Prehospital and disaster medicine
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Prehosp Disaster Med · Jan 2001
A virtual reality patient simulation system for teaching emergency response skills to U.S. Navy medical providers.
Rapid and effective medical intervention in response to civil and military-related disasters is crucial for saving lives and limiting long-term disability. Inexperienced providers may suffer in performance when faced with limited supplies and the demands of stabilizing casualties not generally encountered in the comparatively resource-rich hospital setting. Head trauma and multiple injury cases are particularly complex to diagnose and treat, requiring the integration and processing of complex multimodal data. ⋯ Systems can be deployed to the field enabling trainees to practice repeatedly until their skills are mastered and to maintain those skills once acquired. This paper describes the technologies and the process used to develop the trainers, the clinical algorithms, and the incorporation of teaching points. We also characterize aspects of the actual simulation exercise through the lens of the trainee.
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A disaster is characterized by an imbalance between needs and supplies. In circumstances in which there occur mass casualties, it is not possible to provide care for all of the victims. Thus, it may be necessary to triage the casualties according to pre-established priorities. ⋯ Triage always must follow established medical criteria and cannot be based on any other principles. Triage implies constant re-evaluation of victims as conditions of the victims and of available resources change continuously. In order to facilitate international coordination and cooperation, a universal classification system must be adopted.
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Prehosp Disaster Med · Jan 2001
Volume kinetics of intravenous fluid therapy in the prehospital setting.
To study the volume effect of isotonic and hypertonic crystalloid fluid during ambulance transports after mild trauma, a prospective case-control study was initiated, using the ambulance and helicopter transport system in Stockholm. ⋯ Mild trauma prolonged the intravascular persistence of isotonic and hypertonic crystalloid fluid as compared to a control group.
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Prehosp Disaster Med · Jan 2001
Application of international standards to disasters: summary and action plan.
The need for the application of international standards has been evolving over the last decade. Consistency is needed not just in how we respond, but in when we respond. The discussions in this theme reflected on the progress of standard setting both at the local level and internationally. ⋯ There is a clear need for international standards for the management of disasters. Positions and advocacy for these positions are required to define and implement such standards.
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To evaluate the aseptic efficacy of prefilled syringes compared with ampules when used in a polluted environment similar to that at a disaster site. ⋯ Results indicate that, in environments with airborne contaminants, the use of prefilled syringes may be useful for preventing bacterial contamination of the medicine inside.