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Qualitative Exploration Of Covid-19 Vaccine Uptake Among Healthcare Workers In Sierra Leone: Do The ‘Trusted Messengers’ Trust The Vaccine?, Ifeolu David, Enid Schatz, Wilson Majee Jan 2026

Qualitative Exploration Of Covid-19 Vaccine Uptake Among Healthcare Workers In Sierra Leone: Do The ‘Trusted Messengers’ Trust The Vaccine?, Ifeolu David, Enid Schatz, Wilson Majee

Population Health Leadership and Analytics Faculty Publications and Presentations

Introduction

Vaccine hesitancy is a global issue, and the important role of healthcare workers in addressing vaccine hesitancy is well documented. However, there is limited theory-guided research on the uptake of COVID-19 vaccinations among healthcare workers in low- and middle-income countries (LMICs). This study examined COVID-19 vaccine uptake among healthcare workers in Sierra Leone and assessed the relevance of the 5C model—which posits that vaccine uptake is shaped by confidence, complacency, constraints, calculation and collective responsibility—in explaining their vaccination attitudes, intentions and behaviours.

Methods

24 indepth interviews were conducted in 2022 with healthcare workers in Freetown, Makeni and Kenema. The …


Mitochondrial Transfer To Granulocytic Myeloid-Derived Suppressor Cells Augments Immunosuppressive Activity, Prabhakar Arumugam, Cortney E. Heim, Rachel W. Fallet, Dhananjay Shinde, Vinai Chittezham Thomas, Rafael J. Argüello, Tammy Kielian Jan 2026

Mitochondrial Transfer To Granulocytic Myeloid-Derived Suppressor Cells Augments Immunosuppressive Activity, Prabhakar Arumugam, Cortney E. Heim, Rachel W. Fallet, Dhananjay Shinde, Vinai Chittezham Thomas, Rafael J. Argüello, Tammy Kielian

Journal Articles: Pathology and Microbiology

The anti-inflammatory properties of granulocytic myeloid-derived suppressor cells (G-MDSCs) promote Staphylococcus aureus (S. aureus) biofilm persistence. Evidence suggests that G-MDSC activity is shaped not only by S. aureus products but also by intrinsic metabolic programs. This study explores whether G-MDSC activity can be modulated by increasing mitochondrial abundance using a co-culture paradigm with macrophages as a mitochondrial donor. Macrophages transfer mitochondria directly to G-MDSCs via tunneling nanotubes, enhancing G-MDSC respiration, as reflected by increased basal, maximal, and spare respiratory capacity. Augmenting mitochondrial abundance in G-MDSCs enhances T cell-suppressive activity and reduces tumor necrosis factor (TNF) and interleukin 6 (IL-6) production. …


Winter 2026, Humayun Islam Jan 2026

Winter 2026, Humayun Islam

PMI Newsletter

No abstract provided.


Ebola In The Drc: A Different Problem Compounded By Violence, David Brett-Major Jan 2026

Ebola In The Drc: A Different Problem Compounded By Violence, David Brett-Major

Journal Articles: Epidemiology

A Public Health Emergency of International Concern (PHEIC) has been declared in the Democratic Republic of Congo (DRC) due to Ebola disease from Bundibugyo virus. Non-health-focused factors should be fundamental to how DRC and its partners respond to and recover from the current emergency. Filovirus emergencies are violent in every sense-the disease experience of patients and their caregivers, the tumult in impacted communities, sometimes the physical manifestations of frustration against healthcare services, the fits and starts of concerted response, and the milieu of conflict in which this emergency occurred. Yet, interpersonal and organized violence may contribute to frequency of health …


Challenging Cases In Infection Prevention And Control: Proceedings From Shea Spring 2025., Jessica Seidelman, Tsun Sheng N Ku, Anna Lafountaine, Curtis J Donskey, Edo-Abasi U. Mcgee, Rachel Pryor Jan 2026

Challenging Cases In Infection Prevention And Control: Proceedings From Shea Spring 2025., Jessica Seidelman, Tsun Sheng N Ku, Anna Lafountaine, Curtis J Donskey, Edo-Abasi U. Mcgee, Rachel Pryor

PCOM Scholarly Works

Hospital epidemiologists and infection prevention professionals are frequently required to make high-stakes decisions in complex clinical scenarios where evidence-based guidance is limited or absent. These decisions often carry significant implications for patient safety, healthcare worker protection, hospital operations, and legal or financial risk. This article presents three challenging cases originally featured during the "Interesting Cases" session at the Society for Healthcare Epidemiology of America (SHEA) Spring 2025 Conference, with the goal of sharing practical lessons learned and contributing to the evolving literature in healthcare epidemiology. The first case describes the intraoperative contamination of a polyethylene liner during emergency revision total …


Improving Nasal Decolonization Rates In The Inpatient Medical-Surgical Setting, Francesca Annunziato Royer Jan 2026

Improving Nasal Decolonization Rates In The Inpatient Medical-Surgical Setting, Francesca Annunziato Royer

DNP Projects

Background/Significance

Hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) remains a significant cause of morbidity, mortality, and increased healthcare costs. Alcohol-based nasal decolonization is an evidence-based strategy to reduce MRSA transmission; however, staff compliance with decolonization protocols is often suboptimal, limiting effectiveness in inpatient medical-surgical settings.

Purpose

The purpose of this evidence-based quality improvement (EBQI) project was to evaluate whether implementing a structured, evidence-based nasal decolonization protocol improved staff compliance and reduced missed administrations and patient refusals among eligible medical-surgical inpatients.

Methods

This EBQI project was implemented on five inpatient medical-surgical units at a large academic medical center. Interventions included standardized staff education, …


Longitudinal Implementation Of A Neurodevelopmental Screening Program For Children Born To Mothers Living With Hiv In Maternal–Child Clinics In Kenya: A Mixed Methods Study, Megan S. Mchenry, Eren Oyungu, Amina Abubakar, Ananda Roselyne Ombitsa, Micaela Gaviola, Cleophas Cherop, Beatrice Kaniaru, Carolyne Jerop, Alan Mcguire, Rachel C. Vreeman Jan 2026

Longitudinal Implementation Of A Neurodevelopmental Screening Program For Children Born To Mothers Living With Hiv In Maternal–Child Clinics In Kenya: A Mixed Methods Study, Megan S. Mchenry, Eren Oyungu, Amina Abubakar, Ananda Roselyne Ombitsa, Micaela Gaviola, Cleophas Cherop, Beatrice Kaniaru, Carolyne Jerop, Alan Mcguire, Rachel C. Vreeman

Institute for Human Development, East Africa

Background: Children with perinatal HIV exposure are at increased risk for neurodevelopmental (ND) delays, yet little is known about ND screening implementation for this population.

Methods: This longitudinal study evaluated ND screening implementation at a health clinic in Kenya, from 9/2021 to 8/2023. Children aged 18-36 months with perinatal HIV exposure were screened using a 12-item general ND tool. Implementation outcomes—acceptability, feasibility, fidelity, and sustainability—were assessed through time-motion observations, clinic records, and semi-structured interviews with caregivers and staff.

Results: Of 507 eligible children, 405 (80%) were screened. Screening rates were consistent over 24 months, with average time …


Outbreak Preparedness And Response In A Globalized World: Are We Ready?, Francesca F. Norman, David Brett-Major, Chiara Sepulcri, Emmanuel Bottieau, Theresa Sepulveda, Federica Toscanini, Laura A. Nicolini, Jesse J. Waggoner, Sami Alcedo, Davidson H. Hamer, Ralph Huits, Michael Libman, Geosentinel Network, Tropnet Network, Kevin O'Laughlin Jan 2026

Outbreak Preparedness And Response In A Globalized World: Are We Ready?, Francesca F. Norman, David Brett-Major, Chiara Sepulcri, Emmanuel Bottieau, Theresa Sepulveda, Federica Toscanini, Laura A. Nicolini, Jesse J. Waggoner, Sami Alcedo, Davidson H. Hamer, Ralph Huits, Michael Libman, Geosentinel Network, Tropnet Network, Kevin O'Laughlin

Journal Articles: Epidemiology

BACKGROUND: Recent global epidemics and pandemics have highlighted the need for adequate diagnostic capacities to respond to emerging threats. Strengthening operational capacities can lead to improved preparation; investing in emergency response infrastructure may diminish progression of outbreaks and prevent escalation.

METHODS: An email-linked survey was sent January-March-2025 to two global infectious disease surveillance networks' (GeoSentinel and TropNet) participating clinics assessing capacity for Oropouche virus (OROV) diagnostic testing. Data on testing capacity for other arboviruses was also requested.

RESULTS: Responses were obtained for 58 GeoSentinel/TropNet sites (58/104, 55.8%): 50% responding sites (29/58) had OROV diagnostic testing available at a public reference …


Oral N-Acetylcysteine In Hepatitis C - Induced Acute Liver Injury: A Case Report, Mohammed Irfan Khan, Shuchita Jhaveri, Renu Thomas, Kevin Garnepudi, Galvin Dhaliwal, Ahmed Ouni, Shane P. Sweeney, Julian Nguyen Jan 2026

Oral N-Acetylcysteine In Hepatitis C - Induced Acute Liver Injury: A Case Report, Mohammed Irfan Khan, Shuchita Jhaveri, Renu Thomas, Kevin Garnepudi, Galvin Dhaliwal, Ahmed Ouni, Shane P. Sweeney, Julian Nguyen

Gulf Coast Division GME Research Day 2026

No abstract provided.


A South Texas Mousetrap: A Case Report Of Murine Typhus And Diagnostic Dilemmas, Arjun Kamath, Jose Garza, Matthew Wagner, Deekshita Valiveti, Percy Thomas, Christopher Ganson, Abhay Vakil, Zuhair Ali Jan 2026

A South Texas Mousetrap: A Case Report Of Murine Typhus And Diagnostic Dilemmas, Arjun Kamath, Jose Garza, Matthew Wagner, Deekshita Valiveti, Percy Thomas, Christopher Ganson, Abhay Vakil, Zuhair Ali

Gulf Coast Division GME Research Day 2026

No abstract provided.


Right Upper Quadrant Pain With Perihepatitis, Morgan D. Homan, Jake Valentine, Edwin R. Malone Ii Jan 2026

Right Upper Quadrant Pain With Perihepatitis, Morgan D. Homan, Jake Valentine, Edwin R. Malone Ii

Gulf Coast Division GME Research Day 2026

No abstract provided.


More Than A Scratch: Capnocytophaga Bacteremia Induced Severe Sepsis With Multi-Organ Failure With Occupational Dog Exposure, Cristina Lee, Alex Craig, Dmitriy Scherbak Jan 2026

More Than A Scratch: Capnocytophaga Bacteremia Induced Severe Sepsis With Multi-Organ Failure With Occupational Dog Exposure, Cristina Lee, Alex Craig, Dmitriy Scherbak

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.


The Great Imitator: A Subtle Case Of Syphilis In The Emergency Department Amid Rising National Incidence, Jyotirmaya Jain, Michael Flanders, Manzoor Bevinal Jan 2026

The Great Imitator: A Subtle Case Of Syphilis In The Emergency Department Amid Rising National Incidence, Jyotirmaya Jain, Michael Flanders, Manzoor Bevinal

Gulf Coast Division GME Research Day 2026

No abstract provided.


From Susceptible To Stubborn: Fluconazole Resistant Candida Albicans Bacteremia, Mackenzie Elias, Denise Balcacer-Estevez, Trent Percy Jan 2026

From Susceptible To Stubborn: Fluconazole Resistant Candida Albicans Bacteremia, Mackenzie Elias, Denise Balcacer-Estevez, Trent Percy

West Florida Division GME Research Day 2026

No abstract provided.


Pyoderma Gangrenosum As An Initial Presentation Of Rheumatoid Arthritis & Inflammatory Bowel Disease, Julian Reoyo, Jennifer Cucalon, Milton Alexis Torres, Toni Feghali, Francia Guerrero, Joseph Pino, Shahid Sulaiman Jan 2026

Pyoderma Gangrenosum As An Initial Presentation Of Rheumatoid Arthritis & Inflammatory Bowel Disease, Julian Reoyo, Jennifer Cucalon, Milton Alexis Torres, Toni Feghali, Francia Guerrero, Joseph Pino, Shahid Sulaiman

West Florida Division GME Research Day 2026

No abstract provided.


From Colonization To Invasion: Risk Factors Of Mrsa Bacteremia Among Hospitalized Patients, Stefan Sarkovich, Spoorthi Lawson, Shaival Thakore, Francia Guerrero Jan 2026

From Colonization To Invasion: Risk Factors Of Mrsa Bacteremia Among Hospitalized Patients, Stefan Sarkovich, Spoorthi Lawson, Shaival Thakore, Francia Guerrero

West Florida Division GME Research Day 2026

No abstract provided.


Stewards In The Making: Approaching "Penicillin-Allergies" With Confidence, Trent Percy, Craig Spergel Jan 2026

Stewards In The Making: Approaching "Penicillin-Allergies" With Confidence, Trent Percy, Craig Spergel

West Florida Division GME Research Day 2026

No abstract provided.


Case Of Enterococcus Faecalis Infective Endocarditis 6-Weeks Following Post-Partum Hemorrhage, Zohaib Nadeem, Mason Goforth, Yasasvi Sabbineni, Sadia Zahid, Yugandhra Devarapalli, Javed Akram, Veeranna Vibhuti Jan 2026

Case Of Enterococcus Faecalis Infective Endocarditis 6-Weeks Following Post-Partum Hemorrhage, Zohaib Nadeem, Mason Goforth, Yasasvi Sabbineni, Sadia Zahid, Yugandhra Devarapalli, Javed Akram, Veeranna Vibhuti

North Texas GME Research Forum 2026

Peri-partum infective endocarditis (IE) is a rare but serious condition with high maternal and fetal morbidity and mortality. IE is exceedingly uncommon in young healthy patients, especially without any known risk factors such as intravenous (IV) drug use, congenital heart disease, or rheumatic heart disease. IE is estimated to complicate 0.00002% of in-hospital deliveries. Similar to the general population, staphylococcal and streptococcal species remain the most common pathogens in obstetric patients. Enterococcal species make up less than 10% of IE cases in pregnant women. Very few cases of enterococcal IE in the post-partum period are reported in the literature. We …


The Rapid Case Of Anoxic Brain Injury Secondary To Hyperammonemia, Jacqueline Bekhit, Ngoc Vu, Jiaming Xue, Gabriella David, Qasim Sajawal Jan 2026

The Rapid Case Of Anoxic Brain Injury Secondary To Hyperammonemia, Jacqueline Bekhit, Ngoc Vu, Jiaming Xue, Gabriella David, Qasim Sajawal

North Texas GME Research Forum 2026

Background: Acute hyperammonemia presents as a toxic state with the clinical presentation as altered consciousness, seizures, and coma. Hyperammonemia disrupts astrocytes osmotic balance via glutamine accumulation, triggering brain edema, inflammation, and apoptosis whom mechanism is closely parallel to hypoxic ischemic injury. This overlap necessitates differentiating metabolic causes from hypoxic etiologies, as timely ammonia clearance therapies can prevent catastrophic outcomes. This case underscores the need for close clinical vigilance and early recognition of severe hyperammonemia

Case Presentation: A 65-year-old woman with metabolic dysfunction-associated steatotic liver disease related cirrhosis complicated by recurrent ascites requiring bimonthly paracentesis presented with abdominal distension and pain. …


A Rare Case Of Disseminated Strongyloidiasis Causing Polymicrobial Sepsis In A Patient With Lupus: A Diagnostic Conundrum, Greeshma Molugu, Anupama Chennupati, Ayo Dereje, Machaiah Madhrira Jan 2026

A Rare Case Of Disseminated Strongyloidiasis Causing Polymicrobial Sepsis In A Patient With Lupus: A Diagnostic Conundrum, Greeshma Molugu, Anupama Chennupati, Ayo Dereje, Machaiah Madhrira

North Texas GME Research Forum 2026

Introduction: Disseminated strongyloidiasis is a very rare condition with case-fatality rates approaching 90%. However, the diagnosis is often delayed because of nonspecific presenting symptoms. Early diagnosis relies on a high index of clinical suspicion, especially in immunocompromised hosts. Long-term corticosteroid therapy, leading to some suppression of inflammatory and immunologic responses, is a well-known risk factor for severe strongyloidiasis.

Case presentation: A 52-year-old male with a past medical history of lupus on chronic corticosteroid therapy presented with chief complaints of dyspnea and diarrhea. He has a recent history of travel to Mexico. Hemoglobin was 5.3. CTAP with contrast showed diffuse colitis …


Beyond The Temporal Lobe: Atypical Presentation In Adult Hsv-2 Encephalitis, Analekha Chesnick, Michaela Littlefield, Brock Cardon Jan 2026

Beyond The Temporal Lobe: Atypical Presentation In Adult Hsv-2 Encephalitis, Analekha Chesnick, Michaela Littlefield, Brock Cardon

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.


Fournier Gangrene Incidentally Found And Caused By Actinomyces Odontolyticus, A Rare Finding, Munanchu Poudel, Manzoor Bevinal, Brandi Addison Jan 2026

Fournier Gangrene Incidentally Found And Caused By Actinomyces Odontolyticus, A Rare Finding, Munanchu Poudel, Manzoor Bevinal, Brandi Addison

Gulf Coast Division GME Research Day 2026

No abstract provided.


Diagnostic Complexities In Patients Presenting With Peritoneal Tuberculosis: A Case Report, Christina Mie Minami, Bailey Weidner, Tyler Mcvay Jan 2026

Diagnostic Complexities In Patients Presenting With Peritoneal Tuberculosis: A Case Report, Christina Mie Minami, Bailey Weidner, Tyler Mcvay

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.


West Nile Encephalitis Complicated By Urinary Retention, Morgan Reich, Sabra Rahme, Mattie Brand, Jordan Conley Jan 2026

West Nile Encephalitis Complicated By Urinary Retention, Morgan Reich, Sabra Rahme, Mattie Brand, Jordan Conley

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.


The Uncommon Suspect: Cavitary Pulmonary Tuberculosis In A Previously Healthy Adult In Colorado, Nikita Zanko, Cristina Lee, Dmitriy Scherbak Jan 2026

The Uncommon Suspect: Cavitary Pulmonary Tuberculosis In A Previously Healthy Adult In Colorado, Nikita Zanko, Cristina Lee, Dmitriy Scherbak

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.


Transcriptional Signatures Of Rapid Protection From Sudan Virus Infection By A Single Dose Of A Vesicular Stomatitis Virus-Based Vaccine, Brianna M. Doratt, Sheridan B. Wagner, Delphine C. Malherbe, Gregory T. Smith, Andrea Marzi, Ilhem Messaoudi Jan 2026

Transcriptional Signatures Of Rapid Protection From Sudan Virus Infection By A Single Dose Of A Vesicular Stomatitis Virus-Based Vaccine, Brianna M. Doratt, Sheridan B. Wagner, Delphine C. Malherbe, Gregory T. Smith, Andrea Marzi, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Sudan virus (SUDV) has caused multiple outbreaks of human disease with case fatality rates ranging from 41 to 100%. We have previously shown that a single vaccination with a recombinant vesicular stomatitis virus-based vaccine expressing the SUDV-Gulu glycoprotein (VSV-SUDV) prevented clinical and fatal disease from lethal SUDV challenge in cynomolgus macaques. With the high probability of future outbreaks, it is critical to determine the molecular mechanisms of VSV-SUDV-mediated protection and the ability to impart rapid protection against SUDV infection. In this study, RNA from whole blood samples obtained from nine cynomolgus macaques that were challenged with SUDV-Gulu post-vaccination with either …


Evaluation Of Interventions For Cognitive Symptoms In Long Covid: A Randomized Clinical Trial, David S Knopman, Deborah Koltai, Daniel T Laskowitz, Jacqueline Becker, Leigh Charvet, Juan Wisnivesky, Alex Federman, Adam Silverstein, Yuliya Lokhnygina, Giuseppina Pilloni, Michelle Haddad, Henry Mahncke, Tom Van Vleet, Rong Huang, Wendy Cox, Diana Terry, Jeannie Karwowski, Netia Mccray, Jenny J Lin, Grace A Mccomsey, Upinder Singh, Linda N Geng, Helen Y Chu, Rebecca Reece, James Moy, Zoe Arvanitakis, Sairam Parthasarathy, Thomas F Patterson, Aditi Gupta, Luis Ostrosky-Zeichner, Jeffrey Parsonnet, Elaine T Kiriakopoulos, Tamara G Fong, Janet Mullington, Sarah Jolley, Nirav S Shah, Sarah Shizuko Morimoto, Joyce K Lee-Iannotti, William D S Killgore, Brigid Dwyer, William Stringer, Carmen Isache, Jennifer A Frontera, Jerry A Krishnan, Ashley O'Steen, Melissa James, Barrie L Harper, Kanecia O Zimmerman Jan 2026

Evaluation Of Interventions For Cognitive Symptoms In Long Covid: A Randomized Clinical Trial, David S Knopman, Deborah Koltai, Daniel T Laskowitz, Jacqueline Becker, Leigh Charvet, Juan Wisnivesky, Alex Federman, Adam Silverstein, Yuliya Lokhnygina, Giuseppina Pilloni, Michelle Haddad, Henry Mahncke, Tom Van Vleet, Rong Huang, Wendy Cox, Diana Terry, Jeannie Karwowski, Netia Mccray, Jenny J Lin, Grace A Mccomsey, Upinder Singh, Linda N Geng, Helen Y Chu, Rebecca Reece, James Moy, Zoe Arvanitakis, Sairam Parthasarathy, Thomas F Patterson, Aditi Gupta, Luis Ostrosky-Zeichner, Jeffrey Parsonnet, Elaine T Kiriakopoulos, Tamara G Fong, Janet Mullington, Sarah Jolley, Nirav S Shah, Sarah Shizuko Morimoto, Joyce K Lee-Iannotti, William D S Killgore, Brigid Dwyer, William Stringer, Carmen Isache, Jennifer A Frontera, Jerry A Krishnan, Ashley O'Steen, Melissa James, Barrie L Harper, Kanecia O Zimmerman

Faculty, Staff and Student Publications

Importance: Treatment for cognitive dysfunction due to postacute sequelae of long COVID (ie, symptoms of fatigue, malaise, weakness, confusion that persist beyond 12 weeks after an initial COVID infection) remains a significant unmet need.

Objective: To test evidence-based rehabilitation strategies for improving cognitive symptoms in persons with long COVID.

Design, setting, and participants: This was a 5-arm, multicenter, randomized clinical trial of 3 remotely delivered interventions conducted between August 17, 2023, and June 10, 2024. The study took place at 22 trial sites and included the screening of individuals with cognitive long COVID.

Interventions: Participants were randomized to 1 of …


Intra-Amniotic Infection (Iai) Prevention, Shelbie Clement, Deanna Conley Jan 2026

Intra-Amniotic Infection (Iai) Prevention, Shelbie Clement, Deanna Conley

Articles, Abstracts, and Reports

No abstract provided.


The Utilization Of Uv-C Devices To Improve Cleaning And Disinfection In The Operating Room For Reduction Of Infection Rates: An Integrative Research Review (Irr), Kathrina Joyce L. Manalo Jan 2026

The Utilization Of Uv-C Devices To Improve Cleaning And Disinfection In The Operating Room For Reduction Of Infection Rates: An Integrative Research Review (Irr), Kathrina Joyce L. Manalo

Covenant Nurses Week 2026

No abstract provided.


Utilizing A Suction Catheter As A Makeshift Tracheostomy Tube In A Premature Infant: A Case Report., Ashwini V Bandi, Shaina W Gong, Gabriela G Cruz, Alicia S Lore, Kunal Shetty, Sancak Yuksel Jan 2026

Utilizing A Suction Catheter As A Makeshift Tracheostomy Tube In A Premature Infant: A Case Report., Ashwini V Bandi, Shaina W Gong, Gabriela G Cruz, Alicia S Lore, Kunal Shetty, Sancak Yuksel

Faculty, Staff and Student Publications

One of the most challenging aspects regarding pediatric tracheostomy tube placement is the size selection, particularly in preterm infants. We present the first reported case of a makeshift tracheostomy tube using a 6-French suction catheter in a 31-week-old premature infant in an emergent situation. This approach holds promise as a potentially life-saving intervention for extremely small preterm infants. Furthermore, this case emphasizes the size discrepancy between the premature neonatal airway and the smallest tracheostomy tubes available. Further research is warranted to allow for more diverse clinical solutions that can accommodate similar cases in acute settings.