American journal of disaster medicine
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Recent evidence demonstrates that emergency department (ED) and inpatient hospital crowding contributes to unsafe patient care. The blizzards of 2010 produced conditions that prohibited the safe discharge of admitted inpatients and were identified as a major factor in crowding of the ED at Howard County General Hospital (HCGH). At one point, admitted patients occupied 35 of the 36 treatment beds in the ED. ⋯ During this call, HCFR and HCGH also coordinated the emergency transport of an interventional cardiologist through the blizzard to HCGH to perform emergency cardiac catheterization. At the end of the operational period, the ED had regained all but four beds pending inpatient admission. These efforts fortified a strong partnership between a community hospital and local fire department to facilitate the expeditious discharge and disposition of inpatients during the blizzards of 2010 to decrease crowding.
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To assess the level of pandemic preparedness at emergency departments (EDs) around the country and to better understand current barriers to preparedness in the United States represented by health professionals in the American College of Emergency Physician (ACEP) Disaster Medicine Section (DMS). METHODS, DESIGN, and ⋯ There appear to be significant gaps in pandemic influenza and other infectious disease outbreak planning among the hospitals where ACEP DMS members work. This may reflect a broader underlying inadequacy of preparedness measures.
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To determine whether bioterrorism training provided increased awareness and understanding of bioterrorism and to assess physicians' beliefs about the threat of bioterrorism and how it impacts on preparedness. ⋯ Physicians in New Jersey increased their awareness and understanding of bioterrorism through training. However, concerns remain that a physician's belief in a low threat of bioterrorism translates into a low need for bioterrorism preparedness training.
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Hospitals are physical structures with the same risk as other large buildings; the physical plant is vulnerable to acts of nature and man. When hospitals need to evacuate the patient population, logistical support for patient transport will be required. However, a disaster impacting a hospital will likely also affect the surrounding community, and transport resources such as ambulances may be limited as they will also be needed to support the community response. ⋯ Information was obtained from 62 hospitals within Los Angeles County and was used to establish a tool for determining transportation requirements in the event ofa hospital evacuation. This survey demonstrated that approximately 20 percent of hospital inpatients could be discharged to home within a few hours, about 40 percent of hospital inpatients could be transported via vans, buses, or private cars; and the remaining 40 percent would need ambulance transportation for evacuation. Additionally, the survey provides information about the distribution of emergency department and intensive care unit patients and the resources they would require during a hospital evacuation.
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Train crashes represent a devastating multicasualty event. The purpose of this study was to analyze the injury severity, specific organ injuries, and cause of death in the fatalities of the 2008 Chatsworth, Los Angeles train crash. ⋯ The Metrolink train crash in 2008 in Chatsworth, Los Angeles, was the worst train crash in the history of California with 25 fatalities. The most common cause of death was due to chest injury (cardiac and aortic laceration) followed by head injury. This review could aid in improving passenger protection from head-on collision and in further development of head protection in train seats, as well as be useful in disaster planning and a benchmark for future rescue and triage operations.