Lijec̆nic̆ki vjesnik
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Lijec̆nic̆ki vjesnik · Jan 2007
Review[Vertebrogenic chest pain--"pseudoangina pectoris": etiopathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy].
Vertebrogenic pain localised in the anterior thorax can imitate anginal pain ("pseudoangina pectoris"). The most common causes of vertebrogenic chest pain are segmental dysfunction and degenerative changes at the level of the lower cervical and upper middle thoracic spine. Segmental dysfunction is a source of pseudoradicular pain, and degenerative changes, before all disc hernia and dorsal osteophytes which are compressing corresponding nerve roots, are the sources of radicular pain which irradiates in the chest. ⋯ From therapeutic aspect it is very important to distinguish vertebrogenic from anginal pain. That is, the change of cardiological therapy will not eliminate possible attacks of vertebrogenic pain in patients with angina pectoris. From the aspect of most recent understandings, the article describes etiopathogenesis, characteristics, diagnosis and therapy of vertebrogenic chest pain, and also the differences between vertebrogenic and anginal pain.
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Good organization and coordination of emergency services are one of the most crucial factors, which influences the number of survivors and severity of incident overall health and structural long-term damages. Different studies showed that poor leadership is the main cause for poor intervention results at mass casualty incidents. This article briefly presents French, American, and English incident command systems at mass casualty incident and other crisis. If the incident command want to achieve the best intervention results then they, independently from command level and formal system, should establish a proper level of flexibility, controllable span of command, use of common terminology, effective use and accountability of resources, integrated and available telecommunications with profound exchange of information and intelligence.
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Mass casualty incident is event with several injured or acutely ill persons, which is impossible to manage with available resources bit it can be managed after activation of special plan and spare resources. Every day at least one mass casualty incident happens in the world and that varies from Ljubljana Ambulance Service coverage area where 11 such incidents happened in the last 40 years. Success of intervention at mass casualty incident depends on quality of preparation for such event. ⋯ In general one person can manage only one key element or in the case of smaller mass casualty incident one person can manage few key elements. But in the case of large scale mass casualty event more than one person is needed to successfully manage certain key element. It is very important that all potential providers at mass casualty incident are well informed of functioning and establishing of all possible key elements and that they play all kind of key roles in advance at mass casualty drills.