Prehospital and disaster medicine
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Prehosp Disaster Med · Jan 2002
ReviewNational strategy for mass casualty situations and its effects on the hospital.
A mass-casualty situation (MCS) usually is short in duration and resolves itself. To minimize the risks to patients during MCS, planning is essential. This article summarizes the preparations needed at the hospital level, for a local MCS involving numerous trauma victims arriving to the Emergency Department at a short notice. ⋯ It is based upon knowledge of management techniques that used multi-level documents, which are spread via Intranet between the different key figures. Using this method, it is possible to keep the strategy, the source documentation, and reasons for choosing it, as well as immediate release of checklists for each functions. This detailed, time consuming work is worthwhile in the long run, when the benefits of easy updating and better preparedness are apparent.
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Prehosp Disaster Med · Jan 2002
Comparative StudyPreventing post-injury hypothermia during prolonged prehospital evacuation.
Post-injury hypothermia is a risk predictor in trauma patients whose physiology is deranged. The aim of the present study was to examine the effect of simple, in-field, hypothermia prevention to victims of penetrating trauma during long prehospital evacuations. ⋯ Simple, preventive, in-field measures help to prevent hypothermia during protracted evacuation, and should be part of the trauma care protocol in rural rescue systems.
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Prehosp Disaster Med · Jan 2002
Emergency medical assistance team response following Taiwan Chi-Chi earthquake.
On 21 September, 1999, an earthquake measuring 7.3 on the Richter scale, struck central Taiwan near the town of Chi-Chi. The event resulted in 2,405 deaths and 11,306 injuries. Ad hoc emergency medical assistance teams (EMATs) from Taiwan assumed the responsibility for initiating early assessments and providing medical care. ⋯ 1. The response from EMATs was impressive, but largely uncoordinated in the absence of a pre-existing dispatching mechanism. 2. Most of the EMATs required > 24 hours to reach the disaster sites, and generally, did not arrive in time of affect the outcome of victims with preventable deaths. Therefore, there is an urgent need to strengthen local prehospital care. 3. A central governmental body that ensures better horizontal and vertical integration, and a comprehensive emergency management system is required in order to improve future disaster response and mitigation efforts.
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Prehosp Disaster Med · Jan 2002
Physician attitudes about prehospital 12-lead ECGs in chest pain patients.
The prehospital 12-lead electrocardiogram (ECG) has become a standard of care. For the prehospital 12-lead ECG to be useful clinically, however, cardiologists and emergency physicians (EP) must view the test as useful. This study measured physician attitudes about the prehospital 12-lead ECG. ⋯ Prehospital 12-lead ECGs generally are perceived as worthwhile by cardiologists and EPs. Cardiologists have a higher opinion of the value and utility of field ECGs. Since the reduction in mortality from the 12-lead ECG is small, it is likely that positive physician attitudes are attributable to other factors.
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Prehosp Disaster Med · Jan 2002
Evaluation of a semi-quantitative CO2 monitor with pulse oximetry for prehospital endotracheal tube placement and management.
To evaluate three prototype versions of semi-quantitative end-tidal CO2 monitors with different alarm features during prehospital or interfacility use. ⋯ "Breath beeps" were clearly audible and were a useful feature in all prehospital and transport environments, while audible alarms were desired only in the AirEvac situation. Semi-quantitative CO2 detection is valuable in the ALS/AirEvac environment, even for teams with high intubation success rates.