Articles: emergency-medical-services.
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Prehosp Disaster Med · Apr 1990
Prehospital and emergency department verification of endotracheal tube position using a portable, non-directable, fiberoptic bronchoscope.
Verification of endotracheal tube (ETT) location in prehospital setting and the emergency department (ED) is a challenging task. Unrecognized esophageal intubations with potentially dangerous consequences may occur more frequently in these environments than in less hectic settings. To evaluate the capabilities of a portable, non-directable, fiberoptic bronchoscope (Visicath; Saratoga Medical, Saratoga, Calif., USA) to detect appropriate ETT placement, a prospective series of 22 intubated prehospital, air-medical, or ED patients underwent fiberoptic verification (FOV) of a newly placed ETT. ⋯ FOV confirmed placement in 23 intubations (96%) in less than 25 seconds. Seven intubations (29%) were judged to be "difficult." FOV resulted in five minor changes in management (22%) and was the sole confirmation method for five intubations. We conclude that fiberoptic verification is a promising method of ETT position in air-medical and ED intubations.
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Anaesthesiological and resuscitation service is a special component of disaster medicine. It is of paramount importance in LSFA (life-supporting first aid) training of the lay public. ⋯ The paper discusses quantity and quality of anaesthesiological and resuscitation aid delivered immediately at the disaster scene, during triage before and after evacuation, during transportation. Much attention is devoted to pain management and infusion therapy performed at the disaster scene and during transportation.
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The article deals with the personnel medical support system of ships in emergency at sea. Unfavourable factors, affecting ships people, are described and peculiarities of medical support of nuclear powered ships underlined. Methods of medical service training to perform its tasks in emergency are discussed.
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There is given an expert evaluation of medical response and release efforts during the recent disasters in Arzamas, Sverdlovsk, Armenia and Bashkiria. Special attention is paid to the movable medical units activity, to the work of psychiatric, forensic medicine service. The attention is focused on the problem of establishing national disaster medical system.
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The experience in medical care and treatment of burned patients showed that adequate anti-shock infusion therapy can be established only 4-6 hours after the sustained trauma. However, even despite such a delay, many burned patients (75-80%) get well, due to the later adequate complex treatment controlled by experienced burn specialists [correction of combustiologists] in hospital units specially organized and equipped for this category of patients. Within the first 2-4 days after the trauma, it is recommended to distribute major accident victims between different specialized burn units, using specially equipped air and motor transportation vehicles.