Prehospital and disaster medicine
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Prehosp Disaster Med · Feb 2012
Prehospital trauma system reduces mortality in severe trauma: a controlled study of road traffic casualties in Iraq.
In low-resource communities with long prehospital transport times, most trauma deaths occur outside the hospital. Previous studies from Iraq demonstrate that a two-tier network of rural paramedics with village-based first helpers reduces mortality in land mine and war-injured from 40% to 10%. However, these studies of prehospital trauma care in low-income countries have been conducted with historical controls, thus the results may be unreliable due to differences in study contexts. The aim of this study was to use a controlled study design to examine the effect of a two-tier prehospital rural trauma system on road traffic accident trauma mortality. ⋯ Where prehospital transport time is long, a two-tier prehospital system of trained paramedics and layperson first responders reduces trauma mortality in severe RTA injuries. The findings may be valid for civilian Emergency Medical Services interventions in other low-resource countries.
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Prehosp Disaster Med · Feb 2012
Increasing emergency medicine residents' confidence in disaster management: use of an emergency department simulator and an expedited curriculum.
Disaster Medicine is an increasingly important part of medicine. Emergency Medicine residency programs have very high curriculum commitments, and adding Disaster Medicine training to this busy schedule can be difficult. Development of a short Disaster Medicine curriculum that is effective and enjoyable for the participants may be a valuable addition to Emergency Medicine residency training. ⋯ A simulation-based model of Disaster Medicine training, requiring approximately eight hours of classroom time, was judged by Emergency Medicine residents to be a valuable component of their medical training, and increased their confidence in personal and departmental disaster management capabilities.
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Prehosp Disaster Med · Feb 2012
Medical care at mass gatherings: emergency medical services at large-scale rave events.
The objective of this study was to develop comprehensive guidelines for medical care during mass gatherings based on the experience of providing medical support during rave parties. ⋯ During a five-year field research period at rave dance parties, most presentations on-site for medical evaluation were for mild conditions. A medical team of six healthcare workers for every 10,000 rave party visitors is recommended. On-site medical staff should consist primarily of first aid providers, along with nurses who have event-specific training on advanced life support, event-specific injuries and incidents, health education related to self-care deficits, interventions for psychological distress, infection control, and disaster medicine. Protocols should be available for treating common injuries and other minor medical problems, and for registration, triage, environmental surveillance and catastrophe management and response.
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Prehosp Disaster Med · Feb 2012
Protection against cold in prehospital care: evaporative heat loss reduction by wet clothing removal or the addition of a vapor barrier--a thermal manikin study.
In the prehospital care of a cold and wet person, early application of adequate insulation is of utmost importance to reduce cold stress, limit body core cooling, and prevent deterioration of the patient's condition. Most prehospital guidelines on protection against cold recommend the removal of wet clothing prior to insulation, and some also recommend the use of a waterproof vapor barrier to reduce evaporative heat loss. However, there is little scientific evidence of the effectiveness of these measures. ⋯ Wet clothing removal or the addition of a vapor barrier effectively reduced evaporative heat loss and might thus be of great importance in prehospital rescue scenarios in cold environments with limited insulation available, such as in mass-casualty situations or during protracted evacuations in harsh conditions.
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Prehosp Disaster Med · Feb 2012
Student perception of high fidelity medical simulation for an international trauma life support course.
High fidelity medical simulators (HFMS) are accepted tools for health care instruction. The use of HFMS was incorporated into an International Trauma Life Support course, and course participants were surveyed regarding attitudes toward HFMS. ⋯ High fidelity medical simulation was accepted by medical professionals of different backgrounds and experience. Attitudes towards simulation and self-confidence improved after simulator sessions, as did test scores, suggesting improved comprehension and retention of course materials. Further testing is required to validate the findings of this small, observational study.