Prehospital and disaster medicine
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Disaster preparedness and response have gained increased attention in the United States as a result of terrorism and disaster threats. However, funding of hospital preparedness, especially surge capacity, has lagged behind other preparedness priorities. Only a small portion of the money allocated for national preparedness is directed toward health care, and hospitals receive very little of that. ⋯ Alternatively, the status quo of marginal preparedness can be maintained. In any event, achieving higher levels of preparedness likely will take the combined commitment of the hospital industry, public and private payers, and federal, state, and local governments. Ultimately, the costs of preparedness will be borne by the public in the form of taxes, higher healthcare costs, or through the acceptance of greater risk.
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Prehosp Disaster Med · Jul 2007
Comfort level of emergency medical service providers in responding to weapons of mass destruction events: impact of training and equipment.
Numerous studies have suggested that emergency medical services (EMS) providers are ill-prepared in the areas of training and equipment for response to events due to weapons of mass destruction (WMD) and other public health emergencies (epidemics, etc.). ⋯ Lack of training and education as well as the lack of necessary equipment to respond to WMD events is associated with decreased comfort among emergency medical services providers in responding to chemical, biological, and/or radiological incidents. Better training and access to appropriate equipment may increase provider comfort in responding to these types of incidents.
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Prehosp Disaster Med · Jul 2007
Effect of severe acute respiratory syndrome on bystander willingness to perform cardiopulmonary resuscitation (CPR)--is compression-only preferred to standard CPR?
The effect of the severe acute respiratory syndrome (SARS) outbreak on the willingness of laypersons to provide bystander cardiopulmonary resuscitation (CPR) using standard CPR (SCPR) or compression-only CPR (CCPR) was evaluated. The preferred type of SCPR in the post-SARS era was assessed. ⋯ Concerns about SARS adversely affected the willingness of respondents to perform SCPR or CCPR on strangers and to perform SCPR on family members. Compression-only CPR was preferred to SCPR to resuscitate strangers experiencing cardiac arrest after the emergence of SARS.
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Prehosp Disaster Med · Jul 2007
Emergency department evaluations of non-percutaneous blood or body fluid exposures during cardiopulmonary resuscitation.
The demography of healthcare workers (HCWs) and non-HCWs seeking medical care at emergency departments after a non-percutaneous potential exposure to human immunodeficiency virus (HIV) during cardiopulmonary resuscitation (CPR), the types and body locations of their exposures, the time elapsed from exposure to emergency department presentation, and usage of HIV-post-exposure prophylaxis (PEP) for these exposures are described. ⋯ Nearly half of the patients who presented with non-percutaneous exposures acquired during CPR were not HCWs. Most of the exposures were to saliva or sputum and occurred on their mucous membranes. Continuing education programs on maintaining universal precautions to prevent blood or body fluid exposures and appreciating the benign nature of most non-percutaneous exposures possible during CPR are needed.
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Prehosp Disaster Med · Jul 2007
Prehospital emergency care and medical preparedness for the 2005 World Championship Games in Athletics in Helsinki.
International mass gatherings can cause great challenges to local healthcare system and emergency medical services (EMS). Traditionally, planning has been based on retrospective reports of previous events, but there still is a need for prospective studies in order to make the process more evidence-based. The aim of this study was to analyze the success of medical preparedness, ambulance patient characteristics, emergency care, and the use of pre-hospital resources during the 2005 World Championship Games in Athletics in Helsinki, Finland. ⋯ The medical preparedness and resources for the Games proved to be sufficient. The EMS personnel were able to provide quality emergency care. This prospective study provided new, detailed data for the medical aspects of mass gatherings and confirmed many previous observations.