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In a critical situation where minutes determine life or death, you may think emergency medical services offer your best chance of survival. However, a Johns Hopkins trauma surgeon doesn't think that's always the case.“If it were me, and I know a lot about trauma, drive me to the trauma center as fast as you can,” said Dr. Elliott Haut, associate professor of surgery and emergency medicine at the Johns Hopkins University School of Medicine and senior author of a new study that evaluates emergency transport for shooting and stabbing victims.Haut and colleagues examined data from trauma centers within the 100 most populous U.S. metro areas and compared ambulance versus private vehicle transportation and the relationship between transport-mode and in-hospital mortality. He was not surprised by what he saw.“Patients who are injured with penetrating trauma — so stab wounds and gunshot wounds, in urban settings, so these are in the City — have improved outcomes and improved mortality if they're brought to the trauma center by private vehicle compared to emergency medical services, EMS,” Haut said.The keyword is trauma center; not all hospitals are equipped to handle walk-in patients with these kinds of injuries. And they are injuries that require immediate surgery. The study does not cover cardiac arrest where the most important thing is CPR and a defibrillator.“When we control for all those things, the rapid transport of patients by private vehicle makes a big difference,” Haut said.According to the study, 62 percent of patients are less likely to die when transported by private vehicle compared to EMS.Dr. Gabe Kelen has seen many of these walk-in patients at the Johns Hopkins Hospital emergency department.“You're waiting, waiting, waiting, the ambulance people get there, they do certain things, very skilled, it's all being done out there. Then they load you up, drive through traffic, they get here, that can take twice as long. It sometimes really is better to get you here, let us start doing our more definitive thing that we can do only in the emergency department,” said Kelen, director of the emergency department.He agrees time is of the essence, but also cautions that this is one study.“If you get multiple people being dropped off at one of the smaller hospitals, they may not have the staff to do everything that a place like ours can do so let the system work,” Kelen said.The current standard of care in Maryland is to wait for EMS to arrive. Dr. Richard Alcorta, acting co-executive director of the Maryland Institute for Emergency Medical Services System (MIEMSS), does not support changing the standard.He says not everyone knows where a trauma center is located and EMS can perform certain life-saving procedures that may be crucial before transport. A spokeswoman with the Baltimore Police Department said they do not have a position on the study’s findings and that “preservation of life is paramount." She added that a victim's decision to leave a crime scene "has little if any bearing on the outcome of the investigation. Thanks to video surveillance, CCTV cameras and our crime scene technicians it all seems to work out in the end.” For more information on the study, click here. 3283

HUNTINGTON BEACH (CNS) - Two firefighters and two Oktoberfest celebrants remain hospitalized Sunday with injuries resulting from an electrical vault that exploded at the Old World Village's seasonal celebration in Huntington Beach, authorities said. Witnesses at the scene claimed there were actually three explosions. A witness using the Twitter handle kylen1972 posted video on the platform of what he claimed was the second explosion, in which flames can be seen shooting into the air. Restaurant patron Dawn Orlow-Townsend told KCAL9 the lights flickered before the explosions and that she could feel the heat through the walls. She said that after the initial blast, ``you could hear a pin drop.'' She then described a scene of panic as patrons struggled to get out of the building. ``I pray those firefighters are okay,'' she said. ``It was crazy, it was so intense. There was a second explosion and then a third. We just started running, we left our cellphones. We were freaking out. People were running all over. It was crazy.'' She added, ``It's the world we live in right now. After the first explosion, you just don't know what to think. We didn't know what was going on. The first one, the second one -- then there was mass pandemonium. By the third one, we just couldn't get out of there fast enough.'' KCAL9 also talked to Adam Carlson. ``Everyone was just happy and drinking beer and then the first explosion hit and people started backing away, and security tried to calm everyone,'' he said. ``I didn't see anyone get hurt in my immediate response, but while evacuating, we saw -- I personally saw two people that appeared hurt, one had burns. I just tried to comfort who I could.'' At 8:10 p.m., the Huntington Beach Fire Department received news of the explosion at 7561 Center Ave., a dispatcher said. The flames were out at 8:33 p.m., he said. The injured firefighters were already at Old World Village, investigating reports of a possible electrical fire, Huntington Beach Fire Department Battalion Chief Jeff Lopez told reporters at the scene. They were met by the first explosion when they opened an electrical vault, he said. The second explosion happened within minutes. The injured firefighters and civilians were taken to hospitals for treatment of minor injuries, Lopez said, but added that they were taking those injuries ``very seriously.'' Firefighters and police worked to evacuate employees and patrons of Old World Village, he said. Broadcast reports indicate there were more than 100 visitors at the celebration. A lengthy investigation was begun that will involve the fire department and Edison, Lopez said. 2652

If you’re looking to save money on a vacation, you could spend hours researching and budgeting every minute of it — or you could simply try traveling like a minimalist instead.Minimalists generally live with fewer possessions, freeing up time, money and other resources to focus on things and experiences they value more. The lifestyle also saves them money on consumption when they travel.You, too, can adopt minimalist travel habits and potentially hang on to hundreds — or thousands — of dollars. Consider these travel tips for your next vacation. 573

I flew down to Texas to help with the Biden/Harris bus tour, intended to drum up enthusiasm at polling locations. Instead, I ended up spending the afternoon calling 911. 1/ pic.twitter.com/gKAjv7gv85— Dr. Eric Cervini (@ericcervini) October 31, 2020 257

In a pandemic that relies heavily on the expertise and passion of our healthcare workers, we have seen many doctors and nurses working longer hours and even risking their own health to care for those in need.“This is a pandemic that's going to continue to go on. And a lot of health care providers in different settings have already been asked to work overtime shifts or extra shifts. And the thing is, that’s just increasing the burnout,” said Dr. Jessica Rainbow, RN and UArizona College of Nursing assistant professor.“Before the pandemic burnout was already a normalized issue in Nursing. And what I mean by that is that more nurses than not experienced burnout than those who have what I would call good well-being and don't suffer from burnout,” said Chloe Littzen, RN and UArizona College of Nursing Ph.D. candidate.Rainbow and Littzen are seeking ways to mitigate nurse burnout during the coronavirus pandemic. They say the pandemic has only intensified the problem.“They either leave the setting that they're in. Let's say they're in one unit, they go to another unit. They leave that facility going from, let's say, the hospital setting to the community setting or vice versa, or they leave nursing completely,” said Littzen.That puts the industry in a tough spot. The nursing shortage also affects the ability to educate future nurses and the ability to do more research.“It's important to say that this is not an issue that is the nurse's fault right or any healthcare provider or anyone who works in a healthcare setting,” said Rainbow.From their research, they say health care workers are shown to have good self-care, but it’s the systems of the work environment that can be stressful.“Where they're actually given the resources that they need to be successful. So resources as far as things like PPE, things like having adequate staffing,” said Rainbow.They say a big factor is also the public. Loved ones of those in care can help by being understanding and by adhering to guidelines, such as wearing a mask.“You know, it's important to give grace and struggling times and everyone's emotions are heightened and stressed and you know nurses are people, too. They're also a human being and they're also suffering with you,” said Littzen.They found nurses have done things like meditation, spending more time in nature, and seeking peer groups to voice shared experiences.“Social support is huge for nurses. I mean, especially to when you were a provider and you have a job where your significant other at home may not fully understand what you do. And so it's difficult sometimes if you don't have the social support of other co-workers in the same position,” said Rainbow.Rainbow’s study is called “Working in Healthcare During the COVID-19 Pandemic. Participants can access the consent form with study information online or contact her for more information. Littzen’s dissertation study is called “Young Adult Nurse Work-Related Well-being, Contemporary Practice Worldview, Resilience, and Co-Worker Support.”This story was first reported by Taja Davis at KGUN in Tucson, Arizona. 3106