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BACKGROUND: Emergency Medical Services (EMS) professionals frequently experience job-related injuries, most commonly overexertion or movement injuries. Data on injury reduction in EMS professionals is limited. The Functional Movement Screen (FMS) is a movement analysis tool suggested to predict musculoskeletal injury, but it has not previously been evaluated for EMS professionals. OBJECTIVE: To evaluate the effectiveness of the FMS to predict musculoskeletal injury among EMS professionals. METHODS: In October 2014, EMS professionals employed in an urban third-service EMS agency volunteered to participate in FMS administered by certified screeners. Age, sex, height and weight were recorded. After screening, participants were instructed on exercises to correct movement deficiencies. We reviewed recorded injuries from 2013 to 2016. We performed descriptive statistics. With logistic regression modeling, we described factors that predicted musculoskeletal injury. We generated a receiver operating curve (ROC) for FMS prediction of musculoskeletal injury. RESULTS: 147 of 240 full-time employees participated in the FMS. Participants' mean age was 33.7 years (SD = 9.6) and the majority (65%) were male. The median initial FMS score was 14 (IQR 11–16). Area under the ROC curve was 0.603 (p = 0.213) for FMS ability to predict any musculoskeletal injury within two years. Female sex was associated higher odds of injury (OR 3.98, 95% CI 1.61–9.80). Increasing age, body mass index (BMI) category, and FMS score≤14 did not predict musculoskeletal injury. CONCLUSION: The FMS did not predict musculoskeletal injury among EMS professionals. [ABSTRACT FROM AUTHOR]

Background: Studies have reported COVID-19 as an independent risk factor for arterial thromboemboli. Methods: From a cross-sectional sample, we determined the incidence and location of arterial thromboemboli (myocardial infarction, ischemic stroke, peripheral artery), stratified by COVID-19 status, in the RECOVER database, which included data on patients at 45 United States medical centers in 22 states. Epidemiological factors, clinical characteristics and outcomes were collected through a combination of individual chart review and automatic electronic query and recorded in REDCap®. We investigated the association of baseline comorbidities on the development of arterial thromboemboli and analyzed results based on the presence or absence of concomitant COVID-19 infection, testing this association with Chi-squared. We also described use of anticoagulants and statins. Results: Data were collected on 26,974 patients, of which 13,803 (51.17%) tested positive for COVID-19. Incidence of arterial thromboemboli during hospitalization was 0.13% in patients who tested positive for COVID-19 and 0.19% in patients who tested negative. Arterial thromboemboli tended to be more common in extremities than in core organs (heart, kidney, lung, liver) in patients with COVID-19, odds ratio 2.04 (95% CI 0.707 – 5.85). Patients with COVID-19 were less likely to develop an arterial thrombus when on baseline statin medication (p=0.014). Presence of metabolic syndrome predicted presence of core arterial thrombus (p=0.001) and extremity arterial thrombus (p=0.010) in those with COVID-19. Arterial thromboemboli were less common in patients with COVID-19 than in those who tested negative for COVID-19. Conclusions: Presence of a composite metabolic syndrome profile may be associated with arterial clot formation in patients with COVID-19 infection. [ABSTRACT FROM AUTHOR]

Introduction: The rate of bacterial coinfection with SARS‐CoV‐2 is poorly defined. The decision to administer antibiotics early in the course of SARS‐CoV‐2 infection depends on the likelihood of bacterial coinfection. Methods: We performed a retrospective chart review of all patients admitted through the emergency department with confirmed SARS‐CoV‐2 infection over a 6‐week period in a large healthcare system in the United States. Blood and respiratory culture results were abstracted and adjudicated by multiple authors. The primary outcome was the rate of bacteremia. We secondarily looked to define clinical or laboratory features associated with bacteremia. Results: There were 542 patients admitted with confirmed SARS‐CoV‐2 infection, with an average age of 62.8 years. Of these, 395 had blood cultures performed upon admission, with six true positive results (1.1% of the total population). An additional 14 patients had positive respiratory cultures treated as true pathogens in the first 72 h. Low blood pressure and elevated white blood cell count, neutrophil count, blood urea nitrogen, and lactate were statistically significantly associated with bacteremia. Clinical outcomes were not statistically significantly different between patients with and without bacteremia. Conclusions: We found a low rate of bacteremia in patients admitted with confirmed SARS‐CoV‐2 infection. In hemodynamically stable patients, routine antibiotics may not be warranted in this population. [ABSTRACT FROM AUTHOR]