Bio

Clinical Focus


  • Emergency Medicine
  • Disaster Response

Academic Appointments


Administrative Appointments


  • Santa Clara Assistant Medical Director, SCC EMS (2008 - 2009)

Honors & Awards


  • Stanford EM International Resident Scholar, Stanford (2008)

Professional Education


  • Residency:Stanford Hospital and Clinics - Emergency Medicine (2008) CA
  • Medical Education:Stanford Hospital and Clinics - Emergency Medicine (2005) CA
  • Board Certification: Emergency Medicine, American Board of Emergency Medicine (2009)
  • Fellowship, Stanford, EMS and Disaster Management (2009)
  • Residency, Stanford/Kaiser Residency, Emergency Medicine (2008)
  • M.D., Stanford University, Medicine (2005)
  • B.A., University of Pennsylvania, Molecular Biology (1999)

Community and International Work


  • Racing the Planets-Atacama Desert, Atacama Desert, Chile

    Topic

    Medical Staff for ultra run race

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • Advanced Paramedic Course, Hyderabad, India

    Topic

    Paramedic Education

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • Comparing treatments for high altitude sickness, Everest Trail, Nepal

    Topic

    Acetazolamide vs Gingko Biloba for alititude illness

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Perceptions of acupuncture, Beijing, China

    Topic

    Effects of acupuncture

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

Research & Scholarship

Current Research and Scholarly Interests


Pandemic Preparedness, Physician involvement in disaster management, hospital disaster planning, pre-hospital care, international medicine.

Publications

Journal Articles


  • De qi: Chinese acupuncture patients' experiences and beliefs regarding acupuncture needling sensation--an exploratory survey. Acupuncture in medicine Mao, J. J., Farrar, J. T., Armstrong, K., Donahue, A., Ngo, J., Bowman, M. A. 2007; 25 (4): 158-165

    Abstract

    While de qi, the acupuncture needling sensation, has been considered as an important component of acupuncture, little is known of the acupuncture patient's experience and beliefs about de qi in clinical settings. The aim of this study was to describe Chinese acupuncture patients' perceived sensations of, and beliefs about, acupuncture needling.We developed a questionnaire and conducted a survey study at two time periods among 200 subjects at six outpatient acupuncture clinics in Beijing, China.Respondents were 55% female and had a mean age of 41 years. The most common types of needling sensations reported by subjects were the terms 'distended' (94%), 'sore' (81%), 'electric' (81%) and 'numb' (78%). Eighty-nine percent of subjects reported that the needling sensation travelled away from the puncturing points or travelled among the needling points. Eighty-two percent of subjects believed that the needling sensation was very important for acupuncture treatment, and 68% further indicated that the stronger the needling sensation, the more effective the therapy. Eighty-one percent of subjects found the acupuncture process to be very comfortable and relaxing.Chinese acupuncture patients described the common characteristics of de qi and its migratory nature. The sensations were believed to be important in producing clinical efficacy by most patients. Measuring the sensations described as de qi in future prospective studies will help us understand the degree to which this phenomenon has an effect on the physiological outcome and clinical response to acupuncture. There appears to be a limit to the number of sensations that can be discriminated by each individual patient, and further development of the questionnaire is planned.

    View details for PubMedID 18160926

  • Regional bone mineral density in male athletes: a comparison of soccer players, runners and controls BRITISH JOURNAL OF SPORTS MEDICINE Fredericson, M., Chew, K., Ngo, J., Cleek, T., Kiratli, J., Cobb, K. 2007; 41 (10): 664-668

    Abstract

    To investigate the association of soccer playing and long-distance running with total and regional bone mineral density (BMD).Cross-sectional study.Academic medical centre.Elite male soccer players (n = 15), elite male long-distance runners (n = 15) and sedentary male controls (n = 15) aged 20-30 years.BMD (g/cm2) of the lumbar spine (L1-L4), right hip, right leg and total body were assessed by dual-energy x-ray absorptiometry, and a scan of the right calcaneus was performed with a peripheral instantaneous x-ray imaging bone densitometer.After adjustment for age, weight and percentage body fat, soccer players had significantly higher whole body, spine, right hip, right leg and calcaneal BMD than controls (p = 0.008, p = 0.041, p<0.001, p = 0.019, p<0.001, respectively) and significantly higher right hip and spine BMD than runners (p = 0.012 and p = 0.009, respectively). Runners had higher calcaneal BMD than controls (p = 0.002). Forty percent of the runners had T-scores of the lumbar spine between -1 and -2.5. Controls were similar: 34% had T-scores below -1 (including 7% with T-scores lower than -2.5).Playing soccer is associated with higher BMD of the skeleton at all sites measured. Running is associated with higher BMD at directly loaded sites (the calcaneus) but not at relatively unloaded sites (the spine). Specific loading conditions, seen in ball sports or in running, play a pivotal role in skeletal adaptation. The importance of including an appropriate control group in clinical studies is underlined.

    View details for DOI 10.1136/bjsm.2006.030783

    View details for Web of Science ID 000249621100015

    View details for PubMedID 17473003

  • Effects of ball sports on future risk of stress fracture in runners CLINICAL JOURNAL OF SPORT MEDICINE Fredericson, M., Ngo, J., Cobb, K. 2005; 15 (3): 136-141

    Abstract

    To evaluate whether playing ball sports during childhood and adolescence is associated with the risk of stress fractures in runners later in life.Retrospective cohort study.National track and field championships, held at Stanford University.One hundred fifty-six elite female and 118 elite male distance runners, age 18 to 44 years.A 1-page questionnaire was used to collect data regarding ages during which athletes played basketball and soccer, as well as other important covariates and outcomes.Athletes reported the ages when stress fractures occurred. Time to event was defined as the number of years from beginning competitive running to the first stress fracture or to current age, if no fracture had occurred.In both men and women, playing ball sports in youth correlated with reduced stress fracture incidence later in life by almost half, controlling for possible confounders. In men, each additional year of playing ball sports conferred a 13% decreased incidence of stress fracture (adjusted hazard ratio [HR] and 95% confidence interval, 0.87 [0.79-0.95]. Among women with regular menses, the HR for each additional year of playing ball sports was similar: 0.87 (0.75-1.00); however, there was no effect of length of time played among women with irregular menses (HR, 1.03 [0.92-1.16]). In men, younger ages of playing ball sports conferred more protection against stress fractures (HR for each 1-year-older age at first exposure, 1.29 [1.14, 1.45]).Runners who participate during childhood and adolescence in ball sports may develop bone with greater and more symmetrically distributed bone mass, and with enhanced protection from future stress fractures.

    View details for Web of Science ID 000230329000004

    View details for PubMedID 15867555

  • Physicians and lay people are unable to apply pressure immobilization properly in a simulated snakebite scenario WILDERNESS & ENVIRONMENTAL MEDICINE Norris, R. L., Ngo, J., Nolan, K., Hooker, G. 2005; 16 (1): 16-21

    Abstract

    To determine whether volunteers (with or without prior medical training) can correctly apply pressure immobilization (PI) in a simulated snakebite scenario after receiving standard instructions describing the technique.Twenty emergency medicine physicians (residents and attendings) and 20 lay volunteers without prior formal medical training were given standard printed instructions describing the application of PI for field management of snakebite. They were then supplied with appropriate materials and asked to apply the technique five separate times (twice to another individual [one upper and one lower extremity] and three times to themselves [nondominant upper extremity, dominant upper extremity, and one lower extremity]). Successful application was defined a priori by four criteria previously published in the literature: wrap begins at the bite site, entire extremity is wrapped, splint or sling is applied, and pressures under the dressing are between 40 and 70 mm Hg in upper-extremity application and between 55 and 70 mm Hg in lower-extremity use. Pressures were determined using a specially designed skin interface pressure-measuring device placed at the simulated bite site.The technique was correctly applied as judged by the preset criteria in only 13 out of 100 applications by emergency medicine physicians and in only 5 out of 100 applications by lay people. There was no significant difference in success rates between physicians and lay volunteers. Likewise, there was no significant difference in success based on which extremity was being wrapped. More detailed analysis revealed that the major contributor to failure was inability to achieve recommended target pressures.Volunteers in a simulated snakebite scenario have difficulty applying PI correctly, as defined in the literature. The major source of failure is an inability to achieve recommended pressure levels under the dressing. New methods of instructing people in the proper use of PI or new technologies to guide or automate application are needed if this technique is to be used consistently in an effective manner for field management of bites by venomous snakes not known to cause significant local wound necrosis.

    View details for Web of Science ID 000227979400004

    View details for PubMedID 15813142

  • Efficacy of low-dose acetazolamide (125 mg BID) for the prophylaxis of acute mountain sickness: A prospective, double-blind, randomized, placebo-controlled trial HIGH ALTITUDE MEDICINE & BIOLOGY Basnyat, B., Gertsch, J. H., Johnson, E. W., Castro-Marin, F., Inoue, Y., Yeh, C. 2003; 4 (1): 45-52

    Abstract

    The objective of this study was to determine the efficacy of low-dose acetazolamide (125 mg twice daily) for the prevention of acute mountain sickness (AMS). The design was a prospective, double-blind, randomized, placebo-controlled trial in the Mt. Everest region of Nepal between Pheriche (4243 m), the study enrollment site, and Lobuje (4937 m), the study endpoint. The participants were 197 healthy male and female trekkers of diverse background, and they were evaluated with the Lake Louise Acute Mountain Sickness Scoring System and pulse oximetry. The main outcome measures were incidence and severity of AMS as judged by the Lake Louise Questionnaire score at Lobuje. Of the 197 participants enrolled, 155 returned their data sheets at Lobuje. In the treatment group there was a statistically significant reduction in incidence of AMS (placebo group, 24.7%, 20 out of 81 subjects; acetazolamide group, 12.2%, 9 out of 74 subjects). Prophylaxis with acetazolamide conferred a 50.6% relative risk reduction, and the number needed to treat in order to prevent one instance of AMS was 8. Of those with AMS, 30% in the placebo group (6 of 20) versus 0% in the acetazolamide group (0 of 9) experienced a more severe degree of AMS as defined by a Lake Louise Questionnaire score of 5 or greater (p = 0.14). Secondary outcome measures associated with statistically significant findings favoring the treatment group included decrease in headache and a greater increase in final oxygen saturation at Lobuje. We concluded that acetazolamide 125 mg twice daily was effective in decreasing the incidence of AMS in this Himalayan trekking population.

    View details for Web of Science ID 000181896400005

    View details for PubMedID 12713711

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