Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
To determine if a ventilator available in an emergency department could quickly be modified to provide ventilation for four adults simultaneously. ⋯ A single ventilator may be quickly modified to ventilate four simulated adults for a limited time. The volumes delivered in this simulation should be able to sustain four 70-kg individuals. While further study is necessary, this pilot study suggests significant potential for the expanded use of a single ventilator during cases of disaster surge involving multiple casualties with respiratory failure.
-
As part of the broader "science of surge" consensus initiative sponsored by Academic Emergency Medicine, this report addresses the issues of detection and situational awareness as they relate to surge in the practice of emergency medicine. The purpose of this report, and the breakout group that contributed to its content, was to provide emergency physicians and other stakeholders in the emergency medicine community a sense of direction as they plan, prepare for, and respond to surge in their practice.
-
Both the naturally occurring and deliberate release of a biological agent in a population can bring catastrophic consequences. Although these bioevents have similarities with other disasters, there also are major differences, especially in the approach to triage management of surge capacity resources. Conventional mass-casualty events use uniform methods for triage on the basis of severity of presentation and do not consider exposure, duration, or infectiousness, thereby impeding control of transmission and delaying recognition of victims requiring immediate care. ⋯ Whatever triage system is used, it must first recognize the requirements of those Susceptible but not exposed, those Exposed but not yet infectious, those Infectious, those Removed by death or recovery, and those protected by Vaccination or prophylactic medication (SEIRV methodology). Everyone in the population falls into one of these five categories. This article addresses a population approach to SEIRV-based triage in which decision making falls under a two-phase system with specific measures of effectiveness to increase likelihood of medical success, epidemic control, and conservation of scarce resources.
-
Between 1993 and 2003, visits to U. S. emergency departments (EDs) increased by 26%, to a total of 114 million visits annually. At the same time, the number of U. ⋯ In this article, the authors begin by describing the overlap between the research agendas on daily surge capacity and patient flow. Next, they propose two models that have potential applications for both daily surge capacity and hospitalwide patient-flow research. Finally, they identify potential research questions that are based on applications of the proposed research models.