American journal of disaster medicine
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Recent incidents have demonstrated that the US health system is unprepared for infectious pandemics resulting in a pediatric surge. Development of efficient plans and a structured and coordinated regional response to pediatric pandemic surge remains an opportunity. To address this gap, we conducted a literature review to assess current efforts, propose a response plan structure, and recommend policy actions. ⋯ The review has supported the concern that the US health system is unprepared for a pediatric surge induced by infectious disease pandemics. Common themes suggest that response plans should reflect the 4Ss and national guidelines must be translated into regional response systems that account for local nuances.
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Comparative Study
Comparison of START and SALT triage methodologies to reference standard definitions and to a field mass casualty simulation.
We compared Sort, Assess, Lifesaving Intervention, Treatment/Transport (SALT) and Simple Triage and Rapid Treatment (START) triage methodologies to a published reference standard, and evaluated the accuracy of the START method applied by emergency medical services (EMS) personnel in a field simulation. ⋯ In our study, the SALT triage system was overall more accurate triage method than START at classi-fying patients, specifically in the delayed and immediate categories. In our field exercise, paramedic use of the START methodology yielded a higher rate of undertriage compared to the SALT classification.
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This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. ⋯ Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.
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The 2015 advanced cardiac life support update continues to advocate administering epinephrine during cardiac arrest. The goal of our study is to determine if prehospital intraosseous (IO) access results in shorter time to epinephrine than prehospital peripheral intravenous (PIV) access. ⋯ In the setting of OHCA, the time to administer the first dose of epinephrine was faster in the IO access group when compared to PIV access group. The prehospital use of IO vascular access for time-dependent medical conditions is recommended.
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To describe and compare vascular access practices used by en route care providers during medical evacuation (MEDEVAC). ⋯ Intraosseous access has been used successfully in the combat setting and accounts for approximately 12 percent of vascular access in the MEDEVAC population the authors studied.