Annals of emergency medicine
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Multicenter Study Comparative Study
Light intensity of curved laryngoscope blades in Philadelphia emergency departments.
Laryngoscopy and tracheal intubation requires laryngeal exposure and illumination. The objective of this study is to assess variation in laryngoscope lights across different emergency departments (EDs). ⋯ Curved laryngoscope blades in different EDs have marked variation in light intensity. The contribution of luminance to laryngoscopy performance warrants investigation.
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Comparative Study
A comparison of plastic single-use with metallic reusable laryngoscope blades for out-of-hospital tracheal intubation.
The objective of this study was to compare, in the emergency out-of-hospital environment, intubation success rates during the first laryngoscopy for 2 laryngoscope blade types: a metallic reusable and a plastic single-use. ⋯ In out-of-hospital emergency care, the use of a plastic disposable laryngoscope blade decreased the success rate of tracheal intubation at the first attempt performed by emergency care providers.
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National policy for emergency preparedness calls for hospitals to accommodate surges of 500 new patients per million population in a disaster, but published studies have not evaluated the ability of existing resources to meet these goals. We describe typical statewide and regional hospital occupancy and patterns of variation in occupancy and estimate the ability of hospitals to accommodate new inpatients. ⋯ Typically, there are not enough vacant hospital beds available to serve 500 children per million population. Modified standards of hospital care to expand capacity may be necessary to serve children in a mass-casualty event.
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Out-of-hospital endotracheal intubation is a complex intervention. One strategy for improving the quality of a complex intervention is to limit the procedure to practitioners or agencies that meet minimum procedure experience standards. The system-level influence of such limits is unknown. We seek to determine how minimum endotracheal intubation experience standards influence the number and distribution of out-of-hospital endotracheal intubations. ⋯ Minimum endotracheal intubation experience standards would result in absolute and relative reductions in total and subgroup endotracheal intubations. These findings provide vital perspectives about the system-wide organization of out-of-hospital airway management.
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Over large expanses, the risk for hospital damage from an earthquake attenuates as the distance from the epicenter increases, which may not be true within the immediate disaster zone (near field), however. The following study examines the impact of epicenter distance and ground motion on hospital evacuation and closure for those structures near the epicenter of the 1994 Northridge Earthquake and the implications for patient evacuation. ⋯ The distances from the epicenter for evacuated or condemned facilities and control hospitals do not appear to differ in the near field. Peak ground acceleration is a superior indicator of the risk for hospital damage and evacuation. Physicians can obtain these data in real time from the Internet and should transfer patients to facilities in areas of lower recorded peak ground acceleration regardless of distance from the epicenter.