Prehospital and disaster medicine
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Prehosp Disaster Med · Nov 2008
Seatbelt use in Qatar in association with severe injuries and death in the prehospital setting.
Road traffic crashes (RTCs) are common in Qatar, and are now considered the third leading cause of mortality. In this study, the safety devices used by the Qatari public at the time of RTCs were assessed and the association between seatbelt use by vehicle occupants involved in RTCs and severe injury/death in the prehospital setting was determined. ⋯ Seatbelt use in Qatar is low. Seatbelts are protective: in the prehospital setting unbelted vehicle occupants involved in RTCs were nearly twice as likely to suffer severe injury or death compared to belted patients. Prehospital morbidity and mortality appears to be reduced significantly by the consistent use of seatbelts by the motoring population in Qatar.
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Prehosp Disaster Med · Nov 2008
Near-infrared laser spectroscopy as a screening tool for detecting hematoma in patients with head trauma.
Among imaging techniques, computed tomography (CT) is a reliable method for detecting intracranial hematomas in patients with head trauma, but it is not generally available in special circumstances like prehospital situations and harsh conditions such as those following an earthquake. ⋯ This study speculates that NIRS may be a useful screening tool to detect intracranial hematoma. This capability could be useful in special situations like in a deprived area, medical centers without CT scan capabilities, prehospital situations, and in harsh conditions like those after an earthquake or other disasters that causes increased numbers of victims with closed head trauma.
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Prehosp Disaster Med · Nov 2008
Non-doctors as trauma surgeons? A controlled study of trauma training for non-graduate surgeons in rural Cambodia.
Due to the accelerating global epidemic of trauma, efficient and sustainable models of trauma care that fit low-resource settings must be developed. In most low-income countries, the burden of surgical trauma is managed by non-doctors at local district hospitals. ⋯ Where the rural hospital is an integral part of a prehospital trauma system, systematic training of non-doctors improves the quality of trauma surgery. Initial efforts to improve trauma management in low-income countries should focus on the district hospital.
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Prehosp Disaster Med · Nov 2008
Paramedic identification of electrocardiograph J-point and ST-segments.
Correct identification of the J-Point and ST-segment on an electrocardiograph (ECG) is an important clinical skill for paramedics working in acute healthcare settings. The skill of ECG analysis and interpretation is known to be challenging to learn and often is a difficult concept to teach. ⋯ Undergraduate paramedic students recognize ST-segment elevation. However, inaccuracies occurred with measurements of ST-segment and precise location of J-Points. Errors in ECG analysis may reflect weaknesses in teaching this skill. Consideration should be given to the design of an educational program that can reliably improve performance of this skill.
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Prehosp Disaster Med · Nov 2008
Acquiring and maintaining competence in the application of extrication cervical collars by a group of first responders.
Research on skill acquisition and retention in the prehospital setting has focused primarily on resuscitation and defibrillation. Investigation into other first aid skills is required in order to validate practices and support training regimes. No studies have investigated competency using an extrication cervical collar for cervical spine immobilization. ⋯ Although the sample size was small, this research demonstrates that first responders are able to acquire competence in applying an extrication cervical collar. However, skill retention in the absence of usage or re-training is poor. Larger studies should be conducted to validate these results. In addition, there is a need for research on the clinical practice and outcomes associated with spinal immobilization in the prehospital setting.