ABSTRACT
INTRODUCTION: The goal of the current study was to characterize the rate and estimate associated mortality and morbidity of exertional heat stroke (EHS) in U.S. military service members. MATERIALS AND METHODS: The current study was a retrospective cohort medical chart review study of all active-duty U.S. military service members, hospitalized with EHS at any MTF in the world between January1, 2007 and July 1, 2014. Enrolled patients were identified by altered mental status and elevated temperatures associated with physical exercise. RESULTS: Out of 607 service members with an International Classification of Disease code indicating any type of heat injury, 48 service members met inclusion criteria for EHS. Core temperature was M = 105.8°F (41°C), standard deviation = 1.43, 90% were diagnosed with EHS prior to hospitalization, and 71% received prehospital cooling. Meantime to normothermia post-hospitalization was 56 minutes (standard deviation = 79.28). Acute kidney injury was diagnosed in 40% of patients although none developed hyperkalemia or required dialysis. Disseminated intravascular coagulation was rare (4%, n = 2) and overall observed mortality was very low (2%, n = 1). CONCLUSION: EHS is aggressively identified and treated in U.S. Military Treatment Facilities. Mortality and morbidity were strikingly low.
Subject(s)
Heat Stroke/complications , Heat Stroke/mortality , Military Personnel/statistics & numerical data , Renal Insufficiency/etiology , Adult , Cohort Studies , Female , Heat Stroke/epidemiology , Hospitalization/statistics & numerical data , Hot Temperature/adverse effects , Humans , Incidence , Male , Renal Insufficiency/epidemiology , Retrospective Studies , Risk Factors , United States/epidemiologyABSTRACT
BACKGROUND: Point of care ultrasound (POCUS) is a rapidly expanding aspect of both the practice and education of emergency physicians. The most effective methods of teaching these valuable skills have not been explored. OBJECTIVE: This project aimed to identify those methods that provide the best educational value as determined by the learner. METHODS: Data was collected from pre- and post-course surveys administered to students of the introductory POCUS course provided to emergency medicine residents each year at our facility. Data were collected in 2010 and 2011. Participants were asked to evaluate the effectiveness of small- vs. large-group format, still images vs. video clips, and PowerPoint slides vs. live demonstration vs. hands-on scanning. RESULTS: Students felt the most effective methods to be small-group format, video-clip examples, and hands-on scanning sessions. Students also rated hands-on sessions, still images, and video images as more effective in post-course surveys as compared with pre-course surveys. CONCLUSIONS: The methods perceived as most effective for POCUS education are small-group format, video-clip examples, and hands-on scanning sessions.
