Prehospital and disaster medicine
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Prehosp Disaster Med · Jan 2002
Emergency medical assistance team response following Taiwan Chi-Chi earthquake.
On 21 September, 1999, an earthquake measuring 7.3 on the Richter scale, struck central Taiwan near the town of Chi-Chi. The event resulted in 2,405 deaths and 11,306 injuries. Ad hoc emergency medical assistance teams (EMATs) from Taiwan assumed the responsibility for initiating early assessments and providing medical care. ⋯ 1. The response from EMATs was impressive, but largely uncoordinated in the absence of a pre-existing dispatching mechanism. 2. Most of the EMATs required > 24 hours to reach the disaster sites, and generally, did not arrive in time of affect the outcome of victims with preventable deaths. Therefore, there is an urgent need to strengthen local prehospital care. 3. A central governmental body that ensures better horizontal and vertical integration, and a comprehensive emergency management system is required in order to improve future disaster response and mitigation efforts.
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Prehosp Disaster Med · Jan 2002
Evaluation of a semi-quantitative CO2 monitor with pulse oximetry for prehospital endotracheal tube placement and management.
To evaluate three prototype versions of semi-quantitative end-tidal CO2 monitors with different alarm features during prehospital or interfacility use. ⋯ "Breath beeps" were clearly audible and were a useful feature in all prehospital and transport environments, while audible alarms were desired only in the AirEvac situation. Semi-quantitative CO2 detection is valuable in the ALS/AirEvac environment, even for teams with high intubation success rates.
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Prehosp Disaster Med · Jan 2002
Injury Severity Score versus New Injury Severity Score for penetrating injuries.
The New Injury Severity Score (NISS) was introduced in 1997 to improve outcome prediction based on anatomical severity scoring in trauma victims. Studies on populations of blunt trauma victims indicate that the NISS, predicts better than the Injury Severity Score (ISS) mortality post-injury, which is why the NISS has been recommended as the new "gold standard" for severity scoring. However, so far the accuracy of the NISS for penetrating injuries has not been validated against the ISS. ⋯ The NISS does not perform better than the ISS in penetrating injuries. However, this study was done on a low-risk trauma population, thus the results should not be extrapolated to high severity trauma. Due to statistical shortcomings in studies previously published, studies on far larger cohorts are necessary before the NISS should be adopted as the new "gold standard" for severity scoring.
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Prehosp Disaster Med · Jan 2002
Interface between hospital and fire authorities--a concept for management of incidents in hospitals.
Although every hospital needs a security plan for the support of immobile patients who do not possess autonomous escape capabilities, little information exists to assist in the development of practical patient evacuation methods. ⋯ Experiences from a hospital during an evacuation exercise provided decision criteria for changes in the disaster preparedness plan. Hospital incident leadership was assigned to executives-in-charge in close co-operation with the fire authorities. All beds were equipped with a rescue drag sheet. Both concepts may help to cope with an emergency evacuation of a hospital.