To see the other types of publications on this topic, follow the link: Rapid medical rescue.
Journal articles on the topic 'Rapid medical rescue'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Rapid medical rescue.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Wang, Kui Ying, Kai Wen Hou, and Yun Gui Wang. "Research on City Rapid Medical Decision System Based on GIS." Applied Mechanics and Materials 686 (October 2014): 253–57. http://dx.doi.org/10.4028/www.scientific.net/amm.686.253.
Full textAbstract:
In order to guarantee the validity of the city emergency rescue, it will need to feedback goods demand and injuries to guide accident emergency rescue center in a timely, and also we need to fully grasp with emergency supplies and emergency hospital. Considering the effectiveness of city emergency rescue and timeliness, the paper analyzes and design Rescue Decision Support System for city distribution of emergency supplies and search of wounded man based on GIS. Emergency medical aid model established in this paper, taking ArcGIS+VS2005 as the development platform, C# as development language, design and development the preliminary city emergency medical rescue simulation system based on GIS.
2
Scofield, T. "Helicopter Rescue in the Vietnam War." Journal of the World Association for Emergency and Disaster Medicine 1, no. 1 (1985): 55–56. http://dx.doi.org/10.1017/s1049023x00032702.
Full textAbstract:
The medical successes realized in Vietnam can be attributed to several factors: rapid evacuation of casualties by helicopter or ambulances; the availability of whole blood; well-equipped field hospitals; highly skilled and well-organized surgical teams; and improved medical management. Of these important factors, rapid evacuation by helicopter contributed the most to saving the lives of the wounded. Without effective helicopter evacuation, it would have been difficult to exploit the other factors and management of medical resources would have been less efficient.
3
Jaslow, David, Nathaniel Zahustecher, Fred Ellinger, Derek Zecher, and Ryan Overberger. "An Emergency Medical Triage Tool for Swiftwater Rescue." Prehospital and Disaster Medicine 34, s1 (May 2019): s125—s126. http://dx.doi.org/10.1017/s1049023x19002711.
Full textAbstract:
Introduction:Climate change and overdevelopment increase the intensity and frequency of flash flooding, which may generate more swiftwater rescue (SWR) incidents. Rescue personnel may fail to properly risk stratify (triage) these victims due to limited medical and/or variable SWR training, or due to an adverse rescuer-to-victim ratio. Some victims may attempt to refuse medical evaluation due to lack of awareness of incident-related morbidity and/or comprehension of risk.Aim:To develop an SWR emergency medical triage tool.Methods:A cross-sectional literature search identified SWR-related medical conditions. A flow diagram reliant upon incident history, chief complaint, and observational exam rather than interpretation of vital signs was created to guide medical decision-making.Results:Every SWR victim should receive a medical screening exam focused on six clinical categories—drowning, hypothermia, hazmat exposure, physical trauma, psychological trauma and exacerbation of pre-existing disease. Drowning potential is identified by dyspnea, new cough or a history of (even brief) submersion. Shivering SWR victims and those with altered mental status but no shivering are assumed to be hypothermic. Any victim with open skin lesions/wounds who was immersed in floodwater and anyone who has swallowed floodwater is contaminated; these victims require decontamination and possible antibiotic therapy. SWR victims injured upon entering the water or from contact with either water-borne stationary or floating objects require trauma evaluation. Distraught victims and those who exhibit exacerbation of pre-existing organ-system disease also require ED evaluation.Discussion:Most SWR course curricula are oriented towards technical rescue; they do not address comprehensive medical decision-making. We present a rapid medical screening exam designed to determine which SWR victims require an ED evaluation. Such a triage tool will assist rescuers to simultaneously honor patient autonomy and avoid risky and uninformed refusal of medical aid. Simplified medical decision-making should enable the application of this tool worldwide.
4
Bai, Song, Bao-guo Yu, Yong-Zhong Zhang, Hui Ding, Zhou-wei Wu, Bin Fan, Hao-jun Fan, Shi-ke Hou, and Feng Chen. "Challenges of Treating Adenovirus Infection: Application of a Deployable Rapid-Assembly Shelter Hospital." Disaster Medicine and Public Health Preparedness 12, no. 1 (March 6, 2017): 109–14. http://dx.doi.org/10.1017/dmp.2016.187.
Full textAbstract:
AbstractThis article outlines the evolution of a rescue team in responding to adenovirus prevention with a deployable field hospital. The local governments mobilized a shelter hospital and a rescue team consisting of 59 members to assist with rescue and response efforts after an epidemic outbreak of adenovirus. We describe and evaluate the challenges of preparing for deployment, field hospital maintenance, treatment mode, and primary treatment methods. The field hospital established at the rescue scene consisted of a medical command vehicle, a computed tomography shelter, an X-ray shelter, a special laboratory shelter, an oxygen and electricity supply vehicle, and epidemic prevention and protection equipment. The rescue team comprised paramedics, physicians, X-ray technicians, respiratory therapists, and logistical personnel. In 22 days, more than 3000 patients with suspected adenovirus infection underwent initial examinations. All patients were properly treated, and no deaths occurred. After emergency measures were implemented, the spread of adenovirus was eventually controlled. An emergency involving infectious diseases in less-developed regions demands the rapid development of a field facility with specialized medical personnel when local hospital facilities are either unavailable or unusable. An appropriate and detailed prearranged action plan is important for infectious diseases prevention. (Disaster Med Public Health Preparedness. 2018;12:109–114)
5
Chen, Yu, Jia Shun Ren, Zhi Hao Zheng, Yu Xiang, and Wei Yuan Wang. "Development of Satellite/3G+ Multi-Link Communication Terminal Based on Medical Rescue Information System." Applied Mechanics and Materials 651-653 (September 2014): 1835–39. http://dx.doi.org/10.4028/www.scientific.net/amm.651-653.1835.
Full textAbstract:
This paper introduces a satellite /3G+ multi-link communication terminal based on medical rescue information system, which provides 3G wireless network and satellite communication services and integrates cellular phone, maritime satellite terminal, BeiDou user device and Iridium phone [1]. The new terminal could improve the communication adaptability and transmission efficiency for the emergency medical rescue information system even in hostile environmental conditions [2] (such as earthquake, flood, and war). Tests showed that: this terminal has the advantages of simple access, rapid switch, efficient transmission, it can also guarantee timely and effective interaction of all kinds of information, so as to ensure the time-effect treatment for emergency medical rescue system [3].
6
Köhler, A. F., and P. Dürner. "Operations of Rescue Helicopters and Ambulance Aircrafts at Aircraft and Airport Disasters." Journal of the World Association for Emergency and Disaster Medicine 1, no. 2 (1985): 123–24. http://dx.doi.org/10.1017/s1049023x00065201.
Full textAbstract:
In aircraft and airport disasters help must reach the site of the accident in a very short time. In addition to the ground rescue service, rescue helicopters can also offer help. The rescue helicopter as a mobile intensive care unit contains a medical crew with a flying physician and a paramedic. The following are required basic equipment for rescue helicopters: resuscitation apparatus with and without oxygen; endotracheal intubation set; suction unit; apparatus for measuring blood pressure; infusion sets and solutions with intravenous cannulas; syringes and needles; bandages; special burn dressings; fixation and splinting material; vacuum mattress; surgical pocket kit; stomach tube; ECG monitor; defibrillator with pacemaker; drugs; and otoscope. This medical equipment has to be portable so that it can be used outside the rescue helicopter.The medical crew must be trained in emergency medical treatment and in aeromedical problems. Patients who are fit to fly can be transported by rescue helicopters after triage and support of their vital functions. This method is of most value if rapid transport to a distant specialized medical department, for example, to a burn or neurosurgery center, is required.The German Air Rescue operates seven rescue helicopters at five rescue helicopter centers for primary rescue with the helicopter types BO 105 CBS, BO 105, Bell 206 Long Ranger and 3et Ranger. Another important function of the service are long distance flights with patients to medical centers after aircraft and airport disasters. Specially equipped ambulance aircraft are used in these cases.
7
Nadolny, Klaudiusz, Jerzy Robert Ładny, Daniel Ślęzak, Mateusz Komza, and Robert Gałązkowski. "ANALYSIS OF MEDICAL RESCUE OPERATIONS PERFORMED BY MEDICAL RESCUE TEAMS FROM ALL OVER POLAND IN PATIENTS WITH BURN WOUNDS." Wiadomości Lekarskie 72, no. 1 (January 2019): 26–30. http://dx.doi.org/10.36740/wlek201901105.
Full textAbstract:
Introduction: A burn is a superficial or deep tissue damage caused by the action of: heat (high temperature), chemicals, electric current, solar rays and ionizing radiation. The aim: To analyze the trips of emergency medical teams in the period from November 1, 2017 to April 30, 2018 to patients diagnosed with burns throughout the country. Materials and methods: The analysis covers the whole of Poland, all medical rescue teams. The obtained data comes from the System of Supporting the State Medical Rescue System. The analysis includes the characteristics of the population studied and the medicines used. The study included those that ended with the diagnosis of burns (T-20 to T-32). Taking into account the above criteria, 547 cases were obtained. Results: In 321 cases, there were women and 226 cases of men (58.68% vs 41.32%, p <0.001). More often, it referred to patients over 18 (317 cases vs. 193 below 18 years of age, p <0.001) in 37 cases no data. Most events were recorded in the Masovian and Silesian voivodships (12.97% and 11.33%) and the least in Podlasin (2.92%). In 20.47% of cases, pain treatment was applied, of which in the group of adults in 25.23% vs. 1658% in children, p <0.001. Conclusions: The above results of medical emergency teams’ activities indicate insufficient pharmacological treatment, which requires rapid improvement.
8
Barbera, Joseph A., and Michael Lozano. "Urban Search and Rescue Medical Teams: FEMA Task Force System." Prehospital and Disaster Medicine 8, no. 4 (December 1993): 349–55. http://dx.doi.org/10.1017/s1049023x00040656.
Full textAbstract:
AbstractRecent national and international disasters involving collapsed structures and trapped casualties (Mexico City; Armenia; Iran; Philippines; Charleston, South Carolina; Loma Prieta, California; and others) have provoked a heightened national concern for the development of an adequate capability to respond quickly and effectively to this type of calamity. The Federal Emergency Management Agency (FEMA) has responded to this need by developing an Urban Search and Rescue (US&R) Response System, a national system of multi-disciplinary task forces for rapid deployment to the site of a collapsed structure incident. Each 56person task force includes a medical team capable of providing advanced emergency medical care both for task force members and for victims located and reached by the sophisticated search, rescue, and technical components of the task force. This paper reviews the background and development of urban search and rescue, and describes the make-up and function of the Federal Emergency Management Agency (FEMA) Task Force medical teams.
9
Chen, Xinlin, Lu Lu, Jie Shi, Xin Zhang, Haojun Fan, Bin Fan, Bo Qu, Qi Lv, and Shike Hou. "Application and Prospect of a Mobile Hospital in Disaster Response." Disaster Medicine and Public Health Preparedness 14, no. 3 (April 22, 2020): 377–83. http://dx.doi.org/10.1017/dmp.2020.113.
Full textAbstract:
ABSTRACTDisasters such as an earthquake, a flood, and an epidemic usually lead to large numbers of casualties accompanied by disruption of the functioning of local medical institutions. A rapid response of medical assistance and support is required. Mobile hospitals have been deployed by national and international organizations at disaster situations in the past decades, which play an important role in saving casualties and alleviating the shortage of medical resources. In this paper, we briefly introduce the types and characteristics of mobile hospitals used by medical teams in disaster rescue, including the aspects of structural form, organizational form, and mobile transportation. We also review the practices of mobile hospitals in disaster response and summarize the problems and needs of mobile hospitals in disaster rescue. Finally, we propose the development direction of mobile hospitals, especially on the development of intelligence, rapid deployment capabilities, and modularization, which provide suggestions for further research and development of mobile hospitals in the future.
10
Haagensen, Rolf, Karl-Åke Sjøborg, Anders Rossing, Henry Ingilæ, Lars Markengbakken, and Peter-Andreas Steen. "Long-Range Rescue Helicopter Missions in the Arctic." Prehospital and Disaster Medicine 19, no. 2 (June 2004): 158–63. http://dx.doi.org/10.1017/s1049023x00001679.
Full textAbstract:
AbstractBackground:Search and rescue helicopters from the Royal Norwegian Air Force conduct ambulance and search and rescue missions in the Barents Sea. The team on-board includes an anesthesiologist and a paramedic. Operations in this area are challenging due to long distances, severe weather conditions, and arctic winter darkness.Methods:One-hundred, forty-seven ambulance and 29 search and rescue missions in the Barents Sea during 1994–1999 were studied retrospectively with special emphasis on operative conditions and medical results.Results and Discussion:Thirty-five percent of the missions were carried out in darkness. The median time from the alarm to first patient contact was 3.3 hours and the median duration of the missions was 7.3 hours. Forty-eight percent of the missions involved ships of foreign origin. Half the patients had acute illnesses, dominated by gastrointestinal and heart diseases. Most of the injuries resulted from industrial accidents with open and closed fractures, amputations, and soft tissue damage. Ninety percent of the patients were hospitalized; 7.5% probably would not have survived without early medical treatment and rapid transportation to a hospital.Conclusion:Using a heavy search and rescue helicopter in the Barents Sea was the right decision in terms of medical gain and operative risk.
11
Hou, Shike, Haojun Fan, and Yanmei Zhao. "Practice, Experience, and Prospect of Disaster Medicine in China." Prehospital and Disaster Medicine 34, s1 (May 2019): s21—s22. http://dx.doi.org/10.1017/s1049023x19000621.
Full textAbstract:
Introduction:In recent years, the development of disaster medicine has made rapid progress in China after the Wenchuan earthquake in 2008. China formed a more systematic and specialized health emergency force. In addition, the Ministry of Emergency Management was established In 2018, which demonstrated that the Chinese government is paying more attention to the disaster rescue work. In this report, the practice, experience, and prospect of disaster medicine in China was reviewed.Aim:To explore the current status and prospects of disaster medicine development in China.Methods:The literature research method was used to analyze literature at home and abroad. It was used to retrospectively analyze the rescue experience of Chinese medical rescue teams, sort out the current situation of disaster medical disciplines and rescue teams, and propose disaster medical development recommendations suitable for China’s national conditions.Results:After years of construction, China has formed a more systematic and specialized health emergency force, but the personnel, equipment, plans, and training of the professional rescue team need to be improved. The discipline system of disaster medicine in China is still lagging behind, and it is still unable to meet the needs of the rescue situation at home and abroad.Discussion:Disaster medicine is the area of medical specialization serving the dual areas of providing health care to disaster survivors and providing medically related disaster preparation, disaster planning, disaster response, and disaster recovery leadership throughout the disaster life cycle. It requires multidisciplinary intervention, integration, and application. A forward-looking perspective must be strengthened on the discipline and team building of disaster medicine.
12
Deebaj, Richard, Maaret Castrén, and Gunnar Öhlén. "Asia Tsunami Disaster 2004: Experience at Three International Airports." Prehospital and Disaster Medicine 26, no. 1 (February 2011): 71–78. http://dx.doi.org/10.1017/s1049023x10000105.
Full textAbstract:
AbstractIntroduction: On 26 December 2004, a large earthquake in the Indian Ocean and the resulting tsunami created a disaster on a scale unprecedented in recorded history. Thousands of foreign tourists, predominantly Europeans, were affected. Their governments were required to organize rapid rescue responses for a catastrophe thousands of miles away, something for which they had little or no experience. The rescue operations at three international airports in Sweden, the UK, and Finland are analyzed with emphasis on “lessons learned” and recommendations for future similar rescue efforts.Methods: This report is based on interviews with and unpublished reports from medical personnel involved in the rescue operations at the three airports, as well as selected references from an electronic literature search.Results: In the period immediately following the tsunami, tens of thousands of Swedes, Britons, and Finns returned home from the affected areas in Southeast Asia. More than 7,800, 104, and approximately 3,700 casualties from Sweden, the UK, and Finland, respectively, received medical and/or psychological care at the temporary medical clinics organized at the home airports. Psychiatric presentations and soft tissue and orthopedic injuries predominated.Conclusions: All three airport medical operations suffered from the lack of a national catastrophe plan that addressed the contingency of a natural or disaster due to a natural or man-made project occurring outside the country's borders involving a large number of its citizens. While the rescue operations at the three airports functioned variably well, much of the success could be attributed to individual initiative and impromptu problem-solving. Anticipation of the psychological and aftercare needs of all those involved contributed to the relative effectiveness of the Finnish and Swedish operations.
13
Wang, Chuanyi, Zhe Cheng, Xiao-Guang Yue, and Michael McAleer. "Risk Management of COVID-19 by Universities in China." Journal of Risk and Financial Management 13, no. 2 (February 19, 2020): 36. http://dx.doi.org/10.3390/jrfm13020036.
Full textAbstract:
The rapid spread of new coronaviruses throughout China and the world in 2019–2020 has had a great impact on China’s economic and social development. As the backbone of Chinese society, Chinese universities have made significant contributions to emergency risk management. Such contributions have been made primarily in the following areas: alumni resource collection, medical rescue and emergency management, mental health maintenance, control of staff mobility, and innovation in online education models. Through the support of these methods, Chinese universities have played a positive role in the prevention and control of the epidemic situation. However, they also face the problems of alumni’s economic development difficulties, the risk of deadly infection to medical rescue teams and health workers, infection of teachers and students, and the unsatisfactory application of information technology in resolving the crisis. In response to these risks and emergency problems, we propose some corresponding solutions for public dissemination, including issues related to medical security, emergency research, professional assistance, positive communication, and hierarchical information-based teaching.
14
Fickers, P., M. T. Le Dall, C. Gaillardin, P. Thonart, and J. M. Nicaud. "New disruption cassettes for rapid gene disruption and marker rescue in the yeast Yarrowia lipolytica." Journal of Microbiological Methods 55, no. 3 (December 2003): 727–37. http://dx.doi.org/10.1016/j.mimet.2003.07.003.
Full text
15
Herlinawati, Herlinawati, Indina Tarjiah, and Murti Kusuma Wirasti. "Blended Learning for Medical First Responder Training: Needs Analysis." Jurnal Pendidikan dan Pengajaran 54, no. 1 (March 19, 2021): 160. http://dx.doi.org/10.23887/jpp.v54i1.29221.
Full textAbstract:
The rapid development of technology demands a fast, easy, cheap, effective, and efficient system and can be accessed anytime and anywhere, including education and training. In the world of education, technological progress is marked by the number of people using the blended learning model. This study aims to obtain and collect information, data, and opinions from stakeholders and training participants at the Training Center of National Search and Rescue Agency to develop a blended learning model for Medical First Responder Training for responders. This study uses the Research and Development (RnD) method with the Integrative Learning Design Framework development model and the PEDATI development strategy. This research is limited only to the initial analysis stage, namely in the form of field studies and literature studies to determine the needs of the Medical First Responders Education and Training and the needs of students who will be the first steps in developing blended learning of MFR training for rescuers within the National Search and Rescue Agency. This study indicates that the National Search and Relief Education and Training Center needs an effective and efficient learning model, coupled with the training participants' responses indicating that they wish to have alternative learning sources. The results of this need analysis research can serve as the basis for the development of blended learning training in Medical First Responder.
16
Ravan, S., J. Szarzynski, and D. Stevens. "(A34) Space Technology to Support Disaster Risk Reduction and Emergency Medical and Rescue Teams." Prehospital and Disaster Medicine 26, S1 (May 2011): s10. http://dx.doi.org/10.1017/s1049023x11000471.
Full textAbstract:
Space technology plays important role during emergency as well as non-emergency situation to provide the information that is relevant for disaster preparedness and to the rescue and emergency medical teams. During emergency situation, first and immediate information rescue and medical teams like to have is the area impacted, severity of the disaster and the population at risk. Such information is of critical nature for emergency medical teams in order to plan and mobilize the medical personnel, resources and infrastructure needed to provide effective medical services. Space based observation is the most efficient way to provide this preliminary information. Often emergency maps generated based on the space based observations are useful to the medical and rescue teams during emergency situation while detailed information from the field is still awaited. UN-SPDIER offers the platform for providing such services effectively by connecting with the end users the international and regional mechanism that provides such information. During non-emergency phase, the space technology contributes in strengthening disaster risk reduction (DRR) efforts, especially through telemedicines and Global Positioning System (GPS) technologies. These tools integrated with Geographical Information System (GIS) provide effective mechanism for predicting risks (risk mapping) and early warning. It also ensures the rapid distribution of information during catastrophic events. In recognition of these needs the United Nations General Assembly established the United Nations Platform for Space-based Information for Disaster Management and Emergency Response (UN-SPIDER). The programme aims at providing universal access to all types of space-based information by: being a Gateway to space information for disaster management support; serving as a Bridge to connect the disaster management and space communities; and being a Facilitator of capacity-building and institutional strengthening.
17
Alkhateeb, Hakam, Adrian Chabowski, Jan F. C. Glatz, Brendon Gurd, Joost J. F. P. Luiken, and Arend Bonen. "Restoring AS160 phosphorylation rescues skeletal muscle insulin resistance and fatty acid oxidation while not reducing intramuscular lipids." American Journal of Physiology-Endocrinology and Metabolism 297, no. 5 (November 2009): E1056—E1066. http://dx.doi.org/10.1152/ajpendo.90908.2008.
Full textAbstract:
We examined whether AICAR or leptin rapidly rescued skeletal muscle insulin resistance via increased palmitate oxidation, reductions in intramuscular lipids, and/or restoration of insulin-stimulated AS60 phosphorylation. Incubation with palmitate (2 mM, 0–18 h) induced insulin resistance in soleus muscle. From 12–18 h, palmitate was removed or AICAR or leptin was provided while 2 mM palmitate was maintained. Palmitate oxidation, intramuscular triacylglycerol, diacylglycerol, ceramide, AMPK phosphorylation, basal and insulin-stimulated glucose transport, plasmalemmal GLUT4, and Akt and AS160 phosphorylation were examined at 0, 6, 12, and 18 h. Palmitate treatment (12 h) increased intramuscular lipids (triacylglycerol +54%, diacylglycerol +11%, total ceramide +18%, C16:0 ceramide +60%) and AMPK phosphorylation (+118%), whereas it reduced fatty acid oxidation (−60%) and insulin-stimulated glucose transport (−70%), GLUT4 translocation (−50%), and AS160 phosphorylation (−40%). Palmitate removal did not rescue insulin resistance or associated parameters. The AICAR and leptin treatments did not consistently reduce intramuscular lipids, but they did rescue palmitate oxidation and insulin-stimulated glucose transport, GLUT4 translocation, and AS160 phosphorylation. Increased AMPK phosphorylation was associated with these improvements only when AICAR and leptin were present. Hence, across all experiments, AMPK phosphorylation did not correlate with any parameters. In contrast, palmitate oxidation and insulin-stimulated AS160 phosphorylation were highly correlated ( r = 0.83). We speculate that AICAR and leptin activate both of these processes concomitantly, involving activation of unknown kinases in addition to AMPK. In conclusion, despite the maintenance of high concentrations of palmitate (2 mM), as well as increased concentrations of intramuscular lipids (triacylglycerol, diacylglycerol, and ceramide), the rapid AICAR- and leptin-mediated rescue of palmitate-induced insulin resistance is attributable to the restoration of insulin-stimulated AS160 phosphorylation and GLUT4 translocation.
18
Pretto, Ernesto A., Edmund Ricci, Miroslav Klain, Peter Safar, Victor Semenov, Joel Abrams, Samuel Tisherman, David Crippen, and Louise Comfort. "Disaster Reanimatology Potentials: A Structured Interview Study in Armenia. III. Results, Conclusions, and Recommendations." Prehospital and Disaster Medicine 7, no. 4 (December 1992): 327–37. http://dx.doi.org/10.1017/s1049023x00039741.
Full textAbstract:
AbstractNational medical responses to catastrophic disasters have failed to incorporate a resuscitation component.Purpose:This study sought to determine the lifesaving potentials of modern resuscitation medicine as applied to a catastrophic disaster situation. Previous articles reported the preliminary results (I), and methodology (II) of a structured, retrospective interview study of the 1988 earthquake in Armenia. The present article (III) reports and discusses the definitive findings, formulates conclusions, and puts forth recommendations for future responses to catastrophic disasters anywhere in the world.Results:Observations include: 1) The lack of adequate construction materials and procedures in the Armenian region contributed significantly to injury and loss of life; 2) The uninjured, lay population together with medical teams including physicians in Armenia were capable of rapid response (within two hours); 3) Due to a lack of Advanced Trauma Life Support (ATLS) training for medical teams and of basic first-aid training of the lay public, and scarcity of supplies and equipment for extrication of casualties, they were unable to do much at the scene. As a result, an undetermined number of severely injured earthquake victims in Armenia died slowly without the benefit of appropriate and feasible resuscitation attempts.Recommendations:1) Widespread adoption of seismic-resistant building codes for regions of high seismic risk; 2) The lay public living in these regions should be trained in life-supporting first-aid (LSFA) and basic rescue techniques; 3) Community-wide emergency medical services (EMS) systems should be developed world-wide (tai-lored to the emergency needs of each region) with ATLS capability for field resuscitation; 4) Such systems be prepared to extend coverage to mass casualties; 5) National disaster medical system (NDMS) plans should provide integration of existing trauma-EMS systems into regional systems linked with advanced (heavy) rescue (public works, fire, police); and 6) New techniques and devices for victim extrication should be developed to enable rapid extrication of earthquake casualties within 24 hours.
19
Bhaskar, Priya, Samuel Davila, Aparna Hoskote, and Ravi Thiagarajan. "Use of ECMO for Cardiogenic Shock in Pediatric Population." Journal of Clinical Medicine 10, no. 8 (April 8, 2021): 1573. http://dx.doi.org/10.3390/jcm10081573.
Full textAbstract:
In children with severe advanced heart failure where medical management has failed, mechanical circulatory support in the form of veno-arterial extracorporeal membrane oxygenation (VA ECMO) or ventricular assist device represents life-sustaining therapy. This review provides an overview of VA ECMO used for cardiovascular support including medical and surgical heart disease. Indications, contraindications, and outcomes of VA ECMO in the pediatric population are discussed.VA ECMO provides biventricular and respiratory support and can be deployed in rapid fashion to rescue patient with failing physiology. There have been advances in conduct and technologic aspects of VA ECMO, but survival outcomes have not improved. Stringent selection and optimal timing of deployment are critical to improve mortality and morbidity of the patients supported with VA ECMO.
20
Chen, Ming-Chih, Yi-Wen Chiu, Chien-Hsing Chen, and Ei-Jo Chen. "Implementation of Fall Detection and Localized Caring System." Mathematical Problems in Engineering 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/217286.
Full textAbstract:
We propose the fall detection and localized caring system to effectively detect the postures of a human and provide a service of remote connection with health care center. Especially, when elderly people fall down, they often need to be hospitalized. The system can inform the care center automatically through the wireless sensor network and send the rapid information of the incident for their family through the mobile phone. It also provides the location of incident for immediate rescue by dispatching medical staff from the center. The experimental results show that our system achieves the accurate rate of 99.9% for detecting a human fall and provides the care services effectively.
21
Chan, Yu-Feng, Kumar Alagappan, Arpita Gandhi, Colleen Donovan, Malti Tewari, and Sergey B. Zaets. "Disaster Management following the Chi-Chi Earthquake in Taiwan." Prehospital and Disaster Medicine 21, no. 3 (June 2006): 196–202. http://dx.doi.org/10.1017/s1049023x00003678.
Full textAbstract:
AbstractThe earthquake that occurred in Taiwan on 21 September 1999 killed >2,000 people and severely injured many survivors. Despite the large scale and sizeable impact of the event, a complete overview of its consequences and the causes of the inadequate rescue and treatment efforts is limited in the literature. This review examines the way different groups coped with the tragedy and points out the major mistakes made during the process. The effectiveness of Taiwan's emergency preparedness and disaster response system after the earthquake was analyzed.Problems encountered included: (1) an ineffective command center; (2) poor communication; (3) lack of cooperation between the civil government and the military; (4) delayed prehospital care; (5) overloading of hospitals beyond capacity; (6) inadequate staffing; and (7) mismanaged public health measures.The Taiwan Chi-Chi Earthquake experience demonstrates that precise disaster planning, the establishment of one designated central command, improved cooperation between central and local authorities, modern rescue equipment used by trained disaster specialists, rapid prehospital care, and medical personnel availability, as well earthquake-resistant buildings and infrastructure, are all necessary in order to improve disaster responses.
22
Li, Tianhua, Ningning Qi, Xiaona Gao, and Haili Yu. "Rescue of four pediatric patients with severe influenza A (H3N2) in Weifang, China." Journal of International Medical Research 46, no. 11 (September 13, 2018): 4800–4805. http://dx.doi.org/10.1177/0300060518792795.
Full textAbstract:
In this report, we summarize our experience of rescuing four children with severe type A H3N2 influenza from January to February 2017 in Weifang People’s Hospital, Shandong Province, China for reference in clinical treatment. Two boys and two girls, ranging in age from 3 months to 6 years, with fever, cough, and asthma, were admitted to the pediatric intensive care unit. All children had severe pulmonary infection with respiratory distress. Three children had myocardial damage, two had liver damage, and one had encephalitis. One child had a history of bronchial asthma and one had severe spinal muscular atrophy. After all four children were admitted to the pediatric intensive care unit, they were provided active and effective organ function support and ventilator-assisted respiration. They were treated with gamma globulin, methylprednisolone, and antibiotics. Three children were treated with anti-influenza drugs and recovered from influenza; one child died even before antiviral treatment intervention on the first day. Definite diagnosis of the cases was through clinical manifestations, supplemented by laboratory tests, such as influenza virus H3N2 rapid antigen detection and nucleic acid detection. Early antiviral therapy, high-dose glucocorticoids and immunoglobulins, and systemic comprehensive rescue might be important for rescuing children with severe influenza A (H3N2).
23
Klain, Miroslav, Edmund Ricci, Peter Safar, Victor Semenov, Ernesto Pretto, Samuel Tisherman, Joel Abrams, and Louise Comfort. "Disaster Reanimatology Potentials: A Structured Interview Study in Armenia I. Methodology and Preliminary Results." Prehospital and Disaster Medicine 4, no. 2 (December 1989): 135–52. http://dx.doi.org/10.1017/s1049023x00029939.
Full textAbstract:
AbstractIn general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).
24
Lavon, Ophir, Dan Hershko, and Erez Barenboim. "Large-Scale Airmedical Transport from a Peripheral Hospital to Level-1 Trauma Centers after Remote Mass-Casualty Incidents in Israel." Prehospital and Disaster Medicine 24, no. 6 (December 2009): 549–55. http://dx.doi.org/10.1017/s1049023x00007500.
Full textAbstract:
AbstractIntroduction:Mass-casualty incidents (MCIs) result in the evacuation of many patients to the nearest medical facility. However, an overwhelming number of patients and the type and severity of injuries may demand rapid, mass airmedical transport to more advanced medical centers. This task may be challenging, particularly after a MCI in a neighboring country. The Israeli Air Force Rescue and Airmedical Evacuation Unit (RAEU) is the main executor of airmedical transport in Israel, including MCIs.Problem:The available data on airmedical transport from remote MCIs are limited. The objective of this study was to evaluate the airmedical transport from a rural hospital after two remote MCIs.Methods:The study was retrospective and reviewed descriptive records of airmedical transports.Results:The RAEU was involved in airmedical transports from a peripheral hospital shortly after two remote MCIs that occurred in the Sinai desert near the Egyptian-Israeli border. Nineteen (22.4%) and 25 (100%) of the treated trauma patients from each event were airmedically transported to Level-1 Trauma Centers in Israel within hours of the dispatch. The rapid dispatch and accumulation of medical personnel and equipment was remarkable. The airmedical surge capacity was broad and sufficient. Cooperation with local authorities and a tailored boarding procedure facilitated a quality outcome.Conclusions:The incorporation of a large-scale airmedical transport program with designated multidisciplinary protocols is an essential component to a remote disaster preparedness plan.
25
Kim, Kyeong Han, Soobin Jang, Ju Ah Lee, Bo-Hyoung Jang, Ho-Yeon Go, Sunju Park, Hee-Guen Jo, Myeong Soo Lee, and Seong-Gyu Ko. "Experiences Providing Medical Assistance during the Sewol Ferry Disaster Using Traditional Korean Medicine." Evidence-Based Complementary and Alternative Medicine 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/3203768.
Full textAbstract:
Background. This study aimed to investigate medical records using traditional Korean medicine (TKM) in Sewol Ferry disaster in 2014 and further explore the possible role of traditional medicine in disaster situation. Methods. After Sewol Ferry accident, 3 on-site tents for TKM assistance by the Association of Korean Medicine (AKOM) in Jindo area were installed. The AKOM mobilized volunteer TKM doctors and assistants and dispatched each on-site tent in three shifts within 24 hours. Anyone could use on-site tent without restriction and TKM treatments including herb medicine were administered individually. Results. The total of 1,860 patients were treated during the periods except for medical assistance on the barge. Most patients were diagnosed in musculoskeletal diseases (66.4%) and respiratory diseases (7.4%) and circulatory diseases (8.4%) followed. The most frequently used herbal medicines were Shuanghe decoction (80 days), Su He Xiang Wan (288 pills), and Wuji powder (73 days). Conclusions. TKM in medical assistance can be helpful to rescue worker or group life people in open shelter when national disasters occur. Therefore, it is important to construct a rapid respond system using TKM resources based on experience.
26
Stratton, Samuel J., Virginia Price Hastings, Darlene Isbell, John Celentano, Miguel Ascarrunz, Carol S. Gunter, and Joe Betance. "The 1994 Northridge Earthquake Disaster Response: The Local Emergency Medical Services Agency Experience." Prehospital and Disaster Medicine 11, no. 3 (September 1996): 172–79. http://dx.doi.org/10.1017/s1049023x00042916.
Full textAbstract:
AbstractIntroduction:This paper describes the 1994 Northridge earthquake experience of the local emergency medical services (EMS) agency. Discussed are means that should improve future local agency disaster responses.Methods:Data reported are descriptive and were collected from multiple independent sources, and can be reviewed publicly and confirmed. Validated data collected during the disaster by the Local EMS Agency also are reported.Results:The experience of the Los Angeles County EMS Agency was similar to that of earthquake disasters previously reported. Communication systems, water, food, shelter, sanitation means, power sources, and medical supplies were resources needed early in the disaster. Urban Search and Rescue Teams and Disaster Medical Assistance Teams were important elements in the response to the Northridge earthquake. The acute phase of the disaster ended within 48 to 72 hours and public health then became the predominant health-care issue. Locating community food and water supplies near shelters, providing transportation to medical care, and public-health visits to shelter locations helped prevent the development of long-term park encampments. An incident command system for the field, hospitals, and government responders was necessary for an organized response to the disaster.Conclusion:Disaster preparedness, multiple forms of reliable communication, rapid mobilization of resources, and knowledge of available state and federal resources are necessary for a disaster response by a local EMS agency.
27
Miniati, MS, Roberto, Fabrizio Dori, MS, Ernesto Iadanza, MS, Marco Lo Sardo, BSEE, and Sergio Boncinelli, MD. "Longitudinal expandable shelter for medical response during disasters." American Journal of Disaster Medicine 5, no. 4 (July 1, 2010): 221–27. http://dx.doi.org/10.5055/ajdm.2010.0027.
Full textAbstract:
Introduction: During medical emergencies, hospitals represent the final point of the whole rescue process. Therefore, effective health mobile structures have to be inserted between hospitals and the place of the event with the aim of giving the best of cures (using appropriate and easy to use equipment) for a safer and faster evacuation to hospitals.Methods: Literature review and national and international disaster medicine standards were the basis for this study to provide clinical, hygienical, and organizational needs to satisfy for the medical structure design. Project requirements have been obtained by analyzing structural, organizational, and clinical process necessities. Structural requirements respond to the possibility of installation on every ground type, resistance to every weather condition, and necessity of easy and fast transportation. Technological equipment is obtained from clinical evaluation for patient stabilization.Results: The designed structure results to be a longitudinal expandable shelter (LES) for medical emergencies response organized in three internal functional areas. Possibility of automatic expandability allows rapid transportation and easy deployment. The functional internal organization provides three areas: “Diagnostic,” “Therapeutic,” and “Pre-evacuation monitoring.” Further, longitudinal expandability supports the basic hygienical rules in healthcare processes allowing the unidirectional flow of casualties from dirtier to cleaner areas of the structure.Conclusions: LES represents the answer to expressed requisites by disaster medicine standards and guidelines. It aims to provide an efficient and effective support for sanitary aid in response to disasters or emergencies, by improving aspects related to effectiveness, hygiene, and quality of clinical performances especially for highest critical cases.
28
Elmufdi, Firas S., Susan L. Burton, Nishant Sahni, and Craig R. Weinert. "Clinical and Sociocultural Factors Associated With Failure to Escalate Care of Deteriorating Patients." American Journal of Medical Quality 33, no. 4 (December 19, 2017): 391–96. http://dx.doi.org/10.1177/1062860617748739.
Full textAbstract:
In-hospital medical emergencies occur frequently. Understanding how clinicians respond to deteriorating patients outside the intensive care unit (ICU) could improve “rescue” interventions and rapid response programs. This was a qualitative study with interviews with 40 clinicians caring for patients who had a “Code Blue” activation or an unplanned ICU admission at teaching hospitals over 7 months. Four study physicians independently analyzed interview transcripts; refined themes were linked to the transcript using text analysis software. Nine themes were found to be associated with clinicians’ management of deteriorating patients. Multiple human biases influence daily care for deteriorating hospitalized patients. A novel finding is that “moral distress” affects escalation behavior for patients with poor prognosis. Most themes indicate that ward culture influences clinicians to wait until the last minute to escalate care despite being worried about the patients’ condition.
29
Uchmanowicz, Izabella, Wiesław Bartkiewicz, Jarosław Sowizdraniuk, and Joanna Rosińczuk. "Factors Affecting the Occurrence of Out-of-Hospital Sudden Cardiac Arrest." Emergency Medicine International 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/281364.
Full textAbstract:
Objective. This paper aims to discover the risk factors for sudden cardiac arrest (out-of-hospital sudden cardiac arrest (OHSCA)) which significantly affect the decision about prioritizing emergency interventions before dispatching medical emergency teams, risk of deterioration of the patient’s condition at the scene, and emergency procedures.Methods. A retrospective study taking into account the international classification of diseases ICD-10 based on an analysis of medical records of Emergency Medical Service in Wroclaw (Poland).Results. The main risk factor of OHSCA is coexistence of external cause leading to illness or death (ICD Group V-10) as well as the occurrence of diseases from the group of endocrine disorders (group E), in particular diabetes. The increase in the risk of OHSCA incidence is affected by nervous system diseases (group G), especially epilepsy of various etiologies, respiratory diseases (group J), mainly COPD, and bronchial asthma or mental and behavioral disorders (group F), with particular emphasis on the drugs issue. The procedure for receiving calls for Emergency Notification Centre does not take into account clinical risk factors for sudden cardiac arrest (SCA).Conclusion. Having knowledge of OHSCA risk factors can increase the efficiency of rescue operations from rapid assessment and provision of appropriate medical team, through effective performance of medical emergency treatment and prevention of SCA or finally reducing the costs.
30
Shantyr’, I. I., G. G. Rodionov, E. G. Neronova, I. E. Ushal, and E. A. Kolobova. "Evaluation of the individual detoxification potential in the firefighters and rescuers of emercom of Russia." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 3 (November 11, 2020): 87–95. http://dx.doi.org/10.25016/2541-7487-2020-0-3-87-95.
Full textAbstract:
Relevance. Professional activities of firefighters and rescuers are usually associated with aggressive chemical exposure with increased physical exertion and psychological stress. Therefore, for professional selection and monitoring the health status of firefighters and rescuers of EMERCOM of Russia it is necessary to evaluate the activity of cytochrome P450 isoenzymes that are directly involved in detoxification pathways in the liver.Intention. To evaluate the activity of the CYP3A4 enzyme by phenotyping methods and to establish the frequency of allelic variants of the gene of this enzyme (rs2740574 and rs4987161 polymorphisms) in firefighters and rescuers of EMERCOM of Russia for targeted treatment, rehabilitation and prevention.Methodology. Polymorphisms (rs2740574 and rs4987161) of the CYP3A4 gene and also CYP3A4 activity by the ratio of 6-β-hydroxycortisol / cortisol in the urine were determined during routine periodical medical examination of 64 rescuers and firefighters of rescue units of EMERCOM of Russia. The average age of examined persons was (29.8 ± 5.5) years; 30 of them are rescuers of the North-West Regional Search and Rescue Squad and 34 are firefighters of the territorial fire departments of St. Petersburg.Results and Discussion. According to the results of genotyping of rs2740574 polymorphism of the CYP3A4 gene, EMERCOM employees were divided into 2 groups depending on the presence or absence of a minor allele: “poor” and “rapid” metabolizers (9.4% and 80.6%, respectively). According to the results of genotyping of the rs4987161 polymorphism of the CYP3A4 gene, the examined were classified as “rapid” metabolizers, because patients with a minor allele were not identified. Depending on the ratio of 6-β-hydroxycortisol / cortisol in the urine, the activity level of CYP3A4 was “normal” in 67 %, “poor” in 13 % and “rapid” in 20 % of cases. The ratio of 6-β-hydroxycortisol / cortisol in the urine tended to increase with an increase in work experience and age. No relationship between the studied polymorphic variants of the CYP3A4 gene and the established enzyme activity was observed.Conclusion. Genotyping methods made it possible to identify allelic variants of the CYP3A4 gene that could affect the functionality of the enzyme; however, no association of the studied polymorphisms with enzyme activity was found. In such cases, in the absence of informative genetic markers, it is recommended to evaluate the enzyme activity by phenotyping methods.
31
Reilly, M. "(A292) Disaster Assessment and Gathering Medical Intelligence Following a Major Public Health or Complex Humanitarian Emergency." Prehospital and Disaster Medicine 26, S1 (May 2011): s81. http://dx.doi.org/10.1017/s1049023x11002767.
Full textAbstract:
IntroductionImmediately following a major public health emergency or complex humanitarian emergency such as the South East Asian Tsunami in 2004, the Haitian Earthquake in 2010 or Hurricane Katrina in 2005, there is a critical need to rapidly and as accurately as possible gather information not limited to morbidity and mortality, but necessary to assess the stability and existence of a public health or medical infrastructure, logistic supply chain, condition of food, water and shelter for victims and rescue workers, and particularly the security and stability of the region following the incident. With this information, only then can an effective humanitarian response be planned and executed that meets the actual versus perceived needs of an affected population.MethodsSpecific disaster risk assessment and medical intelligence techniques will be presented that are currently used by a variety of relief organizations. Specific topics of discussion include: Disaster epidemiology; Indicators of health in populations; Systems of surveillance; Impact of weather and climate; Displaced populations and refugee health; Tactical and combat medical intelligence; Zoonotic diseases; Agricultural trends and food security; Public health and health system infrastructure assessment; and Personal and physical security concerns.ConclusionsUtilizing case reports, best-practices and lessons learned from numerous international humanitarian responses, this session will guide participants though the performance of a rapid disaster assessment and the gathering of critical medical intelligence to determine the kinds and types of resources needed in an affected area. And the process of utilizing limited information to plan humanitarian relief efforts.
32
Campbell, S., L. Belle Blagrove, P. Piraino, and S. Dhani. "P015: A phase IV protocol for a real world study on the use of low dose methoxyflurane (PENTHROX™) for the treatment of moderate to severe trauma pain in the Canadian emergency department (ADVANCE-ED)." CJEM 21, S1 (May 2019): S68. http://dx.doi.org/10.1017/cem.2019.206.
Full textAbstract:
Introduction: Pain is a significant driver of demand in emergency care and 65% of adult patients with trauma also report moderate to severe pain. Inhaled low dose methoxyflurane (MEOF) a rapid-acting patient administered inhalational analgesic was recently approved in Canada for the short-term relief of moderate to severe acute pain associated with trauma or interventional medical procedures in conscious adult patients. This study will generate real-world evidence to complement the global clinical development program through evaluation of the effectiveness of MEOF in Canadian emergency departments. Methods: This is a phase IV, prospective open label, multi-centre study. Approximately 100 adult (≥18 yrs) patients with moderate to severe acute pain (NRS0-10≥4) associated with single system trauma will be enrolled at 5-10 EDs across Canada. Patients will receive a single treatment of up to 2 x 3 mL MEOF (2nd 3 mL to be provided only upon request), self-administered by the patient under medical supervision. Rescue medication will be permitted at any time, if required. Results: Planned Assessments and Outcome Measures: Pain will be assessed using the NRS0-10 at 4 time points: screening/triage, 5 minutes and 20 minutes post-start of administration (STA) of MEOF, and when ready for discharge. Secondary assessments will include the speed of action of analgesia (from STA of MEOF); patient and physician satisfaction with treatment (as assessed through Global Medical Performance (GMP) at 20 minutes post-STA and when ready for discharge); patient and physician fulfilment of pain relief expectations (assessed when ready for discharge); use of rescue medication and treatment-emergent adverse events. Exploratory outcomes will include the time to disposition, time to readiness for discharge and responder analysis. The primary outcome measure will be the change in pain intensity over 20 minutes from the start of administration of MEOF as measured on the NRS0-10. Conclusion: We report on the methodology of a phase IV, prospective open label, multi-centre study, evaluating the use of MEOF for the management of acute traumatic pain in Canadian Emergency Departments.
33
Ganz, Aura, James Schafer, Xunyi Yu, Graydon Lord, Jonathan Burstein, and Gregory R. Ciottone. "Real-Time Scalable Resource Tracking Framework (DIORAMA) for Mass Casualty Incidents." International Journal of E-Health and Medical Communications 4, no. 2 (April 2013): 34–49. http://dx.doi.org/10.4018/jehmc.2013040103.
Full textAbstract:
DIORAMA system which is using rapid information collection and accurate resource tracking can assist incident commanders in their attempt to bring order to the chaos as they direct rescue operations for Mass Casualty Incidents (MCI). This system makes use of active Radio Frequency Identification (RFID) tags to identify the location and status of the patients and responders involved in a MCI. The authors introduce DIORAMA’s hardware and software architecture as well as the trials they conducted with up to 40 human subjects. The authors show that the DIORAMA system can significantly reduce the patient’s evacuation time compared to paper triage, consequently reducing the patients’ mortality. Moreover, the evacuation completeness of the DIORAMA based evacuation is always 100% as opposed to the paper-based evacuation where a number of patients are left behind. The information provided by the DIORAMA system can improve the coordination of the response to better match supply (care providers, ambulances, medical equipment) with demand (number of patients, level of acuity).
34
Li, Hong Ying. "Design and Research of Emergency Transport Security Decision Support System." Applied Mechanics and Materials 727-728 (January 2015): 473–76. http://dx.doi.org/10.4028/www.scientific.net/amm.727-728.473.
Full textAbstract:
With China's rapid growth in the number of cars, traffic accidents, traffic congestion and other problems have become the bottleneck of urban economic development. Our cities are in the "abnormal" crisis-prone period. The impact of disasters on people's lives emergencies growing, life and property of residents pose a great threat. As a modern city traffic arteries, any relief activities are inseparable from the smooth roads. And the roads open is the main form of transport security, is the distribution of emergency supplies, personnel, emergency medical aid and other emergency rescue preconditions, while smooth roads can reduce the loss of life and property losses to a minimum to reduce incidents. Therefore, actively carry out research and development organization to protect emergency transportation and emergency transportation decision support system, providing useful information for disaster prevention and relief, reduce the degree of disaster losses, improve our ability to deal with major disasters is important.
35
Krzymień, Wiesław, Michał Szmidt, and Sławomir Cieślak. "Vibration Properties of Steel Constructed Hospital Elevated Helipads." Transactions on Aerospace Research 2020, no. 3 (September 1, 2020): 11–20. http://dx.doi.org/10.2478/tar-2020-0013.
Full textAbstract:
AbstractPolish Medical Air Rescue helicopters facilitate the rapid transport of patients to large hospitals. The requirements of the space around the helipad and the safety of flight operations mean that hospitals closer to city centers create more elevated helipads than ground-based helipads. The helipads can vary in the way they are constructed and located - depending on the possibilities offered by hospital buildings and their surroundings.Vibroacoustics Laboratory of the Institute of Aviation measured the vibration properties of some elevated helipads. The goal of this research was to determine the vibration properties of the helipads itself and the transmission of vibrations to the construction of the helipads, the building and its equipment caused by the landing and taking-off of a helicopter.This article presents some of the results of measurements of vibrations of steel constructed elevated helipads with the use of a modal hammer and while landing and taking-off of a helicopter, as well as comparison of the vibration properties concerning various elevated concrete helipads.
36
Zakrison, Tanya L., Nicholas Namias, Marc M. Grossman, David V. Shatz, Fahim Habib, Louis Pizano, Antonio Marttos, and Gabriel Ruiz. "The Rare Requirement of On-scene Extremity Amputations in the Entrapped Trauma Patient." Panamerican Journal of Trauma, Critical Care & Emergency Surgery 5, no. 2 (2016): 93–100. http://dx.doi.org/10.5005/jp-journals-10030-1151.
Full textAbstract:
ABSTRACT Objectives Entrapment of trauma patients in motor vehicle and other accidents is common. Frequently, Emergency Medical Services (EMS) personnel and firefighters are able to free the patient and initiate rapid transport to trauma centers. In rare circumstances, severe torso and extremity injuries combined with major entrapment may require complex rescue operations. These trauma patients spend the “Golden Hour” at the scene under difficult conditions. The objective of this review is to evaluate the role of the trauma surgeon leading the care at the scene of critically injured and entrapped trauma patients with possible need for surgical interventions. Materials and methods A 10-year review of all trauma surgeon to scene activations between 2005 and 2014 at the Ryder Trauma Center, an urban ACS Level 1 trauma center, was performed. An analysis of the trauma registry, individual cases, and surgical interventions was conducted. Results The University of Miami/Jackson Memorial Hospital (UM/JMH) Ryder Trauma Center and Miami Dade Fire Rescue have an established program in place for trauma surgeon to scene activations. During the study period, the on-call trauma surgeon was activated six times and traveled to the scene by air rescue helicopter four times, by ground in 1 case and in 1 case the patient expired before takeoff. One patient required on-scene amputation of an entrapped non-salvageable upper extremity. Two patients required on-scene amputation of bilateral lower mangled, entrapped extremities. One patient required a localized limb preserving surgical procedure to free him from entrapment. The incidence was 0.016% of 36,872 trauma alert activated patients evaluated at Ryder Trauma Center during the study period. Hemorrhagic shock, associated injuries, and long scene times were present in all patients. The survival of treated patients was 80%. Conclusion The need for on-scene amputations of nonsalvable extremities in entrapped trauma patients is rare. Experienced trauma surgeons should evaluate these patients and decide which interventions are necessary. All efforts should be made to salvage the limb. However, if the entrapped extremity appears nonsalvageable and the patient is in profound life-threatening shock requiring rapid transport, field amputation may be required. Policies, safety training and gear, supply kits, and partnerships with EMS are needed. How to cite this article Pust GD, Grossman MM, Shatz DV, Habib F, Pizano L, Zakrison TL, Marttos A, Ruiz G, Ginzburg E, Namias N. The Rare Requirement of On-scene Extremity Amputations in the Entrapped Trauma Patient. Panam J Trauma Crit Care Emerg Surg 2016;5(2):93-100.
37
Leiba, Adi, Amir Blumenfeld, Ariel Hourvitz, Gali Weiss, Michal Peres, Dani Laor, Dagan Schwartz, et al. "Lessons Learned from Cross-border Medical Response to the Terrorist Bombings in Tabba and Ras-el-Satan, Egypt, on 07 October 2004." Prehospital and Disaster Medicine 20, no. 4 (August 2005): 253–57. http://dx.doi.org/10.1017/s1049023x00002624.
Full textAbstract:
AbstractIntroduction:Large-scale, terrorist attacks can happen in peripheral areas, which are located close to a country's borders and far from its main medical facilities and involve multi-national casualties and responders. The objective of this study was to analyze the terrorist suicide bombings that occurred on 07 October 2004, near the Israeli-Egyptian border, as representative of such a complex scenario.Methods:Data from formal debriefings after the event were processed in order to learn about victim outcomes, resource utilization, critical events, and time course of the emergency response.Results:A total of 185 injured survivors were repatriated: four were severely wounded, 13 were moderately injured, and 168 were mildly injured. Thirty-eight people died. A forward medical team landed at the border town's airport, which provided reinforcement in the field and in the local hospital. Israeli and Egyptian search and rescue teams collaborated at the destruction site. One-hundred sixty-eight injured patients arrived at the small border hospital that rapidly organized itself for the mass-casualty incident, operating as an evacuation “staging hospital”. Twenty-three casualties secondarily were distributed to two major trauma centers in the south and the center of Israel, respectively, either by ambulance or by helicopter.Conclusion:Large-scale, terrorist attacks at a peripheral border zone can be handled by international collaboration, reinforcement of medical teams at the site itself and at the peripheral neighboring hospital, rapid rearrangement of an “evacuation hospital”, and efficient transport to trauma centers by ambulances, helicopters, and other aircraft.
38
Frink, Lynne, and Mary Jane Dalton. "ESTABLISHING A WILDLIFE RESPONSE AFTER THE ASHLAND OIL SPILL." International Oil Spill Conference Proceedings 1989, no. 1 (February 1, 1989): 77–80. http://dx.doi.org/10.7901/2169-3358-1989-1-77.
Full textAbstract:
ABSTRACT On January 2, 1988, an Ashland Oil Company storage tank in Pittsburgh, Pennsylvania, ruptured, spilling about 750,000 gallons of No. 2 diesel fuel into the Monongahela River. This spill, the largest documented inland oil spill in history, occurred in an area that was unprepared for this kind of environmental disaster. Tri-State Bird Rescue & Research, Inc., was requested by state and federal authorities to establish a wildlife response plan, set up a treatment center, and train professionals and volunteers to treat contaminated wildlife. Using previously developed training packets and supplies lists, Tri-State personnel established task forces, trained volunteers in tested medical protocols, equipped a center, and began treating birds within 12 hours of their arrival at the scene. While only 5 percent of the birds affected could be retrieved, 94 percent of the birds retrieved were successfully treated, released, and subsequently monitored in the wild. This paper focuses on the need for rapid response, adherence to protocols, interagency communication, and hands-on experience in establishing a successful response to wildlife contaminated by oil.
39
Garewal, Davinder, and Pallavi Waikar. "Propofol Sedation for ERCP Procedures: A Dilemna? Observations from an Anesthesia Perspective." Diagnostic and Therapeutic Endoscopy 2012 (January 5, 2012): 1–5. http://dx.doi.org/10.1155/2012/639190.
Full textAbstract:
Propofol sedation for endoscopic retrograde cholangiopancreatography (ERCP) procedures is a popular current technique that has generated controversy in the medical field. Worldwide, both anesthetic and nonanesthetic personnel administer this form of sedation. Although the American and Canadian societies of gastroenterologists have endorsed the administration of propofol by nonanesthesia personnel, the US Food and Drug Administration (FDA) has not licensed its use in this manner. There is some evidence for the safe use of propofol by nonanesthetic personnel in patients undergoing endoscopy procedures, but there are few randomized trials addressing the safety and efficacy of propofol in patients undergoing ERCP procedures. A serious possible consequence of propofol sedation in patients is that it may result in rapid and unpredictable progression from deep sedation to general anesthesia, and skilled airway support may be required as a rescue measure. Potential complications following deep propofol sedation include hypoxemia and hypotension. Propofol sedation for ERCP procedures is an area of clinical practice where discussion and mutual cooperation between anesthesia and nonanesthesia personnel may enhance patient safety.
40
White, Kyle, Anne Bernard, and Ian Scott. "Derivation and validation of a risk score for predicting mortality among inpatients following rapid response team activation." Postgraduate Medical Journal 95, no. 1124 (June 2019): 300–306. http://dx.doi.org/10.1136/postgradmedj-2018-136060.
Full textAbstract:
Purpose of the studyDespite mature rapid response systems (RRS) for clinical deterioration, individuals activating RRS have poor outcomes, with up to one in four dying in hospital. We aimed to derive and validate a risk prediction tool for estimating risk of 28-day mortality among hospitalised patients following rapid response team (RRT) activation.Study designAnalysis of prospectively collected data on 1151 consecutive RRT activations involving 800 inpatients at a tertiary adult hospital. Patient characteristics, RRT triggers and actions, and mortality were ascertained from medical records and death registries. A multivariable risk prediction regression model, derived from 600 randomly selected patients, was validated in the remaining 200 patients. Main outcome was accuracy of weighted risk score (measured by area under receiver operator curve (AUC)) and performance characteristics for various cut-off scores.ResultsAt 28 days, 150 (18.8%) patients had died. Increasing age, emergency admission, chronic liver disease, chronic kidney disease, malignancy, after-hours RRT activation, increasing National Early Warning Score, major/intense RRT intervention and multiple RRT activations were predictors of mortality. The risk score (0–105) in derivation and validation cohorts had AUCs 0.86 (95% CI 0.82 to 0.89) and 0.82 (95% CI 0.75 to 0.90), respectively. In the validation cohort, cut-off score of 32.5 or higher maximised sensitivity: 81.6% (95% CI 68.4% to 92.1%), specificity: 56.2% (95% CI 49.4% to 63.6%), positive likelihood ratio (LR): 1.9 (95% CI 1.5 to 2.3) and negative LR: 0.3 (95% CI 0.2 to 0.6).ConclusionA validated risk score predicted risk of post-RRT death with more than 80% accuracy, helping to identify patients for whom targeted rescue care may improve survival.
41
Kong, Heng, and Jixin Chen. "Medical Monitoring and Management System of Mobile Thyroid Surgery Based on Internet of Things and Cloud Computing." Wireless Communications and Mobile Computing 2021 (June 19, 2021): 1–10. http://dx.doi.org/10.1155/2021/7065910.
Full textAbstract:
With the rapid development of the Internet of Things and cloud computing technologies, the Internet of Things technology based on comprehensive perception and interconnection and cloud computing based on virtualization, dynamic resources, and parallel computing have become the driving force for the innovation and development of informatization and intelligence. The cloud-based Internet of Things mobile medical is an ecosystem of health information and medical information, with the medical Internet of Things at its core and highly mobile and highly shared information. Therefore, in the context of in-depth research on mobile medical care, research on mobile postoperative thyroid monitoring and management systems based on the Internet of Things and cloud computing is a practical tool for promoting the development of mobile medical systems. Monitoring and Management. In this experiment, 48 cases of patients undergoing thyroid surgery were selected from a hospital. The experimental group was informed by the experiment that they need to be equipped with sensors. The control panel and GPS positioning module are used to obtain the exact position of the patient at the first time. The loading of the sensor is agreed by the patient and the patient’s family. Afterward, the control group will not be processed. It will conduct functional tests and software performance tests on the mobile medical monitoring and management system and analyze the satisfaction of medical staff with the mobile medical monitoring and management system. Experiments have proved that the cloud computing medical monitoring and management system is used to obtain the exact location of the patient in the first time, and the response time needs to be shorter. The response time of the system increases with the increase of the number of sensors ( P < 0.05 ), which shows that the mobile medical monitoring and management system is essential for medical care and medical care. Obtaining the exact position of the patient for the first time is of great importance for the successful rescue of the patient.
42
Möhler, Andreas. "Lessons from the Brussels Terrorist Attack." Prehospital and Disaster Medicine 34, s1 (May 2019): s91—s92. http://dx.doi.org/10.1017/s1049023x19001900.
Full textAbstract:
Introduction:On March 22, 2016, the capital of Europe was hit by two terrorist attacks. As terrorism becomes more and more violent, it is critical to learn and share experiences in order to enhance effectiveness in saving lives.Methods:A field perspective and experience feedback from the Emergency Medical Response.Results:The first attack hit the departure hall of the airport, which, due to its strategic role, relies upon a dedicated emergency plan. However, it focuses on airplane crashes and not on explosions in a crowded terminal. The second attack hit the subway at rush hour. An attack in such a confined environment is particularly challenging for the rescue teams, as injuries are worsened, access hindered, and exits numerous.Eleven medical teams were sent in order to perform triage and provide vital care. The medical response was organized by two disaster response teams. Advanced Medical Posts were set up and the mass casualty plans of all hospitals were activated. Managing war injuries for civilian teams was challenging. On-site care consisted essentially in prehospital damage control and burn care in order to ensure rapid evacuations for haemostatic surgery. 313 victims were dispatched to thirty hospitals. Another challenge was safety. Several threats were apparent and explosives were found on both sites. Lessons from Paris had prompted a review of our multiple sites Emergency Plan. One single way of communication was used and the evacuations were managed centrally. Finally, the key factor that helped limit the number of casualties was the acquaintanceship between emergency workers and non-medical teams built during exercises, allowing them to adapt and blend in as one team.Discussion:Lessons from previous attacks were crucial to improve our management of the medical response. These should be shared around, as another attack may always occur anywhere and at any time.
43
Subedi, Shiva, Guna Nidhi Sharma, Sagar Dahal, Megha Raj Banjara, and Basu Dev Pandey. "The Health Sector Response to the 2015 Earthquake in Nepal." Disaster Medicine and Public Health Preparedness 12, no. 4 (May 2, 2018): 543–47. http://dx.doi.org/10.1017/dmp.2017.112.
Full textAbstract:
ABSTRACTIn April 2015, Nepal experienced an earthquake of a magnitude of 7.6 on the Richter scale that resulted in deaths, morbidities, and infrastructure damage. In the post-earthquake period, 4 different workshops and a national “Lessons Learnt” conference were organized to assess the adequacy of the preparedness and response of the health sector. This article summarizes the main conclusions of these discussions relating to leadership, timely search and rescue, referral operations, medical relief to response activities, awareness campaigns, and support from the national and international levels, and epidemiological surveillance. The earthquake response was channeled through rapid response teams that spanned from the community level to the central level via a cluster coordination approach. Overall, the health sector’s response was concluded to be largely satisfactory because it focused not only on emergency medical care, but also on the resumption of basic health services and preventive health care (eg, hygiene, risk communication) equally. Post-disaster disease outbreak did not occur because effective surveillance and outbreak monitoring was one of the priority actions. However, services related to birthing centers, neonatal services, and vaccinations were impeded in some rural areas. Some weaknesses in planning, coordination, and management were also noted. The lessons learned can provide the impetus to strengthen future preparedness and response mechanisms. (Disaster Med Public Health Preparedness. 2018;12:543–547)
44
Rodriguez, Alexa, Christopher L. Hunter, Caitlin Premuroso, Salvatore Silvestri, Amanda Stone, Stacie Miller, Christian Zuver, and Linda Papa. "Safety and Efficacy of Prehospital Diltiazem for Atrial Fibrillation with Rapid Ventricular Response." Prehospital and Disaster Medicine 34, no. 03 (May 2, 2019): 297–302. http://dx.doi.org/10.1017/s1049023x19004278.
Full textAbstract:
AbstractIntroduction:Atrial fibrillation (AFIB) with rapid ventricular response (RVR) is a common tachydysrhythmia encountered by Emergency Medical Services (EMS). Current guidelines suggest rate control in stable, symptomatic patients.Problem:Little is known about the safety or efficacy of rate-controlling medications given by prehospital providers. This study assessed a protocol for prehospital administration of diltiazem in the setting of AFIB with RVR for provider protocol compliance, patient clinical improvement, and associated adverse events.Methods:This was a retrospective, cohort study of patients who were administered diltiazem by providers in the Orange County EMS System (Florida USA) over a two-year period. The protocol directed a 0.25mg/kg dose of diltiazem (maximum of 20mg) for stable, symptomatic patients in AFIB with RVR at a rate of >150 beats per minute (bpm) with a narrow complex. Data collected included patient characteristics, vital signs, electrocardiogram (ECG) rhythm before and after diltiazem, and need for rescue or additional medications. Adverse events were defined as systolic blood pressure <90mmHg or administration of intravenous fluid after diltiazem administration. Clinical improvement was defined as a heart rate decreased by 20% or less than 100bmp. Original prehospital ECG rhythm interpretations were compared to physician interpretations performed retrospectively.Results:Over the study period, 197 patients received diltiazem, with 131 adhering to the protocol. The initial rhythm was AFIB with RVR in 93% of the patients (five percent atrial flutter, two percent supraventricular tachycardia, and one percent sinus tachycardia). The agreement between prehospital and physician rhythm interpretation was 92%, with a Kappa value of 0.454 (P <.001). Overall, there were 22 (11%) adverse events, and 112 (57%) patients showed clinical improvement. When diltiazem was given outside of the existing protocol, the patients had higher rates of adverse events (18% versus eight percent; P = .033). Patients who received diltiazem in adherence with protocols were more likely to show clinical improvement (63% versus 46%; P = .031).Conclusion:This study suggests that prehospital diltiazem administration for AFIB with RVR is safe and effective when strict protocols are followed.Rodriguez A, Hunter CL, Premuroso C, Silvestri S, Stone A, Miller S, Zuver C, Papa L. Safety and efficacy of prehospital diltiazem for atrial fibrillation with rapid ventricular response. Prehosp Disaster Med. 2019;34(3):297–302.
45
Batchvarov, Iordan Stefanov, Rachel Williamson Taylor, Ximena Bustamante-Marín, Michael Czerwinski, Erika Segear Johnson, Sally Kornbluth, and Blanche Capel. "A grafted ovarian fragment rescues host fertility after chemotherapy." Molecular Human Reproduction 22, no. 12 (October 2016): 1–10. http://dx.doi.org/10.1093/molehr/gaw064.
Full textAbstract:
STUDY QUESTION Can host fertility be rescued by grafting of a fragment of a healthy ovary soon after chemotherapy? SUMMARY ANSWER We found that grafting a green fluorescent protein (GFP)-positive fragment from a healthy isogenic ovary to the left ovary of a chemo-treated host rescued function and fertility of the grafted host ovary, and resulted in the production of host-derived offspring as late as the sixth litter after chemotherapy (CTx) treatment, whereas none of the ungrafted controls produced a second litter. WHAT IS KNOWN ALREADY In women and girls undergoing chemotherapy, infertility and premature ovarian failure are frequent outcomes. There are accumulating reports of improved endocrine function after autotransplantation of an ovarian fragment, raising the possibility that the transplant is beneficial to the endogenous ovary. STUDY DESIGN, SIZE, DURATION We first established a CTx treatment regimen that resulted in the permanent loss of fertility in 100% of female mice of the FVB inbred strain. We grafted an isogenic ovary fragment from a healthy female homozygous for a GFP transgene to the left ovary of 100 CTx-treated hosts, and compared fertility to 39 ungrafted controls in 6 months of continuous matings, using GFP to distinguish offspring derived from the graft, and those derived from the host. PARTICIPANTS/MATERIALS, SETTING, METHODS Immunofluoresece and western blot analysis of 39 treated ovaries during and 15 days after CTx treatment revealed elevated apoptosis, rapid loss of granulosa cells and an increased recruitment of growing follicles. Using immunofluorescence and confocal imaging, we tracked the outcome of the grafted tissue over 4 months and its effect on the adjacent and contralateral ovary of the host. MAIN RESULTS AND THE ROLE OF CHANCE Fifty-three percent of grafted females produced a second litter whereas none of the ungrafted females produced a second litter. The likelihood that this could occur by chance is very low (P < 0.0001). LIMITATIONS, REASONS FOR CAUTION These results are shown only in mice, and whether or how they might apply to chemotherapy patients subjected to different CTx regimens is not yet clear. WIDER IMPLICATIONS OF THE FINDINGS Our experiments prove that rescue of a chemo-treated ovary is possible, and establish a system to investigate the mechanism of rescue and to identify the factors responsible with the long-term goal of developing therapies for preservation of ovarian endocrine function and fertility in women undergoing chemotherapy. LARGE SCALE DATA No large datasets were produced. STUDY FUNDING/COMPETING INTEREST(S) Duke University Medical Center Chancellor's Discovery Grant to BC; ESJ was supported by an NRSA 5F31CA165545; SK was supported by NIH RO1 GM08033; RWT was supported by the Duke University School of Medicine Ovarian Cancer Research Fellowship; XBM was supported by CONICYT. The authors have no conflicts of interest to declare.
46
Gautam, Sima, Navneet Sharma, Rakesh Kumar Sharma, and Mitra Basu. "Human Patient Simulator based CBRN Casualty Management Training." Defence Life Science Journal 2, no. 1 (March 29, 2017): 80. http://dx.doi.org/10.14429/dlsj.2.11073.
Full textAbstract:
<p>Chemical, biological, radiological and nuclear (CBRN) emergency are becoming an impending threat. Effective preparedness needs to be raised for prompt response of CBRN incidents. During mass casualty incidents the strategy of the first responders must be beyond the triage, evacuation and medical first aid. Response process is advanced by the presence of CBRN contaminants and it becomes more complex when the rescue operations have to be performed immediately after the incident. Methodological approach is required to identify and decontaminate the CBRN victims. To manage CBRN emergencies, skill based training of appropriate degree is a key to the right level of preparedness. Intervention by first responders requires specialised inputs in knowledge, skills and aptitude. In India, CBRN defence training has traditionally been a military oriented domain, involving the quick reaction team, quick reaction medical team, rapid action medical team, etc. The training concept discussed in this study contemplates around standardised simulated CBRN casualty referred to as CBRN human patient simulator (HPS), which conceptualised in the division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi. HPS provides an opportunity to learn about the health impact of CBRN contaminants and practise medical management. Simulation as training and planning tools, offers repeatability, controllability, possibility for evaluation and provides a platform to learn from costly mistakes. Group training and demonstrations conducted on the HPS offers an additive benefit to enhance performance as a team and also help to reduce errors. This paper provides the information on the potentials of simulation based training of emergency response teams in the management of CBRN victims.</p><p> </p>
47
Autrey, Allen W., John L. Hick, Kurtis Bramer, Jeremy Berndt, and Jonathan Bundt. "3 Echo: Concept of Operations for Early Care and Evacuation of Victims of Mass Violence." Prehospital and Disaster Medicine 29, no. 4 (June 9, 2014): 421–28. http://dx.doi.org/10.1017/s1049023x14000557.
Full textAbstract:
AbstractThis report describes the successful use of a simple 3-phase approach that guides the initial 30 minutes of a response to blast and active shooter events with casualties: Enter, Evaluate, and Evacuate (3 Echo) in a mass-shooting event occurring in Minneapolis, Minnesota USA, on September 27, 2012. Early coordination between law enforcement (LE) and rescue was emphasized, including establishment of unified command, a common operating picture, determination of evacuation corridors, swift victim evaluation, basic treatment, and rapid evacuation utilizing an approach developed collaboratively over the four years prior to the event. Field implementation of 3 Echo requires multi-disciplinary (Emergency Medical Services (EMS), fire and LE) training to optimize performance. This report details the mass-shooting event, the framework created to support the response, and also describes important aspects of the concepts of operation and curriculum evolved through years of collaboration between multiple disciplines to arrive at unprecedented EMS transport times in response to the event.AutreyAW, HickJL, BramerK, BerndtJ, BundtJ. 3 Echo: concept of operations for early care and evacuation of victims of mass violence. Prehosp Disaster Med. 2014;29(4):1-8.
48
Badiali, Stefano, Aimone Giugni, and Lucia Marcis. "Testing the START Triage Protocol: Can It Improve the Ability of Nonmedical Personnel to Better Triage Patients During Disasters and Mass Casualties Incidents ?" Disaster Medicine and Public Health Preparedness 11, no. 3 (January 9, 2017): 305–9. http://dx.doi.org/10.1017/dmp.2016.151.
Full textAbstract:
AbstractObjectiveSTART (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether “last-minute” START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients.MethodsIn this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group). The START group received last-minute START training. Each group examined 6000 patients, obtained from the Emergo Train System (ETS Italy, Bologna, Italy) victims database, and assigned patients a triage code (black-red-yellow-green) along with a reason for the assignment. Each rescuer triaged 30 patients within a 30-minute time frame. Results were analyzed according to Fisher’s exact test for a P value<0.01. Under- and over-triage ratios were analyzed as well.ResultsThe START group completed the evaluations in 15 minutes, whereas the non-START group took 30 minutes. The START group correctly triaged 94.2% of their patients, as opposed to 59.83% of the non-START group (P<0.01). Under- and over-triage were, respectively, 2.73% and 3.08% for the START group versus 13.67% and 26.5% for the non-START group. The non-START group had 458 “preventable deaths” on 6000 cases because of incorrect triage, whereas the START group had 91.ConclusionsEven a “last-minute” training on the START triage protocol allows nonmedical personnel to better identify and triage the victims of a disaster or MCI, resulting in more effective and efficient medical intervention. (Disaster Med Public Health Preparedness. 2017;11:305–309)
49
Foo, Ning-Ping, Edmund Cheung So, Nai-Chen Lu, Shih-Wei Hsieh, Shih-Tien Pan, Yu-Long Chen, Yu-Cheng Hung, Siu-Fung Wong, Chi-Feng Hsu, and Chung-Yu Chen. "A 36-Hour Unplugged Full-Scale Exercise: Closing the Gaps in Interagency Collaboration between the Disaster Medical Assistance Team and Urban Search and Rescue Team in Disaster Preparedness in Taiwan." Emergency Medicine International 2021 (April 6, 2021): 1–8. http://dx.doi.org/10.1155/2021/5571009.
Full textAbstract:
Introduction. Disaster medical assistance team (DMAT) and urban search and rescue team (USAR) need to cooperate seamlessly to save lives in disasters, but related research is limited. Objectives. To estimate the disaster preparedness of the DMAT and the barriers affecting interagency cooperation between the DMAT and the USAR team. Methods. This was an observational study of a full-scale exercise conducted in Taiwan from November 16 to 18, 2018. The exercise scenario simulated a magnitude 7 earthquake in Tainan City. DMATs from other counties were deployed and cooperated with local USAR teams to carry out disaster relief. Our study invited 7 experts to evaluate DMATs on disaster preparedness capabilities and the interagency collaboration between DMATs and USAR. Results. A total of eight DMATs, consisting of 30 physicians, 65 nurses, 74 logisticians, 5 health bureau personnel, and 85 USAR teams, participated in this exercise. During the mission, 176 patients were treated. The capabilities of each team were generally consistent with the basic technical standards for type I emergency medical teams, but the compliance rates for basic local anesthesia, cold chain equipment for medication, rapid blood test tools, and sterilization devices were only 50%, 12.5%, 12.5%, and 9%, respectively. In addition, 53% of participants reported abnormal vital signs, indicating that it was a high-stress situation. Moreover, the main barriers to interagency collaboration were differing perspectives and poor mutual understanding. Conclusion. A full-scale exercise carried out jointly with DMATs and USAR teams was valuable for disaster preparedness, particularly in terms of understanding the weaknesses of those teams and the barriers to interagency collaboration.
50
Haddad, Philip A. "Efficacy of Short Oral Leucovorin Rescue (SOLR) In Managing Recurrent Pralatrexate (Folotyn) Induced Mucositis (RPIM) Despite Dose Reduction." Blood 118, no. 21 (November 18, 2011): 4745. http://dx.doi.org/10.1182/blood.v118.21.4745.4745.
Full textAbstract:
Abstract Abstract 4745 Mucositis is a frequent complication experienced by patients receiving weekly Pralatrexate, an antifolate agent, which often leads to significant morbidity, decreased quality of life, and early discontinuation of this active therapy in aggressive and almost universally fatal Peripheral T-cell Lymphomas (PTCL). Despite its frequency, there is no standard medical management currently except omitting doses followed by one step dose reduction and subsequent discontinuation, many times despite notable responses. Since Leucovorin is approved as antidote for Pralatrexate overdose, we reviewed our clinical experience with its reactive (not pre-emptive) use in our PTCL patients with Grade 2+ RPIM that have already gone through dose omissions and dose reductions and had no other alternative but to discontinue therapy. SOLR consisted of 25 mg po Q6h for 5 days the week of RPIM to be stopped at least 48hours prior to the planned subsequent weekly dose. We reviewed our experience with such approach which amounted to 17 such interventions. All 17 SOLR regardless of grade lead to resolution of subjective symptoms by the 7th day with time to initial subjective improvement at around the 4th day from SOLR initiation. Sixteen SOLR interventions had complete resolution of RPIM on exam on the 7th day and one had almost complete resolution. As such, all cases were ready to resume weekly recommended dosing per standard PTCL regimen. None of SOLR patients discontinued Pralatrexate for RPIM. None of SOLR patients lost their response attained prior to the intervention. In fact, the patient with transformed Mycosis Fungoides continued to show notable further skin response. When compared to the PROPEL Trial which used dose omission and delay to address mucositis, SOLR further shortened the time to resolution by 3–5 days (7 days vs. median of 10 days for Grade 2 and 12 days for Grade 3- Allos unpublished data). Although further controlled studies are recommended, our clinical observation suggests that reactive SOLR intervention in RPIM offers rapid and effective symptom management by aiding faster mucosal healing and further decreases drug holidays and discontinuation of therapy without any discernable compromise in efficacy. Disclosures: Haddad: Allos: Consultancy, Honoraria, Research Funding, Speakers Bureau. Off Label Use: Use of Leucovorin in treating Pralatrexate induced Mucositis.