Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To review the current literature on the effects of ambulance diversion (AD). ⋯ Despite its common use, there is a relative paucity of studies on the effects of AD. Further research into these effects should be performed so that we may understand the role of AD in the health system.
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To describe the characteristics of the demand for medical care during sudden-impact disasters, focusing on local U.S. communities and the initial phases of sudden-impact disasters. ⋯ As part of planning for sudden-impact disasters, communities should be expected to sustain medical services for 24 hours, and up to 96, before arrival of external resources. For effective medical surge-capacity response during sudden-impact disasters, there should be a priority for emergency medical care with a focus on ambulatory injuries and illnesses.
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There are no standardized measures of hospital disaster preparedness or hospital "surge capacity." ⋯ Among hospitals in Los Angeles County, disaster preparedness and surge capacity appear to be limited by a failure to fully integrate interagency training and planning and a severely limited surge capacity, although there is a generally high level of availability of equipment and supplies.
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This article reviews what is known about daily emergency department (ED) surge and ED surge capacity and illustrates its potential relevance during a catastrophic event. Daily ED surge is a sudden increase in the demand for ED services. There is no well-accepted, objective measure of daily ED surge. ⋯ A multidimensional measure is needed that reflects both the core components and their relative contribution to ED surge capacity. Although many types of factors may influence ED surge capacity, relatively little formal research has been conducted in this area. A better understanding of daily ED surge capacity and influencing factors will improve our ability to simulate the potential impact that different types of catastrophic events may have on the surge capacity of hospital EDs nationwide.