Articles: emergency-medical-services.
-
In August 1988 an aircraft of the Italian aerobatic display team fell into the spectator enclosure at the Ramstein Airshow, causing over 500 casualties. The survivors were triaged, treated and evacuated from Ramstein within 96 minutes. The speed and efficiency of this evacuation was a result of prior planning, thorough training, medical reinforcement, co-operation with other agencies and the availability of an abundance of vehicles for both air and road evacuation. Not suprisingly, though, problems did occur, especially with communications, casualty identification and documentation.
-
The injuries likely to occur during a future general war will differ in severity and number from those experienced during recent short campaigns, terrorist incidents and natural disasters. If general war should break out in Europe, casualty numbers will lean towards the First World War rather than the Second in scale. Medical assets can expect, at least temporarily, to be overwhelmed with casualties. ⋯ Sorting will be achieved by the application of a crude scoring system known as Military Triage. We examine this concept and discuss its likely effectiveness in a scenario characterised by limited medical resources and a high flow of casualties. With the widespread introduction of modern and complex injury severity scoring systems into civilian trauma practice it is timely to examine their potential role in augmenting or replacing the current Military Triage system.
-
Following a large earthquake in Nepal, the experience of a small hospital in dealing with the resulting mass casualties is described. The value of pre-planning and effective triage of the injured is stressed, and aspects of surgical and medical care specific to earthquake victims discussed. Clinical and administrative challenges encountered in mounting a major relief exercise in a Third World setting are also described. frequent exercising of military hospitals and personnel in handling mass casualties is an applicable to civilian natural catastrophies as to battlefield medical support.
-
J Paediatr Child Health · Feb 1990
Paediatric post-injury management: a hospital-based review of deaths.
In order to begin to evaluate the need for an integrated trauma management service for injured children, a retrospective review of deaths following admission to a suburban teaching hospital was conducted. The medical records and coroners' reports for 64 consecutive cases over 68 months were reviewed, looking for errors in care which may have contributed to fatal outcomes. There was a male predominance (64%). ⋯ This can be explained partly by the predominance of what were judged to be irretrievable intracranial injuries (90%) in patients suffering blunt injuries. In contrast, an analysis of the same patient group revealed that in 30-50% the fatality could have been prevented by the full application of well recognized safety strategies. While strategies such as triage and trauma teams should reduce the error rate, it is yet to be proven that optimal post-injury care will significantly reduce mortality.
-
All patient care aspects of prehospital health care delivery must be physician directed. This process of medical accountability seeks to assure quality EMS patient care. Emphasis in this chapter is on the two main configurations of EMS medical accountability, off-line medical direction and on-line medical control. Topics include EMS physician qualifications, responsibilities, and authority; the role of protocols and standing orders; medical control configurations; and others.