“Anaphylactic Shocker!”: The Creation and Use of a Novel Dynamic QR Code Medical Bracelet to Locate and Administer a Practice Epinephrine Auto-Injector During a Staged Medical Emergency
Medical bracelets can save lives, but often lack the information for appropriate medical care in emergency scenarios. The focus of this research was to determine whether a dynamic QR code medical bracelet connected to a Bluetooth carrying case allowed participants to react faster to a staged medical emergency when compared to standard medical bracelets, static QR code medical bracelets, or non-Bluetooth dynamic QR code medical bracelets, where all QR bracelets were made by the researcher. A mock medical scenario for anaphylactic shock was tested where the person receiving medical attention wore one of four medical bracelets (standard, static, dynamic, and dynamic/Bluetooth) with participants timed in locating and administering a practice epinephrine auto-injector. Both dynamic bracelets displayed the location and use of the auto-injector, while the connected Bluetooth carrying case system emitted a buzzing sound, allowing participants to listen and look for the auto-injector. The static bracelet informed participants of the need for an auto-injector. The standard bracelet displayed only the medical condition. The dynamic QR code bracelet with connected Bluetooth carrying case was faster and more precise in all trials (p<.0001). This dynamic scannable-interface (QR code) medical bracelet is unique in its connectivity to Bluetooth and its aim in supporting bystanders (vs. medical professionals) in the case of a medical emergency. The dynamic bracelet and Bluetooth carrying case system could improve the medical response time and care in emergency scenarios, leading to fewer hospital stays and lower mortality for those with medical conditions.
Sertraline Concentrations in Children Stratified by the CYP2C19 Genotype
Off-label medication is commonly used in child and adolescent psychiatry, which raises concerns of both safety and efficacy, as common genetic variants of pharmacokinetic enzymes may significantly affect serum concentrations at a standard dosing level. Knowing an individual’s genotype, combined with trough serum levels, gives useful information to clinicians to help in determining an appropriate medication and dose. What remains unknown is what are the serum concentrations of psychiatric medications from standard dosing of sertraline in children with increased or decreased enzymatic activity. Therefore, there is an urgent need to define the range of serum concentrations for commonly used prescribed psychiatric medications frequently prescribed in children, such as sertraline. The purpose of this study is to [1] compare sertraline and desmethylsertraline concentrations and ratios in children (ages 6-17) taking sertraline (Zoloft) across different Cytochrome P450 2C19 (CYP2C19) genotype groups at a standard dosing level, to [2] assess clinical outcomes (including adverse drug events) across the different CYP2C19 metabolizer groups (poor, intermediate, normal, rapid or ultra-rapid), and [3] relate the results of this study to other pediatric pharmacogenetic studies of medication metabolization to synthesize novel conclusions about the pharmacogenetic differences between the chosen population (children and adolescents) and adults.