Performance and return-to-sport after ACL reconstruction in NFL quarterbacks.

Anterior cruciate ligament (ACL) rupture is a significant injury in National Football League (NFL) quarterbacks. The purpose of this study was to determine (1) return-to-sport (RTS) rate in NFL quarterbacks following ACL reconstruction, (2) performance upon RTS, and (3) the difference in RTS and performance between players who underwent ACL reconstruction and controls. Thirteen quarterbacks (14 knees) who met inclusion criteria underwent ACL reconstruction while in the NFL. Matched controls were selected from the NFL during the same time span to compare and analyze age, body mass index (BMI), position, performance, and NFL experience. Student t tests were performed for analysis of within- and between-group variables. Bonferroni correction was used in the setting of multiple comparisons. Twelve quarterbacks (13 knees; 92%) were able to RTS in the NFL. Mean player age was 27.2±2.39 years. Mean career length in the NFL following ACL reconstruction was 4.85±2.7 years. Only 1 player needed revision ACL reconstruction. In both cases and controls, player performance was not significantly different from preinjury performance after ACL reconstruction (or index year in controls). There was also no significant performance difference between case and control quarterbacks following ACL reconstruction (or index year in controls). There is a high rate of RTS in the NFL following ACL reconstruction. In-game performance following ACL reconstruction was not significantly different from preinjury or from controls.

Structured communication for patient safety in emergency medical services: a legal case report.

Providers of emergency medical services (EMS) must communicate vital information during critical phases of operations. Errors in communications, for example, the failure to hear a directive, will compromise safe and effective patient care. This article presents a case that resulted in litigation because of communication failures during the interfacility transfer of a trauma patient who subsequently died in the ambulance. The communication failure involved members of a ground ambulance crew, their dispatcher, and a supervisor. The failure of the emergency medical technician (EMT) who was driving to hear from the treating EMT and her dispatcher vital information pertaining to changes in their destination and of plans to intercept another ambulance, or alternatively, the driver's ignoring this information, led to a delay in care and may have contributed to the patient's death. Factors contributing to the cause of this communication failure may have been related to the nature of the EMS setting: the physical separation between crew members (the driver, and the care provider in the back of the ambulance); the noise of the ground ambulance transport environment, most notably, the siren; and the stress of treating a patient in critical condition. The case highlights the importance of using structured forms of communication, specifically the read-back tool and the critical assertion strategy, to limit failures in communication during EMS operations and in operations in other high-risk medical settings.