American journal of disaster medicine
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Randomized Controlled Trial Comparative Study
A comparison of different types of hazardous material respirators available to anesthesiologists.
Despite anesthesiology personnel involvement in initial treatment of patients exposed to potentially lethal agents, less than 40 percent of US anesthesiology training programs conduct training to manage these patients.(1) No previous studies have evaluated performance of anesthesiologists wearing protective gear. The authors compared the performance of anesthesiologists intubating a high-fidelity mannequin while wearing either a powered air-purifying respirator (PAPR) or a negative pressure respirator (NPR). ⋯ The use of an NPR or PAPR does not preclude an anesthesiologist from successfully intubating, but practice is necessary. The slightly better performance with the NPR is weighed against the improved comfort of the PAPR and the fact that PAPR users could wear eyeglasses. Neither type of gear allowed the users to auscultate the lung fields to confirm correct endotracheal tube placement.
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Little work has been devoted to the links between natural disasters, subsequent Emergency Medical Services (EMS) network utilization, triage, and public awareness. The aim of this study was to investigate the types and distribution of emergency calls recorded after each South Florida hurricane during the 2005 season, identifying target areas for public health education, and emergency personnel use and training. ⋯ This study suggests that 911 calls regarding respiratory complaints, convulsions, seizures, and hazardous situations can be expected to significantly increase after a hurricane. Educational initiatives, EMS resource allocation, and modified triage systems designed to target these areas may limit EMS system-wide strain and improve health outcomes following natural disasters.
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On January 12, 2010, one of the most destructive earthquakes in history struck the Haitian capital Port-au-Prince. This study aims to characterize the impact of the earthquake and humanitarian response on well being of the affected households as means of evaluating the effectiveness of response efforts. ⋯ The immediate impacts of injury and mortality had marginal influences on long-term household economic security, whereas displacement into camps was stongly associated with negative outcomes for income, employment, and food access.
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The provision of critical care in any environment is resource intensive. However, the provision of critical care in an austere environment/mass disaster zone is particularly challenging. ⋯ Based primarily on our experiences at a field hospital in Haiti, we created a short guide to critical care in a mass disaster in an austere environment. This guide will be useful to the team of physicians, nurses, respiratory care, logistics, and other support personnel who volunteer in future critical care relief efforts in limited resource settings.
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Little is known about the capacity and activity of emergency medical services (EMS) during large-scale disasters. This article provides a case study of the role of EMS in one large urban city during a major hurricane. ⋯ A strategy for managing surges in prehospital care from major disasters is a requirement for modern EMS.