Prehospital and disaster medicine
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Prehosp Disaster Med · Jan 2003
Review Comparative StudyAnglo-American vs. Franco-German emergency medical services system.
It has been stated that the Franco-German Emergency Medical Services System (FGS) has considerable drawbacks compared to the Anglo-American Emergency Medical Services System (AAS): 1. The key differences between the AAS and the FGS are that in the AAS, the patients is brought to the doctor, while in the FGS, the doctor is brought to the patient. 2. In the FGS, patients with urgent conditions usually are evaluated and treated by general practitioners in their offices or at the patient's home; initially, very few approach an emergency department. 3. ⋯ The German healthcare system creates less expenses/capita than the does the U. S. system at a similar level of quality of care. 16. Emergency procedures are carried out by anesthesiologists, emergency physicians, surgeons, internists, and other specialists.
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Prehosp Disaster Med · Jan 2003
Comparative StudyPrehospital hyperventilation after brain injury: a prospective analysis of prehospital and early hospital hyperventilation of the brain-injured patient.
The Brain Trauma Foundation's Guidelines for the Management of Severe Head Injury state that the use of prophylactic hyperventilation after traumatic brain injury (TBI) should be avoided because it can compromise cerebral perfusion. The objective of this study was to assess the prevalence of unintentional hyperventilation. ⋯ Hyperventilation was common after TBI. However, patients ventilated to a normal PaCO2 were significantly more acidotic. Prehospital personnel should undergo educational training after development of strict ventilation protocols for patients suffering TBI.
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Medical care must be well-planned for mass gatherings. Events such as fairs, concerts, parades, and rallies cause many people to gather in one place, increasing the chance of injuries and for the development of a disaster. In this study, the level and quality of medical care were evaluated at a mass gathering of approximately 100,000 children. The event was a television-sponsored fun fair. ⋯ Most of the medical needs in the patients attending the children's fun fair were minor. Nevertheless, for similar events in the future, the medical team should be qualified for all serious medical emergencies, as well as major trauma; and should be prepared to meet the requirements of the specific group of spectators. The overall usage rate in the children's fun fair described was 19.2 patient encounters per 10,000 spectators. Half of all of the patients were children below the age of 14 years. Medical services should consider that this study shows that up to 33% of children seeking medical assistance may not be accompanied by adults.
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Prehosp Disaster Med · Jan 2003
Comment Letter Comparative StudyDoctor-based basic cardiopulmonary resuscitation course.