A5055192037- Disaster Response and Management
- Emergency and Acute Care Studies
- Cardiac Arrest and Resuscitation
- Opioid Use Disorder Treatment
- Healthcare Policy and Management
- Airway Management and Intubation Techniques
- Substance Abuse Treatment and Outcomes
- Acute Myocardial Infarction Research
- Global Health Workforce Issues
- Simulation-Based Education in Healthcare
- Poisoning and overdose treatments
- Antiplatelet Therapy and Cardiovascular Diseases
- Tracheal and airway disorders
- COVID-19 epidemiological studies
- Poxvirus research and outbreaks
- Child Therapy and Development
- COVID-19 and Mental Health
- COVID-19 and healthcare impacts
- Hospital Admissions and Outcomes
- Foreign Body Medical Cases
- Nerve injury and regeneration
- Alzheimer's disease research and treatments
- Health Systems, Economic Evaluations, Quality of Life
- Public Health Policies and Education
- Racial and Ethnic Identity Research
University of California, San Francisco
2015-2025
San Francisco General Hospital
2015-2024
San Francisco Department of Public Health
2024
Washington University in St. Louis
2021
University of North Carolina at Chapel Hill
2021
Mayo Clinic in Arizona
2021
University of Washington
2021
Boston Medical Center
2021
Mayo Clinic
2021
University of California San Francisco Medical Center
2021
Reduction of Aβ deposition is a major therapeutic strategy in Alzheimer's disease (AD). The concentration the brain modulated not only by production but also its degradation. One proteases involved degradation peptides endothelin-converting enzyme (ECE). In this study, we investigated effects an intracranial administration seroptype 5 recombinant adeno-associated viral vector (rAAV) containing ECE-1 synthetic gene on amyloid precursor protein (APP) plus presenilin-1 (PS1) transgenic mice....
This JAMA Performance Improvement article uses the case of a patient who presented to emergency department but left after waiting 4 hours without being seen discuss interdisciplinary improvement efforts for reducing system inefficiencies and improving access care in departments.
Introduction: In response to the ongoing opioid overdose crisis, US officials urged expansion of access naloxone for reversal. Since then, emergency medical services’ (EMS) dispensing kits has become an emerging harm reduction strategy. Methods: We created a training and low-barrier distribution program in San Francisco: Project FRIEND (First Responder Increased Education Naloxone Distribution). The team assembled advisory committee stakeholders subject-matter experts, worked with local...
Introduction National practice guidelines recommend early aspirin administration to reduce mortality in acute coronary syndrome (ACS). Although timely of has been shown ACS by 23%, prior regional Emergency Medical Service (EMS) data have inadequate prehospital patients with suspected cardiac ischaemia. Objectives Using the EMS Information System (NEMSIS) database, we sought determine (1) proportion ischaemia who received and (2) patient characteristics that independently predicted aspirin....
POSITION STATEMENTEmergency medical services (EMS), similar to all aspects of health care systems, can play a vital role in examining and reducing disparities through educational, operational, quality improvement interventions. Public statistics existing research highlight that patients certain socioeconomic status, gender identity, sexual orientation, race/ethnicity are disproportionately affected with respect morbidity mortality for acute conditions multiple disease processes, leading...
Introduction: During major disasters, hospitals experience varied levels of absenteeism among healthcare workers (HCWs) in the immediate response period. Loss critical hospital personnel, including Emergency Department (ED) staff, during this time can negatively impact a facility's ability to effectively treat large numbers ill and injured patients. Prior studies have examined factors contributing HCW willingness report for duty disaster. The purpose study was determine if degree readiness...
San Francisco implemented one of the most intensive, comprehensive, multipronged COVID-19 pandemic responses in United States using 4 core strategies: (1) aggressive mitigation measures to protect populations at risk for severe disease, (2) prioritization resources neighborhoods highly affected by COVID-19, (3) timely and adaptive data-driven policy making, (4) leveraging partnerships public trust. We collected data describe programmatic population-level outcomes. The excess all-cause...
Prehospital airway management encompasses a multitude of complex decision-making processes, techniques, and interventions. Quality (encompassing quality assurance improvement activities) in EMS is dynamic, evidence-based, most all, patient-centric. Long mainstay the clinician skillset, deserves specific focus attention dedicated processes to ensure delivery high-quality clinical care.It position NAEMSP that:All agencies should dedicate sufficient resources patient-centric, comprehensive...
Introduction: Opioids contributed to over 300,000 deaths in the United States past 10 years. Most research on drug use occurs clinics or hospitals; few studies have evaluated impact of opioid emergency medical services (EMS) EMS response disorder (OUD). This study describes perceived burden disease, data collection, and interventions California local agencies (LEMSA).Methods: We surveyed directors all 33 LEMSAs with 25 multiple-choice free-answer questions. Results were collected RedCap...
One of the six guiding principles EMS Agenda 2050 is to foster a socially equitable care delivery system. A specific recommendation within this principle that "local leadership, educators and clinicians [should] reflect diversity their communities." Research has shown women comprise minority emergency medicine services (EMS) field clinicians. In academic settings, are represented at lower rates among experienced faculty than Emergency Medicine or large. The reasons for these differences also...
Abstract Introduction Emergency medical services ( EMS ) fellowships are growing in significance within the United States prehospital health care system. While represent a cornerstone of subspecialty education, an individual learner's experiences limited by local resources and practices. California have developed innovative method for expanding fellows’ educational outside their immediate programs. The Innovative Education Method Each month, fellows, fellowship directors, directors from...
An 80-year-old man presented with right medial orbit pain 3 months after having a suspected squamous cell carcinoma of the canthus “frozen.” The skin in this area appeared normal (Fig. 1) and biopsy showed chronic inflammation mild scarring. A CT was obtained several later as diplopia progressed. scan normal. Eleven initial cryotherapy another revealed mass posterior 2). Biopsy then orbital exenteration extensive perineural invasion extending from belly rectus muscle to apex 3). systemic...
The Covid-19 pandemic challenged health care delivery systems worldwide. Many acute hospitals in communities that experienced surges cases and hospitalizations had to make decisions such as rationing scarce resources. Hospitals serving low-income communities, of color, those other historically marginalized or vulnerable groups reported the greatest operational impacts surges. However, cross-institutional collaborations within jurisdictions offer unique opportunities prevent mitigate...
Disaster medicine has emerged as a critical discipline within emergency in recent years. Mass casualty incidents and large-scale environmental events have shed light on the need for more formalized disaster curricula structured response plans. Koenig Schultz’ Medicine: Comprehensive Principles Practices, 2nd Edition, lives up to its title yet again delivers in-depth, evidence-based recommendations healthcare providers, educators, administrators working management. The text successfully...
Since 2009, the seminal text in emergency medical services (EMS) medicine has been used to guide academic development of new subspecialty but direct application material into EMS oversight not previously described. The EMS/Disaster Medicine fellowship program at our institution scheduled a monthly meeting systematically review and develop study assist fellow affiliated faculty preparation for board examination. In addition summary chapter content, included an assessment areas from each...
Emergency medical services (EMS) systems can become impacted by sudden surges that occur throughout the day, as well natural disasters and current pandemic. Because of this, emergency department crowding ambulance "bunching," or in ambulance-transported patients at receiving hospitals, have a detrimental effect on patient care financial implications for an EMS system. The Centralized Ambulance Destination Determination (CAD-D) project was initially created pilot to look impact active, online...
Over the past several years, emergency medical services (EMS) has become a formal subspecialty of medicine, as recognized by Accreditation Council Graduate Medical Education (ACGME). Now, freshly minted fellows and highly experienced directors alike face challenges passing maintaining board certification. Although there are well-respected texts for technicians that detail science art paramedicine, very few exclusively target EMS medicine physicians. The first edition Cooney's Medicine is...