Prehospital and disaster medicine
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Prehosp Disaster Med · Feb 2013
Design of a model to predict surge capacity bottlenecks for burn mass casualties at a large academic medical center.
To design and test a model to predict surge capacity bottlenecks at a large academic medical center in response to a mass-casualty incident (MCI) involving multiple burn victims. ⋯ This model, and similar models for non-burn-related MCIs, can serve as a real-time estimation and management tool for hospital capacity in the setting of MCIs, and can inform supply decision support for disaster management.
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Prehosp Disaster Med · Feb 2013
Relationship between time from ambulance call to arrival at emergency center and level of consciousness at admission in severe stroke patients.
Timely access to acute medical treatment can be critical for patients suffering from severe stroke. Little information is available about the impact of prehospital delays on the clinical conditions of stroke patients, but it is possible that prehospital delays lead to neurological deterioration. The aim of this study was to examine the impact of prehospital delays related to emergency medical services on the level of consciousness at admission in patients with severe stroke. ⋯ Prehospital delays were significantly associated with decreased levels of consciousness at admission in patients suffering from a stroke. As level of consciousness is the strongest predictor of outcome, reducing prehospital delays may be necessary to improve the outcomes in patients with severe stroke.
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Prehosp Disaster Med · Feb 2013
The impact of post-election violence on HIV and other clinical services and on mental health-Kenya, 2008.
In December 2007, civil disruption and violence erupted in Kenya following national elections, displacing 350,000 people and affecting supply chains and services. The Kenyan government and partners were interested in assessing the extent of disruption in essential health services, especially HIV treatment. ⋯ More than 85% of patients in highly affected provinces avoided treatment interruptions; this may be in part related to practitioners anticipating potential disruption and providing patients with medications for an extended period. During periods of similar crisis, anticipating potential limitations on medication access and increased mental health needs could potentially prevent negative health impacts.
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Prehosp Disaster Med · Dec 2012
ReviewFactors associated with the willingness of health care personnel to work during an influenza public health emergency: an integrative review.
The first decade of the 21st century has witnessed three major influenza public health emergencies: (1) the severe acute respiratory syndrome of 2002-2003; (2) the avian flu of 2006; and (3) the 2009 H1N1 pandemic influenza. An effective public health response to an influenza public health emergency depends on the majority of uninfected health care personnel (HCP) continuing to report to work. The purposes of this study were to determine the state of the evidence concerning the willingness of HCP to work during an influenza public health emergency, to identify the gaps for future investigation, and to facilitate evidence-based influenza public health emergency planning. ⋯ Understanding the factors that contribute to the willingness of HCP to report to work during an influenza public health emergency is critical to emergency planning and preparedness. Information from this review can guide emergency policy makers, planners, and implementers in both understanding and influencing the willingness of HCP to work during an influenza public health emergency.
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Prehosp Disaster Med · Dec 2012
Multiple patients with carbon monoxide toxicity from water-pipe smoking.
This case report describes carbon monoxide toxicity from prolonged shisha (water-pipe) smoking. The evidence base for the source and pathway of toxicity is discussed. This practice has been increasing in the UK in recent years, and emergency physicians need to be aware of the high levels of CO, with the consequent risk of clinical poisoning from water-pipe smoking.