Prehospital and disaster medicine
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Prehosp Disaster Med · Apr 1997
Case ReportsAn eight-year review of legal cases related to an urban 9-1-1 paramedic service.
An eight year retrospective analysis was conducted to determine the type and outcome of lawsuits related to the provision of 9-1-1 paramedic service in an urban environment. ⋯ The data suggest that motor vehicle collisions are a significant medical-legal risk to the EMS community. In addition, it was found that the use and lack of use of seatbelts was an important component in many of the suits.
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Prehosp Disaster Med · Apr 1997
A model for a statewide critical incident stress (CIS) debriefing program for emergency services personnel.
Emergency services personnel are highly vulnerable to acute and cumulative critical incident stress (CIS) that can manifest as anger, guilt, depression, and impaired decision-making, and, in certain instances, job loss. Interventions designed to identify such distress and restore psychological functioning becomes imperative. ⋯ CIS debriefings are judged as beneficial. A statewide response team is an effective way to provide these services at no cost to agencies.
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Prehosp Disaster Med · Apr 1997
Comparative Study Clinical TrialParamedic interpretation of prehospital lead-II ST-segments.
To determine the reliability of ST-segment interpretation by paramedics from lead-II rhythm strips obtained in the prehospital setting. ⋯ Field interpretation of ST-segments by paramedics is fairly accurate as judged both by emergency physicians and correlation with final patient outcome, but its clinical utility is unproved. A small but clinically significant number of outliers, consisting of markedly discrepant false positives, reflects paramedic uncertainty in identifying the deviations of the ST-segment.
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Prehosp Disaster Med · Apr 1997
ReviewLessons learned and unsolved public health problems after large-scale disasters.
This paper examines the considerable medical and psychological problems that ensue after disasters in which massive populations are affected for extended and sometimes unknown time periods. The organization of disaster response teams after large-scale disasters is based on experiences as a medical specialist at Chernobyl immediately after this catastrophe. Optimal ways of dealing with the immediate medical and logistical demands as well as long-term public health problems are explored with a particular focus on radiation disasters. Other lessons learned from Chernobyl are explained. ⋯ The use of a mobile diagnostic and continuously operating pre-hospital triage system for rapid health screening of large populations at different stages after a large-scale disaster is advisable. The functional systems of the body to be observed at different stages after a radiation disaster are specified. There is a particularly strong need for continued medical and psychosocial evaluation of radiation-exposed populations over an extended time and a need for international collaboration among investigators.
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Prehosp Disaster Med · Apr 1997
ReviewEmergency Medical Services System in Hong Kong: a pearl in the South China Sea.
Each Emergency Medical Services (EMS) system is unique in its development and scope of practice. In many instances, it incorporates components of other models. ⋯ This article describes the EMS system that exists in Hong Kong. It explores the changes that are occurring, defines the relationship between Hong Kong and China, and considers the influence that this evolving model might have on China after 1997.