Prehospital and disaster medicine
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Prehosp Disaster Med · May 2010
-PLUS prehospital mass-casualty triage: a strategy for addressing unusual injury mechanisms.
Simple Triage and Rapid Treatment (START) and more recently developed prehospital casualty triage algorithms are widely used, in part because they are easy to teach and learn, and can be performed rapidly. Every rapid triage protocol has inherent, significant limitations: (1) no mechanism of injury (MOI) considerations; (2) limited assessment points; and (3) no refinement in truly mass-casualty situations where transport of "minor" or "moderate" patients may be delayed. ⋯ "-PLUS" Prehospital Casualty Triage may supplement the strengths of already existing, widely accepted mass-casualty triage strategies. It does not displace START or other rapid initial triage protocols, but in mass-casualty situations with extensive delays in transport, it provides a method to identify under-triage of seriously injured casualties. "-PLUS" also presents a framework for capturing the triage considerations used by experienced medical providers, and so may provide a valuable teaching tool for training future triage professionals. Further research and field assessment is required.
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Prehosp Disaster Med · May 2010
Care of children at a large outdoor music festival in the United Kingdom.
Limited data exist on the standard of care provided for children at mass gatherings and special events (MGSE). Some studies provide valuable insight into the proportion of pediatric patients that can be expected at various types of MGSEs, but an accurate breakdown of the range of pediatric conditions treated at major events has yet to be produced. Such data are essential for the preparation of MGSEs so that the health and safety of children at such events can be adequately safeguarded. The aim of this study is to examine the care requirements for children at a large, outdoor music festival in the United Kingdom. ⋯ Mass gatherings and special events in the UK, such as outdoor music festivals, can involve a large number of children who access medical care for a different range of conditions compared to adults. The care of children at large, outdoor music events should not be overlooked. Event planning in the UK should include measures to ensure that appropriately trained and equipped medical teams are used at music festivals to safeguard the welfare of children who may attend. Further research into this exciting area is required.
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Prehosp Disaster Med · Mar 2010
Multicenter StudyCan undergraduate paramedic and nursing students accurately estimate patient age and weight?
Accurate estimation of a patient's age and weight are skills expected of all healthcare clinicians, including paramedics and nurses. It is necessary because patients may be unable to communicate such information due to unconsciousness or an altered state of conscious. Age and weight estimation influence calculation for medication dosages, defibrillation, equipment sizing, and other invasive procedures such as intubation. The objective of this study was to identify whether undergraduate paramedic and nursing students were able to accurately estimate a patient's age and weight based on digital patient photos. ⋯ Results from this study identified variations in students' ability to accurately estimate a patient's age and weight. This study shows that consideration should be given to age and weight estimation education, which could be incorporated into undergraduate healthcare curriculum.
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Prehosp Disaster Med · Mar 2010
Evaluation of medical command and control using performance indicators in a full-scale, major aircraft accident exercise.
Large, functional, disaster exercises are expensive to plan and execute, and often are difficult to evaluate objectively. Command and control in disaster medicine organizations can benefit from objective results from disaster exercises to identify areas that must be improved. ⋯ It is possible to use performance indicators in a full-scale, major incident exercise for evaluation of medical command and control. The results could be used to compare similar exercises and evaluate real incidents in the future.