JACEP
-
Based on the recommendations of the Health Services Administration and the Committee on Trauma of the American College of Surgeons, optimal staffing patterns for a trauma center are unrealistic in cost and personnel needs for all but a few large, urban teaching hospitals. As an alternative, the staffing pattern for a trauma program for a nonuniversity community hospital consists of one general surgeon, an anesthesiologist and one emergency physician. ⋯ Need for trauma centers versus trauma programs can be assessed by using 5% of the number of motor vehicle accidents in an area to forecast the number of traumatic injuries. This is done in California as an example.
-
The fibertopic bronchoscope was used in 14 cases in the emergency department between September 1974 and September 1976 at Lock Haven Hospital, Lock Haven, Pennsylvania and St. Charles Hospital, Toledo, Ohio. It was used successfully to remove foreign bodies from the trachea and esophagus; in difficult or hazardous endotracheal intubation; intubation in a victim of cardiac arrest with a cervical deformity; evaluation of laryngeal and tracheal injury; localization of bleeding from the posterior nose; evaluation of hemoptysis, and evaluation of thermal injuries from smoke inhalation.
-
Thirty trained paramedics were studied to measure cognitive and technical skill deterioration 6 to 30 months after completion of their individual training programs. The group of 30 paramedics included those with six months and those with one year of training. The purpose of the study was to identify areas in need of continuing education and to see if the rate of skill deterioration correlated with the time from completion of the training program. ⋯ The skills requiring the most technical knowledge deteriorated the fastest. Also, basic skills, despite frequent use in the field, had deteriorated. The amount of skill deterioration was greatest among the group of trained paramedics that had completed their training 30 months prior to this study.