Prehospital and disaster medicine
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Prehosp Disaster Med · Feb 2012
Analysis of trends and emergency activities relating to critical victims of the Chuetsuoki Earthquake.
When a large-scale disaster occurs, it is necessary to use the available resources in a variety of sites and scenes as efficiently as possible. To conduct such operations efficiently, it is necessary to deploy limited resources to the places where they will be the most effective. In this study, emergency and medical response activities that occurred following the Chuetsuoki Earthquake in Japan were analyzed to assess the most efficient and effective activities. ⋯ During the acute emergency period following a disaster-causing event, it is difficult to meet all requests for emergency services. In such cases, it is necessary to conduct efficient activities that target critically injured patients. Since hospital transfers are matters of great urgency, it is necessary to consider assigning resource investment priority to hospital transfers during this acute period, when ambulance services may be insufficient to meet all needs. To deal with such disasters appropriately, it is necessary to ensure effective information exchange and close collaboration between ambulance services, firefighting organizations, disaster medical assistance teams, and medical institutions.
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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
Time for order in chaos! A health system framework for foreign medical teams in earthquakes.
The number of reported natural disasters is increasing, as is the number of foreign medical teams (FMTs) sent to provide relief. Studies show that FMTs are not coordinated, nor are they adapted to the medical needs of victims. Another key challenge to the response has been the lack of common terminologies, definitions, and frameworks for FMTs following disasters. ⋯ This framework was developed using expert panels and personal experience, as well as an exhaustive literature review. The framework can facilitate decisions for deployment of FMTs, as well as facilitate coordination in disaster-affected countries. It also can be an important tool for registering agencies that send FMTs to sudden onset disasters, and ultimately for improving disaster response.
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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.