Southern medical journal
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The objective of this review is to stimulate the reader's considerations for developing community disaster mitigation. Disaster mitigation begins long before impact and is defined as the actions taken by a community to eliminate or minimize the impact of a disaster. The assessment of vulnerabilities, the development of infrastructure, memoranda of understanding, and planning for a sustainable response and recovery are parts of the process. Empowering leadership and citizens with knowledge of available resources through the planning and development of a disaster response can strengthen a community's resilience, which can only add to the viability and quality of life enjoyed by the entire community.
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Rarely are hospitals forced to evacuate their nonambulatory patients; however, when a disaster occurs, evacuating nonambulatory patients, particularly from multilevel facilities, represents a major logistical hurdle. Hospital disaster plans often rely on outside agencies and limited equipment to perform vertical evacuations. This article describes a novel method using readily available materials (patient mattresses and bedsheets) to effect a rapid, safe vertical evacuation. This method also can be used in nonhealthcare facilities for less-than-fully ambulatory individuals.
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Southern medical journal · Dec 2012
Conventional and endobronchial ultrasound-guided transbronchial needle aspiration: complementary procedures.
The diagnosis of mediastinal and hilar lymphadenopathy and staging lung cancer with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are on the rise. Most reports have demonstrated high yields with EBUS-TBNA and superiority of this procedure over conventional TBNA (cTBNA), but the relative roles of these procedures remain undefined. We present a comprehensive comparison of EBUS-TBNA to cTBNA. ⋯ EBUS-TBNA and cTBNA are complementary bronchoscopic procedures, and the appropriate diagnostic modality can be selected in a cost-effective manner based upon the primary indication for TBNA, lymph node size, and lymph node location.
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Southern medical journal · Dec 2012
Endobronchial ultrasound transbronchial needle aspiration in mediastinal and hilar lymphadenopathies.
Endobronchial ultrasound (EBUS)-transbronchial needle aspiration (TBNA) is a relatively noninvasive technique that allows sampling of mediastinal and hilar lymph nodes or masses under real-time and direct visualization, overcoming some of the problems associated with mediastinoscopy and blind TBNA. The goal of this study was to evaluate the yield of this technique in patients with and without malignant disease in a newly started EBUS program involving physicians not previously fully trained in interventional pulmonology. ⋯ EBUS-TBNA is a safe and effective approach with high diagnostic yield and minimal complications for diagnosing and staging of mediastinal/hilar lymph nodes. Satisfactory results can be obtained immediately by pulmonologists experienced in conventional bronchoscopy with the provision of additional training on the technique.