Prehospital and disaster medicine
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Prehosp Disaster Med · Oct 2004
Comparative StudyCost-effectiveness and benefit of alternatives to improve training for prehospital trauma care in Mexico.
In Latin America, there is a preponderance of prehospital trauma deaths. However, scarce resources mandate that any improvements in prehospital medical care must be cost-effective. This study sought to evaluate the cost-effectiveness of several approaches to improving training for personnel in three ambulance services in Mexico. ⋯ This study highlights the importance of assuring uniform, basic training for all prehospital providers. This is a more cost-effective approach than is higher-cost ALS training for improving prehospital trauma care in environments such as Latin America.
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Prehosp Disaster Med · Oct 2004
Comparative StudyWhere's the tube? Evaluation of hand-held ultrasound in confirming endotracheal tube placement.
The diagnosis of endotracheal tube (ETT) mal-position may be delayed in extreme environments. Several methods are utilized to confirm proper ETT placement, but these methods can be unreliable or unavailable in certain settings. Thoracic sonography, previously utilized to detect pneumothoraces, has not been tested to assess ETT placement. ⋯ This report raises the possibility that thoracic sonography may be another tool that could be used to confirm proper ETT placement. This technique may have merit in extreme environments, such as in remote, pre-hospital settings or during aerospace medical transports, in which auscultation is impossible due to noise, or capnography is not available, and thus, requires further scientific evaluation.
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Prehosp Disaster Med · Oct 2004
Out-of-hospital cardiac arrest locations in a rural community: where should we place AEDs?
Early defibrillation improves survival for patients suffering cardiac arrest from ventricular fibrillation (VF) or ventricular tachycardia (VT). Automated external defibrillators (AEDs) should be placed in locations in which there is a high incidence of out-of-hospital cardiac arrest (OOHCA). The study objective was to identify high-risk, rural locations that might benefit from AED placement. ⋯ Most (52.1%) non-residential OOHCAs occurred as isolated events in 146 different locations. Almost half of the OOHCAs that occurred in non-residential areas took place in healthcare-related facilities suggesting that patients at these locations may benefit from AED placement. First responders with AEDs are likely to have the greatest impact in a rural community.
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Prehosp Disaster Med · Oct 2004
Comment Letter Comparative StudyThe impact of terrorism on children: a two-year experience.
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Prehosp Disaster Med · Jul 2004
ReviewEffectiveness of hospital staff mass-casualty incident training methods: a systematic literature review.
Recently, mass-casualty incident (MCI) preparedness and training has received increasing attention at the hospital level. ⋯ Current evidence on the effectiveness of MCI training for hospital staff is limited. A number of studies suggest that disaster drills can be effective in training hospital staff. However, more attention should be directed to evaluating the effectiveness of disaster training activities in a scientifically rigorous manner.