Prehospital and disaster medicine
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Prehosp Disaster Med · Jun 2019
ReviewParamedic Disaster Health Management Competencies: A Scoping Review.
Paramedics are tasked with providing 24/7 prehospital emergency care to the community. As part of this role, they are also responsible for providing emergency care in the event of a major incident or disaster. They play a major role in the response stage of such events, both domestic and international. Despite this, specific standardized training in disaster management appears to be variable and inconsistent throughout the profession. A suggested method of building disaster response capacities is through competency-based education (CBE). Core competencies can provide the fundamental basis of collective learning and help ensure consistent application and translation of knowledge into practice. These competencies are often organized into domains, or categories of learning outcomes, as defined by Blooms taxonomy of learning domains. It is these domains of competency, as they relate to paramedic disaster response, that are the subject of this review. ⋯ The most common domains of core competencies for paramedic first responders to manage major incidents and disasters described in the literature were identified. If it's accepted that training paramedics in disaster response is an essential part of preparedness within the disaster management cycle, then by including these competency domains into the curriculum development of localized disaster training programs, it will better prepare the paramedic workforce's competence and ability to effectively respond to disasters and major incidents.
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Prehosp Disaster Med · Apr 2019
The Tsukui (Japan) Yamayuri-en Facility Stabbing Mass-Casualty Incident.
In July 2016, a mass-casualty stabbing attack took place at a facility for disabled persons located in Sagamihara City (Kanagawa Prefecture, Japan). The attack resulted in 45 casualties, including 19 deaths. The study hospital dispatched physicians to the field and admitted multiple casualties. This report aimed to review the physicians' experiences and to provide insights for the formulation of response measures for similar incidents in the future. ⋯ Regional core disaster medical hospitals must take on a central role, particularly in the case of local disasters. Horizontal communication and interactions should be reinforced by devising protocols and conducting joint training for effective inter-department collaborations on the field.Maruhashi, T, Takeuchi, I, Hattori, J, Kataoka, Y, Asari, Y. The Tsukui (Japan) Yamayuri-en facility stabbing mass-casualty incident. Prehosp Disaster Med. 2019;34(2):203-208.
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Prehosp Disaster Med · Apr 2019
Development and Implementation of a Disaster Medicine Certificate Series (DMCS) for Medical Students.
The recent increase in natural disasters and mass shootings highlights the need for medical providers to be prepared to provide care in extreme environments. However, while physicians of all specialties may respond in emergencies, disaster medicine training is minimal or absent from most medical school curricula in the United States. A voluntary Disaster Medicine Certificate Series (DMCS) was piloted to fill this gap in undergraduate medical education. ⋯ The DMCS voluntary certificate series model served as an innovative method for providing disaster medicine education to medical students.Kommor MB, Hodge B, Ciottone G. Development and implementation of a Disaster Medicine Certificate Series (DMCS) for medical students. Prehosp Disaster Med. 2019;34(2):197-202.
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Prehosp Disaster Med · Apr 2019
Comparative StudyA Cross-Over Trial Comparing Conventional to Compression-Adjusted Ventilations with Metronome-Guided Compressions.
Hyperventilation during cardiopulmonary resuscitation (CPR) negatively affects cardiopulmonary physiology. Compression-adjusted ventilations (CAVs) may allow providers to deliver ventilation rates more consistently than conventional ventilations (CVs). This study sought to compare ventilation rates between these two methods during simulated cardiac arrest.Null Hypothesis:That CAV will not result in different rates than CV in simulated CPR with metronome-guided compressions. ⋯ In this simulated model of cardiac arrest, CAV had more accurate ventilation rates and fewer episodes of hyperventilation compared with CV.Nikolla DA, Kramer BJ, Carlson JN. A cross-over trial comparing conventional to compression-adjusted ventilations with metronome-guided compressions. Prehosp Disaster Med. 2019;34(2):220-223.
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Prehosp Disaster Med · Apr 2019
Randomized Controlled TrialThe Impact of Backboard Placement on Chest Compression Quality: A Mannequin Study.
High-quality chest compressions (CCs) are associated with high survival rates and good neurological outcomes in cardiac arrest patients. The 2015 American Heart Association (AHA; Dallas, Texas USA) Guidelines for Resuscitation defined and recommended high-quality CCs during cardiopulmonary resuscitation (CPR). However, CPR providers struggle to achieve high-quality CCs. There is a debate about the use of backboards during CPR in literature. Some studies suggest backboards improve CC quality, whereas others suggest that backboards can cause delays. This is the first study to evaluate all three components of high-quality CCs: compression depth, recoil depth, and rate, at the same time with a high number of subjects. This study evaluated the impact of backboards on CC quality during CPR. The primary outcome was the difference in successful CC rates between two groups. ⋯ The results suggest that using a backboard during CPR improves the quality of CCs in accordance with the 2015 AHA Guidelines.Sanri E, Karacabey S. The impact of backboard placement on chest compression quality: a mannequin study. Prehosp Disaster Med. 2019;34(2):182-187.