Les R&urn& 0 COMMUNICATION MkDECIN-MALADE AU MO-0 L'EFFICACITl? DU DROPriRIDOL INTRA-MENT DU CONG... more Les R&urn& 0 COMMUNICATION MkDECIN-MALADE AU MO-0 L'EFFICACITl? DU DROPriRIDOL INTRA-MENT DU CONGk DU DLh'ARTEMENT D'URGENCE. VEINEUX EN MILIEU PRti-HOSPITALIER. liocal Crane JA CL. Katliff AF. Wolfe RE. Branney SW. Rot EJ. Pans PT Une entrevue fut men& au tours du mois de mars 1994 aup& de 3 14 malades qui avaient &d trait& au dipartement d'urgence du Kern Medical Center B Bakersfield, Califomie et avaient rqu leur congC. Le questionnaire Ctait conqu pour Cvaluer la compr6hension du diagnostic, des ordonnances, des instructions suppl6mentaires et de la planification du suivi. On d&ermina Cgalement les perceptions personnelles du malade quant 2 la qualit de la communication qui, selon lui, 6tait la plus importante. Globalement, les malades identifikrent conectement 50% des instructions regues. On pro&da B une comparaison de la performance des malades anglophones par rapport aux hispanophones. Les r6sultats Ctaient significativement plus faibles pour toutes les questions chez les malades de langue espagnole. La plupart des malades (63, 8%) identifikrent le m&decin comme Ctant la source du plus grande nombre de renseignements.

ACEP's Paramedic Field Care is a core paramedic textbook that supports the EMT-Paramedic Nati... more ACEP's Paramedic Field Care is a core paramedic textbook that supports the EMT-Paramedic National Standard Curriculum, yet moves in a bold new direction. Its patient-presentation (complaint-based) approach encourages linkage of information gleaned from lectures and books to actual field care.

Emergency Medicine Clinics of North America, 1988

The esophageal obturator airway has been in use for the past 20 years. It is promoted as being ea... more The esophageal obturator airway has been in use for the past 20 years. It is promoted as being easy to use and can be rapidly inserted blindly; however, numerous complications have been noted. The device is reviewed in this article and compared to endotracheal intubation.

JAMA Network Open, 2020

IMPORTANCE Trauma is the leading cause of death for US individuals younger than 45 years, and unc... more IMPORTANCE Trauma is the leading cause of death for US individuals younger than 45 years, and uncontrolled hemorrhage is a major cause of trauma mortality. The US military's medical advancements in the field of prehospital hemorrhage control have reduced battlefield mortality by 44%. However, despite support from many national health care organizations, no integrated approach to research has been made regarding implementation, epidemiology, education, and logistics of prehospital hemorrhage control by layperson immediate responders in the civilian sector. OBJECTIVE To create a national research agenda to help guide future work for prehospital hemorrhage control by laypersons. EVIDENCE REVIEW The 2-day, in-person, National Stop the Bleed (STB) Research Consensus Conference was conducted on February 27 to 28, 2019, to identify and achieve consensus on research gaps. Participants included (1) subject matter experts, (2) professional society-designated leaders, (3) representatives from the federal government, and (4) representatives from private foundations. Before the conference, participants were provided a scoping review on layperson prehospital hemorrhage control. A 3-round modified Delphi consensus process was conducted to determine high-priority research questions. The top items, with median rating of 8 or more on a Likert scale of 1 to 9 points, were identified and became part of the national STB research agenda. FINDINGS Forty-five participants attended the conference. In round 1, participants submitted 487 research questions. After deduplication and sorting, 162 questions remained across 5 a prioridefined themes. Two subsequent rounds of rating generated consensus on 113 high-priority, 27 uncertain-priority, and 22 low-priority questions. The final prioritized research agenda included the top 24 questions, including 8 for epidemiology and effectiveness, 4 for materials, 9 for education, 2 for global health, and 1 for health policy. CONCLUSIONS AND RELEVANCE The National STB Research Consensus Conference identified and prioritized a national research agenda to support laypersons in reducing preventable deaths due to life-threatening hemorrhage. Investigators and funding agencies can use this agenda to guide their future work and funding priorities.

Prehospital Emergency Care, 2019

On March 13, 2019 the EMS Examination Committee of the American Board of Emergency Medicine (ABEM... more On March 13, 2019 the EMS Examination Committee of the American Board of Emergency Medicine (ABEM) approved modifications to the Core Content of EMS Medicine. The Core Content is used to define the subspecialty of EMS Medicine, provides the basis for questions to be used during written examinations, and leads to development of a certification examination blueprint. The Core Content defines the universe of knowledge for the treatment of prehospital patients that is necessary to practice EMS Medicine. It informs fellowship directors and candidates for certification of the full range of content that might appear on certification examinations.

Emergency Medicine Secrets, 2011