Prehospital and disaster medicine
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Prehosp Disaster Med · Nov 2007
Leadership as a component of crowd control in a hospital dealing with a mass-casualty incident: lessons learned from the October 2000 riots in Nazareth.
Crowd control is essential to the handling of mass-casualty incidents (MCIs). This is the task of the police at the site of the incident. For a hospital, responsibility falls on its security forces, with the police assuming an auxiliary role. Crowd control is difficult, especially when the casualties are due to riots involving clashes between rioters and police. This study uses data regarding the October 2000 riots in Nazareth to draw lessons about the determinants of crowd control on the scene and in hospitals. ⋯ During riots, city, community, and even makeshift leaders within a crowd can play a pivotal role in helping hospital management control crowds. It may be advisable to train medical teams and hospital management to recognize potential leaders, and gain their cooperation in such an event. To optimize such cooperation, community leaders also should be acquainted with the roles of public health agencies and emergency services systems.
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Prehosp Disaster Med · Nov 2007
ReviewPrinciples of disaster planning for the pediatric population.
Unique physiological, developmental, and psychological attributes of children make them one of the more vulnerable populations during mass-casualty incidents. Because of their distinctive vulnerabilities, it is crucial that pediatric needs are incorporated into every stage of disaster planning. Individuals, families, and communities can help mitigate the effects of disasters on pediatric populations through ongoing awareness and preventive practices. ⋯ Pediatric response can be improved in a number of ways, including: (1) enhanced pediatric disaster expertise; (2) altered decontamination protocols that reflect pediatric needs; and (3) minimized parent-child separation. Recovery efforts at the pediatric level include promoting specific mental health therapies for children and incorporating children into disaster relief and recovery efforts. Improving pediatric emergency care needs should be at the forefront of every disaster planner's agenda.
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Prehosp Disaster Med · Nov 2007
Estimation of external blood loss by paramedics: is there any point?
There are many patient assessment challenges in the prehospital setting, especially the estimation of external blood loss. Previous studies of experienced paramedics have demonstrated that external blood loss estimation is highly inaccurate. The objective of this study was to determine if undergraduate paramedic students could accurately estimate external blood loss on four surfaces commonly found in the prehospital environment. ⋯ External blood loss estimation by undergraduate paramedic students generally is too inaccurate to be of any clinical benefit. Particularly, absorbent and impermeable surfaces precipitated inaccuracies by undergraduate paramedic students.
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Prehosp Disaster Med · Nov 2007
Emergency preparedness for the health sector and communities--challenges and the way forward. WHO Expert Consultation. Geneva, 15-17 February 2006.
In accordance with the World Health Assembly Resolution 58.1, the World Health Organization (WHO) convened an Expert Consultation in Geneva, Switzerland from 15-17 February 2006 to discuss and provide recommendations for enhancing emergency preparedness and capacity building at the community, country, regional, and global levels. The consultation included experts and representatives of non-governmental and inter-governmental organizations. ⋯ The recommendations, therefore, were focused at the community and country levels and outlined processes by which WHO could assist countries in augmenting their abilities to cope with health emergencies. This document provides a detailed discussion of the issues addressed, the conclusions reached, and recommendations based on the conclusions.