Annals of emergency medicine
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Law enforcement agencies are recognizing the need to have emergency medical care available at the scene of any incident involving tactical operations. The potentially volatile and dangerous atmosphere surrounding tactical operations is conducive to severe injury to officers, hostages, suspects, and bystanders. This mandates the immediate availability of basic and advanced life support services. ⋯ It also may disrupt the law enforcement mission. These factors mandate a different set of field assessment and treatment priorities. To meet these needs, selected prehospital personnel and emergency physicians train to work with and support special weapons and tactics teams.
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Hospital disaster planning should encompass events that affect the safety of the hospital environment and address those measures that ensure the availability of necessary services. Although most of the emphasis has been placed on general disaster planning, there is little written about disasters occurring within a hospital. In recent years, several incidents at our medical center involving fire, flood, and power failure resulted in a reevaluation of our preparedness to handle such situations. These experiences prompted this discussion and literature review of internal disaster plan because it is likely that at some time an internal emergency may occur.
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To determine whether intracranial hemorrhage is a predictor of occult cervical-spine fracture. ⋯ Despite a high percentage of patients with traumatic intracranial hemorrhage, our study failed to demonstrate that intracranial hemorrhage is predictor of occult cervical-spine fracture.
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To determine the feasibility of a case-finding program for cognitive impairment in elderly emergency department patients, and to describe the prevalence of cognitive impairment in screened patients and identify factors associated with impairment. ⋯ Screening for cognitive impairment in elderly ED patients using the OMC Test is feasible. There is a high prevalence of cognitive impairment in elderly ED patients, and the prevalence increases with age. Identification of cognitive impairment is important in the assessment of elderly ED patients and may affect clinical evaluation, patients' understanding of medical information, and compliance with discharge instructions.
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To determine the effect of Hurricane Andrew on a pediatric emergency department. ⋯ Following a hurricane, personnel in a pediatric ED can expect to see an increased census, with more diagnoses of open wounds, gastroenteritis, and skin infections. They may also see hydrocarbon and bleach ingestions. Alerting parents to the potential for injury and accidental poisoning in their children after a hurricane may help prevent the reported morbidity.