Prehospital and disaster medicine
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Prehosp Disaster Med · Jun 2019
An Overview of Chicago (Illinois USA) Marathon Prehospital Care Demographics, Patient Care Operations, and Injury Patterns.
Large-scale mass-sporting events are increasingly requiring greater prehospital event planning and preparation to address inherent event-associated medical conditions in addition to incidents that may be unexpected. The Bank of America Chicago Marathon (Chicago, Illinois USA) is one of the largest marathons in the world, and with the improvement of technology, the use of historical patient and event data, in conjunction with environmental conditions, can provide organizers and public safety officials a way to plan based on injury patterns and patient demands for care by predicting the placement and timing of needed medical support and resources. ⋯ The Chicago Marathon is one of the largest marathons in the world, and this study identified an equal number of participants requiring care on-course and at the finish line. Most medical complaints were musculoskeletal in nature; however, there were life-threatening conditions such as hyperthermia and cardiac incidents that highlight the need for detailed planning, multi-disciplined coordination, and communication to ensure a safe and secure event. As technology has evolved, the use, analysis, and implementation of historical digital data with various environmental conditions can provide organizers and public safety officials a map to plan injury patterns and patient demands by predicting the placement and timing of needed medical support, personnel, and resources.
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Prehosp Disaster Med · Apr 2019
Randomized Controlled TrialThe Impact of Backboard Placement on Chest Compression Quality: A Mannequin Study.
High-quality chest compressions (CCs) are associated with high survival rates and good neurological outcomes in cardiac arrest patients. The 2015 American Heart Association (AHA; Dallas, Texas USA) Guidelines for Resuscitation defined and recommended high-quality CCs during cardiopulmonary resuscitation (CPR). However, CPR providers struggle to achieve high-quality CCs. There is a debate about the use of backboards during CPR in literature. Some studies suggest backboards improve CC quality, whereas others suggest that backboards can cause delays. This is the first study to evaluate all three components of high-quality CCs: compression depth, recoil depth, and rate, at the same time with a high number of subjects. This study evaluated the impact of backboards on CC quality during CPR. The primary outcome was the difference in successful CC rates between two groups. ⋯ The results suggest that using a backboard during CPR improves the quality of CCs in accordance with the 2015 AHA Guidelines.Sanri E, Karacabey S. The impact of backboard placement on chest compression quality: a mannequin study. Prehosp Disaster Med. 2019;34(2):182-187.
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Prehosp Disaster Med · Apr 2019
Comparative StudyA Cross-Over Trial Comparing Conventional to Compression-Adjusted Ventilations with Metronome-Guided Compressions.
Hyperventilation during cardiopulmonary resuscitation (CPR) negatively affects cardiopulmonary physiology. Compression-adjusted ventilations (CAVs) may allow providers to deliver ventilation rates more consistently than conventional ventilations (CVs). This study sought to compare ventilation rates between these two methods during simulated cardiac arrest.Null Hypothesis:That CAV will not result in different rates than CV in simulated CPR with metronome-guided compressions. ⋯ In this simulated model of cardiac arrest, CAV had more accurate ventilation rates and fewer episodes of hyperventilation compared with CV.Nikolla DA, Kramer BJ, Carlson JN. A cross-over trial comparing conventional to compression-adjusted ventilations with metronome-guided compressions. Prehosp Disaster Med. 2019;34(2):220-223.
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Prehosp Disaster Med · Apr 2019
Development and Implementation of a Disaster Medicine Certificate Series (DMCS) for Medical Students.
The recent increase in natural disasters and mass shootings highlights the need for medical providers to be prepared to provide care in extreme environments. However, while physicians of all specialties may respond in emergencies, disaster medicine training is minimal or absent from most medical school curricula in the United States. A voluntary Disaster Medicine Certificate Series (DMCS) was piloted to fill this gap in undergraduate medical education. ⋯ The DMCS voluntary certificate series model served as an innovative method for providing disaster medicine education to medical students.Kommor MB, Hodge B, Ciottone G. Development and implementation of a Disaster Medicine Certificate Series (DMCS) for medical students. Prehosp Disaster Med. 2019;34(2):197-202.
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Prehosp Disaster Med · Apr 2019
Consideration of Medical and Public Health Coordination - Experience from the 2016 Kumamoto, Japan Earthquake.
The aim of this study was to identify disaster medical operation improvements from the 2016 Kumamoto Earthquake (Kumamoto Prefecture, Japan) and to extract further lessons learned to prepare for future expected major earthquakes. ⋯ During the 2016 Kumamoto Earthquake, needs of public health and welfare increased enormously due to the sudden evacuation of a large number of residents. To provide constant medical assistance at the disaster area, DMAT, logistic teams, and other disaster medical relief teams must operate constant coordination at the medical headquarter command. For future expected major earthquakes in Japan, it will be required to educate and secure high enough numbers of disaster medical assistance and health care personnel to provide continuous medical and public health care for the affected area residents.Kondo H, Koido Y, Kawashima Y, Kohayagawa Y, Misaki M, Takahashi A, Kondo Y, Chishima K, Toyokuni Y. Consideration of medical and public health coordination - experience from the 2016 Kumamoto, Japan Earthquake. Prehosp Disaster Med. 2019;34(2):149-154.