Prehospital and disaster medicine
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Prehosp Disaster Med · Feb 2012
The ethics of resuscitation: how do paramedics experience ethical dilemmas when faced with cancer patients with cardiac arrest?
Research on prehospital emergency work traditionally has focused on medical issues, but paramedics often have to make ethical choices. The goal of this exploratory study was to understand how paramedics experience difficult ethical dilemmas regarding resuscitation of cancer patients. ⋯ The findings of this qualitative, exploratory study suggest that ethical concepts and analyses of double pressure situations should have an important role in education and training designed to prepare emergency personnel for difficult life and death choices. More research is needed to shed light on how ethical dilemmas arise in prehospital work.
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Prehosp Disaster Med · Feb 2012
Increased situation awareness in major incidents-radio frequency identification (RFID) technique: a promising tool.
In mass-casualty situations, communications and information management to improve situational awareness is a major challenge for responders. In this study, the feasibility of a prototype system that utilizes commercially available, low-cost components, including Radio Frequency Identification (RFID) and mobile phone technology, was tested in two simulated mass-casualty incidents. ⋯ The tested prototype system was quick, stable, and easy to use, and proved to work seamlessly even in harsh field conditions. It surpassed the paper-based system in all respects except simplicity of use. It also improved the general view of the mass-casualty situations, and enhanced medical emergency readiness in a multi-organizational medical setting. The tested technology is feasible in a mass-casualty incident; further development and testing should take place.
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Prehosp Disaster Med · Feb 2012
Balancing between closeness and distance: emergency medical services personnel's experiences of caring for families at out-of-hospital cardiac arrest and sudden death.
Out-of-hospital cardiac arrest (OHCA) is a lethal health problem that affects between 236,000 and 325,000 people in the United States each year. As resuscitation attempts are unsuccessful in 70-98% of OHCA cases, Emergency Medical Services (EMS) personnel often face the needs of bereaved family members. ⋯ Ethical caring competence is needed in the care of bereaved family members to avoid additional suffering. Opportunities to reflect on these situations within a framework of care ethics, continuous moral education, and clinical ethics training are needed. Support in dealing with personal discomfort and clear guidelines on family support could benefit EMS personnel.
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Prehosp Disaster Med · Feb 2012
Time for order in chaos! A health system framework for foreign medical teams in earthquakes.
The number of reported natural disasters is increasing, as is the number of foreign medical teams (FMTs) sent to provide relief. Studies show that FMTs are not coordinated, nor are they adapted to the medical needs of victims. Another key challenge to the response has been the lack of common terminologies, definitions, and frameworks for FMTs following disasters. ⋯ This framework was developed using expert panels and personal experience, as well as an exhaustive literature review. The framework can facilitate decisions for deployment of FMTs, as well as facilitate coordination in disaster-affected countries. It also can be an important tool for registering agencies that send FMTs to sudden onset disasters, and ultimately for improving disaster response.
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Prehosp Disaster Med · Feb 2012
Analysis of trends and emergency activities relating to critical victims of the Chuetsuoki Earthquake.
When a large-scale disaster occurs, it is necessary to use the available resources in a variety of sites and scenes as efficiently as possible. To conduct such operations efficiently, it is necessary to deploy limited resources to the places where they will be the most effective. In this study, emergency and medical response activities that occurred following the Chuetsuoki Earthquake in Japan were analyzed to assess the most efficient and effective activities. ⋯ During the acute emergency period following a disaster-causing event, it is difficult to meet all requests for emergency services. In such cases, it is necessary to conduct efficient activities that target critically injured patients. Since hospital transfers are matters of great urgency, it is necessary to consider assigning resource investment priority to hospital transfers during this acute period, when ambulance services may be insufficient to meet all needs. To deal with such disasters appropriately, it is necessary to ensure effective information exchange and close collaboration between ambulance services, firefighting organizations, disaster medical assistance teams, and medical institutions.