Saturday, June 17, 2023

Journal Watch June 2023



 

COVID-19 

One in 10 People Who Had Omicron Got Long COVID: About 10% of people infected with Omicron reported having long COVID, a lower percentage than estimated for people infected with earlier strains of the coronavirus, says a study published in The Journal of the American Medical Association. 

 

The best drug combos to prevent COVID recurrence: A groundbreaking machine-learning study has unmasked the best drug combinations to prevent COVID-19 from coming back after an initial infection. It turns out these combos are not the same for every patient.  Using real-world data from a hospital in China, the UC Riverside-led study found that individual characteristics, including age, weight, and additional illness determine which drug combinations most effectively reduce recurrence rates. This finding has been published in the journal Frontiers in Artificial Intelligence. 

 

FDA Advisers Back up Updated Covid Shots for Fall vaccinations: A panel of expert advisers to the FDA voted unanimously to recommend that the COVID-19 vaccine be updated to target emerging subvariants of omicron. The COVID shot that's currently available is known as a "bivalent" vaccine because it was tailored to target both the original strain of the coronavirus and the omicron subvariants that dominated last winter.  But the FDA panel recommended that drugmakers abandon the bivalent design and instead move to a "monovalent" vaccine that only targets omicron subvariants. The idea is to roll out the newly formulated shots in anticipation of a possible uptick in cases this fall. The committee specifically supported targeting the subvariant XBB.1.5, which accounts for about 40% of new infections in the U.S. NPR 

 

 


PAIN

Regular Exercise May Boost Pain Tolerance: In a large observational study of more than 10,000 adults, researchers found those who consistently engage in moderate-to-vigorous physical activity over the 7- to 8-year study period reported the highest pain tolerance. However, the results also showed that even light exercise was associated with greater pain tolerance. The findings were published online May 24 in PLOS One.

 

Exercise and Empathy Can Help Chronic Back Pain Patients in Primary Care Medscape 

 

Your thoughts can harm your neck and back during lifting tasks: The mental distress of cognitive dissonance -- encountering information that conflicts with how we act or what we believe -- can lead to added pressure on the neck and low back during lifting and lowering tasks, new research suggests. When study participants were told they were performing poorly in a precision lowering experiment in the lab, after initially being told they were doing well, their movements were linked to increased loads on vertebrae in their neck and low back. Results showed that the higher the cognitive dissonance score, the greater the extent of loading on the upper and lower parts of the spine. Ergonomics 


Limiting opioids during surgery may lead to more postoperative pain and opioid use for patients: A recent analysis in JAMA Surgery  indicates that overly restricting use of opioids during surgery may be doing more harm than good. For the study, researchers analyzed information on 61,249 adults who had surgery at MGH from 2016–2020. Patients administered more of the opioids fentanyl and hydromorphone during surgery were less likely to experience pain and used less opioids in the hospital after waking up from anesthesia.

 

Study of former NFL players reveals racial disparities in chronic pain: A new study by researchers from Mass General Brigham and Harvard Medical School found that among participants in the Football Players Health Study at Harvard University, Black players experienced more intense and higher levels of pain that interfered with daily activities than white players. The findings, published in the journal Pain, represent one of the largest studies on pain in racial and ethnic minorities, and lend support to similar findings of race-related disparities in chronic pain in general populations.

 


COMPLEMENTARY AND ALTERNATIVE MEDICINE

Teens Using Marijuana 2 to 4 Times More Likely to Develop Mental Health Disorders: Teens who use marijuana recreationally are two to four times as likely to develop psychiatric disorders, such as depression and suicidality, than teens who don’t use cannabis at all, according to researchTrusted Source from Columbia University. Plus, even using cannabis casually increases a teen’s risk for behavioral issues, including poor grades, truancy, and trouble with the law.

 

Marijuana Users More Likely to Develop Peripheral Artery Disease: New research suggests there may be a link between marijuana use and developing vascular disease. 

A study of over 623,000 cannabis users found that they had a higher risk of developing peripheral artery disease (PAD). Though PAD typically develops in people over 60 years of age, the study found that younger cannabis users were also at an increased risk. The new study was presented May 17 at the annual meeting of the Society for Cardiovascular Angiography & Interventions

 


FDA ACTION

• Warns against Off Brand versions of Ozempic and Wegovy

• Approved the antipsychotic brexpiprazole (Rexulti, Otsuka and Lundbeck) for agitation associated with Alzheimer's disease (AD), making it the first FDA-approved drug for this indication.

• Approved a new topical gel MED3000 to be sold over the counter (OTC) as an aid for those with erectile dysfunction (ED).

• Approved the oral antiviral Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. Paxlovid is the fourth drug—and first oral antiviral pill—approved by the FDA to treat COVID-19 in adults.

• Approved Brixadi (buprenorphine) extended-release injection for subcutaneous use (under the skin) to treat moderate to severe opioid use disorder (OUD).

• Approved Vyjuvek, a herpes-simplex virus type 1 (HSV-1) vector-based gene therapy, for the treatment of wounds in patients 6 months of age and older with dystrophic epidermolysis bullosa (DEB)

• Cleared the Beta Bionics iLet ACE Pump and the iLet Dosing Decision Software for people six years of age and older with type 1 diabetes. These two devices, along with a compatible FDA-cleared integrated continuous glucose monitor (iCGM), will form a new system called the iLet Bionic Pancreas. This new automated insulin dosing (AID) system uses an algorithm to determine and command insulin delivery.

 

PREVENTION


Exercise

Exercise seems to protect against major brain hemorrhage: Regular physical activity and exercise may reduce bleeding in individuals with intracerebral hemorrhage, a new study shows. The researchers emphasize the importance of physical activity to protect the brain. Stroke and Vascular Neurology

 

Best Time of Day to Exercise for People with Type 2 Diabetes: Published new research in the journal Diabetes Care indicating that people with type 2 diabetes might see the most improvements in blood sugar control if they exercise in the afternoon rather than the morning or evening.

 

Brain connectivity, memory improves in older adults after walking: Published this month in the Journal for Alzheimer’s Disease Reports, the study examined the brains and story recollection abilities of older adults with normal brain function and those diagnosed with mild cognitive impairment, which is a slight decline in mental abilities like memory, reasoning and judgment and a risk factor for Alzheimer’s. Thirty-three participants, who ranged between 71 and 85 years old, walked while supervised on a treadmill four days a week for 12 weeks. Before and after this exercise regimen, researchers asked participants to read a short story and then repeat it out loud with as many details as possible. After 12 weeks of exercise, researchers repeated the tests and saw significant improvements in participants’ story recall abilities. 

 

Walking a leashed dog associated with risk of traumatic brain injury among adults: Finger fracture, traumatic brain injury, and shoulder sprain or strain were the three most common injuries related to leash-dependent dog walking among adults treated in U.S. emergency rooms from 2001 to 2020. Researchers have found that traumatic brain injuries (TBIs) were the second most common injury among adults treated in U.S. emergency rooms for injuries related to walking a leashed dog from 2001 to 2020. Medicine & Science in Sports & Exercise 

 

Can exercise help counteract genetic risk of disease? New research has revealed being active could lower the risk of type 2 diabetes, even in people with a high genetic risk of developing the medical condition. British Journal of Sports Medicine.

 

A supervised hospital walking program may reduce nursing facility admissions for older adults: A randomized trial of older veterans found that hospitalized persons enrolled in a supervised walking program known as STRIDE (AssiSTed EaRly MobIlity for HospitalizeD VEterans) were less likely to be discharged to a skilled nursing facility. However, the authors noted that participation in the program was low and there was no change associated with length of hospital stay or inpatient falls. The study is published in Annals of Internal Medicine.  

 

Improvement in older adults' cognitive function and manual dexterity due to repetitive training: The intervention group performed manual dexterity training daily for 12 weeks. It was found that the intensity of the level of training undertaken positively correlated with the amount of active blood hemoglobin that could be measured in the prefrontal cortex. Among the cognitive functions, executive function was observed to considerably improve in the intervention group compared with the control group. Other cognitive functions did not considerably improve; however, the effect size of these functions was higher in the intervention group than in the control group. Therefore, the findings of this study suggest that home-based manual dexterity training can improve hand dexterity and cognitive functioning in older adults. European Review of Aging and Physical Activity

 


Diet/Nutrition

Eating Foods With Flavanols May Help Boost Your Memory: New research, published May 30 in Proceedings of the National Academy of Sciences, suggests that consumption of flavanols—a chemical compound found in foods like cocoa, tea and grapes—could boost memory in some older adults. The study included more than 3,500 people and spanned three years. They found that those who had a poor diet, but who received a flavanol pill had a sustained increase in baseline memory levels as compared to those who received a placebo pill. The pill contained about 500 milligrams of cocoa-based flavanols, a naturally occurring compound.

 

Want to Stay Strong as You Age? Flavonol-rich Foods Like Blackberries and Apples Can Help:New research has found that eating flavonol-rich foods, like apples and blackberries, may lower your chances of developing the latter. The study, conducted at the Marcus Institute for Aging Research, found that for every 10mg higher intake of flavonols per day, the odds of developing frailty – a condition that carries a greater risk of falls, fractures, disability, hospitalization, and mortality and affects approximately 10-15% of older adults – were reduced by 20%.

 

Traditional Mexican Food Has Health Benefits: The phenolic compound intake (PCI) of traditional Mexican food positively affects health conditions and supports the hypothesis that specific nutritional foods have a particular effect on certain diseases, according to researchers from the Institute of Sciences at Benemérita Autonomous University of Puebla (BUAP), Puebla, Mexico. Their study, published in the journal Foods, is the first to produce tables showing the phenolic content of Mexican dishes. Physicians and nutritionists can use this information as a reference tool when drawing up diet recommendations for patients who could benefit from a higher intake of phenolic compounds (PC). Medscape 


Eating a Mediterranean-Style Diet Is Good for You and Can Save You Money Too: New research shows that eating a Mediterranean-style diet is not only better for your health than a typical Western diet, but it’s better for your bank account too. The studyTrusted Source found that eating a Mediterranean-style diet saved a family of four $28 per week, adding up to a savings of $1,456 per year, when compared to the typical Western diet. The Mediterranean diet offers many health benefits, including a lower risk of obesity, heart disease, and type 2 diabetes.

 

 Being Stressed Leads Your Brain to Crave More Comfort Foods: According to a new study published in the journal NeuronTrusted Source June 8, stress paired with high-calorie ‘comfort’ food results in brain changes that cause more eating, and increase cravings for sweet, satiating food. Over time, this can cause weight gain.

 

This Common Sugar Substitute May Damage Your DNA and Increase Your Cancer Risk: Sucralose, known in the United States by the brand name Splenda, is used in thousands of products, including baked goods, beverages, chewing gum, gelatins and frozen dairy desserts. In addition to DNA damage, the new study found that sucralose may lead to a leaky gut lining, and increase the activity of genes related to inflammation and cancer. The findings from this study “raise health and safety concerns regarding the continued presence of sucralose in the food supply,” the authors wrote May 29 in a paper published in the Journal of Toxicology and Environmental Health, Part B.

 

Cutting breakfast carbs can benefit people with Type 2 diabetes: Their latest study, published in the American Journal of Clinical Nutrition, confirms that switching from a traditional western-style low-fat breakfast, like oatmeal, toast and fruit, to a low-carb meal higher in protein and fat, like eggs with bacon or cheese, can help people with T2D better manage their blood sugar for most of the day.

 

 


Sleep

People With 5 or More Symptoms of Insomnia Have 50% Increased Stroke Risk : A new study, published in the research journal Neurology, has found that symptoms of insomnia may significantly increase your risk of stroke, especially if you are below the age of 50.

 

Regular, Optimal Sleep Tied to Lower: Mortality Risk: In a diverse group of older adults, those with regular and optimal sleep had about a 40% lower risk of dying of any cause during follow-up than peers who with irregular and insufficient sleep. The findings were presented at SLEEP 2023, the 37th annual meeting of the Associated Professional Sleep Societies. 

 

Too Much or Too Little Sleep May Raise Your Risk of Diabetes: According to new research presented at ENDO 2023 in Chicago, Illinois, the duration of sleep, as well as its quality, are linked with the risk of developing diabetes. Getting fewer than six hours or more than 10 hours of sleep appears to put people at increased risk for developing the condition.  Longer duration of sleep presented the highest degree of risk.

 

Alcohol and smoking to blame for premature deaths among night owls, 37-year study suggests:Staying up late at night has little impact on how long ‘night owls’ live, according to new research published in the peer-reviewed journal Chronobiology International. Data based on nearly 23,000 twins, however shows that evening types have a slightly increased risk of dying than morning types, but this is largely linked to smoking and drinking.

 


Vitamins/Supplements

Taking a Daily Multivitamin May Protect Your Memory Later in Life: A daily multivitamin or multi-mineral supplement improved memory in older adults over a three-year period, a new study shows. In the study, which, involved more than 3,500 adults over age 60, researchers randomly assigned participants to take a daily multivitamin supplement or an inactive placebo for three years. At the start of the study and at the end of each year, participants took an online cognitive test at home to assess their short-term memory. By the end of the first year, both groups saw improvements in memory, but the group taking a daily multivitamin saw a larger improvement.  The researchers estimate that the changes in the multivitamin group, which were sustained over the three years of the study, were equivalent to about three years of age-related memory decline. Still, that improvement was modest and the data does not account for the long term. Study subjects with cardiovascular disease who took a daily multivitamin saw the greatest improvement in cognition. The results were published May 24 in the American Journal of Clinical Nutrition.

 

B-Vitamin May Help Boost Antidepressant Efficacy: Investigators analyzed six studies and found support for adjunctive use of the B vitamin, L-methylfolate (LMT) with patients with MDD not responding to antidepressant monotherapy. Treatment response was highest in those with obesity and inflammatory biomarkers. Journal of Clinical Psychiatry 

 

Almond Milk Yogurt or Dairy-Based? Here’s Which One Is Better for You: When it comes to its nutrient density, almond milk yogurt comes out ahead compared to dairy-based yogurt, says research out of the University of Massachusetts Amherst. However, there were certain areas where dairy milk excels, such as protein, calcium, and potassium. Nutrition experts say it’s important to consider your individual needs when choosing which type to eat. A plant-based diet can have multiple benefits for health as well as the environment.

 


Other

Developing Type 2 Diabetes at a Younger Age Increases Dementia Risk: The risk of developing dementia appears to increase the younger a person develops diabetes.

The findings highlight the need to delay — and, if possible, prevent — the progression of prediabetes to diabetes in order to protect cognitive function. Being diagnosed with diabetes after age 80 was not associated with a higher risk of dementia. Diabetologia 

 

Colder Climates Help You Live Longer: Moderately cold temperatures increase longevity and decrease susceptibility to age-related diseases, according to research conducted at the University of Cologne. Medscape

 

Aspirin Use Tied to Lower Risk for Early Colorectal Cancer: The regular use of aspirin or other nonsteroidal anti-inflammatory drugs was found to be associated with a lower risk of early-onset conventional and advanced adenomas. The authors say that aspirin could prove to be an effective strategy in preventing early-onset (age. <50 years) colorectal cancer cases. Medscape 

 

How You Unwind After Work Can Affect Your Mood the Next Day: The quality of your recovery after work can affect your mood the next day. Good recovery leaves you feeling calmer and more alert. On the other hand, bad recovery has the opposite effect.

Experts say it is important to prioritize recovery each day. New researchTrusted Source published in the Journal of Occupational and Organizational Psychology 

 

Social participation promotes optimal aging in older adults: A new study followed more than 7000 middle aged and older Canadians for approximately three years to understand whether higher rates of social participation were associated with successful aging in later life. They found that those who participated in volunteer work and those participating in recreational activities were more likely to maintain excellent health across the subsequent 3-year study period and less likely to develop physical, cognitive, mental, or emotional problems. International Journal of Environmental Research and Public Health 

 

Exposure to Heavy Metals Increases Your Heart Disease Risk: According to a scientific statement published in the Journal of the American Heart Association,Trusted Source chronic exposure to contaminant metals (lead, cadmium and arsenic) found in household products, air, water, soil and food is linked to a greater risk of cardiovascular disease. Even low-level exposure to these metals is considered dangerous.  “The most surprising finding to me is the multi-decade disconnect between public health scientists, who proved over and over again that toxic metals were related to cardiovascular disease, and cardiologists, who only now accept the connection and the validity of environmental cardiology. Exposure to contaminant metals most often occurs involuntarily, through activities of daily living. Lead may be found in a variety of items such as paint in old homes (lead paint was banned in the U.S. in 1978), tobacco products, second-hand smoke, contaminated foods (ground water and some pottery, ceramics and kitchenware are sources of lead contamination in food), water pipes, spices, cosmetics, electronics and industrial emissions. Cigarette smoking is a source of both lead and cadmium. Cadmium is found in nickel-cadmium batteries, pigments, plastic, ceramics and glassware, and construction products. Industrially produced fertilizers use phosphate rock that is naturally rich in cadmium, which then contaminates root vegetables and leafy green plants (including tobacco). Arsenic exposure is primarily through groundwater, which affects drinking water, soil and food grown in contaminated soil. Notably, arsenic builds up in rice more than other food crops.

New study links contraceptive pills and depression: Women who used combined contraceptive pills were at greater risk of developing depression than women who did not, according to a new study. Contraceptive pills increased women's risk by 73 per cent during the first two years of use. Epidemiology and Psychiatric Sciences 

 


TREATMENT

After One Year, Popular Weight Loss Drug Semaglutide (Wegovy/Ozempic) Improved Heart Health:  A small study found that the popular weight loss drug semaglutide may help lower the risk of developing cardiovascular disease. After one year, study participants showed improvements in multiple cardiovascular risk factors, including blood pressure, total cholesterol, and triglycerides. Some experts suggest that by treating obesity, Ozempic appears to decrease risk factors that can lead to heart disease.  European Congress on Obesity 

 

Psoriatic Arthritis Medication Brepocitinib Reduced Symptoms by 20% in Phase 2 Trial: A new clinical trial shows potential for the drug brepocitinib to treat psoriatic arthritis. The medication works by limiting the autoimmune response that causes the inflammation that is at the core of psoriatic arthritis. The trial’s results were published online Trusted Sourceby the journal Arthritis and Rheumatology.

 

Study Finds Some People With Rectal Cancer May Be Able to Skip Radiation: A new study finds some people with rectal cancer may be able to forgo radiation. The trial involved more than 1,100 people with locally advanced rectal cancer, meaning it had not spread to other parts of the body. After five years, researchers found that people who received chemotherapy alone before surgery did as well as those who underwent both chemotherapy and radiation before surgery. The results of the study were revealed in early June at the annual meeting of the American Society of Clinical Oncology and in a paper in the New England Journal of Medicine.

 

Oral Estrogen May Raise Your Risk of Hypertension by 19% Compared to Other Forms of Hormone Replacement Therapy: Women taking oral estrogen hormones may be at greater risk of developing high blood pressure than women taking non-oral forms of hormone replacement therapy (HRT). That’s according to new researchTrusted Source published in the peer-reviewed American Heart Association journal, Hypertension. Data was examined which included blood pressure readings from over 100,000 women (ages 45 years and older) who filled at least two consecutive prescriptions (a six-month cycle) forestrogen-only hormone therapy in Alberta, Canada between 2008 and 2019.

 

Intraocular corticosteroids best for treating complications of chronic inflammatory eye condition:Repeat treatment with corticosteroid injections improved vision in people with persistent or recurrent uveitis-related macular edema better than two other therapies, according to results from a clinical trial funded by the National Eye Institute (NEI). Compared with methotrexate or ranibizumab intravitreal (in-the-eye) injections, the corticosteroid treatment achieved greater reductions in retinal swelling and was the only therapy in the study that improved vision. The report was published today in the journal Ophthalmology. 

 

‘Prehabilitation’ boosts surgery outcomes: Pre-surgery exercise and education – widely known as ‘Prehabilitation’ – can significantly improve outcomes for patients undergoing orthopaedic surgery, according to new research published in the Journal of the American Medical Association (JAMA Network Open). This may include exercise, patient education, pain management and psychological support. 

 

Groundbreaking New Regimen for Advanced Hodgkin Lymphoma: Across patients' age groups, adding the immune checkpoint inhibitor nivolumab to chemotherapy significantly improves progression-free survival in advanced stage Hodgkin lymphoma while also reducing toxicities, making it a new standard of care, compared with the CD30-targeting drug brentuximab vedotin. Medscape 

 

This Statin Alternative Helped Reduce Bad Cholesterol By 21%: According to research being presented at the Endocrine Society’s annual meeting in Chicago, ENDO 2023, the medication bempedoic acid demonstrated effectiveness in reducing the risk of cardiac events along with statins. It may also act as an alternative to the popular medications. Research showed that bempedoic acid reduced LDL cholesterol levels by an average of 21% and lowered the risk of heart attack, stroke, and procedures to unblock heart blood vessels by 13%.

 

Elimination of type of bacteria suggests treatment for endometriosis: Using an antibiotic to target Fusobacterium reduced the formation of lesions associated with endometriosis. Their findings suggest an alternative treatment for this disorder. The study was published in Science Translational Medicine.

 

OTHER

Women feel the pain of losses more than men when faced with risky choices: Women are less willing to take risks than men because they are more sensitive to the pain of any losses they might incur than any gains they might make, new research from the University of Bath School of Management shows. Published in the British Psychological Society’s British Journal of Psychology, the study – “Gender differences in optimism, loss aversion and attitudes toward risk" - also finds that men are ‘significantly’ more optimistic than women, making them more willing to take risks.


Saturday, June 10, 2023

Life with Chronic Conditions: How to Protect Yourself from Wildfire Smoke


This past week, much of the east coast and other parts of the country were blanketed in smoke from the wildfires in Canada. New York City and Washington had the worse air quality in the world as smoke particulate made it challenging for many.

 Wildfire smoke is a mix of gases and fine particles from burning vegetation, building materials, and other materials. It contains fine particulates, also known as PM2.5, which are lightweight and tiny,  and can go deep into your lungs and bloodstream, causing inflammation, heart attacks, strokes, asthma and other breathing issues. Breathing in smoke can have immediate health effects, including: coughing, trouble breathing; wheezing and shortness of breath; stinging eyes; scratchy throat; runny nose; irritated sinuses; chest pain; headaches; an asthma attack; tiredness; and fast heartbeat.

 

Those most at risk from the smoke are the elderly, children and people with preexisting respiratory and heart conditions.

 

Note: Watching for smoke or smelling the air is not a good indication of whether or not these particles are present and affecting you. The micromillimeter-sized particles can’t always be seen or smelled. I put that in as my husband kept insisting that he didn’t smell anything so it couldn’t be a problem. 

 

Steps to Take During an Air Quality Alert 

Check your local weather at least daily for Air Quality alerts. Smart phone weather forecasts will provide this information, so it’s easy to use the App that comes with your phone to check regularly. Some times when a “controlled burn” is taking place, air quality alerts may not be noted. Therefore if you notice a haze, the sky looks an unusual color or the air smells like campfire, stay indoors. 

 

Understand the Air Quality Index (AQI): The higher the AQI number, the greater the level of air pollution and potential for health concerns. This AQI chart can be a handy way of judging risk



 

Talk to your medical provider about medications, particularly if you have asthma, heart or lung disease or any condition that would make you more vulnerable during an air quality alert. If you start feeling sick during an alert, call your provider. 

 

Reduce exposure indoors: During alerts, stay indoors use an air conditioner if you have one, but keep the fresh-air intake closed and the filter clean to prevent outdoor smoke from getting inside. You can also make a DIY box fan air filter for wildfire smoke. Seek shelter elsewhere if you do not have an air conditioner and it is too warm to stay inside with the windows closed. 

 

Reduce Exposure While Driving: Press the recirculate button so your car won't be pulling air from outside but just recirculating the air that's already in the car.

 

Do not add to indoor pollution. When smoke levels are high, do not use anything that burns, such as candles and fireplaces. Do not vacuum, because vacuuming stirs up particles already inside your home. Do not smoke tobacco or other products, because smoking puts even more pollution into the air.

 

An “N95” mask, properly worn, will offer some protection. Note that “dust”  masks or bandannas do not provide protection. We learned a lot about masks during Covid, so put that knowledge to good use and use an N95 or KN95. 

 

 

 

Saturday, June 3, 2023

Life with chronic conditions You are the help until help arrives




Accidents and emergencies can happen at any time, and often occur where there is no immediate help. FEMA has a program called “You are the Help Until Help Arrives,  to help you respond appropriately in emergent situations. Many parts  of the country offers the You are the Help training. If they don’t, today’s post identifies the five simple steps that can save a life and where you can learn more.







STEPS

• Call 9-1-1

• Stay Safe: Protect the injured from harm

• Stop the Bleeding 



Position the Injured  


• Provide Comfort

 

Use the FEMA web-based training program to learn more about each of the steps


Check out Hands only CPR 


 

Resources for training

National 

 American Red Cross: Offers training and certification in first aid, CPR and AED 

• American Heart Association: CPR and AED learning programs for adults and students 

• American College of Surgeons, Bleeding Control: Includes a class list for bleeding control training 

• SAMHSA Disaster Distress Helpline Call 1-800-985-5990
Text: “TalkWithUs” to 66746 

• Mental Health First Aid  

 

Local: Check area hospitals, fire departments and news outlets, including social media, for courses in community CPR, basic 1st aid and Stop the Bleed