Articles: emergency-medical-services.
-
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.
-
Emerg. Med. Clin. North Am. · Feb 1990
ReviewMass casualty incident. Integration with prehospital care.
Mass casualty incident involves the use of limited resources for multiple casualties. The emergency physician must be familiar with both prehospital and hospital plans for mass casualty care in order to facilitate optimal care and to maintain the continuum from field care to definitive treatment. ⋯ Emergency physicians involved in prehospital care should be certain that the local EMS system has adequate training and chances to update their skills and knowledge. Disaster drills of the EMS system are excellent ways to practice, to identify weaknesses, and for preplanning to enhance disaster medical care.
-
Emerg. Med. Clin. North Am. · Feb 1990
ReviewCommunication with emergency medical services providers.
Communication between the emergency medical services provider and the emergency physician can be either a rewarding or a frustrating experience. As many emergency physicians have found to their chagrin, the EMS provider has a memory for mistakes or bad tidings. This article discusses the relationship between EMS providers and emergency physicians.
-
Emerg. Med. Clin. North Am. · Feb 1990
Emergency medical services legal issues for the emergency physician.
This article discusses the elements of the legal system that impact emergency physicians and their legal responsibilities. It addresses the specific responsibilities of the emergency physician providing on-line direction to EMS units in the field, and the legal principles that control. Special emphasis is placed on compliance with new federal legislation and addressing medical-legal issues presented by field personnel during patient care situations.
-
The purpose of this study was to determine the effectiveness and associated problems of emergency intubation in 605 injured infants and children admitted to the Children's Hospital of Pittsburgh in 1987. We identified 63 patients (10.4%) undergoing endotracheal intubation at the scene of injury, at a referring hospital or in our emergency department. Injuries were to the head (90.5%), abdomen (12.7%), face (11.1%), chest (6.3%), neck (3.2%); or were orthopedic (19%) or multiple (39.7%). ⋯ Head injury with coma is the most common setting for emergency intubation. Airway complications are common, and are more frequent in treatment attempt at the scene. Despite endotracheal intubation, injured children in our series remain at high risk for hypoxemia, elevated arterial PCO2, and major airway complications, all of which contribute to secondary brain injury.