Journal of the Mississippi State Medical Association
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J Miss State Med Assoc · Feb 2016
Observational StudyValidation of the Sonographic Ottawa Foot and Ankle Rules (SOFAR) Study in a Large Urban Trauma Center.
Differentiating the severity of acute ankle injuries is a common problem in the emergency department (ED). The Ottawa Foot and Ankle Rules (OFAR) were designed to obviate the need for unnecessary x-rays. Although these rules have been determined to be very sensitive, they lack the specificity necessary to make them practically useful for a condition in which a misdiagnosis could result in a significant disability. Our study objective was to determine if the addition of a bedside ultrasound (US) to the evaluation process could be used to significantly reduce the number of negative x-rays in OFAR positive patients. ⋯ Among OFAR positive patients, bedside US has high sensitivity and specificity for detecting foot and/or ankle fractures. Further studies should be conducted to determine if utilizing bedside US in addition to OFAR could significantly reduce the number of x-rays and improve the efficiency and costs associated with evaluating these injuries in the ED. Implication for health policy/medical education/research/ practice. Utilizing bedside ultrasonography in addition to Ottawa Foot and Ankle Rules in acutely injured patients could significantly reduce the number of ordered x-rays and length of stay in the emergency department.
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J Miss State Med Assoc · Aug 2015
Tuberculosis Containment among the Homeless in Metropolitan Jackson, Mississippi.
Preventing tuberculosis among the homeless has emerged as an especially difficult challenge. ⋯ Sustained adherence to local shelter and correctional facility TB prevention measures based on standards and policies proved effective in other settings is most crucial. These include requirements for periodic tuberculosis prevention and awareness training for shelter and correctional facility staff, ongoing tuberculosis screening and follow-up among homeless shelter clients and inmates of local correctional facilities, and attention to shelter and correctional facility environmental sanitation, proper ventilation, ultraviolet light fixtures and capacity/bed alignment standards.