Prehospital and disaster medicine
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Prehosp Disaster Med · Jan 2002
Interface between hospital and fire authorities--a concept for management of incidents in hospitals.
Although every hospital needs a security plan for the support of immobile patients who do not possess autonomous escape capabilities, little information exists to assist in the development of practical patient evacuation methods. ⋯ Experiences from a hospital during an evacuation exercise provided decision criteria for changes in the disaster preparedness plan. Hospital incident leadership was assigned to executives-in-charge in close co-operation with the fire authorities. All beds were equipped with a rescue drag sheet. Both concepts may help to cope with an emergency evacuation of a hospital.
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Prehosp Disaster Med · Oct 2001
Physicians and international humanitarian law in complex emergencies: controversies and future opportunities.
This paper describes the areas in which the Geneva Conventions no longer are adequate as a source of legal description or prescription for the challenges faced by physicians working in complex emergencies. It covers the conceptual pitfalls facing the medical profession in connection with humanitarian interventions, which often are conventional military operations, but are not recognized as such because they may vary in some respects from more familiar forms of interstate conflict. Emerging categories of combatants who pose a major threat during complex emergencies also are identified. ⋯ The paper proposes that new, epidemiological standards should be developed in order to identify the outbreak of armed conflicts and the trigger points for application of international humanitarian law. Such could replace the political model that presently underlies international humanitarian law. It also argues that international humanitarian law is not the starting point for application of humanitarian standards in war zones, but rather is built upon a peacetime medical culture that must be replicated in complex emergencies as a precursor to effective application of the law.
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Prehosp Disaster Med · Oct 2001
Relevant in times of turmoil: WHO and public health in unstable situations.
For millions of people world-wide, surviving the pressure of extreme events is the predominant objective in daily existence. The distinction between natural and human-induced disasters is becoming more and more blurred. Some countries have known only armed conflict for the last 25 years, and their number is increasing. ⋯ The World Health Organization must improve its own performance. This requires three key pre-conditions: 1) presence; 2) surge capacity; and 3) institutional support, knowledge, and competencies. Thus, in order to be effective, WHO's presence and surge capacity in emergencies must integrate the institutional knowledge, the competencies, and the managerial set-up of the Organization.
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Prehosp Disaster Med · Jul 2001
Comparative StudyA comparison of rural and urban Emergency Medical System (EMS) personnel: a Texas study.
In treating accident victims, actions by the Emergency Medical Personnel (EMP) at the scene may be the difference between life or death, full recovery or permanent disability. Development of selected profiles based on locale of services, tenure, and paramedic certification will provide valuable insight into the diversity within the Emergency Medical Services (EMS) profession. Not only will these profiles enable administrators to improve their recruitment, training, and retention of the emergency medical workforce, it potentially could enhance the quality of health care in the community. ⋯ In Texas, locale of service (urban or rural), length of tenure as an EMP (> or = 9 years), and paramedic certification appear to be significant factors that define the EMP population in Texas.
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Prehosp Disaster Med · Jul 2001
Mass gathering medicine: a predictive model for patient presentation and transport rates.
This paper reports on research into the influence of environmental factors (including crowd size, temperature, humidity, and venue type) on the number of patients and the patient problems presenting to first-aid services at large, public events in Australia. Regression models were developed to predict rates of patient presentation and of transportation-to-a-hospital for future mass gatherings. ⋯ Several features of the event environment influence patient presentation rates, and that the prediction of patient load at these events is complex and multifactorial. The use of regression modeling and close attention to existing historical data for an event can improve planning and the provision of health care services at mass gatherings.