Prehospital and disaster medicine
-
Prehosp Disaster Med · Apr 1997
Comparative Study Clinical TrialParamedic interpretation of prehospital lead-II ST-segments.
To determine the reliability of ST-segment interpretation by paramedics from lead-II rhythm strips obtained in the prehospital setting. ⋯ Field interpretation of ST-segments by paramedics is fairly accurate as judged both by emergency physicians and correlation with final patient outcome, but its clinical utility is unproved. A small but clinically significant number of outliers, consisting of markedly discrepant false positives, reflects paramedic uncertainty in identifying the deviations of the ST-segment.
-
Prehosp Disaster Med · Apr 1997
ReviewLessons learned and unsolved public health problems after large-scale disasters.
This paper examines the considerable medical and psychological problems that ensue after disasters in which massive populations are affected for extended and sometimes unknown time periods. The organization of disaster response teams after large-scale disasters is based on experiences as a medical specialist at Chernobyl immediately after this catastrophe. Optimal ways of dealing with the immediate medical and logistical demands as well as long-term public health problems are explored with a particular focus on radiation disasters. Other lessons learned from Chernobyl are explained. ⋯ The use of a mobile diagnostic and continuously operating pre-hospital triage system for rapid health screening of large populations at different stages after a large-scale disaster is advisable. The functional systems of the body to be observed at different stages after a radiation disaster are specified. There is a particularly strong need for continued medical and psychosocial evaluation of radiation-exposed populations over an extended time and a need for international collaboration among investigators.
-
Prehosp Disaster Med · Apr 1997
ReviewEmergency Medical Services System in Hong Kong: a pearl in the South China Sea.
Each Emergency Medical Services (EMS) system is unique in its development and scope of practice. In many instances, it incorporates components of other models. ⋯ This article describes the EMS system that exists in Hong Kong. It explores the changes that are occurring, defines the relationship between Hong Kong and China, and considers the influence that this evolving model might have on China after 1997.
-
Prehosp Disaster Med · Apr 1997
Feedback to emergency medical services providers: the good, the bad, and the ignored.
To determine the type and frequency of immediate unsolicited feedback received by emergency medical service (EMS) providers from patients or their family members and emergency department (ED) personnel. ⋯ The two groups provided feedback to emergency medical service providers in approximately one quarter of the calls. When feedback was provided, it was positive more than twice as often as it was negative. Emergency physicians should give regular and constructive feedback to emergency medical services providers more often than currently is the case.
-
Prehosp Disaster Med · Apr 1997
Case ReportsThe efficacy of integrating "smart simulated casualties" in hospital disaster drills.
Full-scale disaster drills are complex, expensive, and may involve hundreds or thousands of people. However, even when carefully planned, they often fail to manifest the details of medical care given to the casualties during the drill. ⋯ Integrating physicians among the simulated casualties in a hospital disaster drill may contribute to achieving the objectives of hospital disaster drills and add to disaster management education of the simulated casualty physicians.