Prehospital and disaster medicine
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Prehosp Disaster Med · Aug 2013
Managing multiple-casualty incidents: a rural medical preparedness training assessment.
The objectives of this study were to develop a novel training model for using mass-casualty incident (MCI) scenarios that trained hospital and prehospital staff together using Microsoft Visio, images from Google Earth and icons representing first responders, equipment resources, local hospital emergency department bed capacity, and trauma victims. The authors also tested participants' knowledge in the areas of communications, incident command systems (ICS), and triage. ⋯ Mass-casualty incidents offer significant challenges for prehospital and emergency room workers. Fire, Police and EMS personnel must secure the scene, establish communications, define individuals' roles and responsibilities, allocate resources, triage patients, and assign transport priorities. After emergency department notification and in advance of arrival, emergency department personnel must assess available physical resources and availability and type of manpower, all while managing patients already under their care. Mass-casualty incident trainings should strengthen the key, individual elements essential to well-coordinated response such as communications, incident management system and triage. The practice scenarios should be matched to the specific resources of the community. The authors also believe that these trainings should be provided with all disciplines represented to eliminate training "silos," to allow for discussion of overlapping jurisdictional or organizational responsibilities, and to facilitate team building.
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Prehosp Disaster Med · Aug 2013
Effect of hydroxocobalamin on surface oximetry in nonexposed humans.
The newer cyanide antidote, hydroxocobalamin, due to its pigmentation, has been found to cause interferences in some laboratory assays. Co-oximetry may also be affected by hydroxocobalamin, leading to false elevations in hemoglobin concentration, methemoglobin, carboxyhemoglobin, and false decreases in oxyhemoglobin. The Masimo Radical-7 is a medical device that performs noninvasive oximetry and estimates hemoglobin (Hb) concentration and percent carboxyhemoglobin (COHb), methemoglobin (MetHb), and oxyhemoglobin saturation (O2Hb). ⋯ The administration of hydroxocobalamin does not significantly impact noninvasive oximetry.
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Prehosp Disaster Med · Aug 2013
Risk factors for injuries in landslide- and flood-affected populations in Uganda.
The frequency of occurrence of natural disasters has increased over the past several decades, which necessitates a better understanding of human vulnerability, particularly in low-resource settings. This paper assesses risk factors for injury in the March 2010 floods and landslides in Eastern Uganda, and compares the effects of location, injury type, and severity. ⋯ This study illustrates differences between populations injured by flood and landslide disasters that occurred simultaneously in Eastern Uganda in 2010. In areas where landslides are prone to occur due to massive rainfalls or floods, preventative measures, such as early warning systems and evacuation, are more likely to increase the likelihood of people surviving, while for areas with massive floods, immediate and effective medical attention can save lives and improve injury outcomes.
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Prehosp Disaster Med · Aug 2013
A poor association between out-of-hospital cardiac arrest location and public automated external defibrillator placement.
Much attention has been given to the strategic placement of automated external defibrillators (AEDs). The purpose of this study was to examine the correlation of strategically placed AEDs and the actual location of cardiac arrests. ⋯ A poor association exists between the location of cardiac arrests and the location of AEDs.
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Prehosp Disaster Med · Aug 2013
Methicillin-resistant staphylococcus aureus nasal colonization prevalence among Emergency Medical Services personnel.
The prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among Emergency Medical Services (EMS) personnel is not well studied. Methicillin-resistant Staphylococcus aureus colonization can be a health hazard for both EMS personnel and patients. The aim of this study was to quantify the prevalence of MRSA colonization among EMS personnel. This study will help the scientific community understand the extent of this condition so that further protocols and policies can be developed to support the health and wellbeing of EMS personnel. Hypothesis/ Problem The hypothesis of this study was that the prevalence of MRSA colonization among EMS personnel is significantly higher than among the general population. ⋯ There is evidence that EMS personnel have a higher prevalence of MRSA colonization than the general population. This can be a risk to patients and can be recognized as an occupational hazard.