Prehospital and disaster medicine
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The 2009 H1N1 influenza pandemic created a surge of patients with low-acuity influenza-like-illness (ILI) to hospital Emergency Departments (EDs). The development and results of a tiered surge plan to care for these patients at a Pediatric Emergency Department (PED) were studied. ⋯ The tiered surge response plan represented a success in managing large volumes of low-acuity patients during an extended period of time. This design can be utilized effectively in the future during times of patient surge.
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A 20-year-old male was impaled through the chest, abdomen, and right upper thigh by three 1.5 cm (0.59 in) diameter rods, each 2 m (6.56 ft) in length. The first rod entered below his right nipple, the second through the right hypochondrium, and the third through the right upper thigh. ⋯ This paper provides insight as to how these unusual injuries were managed in a limited-resource environment. Even in a developing country, the challenges posed by multiple impalement injuries can be managed successfully by rapid prehospital transfer, along with an adequate and coordinated hospital team effort.
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Prehosp Disaster Med · Feb 2012
The evaluation of research methods during disaster exercises: applicability for improving disaster health management.
The objective of this study was to investigate whether disaster exercises can be used as a proxy environment to evaluate potential research instruments designed to study the application of medical care management resources during a disaster. ⋯ Research instruments can be evaluated and improved when tested during a disaster exercise. Lack of data recovery hampers disaster research even in the artificial setting of a national disaster exercise. Providers at every level must be aware that proper data collection is essential to improve the quality of health care during a disaster, and that predisaster cooperation is crucial to validate patient outcomes. These problems must be addressed pre-exercise by stakeholders and decision-makers during planning, education, and training. If not, disaster exercises will not meet their full potential.
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Prehosp Disaster Med · Feb 2012
Prehospital trauma system reduces mortality in severe trauma: a controlled study of road traffic casualties in Iraq.
In low-resource communities with long prehospital transport times, most trauma deaths occur outside the hospital. Previous studies from Iraq demonstrate that a two-tier network of rural paramedics with village-based first helpers reduces mortality in land mine and war-injured from 40% to 10%. However, these studies of prehospital trauma care in low-income countries have been conducted with historical controls, thus the results may be unreliable due to differences in study contexts. The aim of this study was to use a controlled study design to examine the effect of a two-tier prehospital rural trauma system on road traffic accident trauma mortality. ⋯ Where prehospital transport time is long, a two-tier prehospital system of trained paramedics and layperson first responders reduces trauma mortality in severe RTA injuries. The findings may be valid for civilian Emergency Medical Services interventions in other low-resource countries.
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Prehosp Disaster Med · Feb 2012
Increasing emergency medicine residents' confidence in disaster management: use of an emergency department simulator and an expedited curriculum.
Disaster Medicine is an increasingly important part of medicine. Emergency Medicine residency programs have very high curriculum commitments, and adding Disaster Medicine training to this busy schedule can be difficult. Development of a short Disaster Medicine curriculum that is effective and enjoyable for the participants may be a valuable addition to Emergency Medicine residency training. ⋯ A simulation-based model of Disaster Medicine training, requiring approximately eight hours of classroom time, was judged by Emergency Medicine residents to be a valuable component of their medical training, and increased their confidence in personal and departmental disaster management capabilities.