Prehospital and disaster medicine
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Prehosp Disaster Med · May 2010
Triage performance of first-year medical students using a multiple-casualty scenario, paper exercise.
Large-scale events may overwhelm the capacity of even the most advanced emergency medical systems. When patient volume outweighs the number of available emergency medical services (EMS) providers, a mass-casualty incident may require the aid of non-medical volunteers. These individuals may be utilized to perform field disaster triage, lessening the burden on EMS personnel. ⋯ First-year medical students who received brief START training achieved triage accuracy scores similar to those of emergency physicians, registered nurses, and paramedics in previous studies. Observed rates of under and over-triage suggest that a need exists for improving the accuracy of triage decisions made by medical and non-medical personnel. This study did not find that printed materials significantly improved triage accuracy, nor did it find that patient age affected the ability of participants to correctly assign triage categories. Future research might further evaluate disaster triage by non-medical volunteers.
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Prehosp Disaster Med · May 2010
Non-invasive carboxyhemoglobin monitoring: screening emergency medical services patients for carbon monoxide exposure.
Carbon monoxide (CO) toxicity is a significant health problem. The use of non-invasive pulse CO-oximetry screening in the emergency department has demonstrated that the rapid screening of numerous individuals for CO toxicity is simple and capable of identifying occult cases of CO toxicity. ⋯ Screening for CO toxicity in the EMS setting is possible, and may aid in the early detection and treatment of CO-poisoned patients.
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Prehosp Disaster Med · May 2010
Frequent use of emergency medical services by the elderly: a case-control study using paramedic records.
To identify the factors that lead to increased use of emergency medical services (EMS) by patients 65 years of age and older in an urban EMS system. ⋯ This analysis highlights homelessness as being strongly associated with frequent EMS use among the elderly and downplays other associated factors, such as psychiatric disease and substance use. Medical illness severity, particularly asthma when no primary care physician is available, also appears to drive frequent EMS use. Both findings have implications in terms of targeting of public resources; providing housing to medically ill elderly and primary care to asthmatics in particular, may provide dividends not only in terms of social welfare and medical care, but in preventing frequent EMS use by the elderly.
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The devastating Haiti earthquake rightly resulted in an outpouring of international aid. Relief teams can be of tremendous value during disasters due to natural hazards. Although nobly motivated to help, all emergency interventions have unintended consequences. In the immediate aftermath of the earthquake, many selfless individuals committed to help, but was this really all in the name of reaching out a helping hand? This case report illustrates that medical disaster tourism is alive and well.
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The increase in adverse health impacts of disasters has raised awareness of the need for education in the field of emergency public health. In the past, most traditional models of graduate education in schools of public health have not incorporated the theory and practice of disaster public health into their curricula. ⋯ The interdisciplinary nature of the faculty, close ties with public health practitioners, and practical applications of the nine courses in this program are highlighted. The curriculum is presented as one model that can be used to meet the educational needs of professionals who will assume the responsibility for planning for and responding to the public health impacts of mass-populations disasters.