Canadian Medical Association journal
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In London, Ont. two mock disaster exercises have indicated the need for re-evaluating the role of medical disaster teams. To coordinate and direct these teams a medical on-site coordinating team, composed of three emergency physicians with an expanded and more clearly defined role, was formed. ⋯ In addition, the communication systems, availability and deployment of medical supplies, identification of medical personnel and tagging of casualties are discussed. Because a mass casualty episode is possible in any community, disaster planning and clear outlining of the role of medical disaster teams are needed.
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Equipment malfunction is a problem of particular importance during anesthesia and resuscitation. A review of published reports shows that the most common clinical events involve endotracheal tubes, the inspired oxygen concentration, the volume of inspired anesthetic vapours and gases, and pressures in the breathing or ventilation system. It is concluded that protection of a patient from equipment malfunction depends on: (a) appropriate application of standards set by a national standards association; (b) careful evaluation of equipment prior to purchase; (c) comprehension of equipment function by the user; (d) conscientious routine servicing of all systems concerned with anesthesia and resuscitation, and checking after service and before clinical use; (e) preanesthesia testing of equipment, including the use of an oxygen analyser in the breathing circuit; (f) early inclusion of equipment malfunction in the differential diagnosis of events during anesthesia; and (g) rapid action that cannot present a new hazard to the patient to correct the results of apparatus malfunction.