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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

If you're planning on voting with an absentee or mail-in ballot, chances are you feel pretty protected from COVID-19 while voting this year. But what if you're voting in-person? Experts weigh in on staying safe when heading to your polling place. The first piece of advice is to have a plan."The example I would give would be going to the grocery store. That's something that caused people a lot of anxiety when we first were dealing with the pandemic back in March, and I think for many of us, it’s becoming relatively routine. It's not how we shopped for groceries back in January but it's something that we’ve learned to do. I think voting can be the same," said Dr. Jay Varkey, an infectious disease doctor and Associate Professor at Emory University.Dr. Varkey says to know the COVID-19 transmission rates in your community, as well as your own personal risk, if you were to become infected with COVID-19."To give some specific examples, masking is absolute, and I would want to make sure that there is a universal mask mandate in place and not just those that are going to cast their votes but workers as well," said Dr. Varkey.Dr. Varkey says wearing a mask that has at least two layers and wearing it properly is key. Also, ensure your polling place allows you to socially distance from other voters. Dr. Varkey says standing more than 6 feet away from others is preferred. Also, it’s great if your polling place is keeping doors and windows open to increase airflow."The other thing, and I know this is hard to do, the more we can actually limit the amount of talking, or certainly yelling or singing or anything else going on, is the more we can reduce our chances of passing these infectious droplets that can aerosolize, and that tends to really occur when people are talking. Masks reduce that risk, but we can really reduce it more by, well, talking less," says Dr. Varkey.In Madison, Wisconsin, poll workers will be ensuring voters are socially-distanced and frequently disinfecting all voting booths, pens and other frequently touched items. City Clerk Maribeth Witzel-Behl has been working closely with their local health department."We will have plexiglass glass set up for stations where poll workers have to interact with voters within 6 feet of each other, and for other poll workers who are not at those stations, they’ll have access to face shields if they like," said Witzel-Behl.Poll workers are also being told to follow a strict set of health guidelines in order to volunteer."If they've had a fever within the last few days or taken a fever-reducing medication in the past few days, they can’t work at the poll. If they've had any COVID-19 symptoms or been exposed to someone with COVID-19 or had a cough within the past week they can’t work at the polls," said Witzel-Behl.So, do you need to bring a container of disinfecting wipes with you to the polls?"I put the priority first on the masks and keeping your distance but that last part on how to take a relatively safe activity, like voting and make it extra safe, there’s two things I would bring with me into the voting booth. One is my own pen the other is hand sanitizer," said Dr. Varkey. 3182

If you are thinking of taking the next step with your significant other, Oscar Mayer wants to help make your wedding proposal unique.The company announced on Wednesday that you could rent out the Wienermobile to be used for proposals.The promotional idea came when a driver of the Wienermobile, Zach N Cheese, used the 27-foot-long hot dog on wheels as a backdrop when he proposed to his girlfriend at Yellowstone National Park. 436

Hurricane Delta has made landfall near Creole, Louisiana, as a Category 2 hurricane, but as it's moved inland, it has weakened to a Category 1 storm.WATCH LIVE: According to the National Hurricane Center, the storm made landfall at 6 p.m. CT with maximum sustained winds of 100 mph.A Florida Coastal Monitoring Tower near Lake Arthur, Louisiana, sustained wind of 77 mph and a gust to 96 mph, the NHC said. A NOAA National Weather Service water level gauge at Freshwater Canal Locks, Louisiana, recently reported a storm surge of over 8 feet above ground level. Louisiana has taken the brunt of the impact of the 2020 hurricane season. Hurricanes Marco and Laura have already made landfall in the state, causing inland flooding and significant damage along the coast. Hurricane Sally also did significant damage nearby Gulf Shores, Alabama, when it made landfall in September.The Associated Press reports that Delta marks the sixth time this year that evacuations have been ordered from Louisiana's barrier islands.After making landfall this afternoon, forecasters expect Delta to move north and dump heavy rain on the rest of Louisiana before moving west into Mississippi on Saturday. 1193

I’m happy to report that Jill and I have tested negative for COVID. Thank you to everyone for your messages of concern. I hope this serves as a reminder: wear a mask, keep social distance, and wash your hands.— Joe Biden (@JoeBiden) October 2, 2020 256