Christopher E. Bork

Single-Breath-Count Test: An Important Adjunct in the Triaging of Patients in a Mass-Casualty Incident Due to Botulism

Clostridium botulinum toxins, the most poisonous substance known to humankind, are considered to be a [US] Centers for Disease Control and Prevention Category A bioterrorist agent. Despite this concern, little has been published with regard to the tactical aspects of triaging a mass-casualty event involving botulism victims arriving at an emergency department. Because neuromuscular-ventilatory failure is a principal reason for botulisms early morbidity and mortality, using a quick and sensitive test to evaluate this possibility is imperative. The purpose of this article is to propose the adoption of the Single-Breath-Count Test (SBCT). The ease and validity of the use of the SBCT in evaluating complications associated with various neuromuscular disorders make it an attractive adjunct for triage during a mass-casualty incident due to botulism. While education, immune globulin, antitoxin, and invasive airway techniques are well-recognized steps in treating botulism, incorporating a time-honored technique such as the SBCT, will be an important addition to the triage process.

Emergency contraception knowledge among nurse practitioner students.

Purpose: The purpose of this study was to ascertain the knowledge level of nurse practitioner (NP) students about emergency contraception (EC), and to explore attitudes about EC that may intersect with willingness to prescribe EC. Data sources: Four hundred and sixty‐seven NP students completed a 30‐item web‐based survey using Vovici survey software. Conclusions: Students who reported formal content on EC in their program of study showed significantly better mean knowledge scores (t= 5.279, df = 459, p < .001). Gaps in NP students’ knowledge of EC mechanisms of action, understanding of indications and contraindications were apparent. Younger students (F(3,457) = 4.994, p < .002), those newer to nursing (F(4,456) = 6.641, p < .0005), and womens health NP students (F(4,445) = 3.488, p < .008), demonstrated significantly better knowledge. Attitudes regarding EC appeared to be tied to the respondents knowledge about EC. Implications for practice: Knowledge is an important factor in informing NP practice decisions. Clinicians need accurate, evidence‐based knowledge to provide health education and counseling to reproductive age women if unintended pregnancies are to be reduced.

Botulism Questionnaire: a tactical tool for community use in a mass casualty incident.

A botulism-induced mass casualty incident has the potential to severely compromise a communitys health-care infrastructure, based upon its lethality, rare occurrence, and duration of symptoms, which require extensive support and care. Although early recognition and treatment with antitoxin or botulism immunoglobulin are essential to the effective management of this type of an incident, the two major challenges in recognition and treatment are the hundreds, if not thousands, of casualties or potential casualties requiring rapid screening and the fact that most clinicians remain ignorant of the management of botulism. The purpose of this article is to present the Botulism Questionnaire, which will assist with the screening of casualties, provide educational and diagnostic cues for clinicians and the lay public, and create a layer of protection for the health-care infrastructure. The applications of this questionnaire in various formats, the numerous points of distribution, and the variety of platforms from which it can be launched will be explored.

Chikungunya virus: An emerging condition in the industrialized world

Once found only in developing tropical nations, CHIKV has spread to the world at large. With proper management and close communication with authorities, it can be contained.