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PubMed1982

A metropolitan airport disaster plan--coordination of a multihospital response to provide on-site resuscitation and stabilization before evacuation.

At the John F. Kennedy International Airport in New York City, disaster planning has been an integral part of the airport operations for the past 20 years. The medical component of this disaster planning has focused around the Medical Office at JFK. Through this office, on-site emergency medical teams have been established and trained from all ranks of airport personnel. Following the crash of a Boeing 727 aircraft in 1975, a new concept was added to disaster planning for JFK, which involves bringing the hospital, its facilities, and its personnel to the scene. A new piece of equipment, known as Emergency Mobile Hospital, was developed with the cooperation of the airlines, the operating authority of the airport, and other interested parties. Two such vehicles are now in constant readiness at the airport, and together provide two operating rooms, 12 monitored ICU beds, a 16-bed burn unit, and 72 other beds to be used for on-site stabilization of critically ill patients, before transfer to a definitive care facility. Under the auspices of a single area medical school (New York Medical College) and its affiliated departments of surgery, trauma teams are made available to be airlifted to the scene within 30 minutes of notification. Additional medical teams from other medical school hospitals serve as backup support. The principle of bringing the hospital to the emergency, and of assembling trauma teams for the initial phase, remains the same for Kennedy Airport as for that of any other metropolitan airport.

Accidents, Aviation↗
PubMed1993

Special report. Dealing with disasters: what hospitals learned from recent crises.

In times of crisis, hospitals are relied on to provide simultaneous emergency treatment to a large number of victims of natural disasters, accidents, or other traumatic events. Sometimes the hospital itself faces a crisis situation. Hospital officials recognize that the only way to continue providing patients with the best care possible in dire circumstances is through the activation of an effective disaster plan. "Disaster planning is something that cannot be planned enough," says Louis Gasbarro, president of the International Association for Healthcare Security and Safety (IAHSS) and security and safety director at Tampa General Hospital, Tampa, FL. "There's no such thing as over-planning or over-drilling. You must have a written plan known by all people, all departments, all personnel in the building. Everyone has to know their role." This special report will look at several events that brought an influx of patients to hospitals around the country, the disaster plans that were implemented, and what hospital officials learned from those experiences.

Accidents↗
PubMed2006

Air quality survey carried out by schoolchildren: an innovative tool for urban planning.

An educational project on biological monitoring of air quality was launched in 2004 to involve about 650 young students (age 6 to 16) from 21 schools of nine municipalities in Tuscany (Central Italy) in active detection of the crucial pollutant ozone with indicator sensitive tobacco seedlings. Results implied the reading of 9,300 raw biological figures and were fortified by the data captured by six photometric analysers. Under the guidance of their teachers, the students had several opportunities to practice with many basic and applied study areas and were initiated into the scientific method in a simple and absorbing manner. Curiosity and involvement were widespread; a sort of emotional and responsible relationship was developed by several pupils. Though primarily an educational exercise, the survey introduced a research element and the regional picture of air pollution that emerged has increased our knowledge of the air quality situation in the area. Biological monitoring of air quality is a powerful tool to improve the awareness and involvement in key topics of environmental education. In addition, it represents a crucial element for improving the awareness of problems and implies the active participation of citizens in the assessment of several indicators of the state of the environment. Its potential as a robust implement in landscape and urban planning is noteworthy.

Adolescent↗
PubMed1983

Mild cervical dysplasia. Experience in a family planning clinic.

To evaluate mild cervical dysplasia, the results of Papanicolaou smears were reviewed for a six-month period in an inner-city family planning program. Papanicolaou smear evidence of mild dysplasia was consistent with the biopsy diagnosis in most cases. A single Papanicolaou smear is not a reliable indication of condylomata, nor is a single normal Papanicolaou smear in this setting completely reassuring. Persistent mild dysplasia is an indicator of high risk for cervical dysplasia and cervical infection. Aggressive initial cervical surgery is not indicated, but close follow-up is required.

Adolescent↗
PubMed1998

Experience and acceptability of emergency hormonal contraception.

Objective: The study was designed to evaluate the experience and acceptability of emergency hormonal contraception service for inner-city women in Planned Parenthood clinics.Methods: In 1995, emergency hormonal contraception was introduced as a new service in three clinics of New York City's Planned Parenthood that served low-income women. Shortly after inception of this service, the agency undertook a survey to investigate patient experience and acceptability of the service. The survey addressed side effects and patients attitudes about emergency hormonal contraception. It also addressed suggestions for improving the service.The indication for the use of this method was unprotected intercourse within the previous 72 hours of first dosage of certain birth control pills. We used Lo/Ovral (norgestrel 0.3 mg + ethinyl estradiol 30 µg) 4 tablets given stat and second dose 12 hours later.Results: There were 118 patients who responded to the survey. The average patient age was 25 years. Approximately half of the women were white and half were other. The majority were nulliparous, and 42% had one or more abortions in the past. Side effects such as nausea, vomiting, and fatigue and their prevalence were noted. Two women reported method failure. Both patients elected abortion. The vast majority (92%) stated that they would use the method again. Patients also made several recommendations for enhancing the service.Conclusion: As a result of this survey, Planned Parenthood of New York City completely revised its emergency hormonal contraception protocols in order to increase patient satisfaction while maintaining high medical standards to ensure lower method failure and drug side effects in more than 1,000 patients so far.

Journal Article↗
PubMed1992

Cervical cancer screening and detection of genital HPV-infection and chlamydial infection by PCR in different groups of Kenyan women.

A pilot study was conducted in Nairobi, Kenya, to evaluate the feasibility of a larger study on the prevalence of cervical cancer and precancerous lesions and on the role of Sexually Transmitted Diseases (STD) as risk factors for cervical cancer in Kenya. 692 women were screened for cervical cancer by cytology in 3 City Commission family planning clinics and in 1 City Commission STD referral clinic in Nairobi. In one family planning clinic and in the STD clinic, a sample of the participating women (n = 212) was also screened for genital Human Papillomavirus (HPV) and chlamydial infection by Polymerase Chain Reaction (PCR). Of all women screened for cancer, 5.1% had a PAP smear showing mild dysplasia, 1.2% moderate dysplasia and 0.15% severe dysplasia or worse. Of the women screened for genital HPV infection and for chlamydial infection, the following results can be reported: in women attending the family planning clinic, HPV-DNA was detected in 3.7% (0.9% HPV6/11 and 2.8% HPV 16/18/31/33) and Chlamydia trachomatis in 6.4%; in women attending the STD clinic, HPV-DNA was detected in 16.5% (1% HPV6/11 and 2.8% HPV 16/18/31/33) and Chlamydia trachomatis in 4%. A significantly higher frequency of HPV-infection was observed in the STD clinic, while this was not the case for chlamydial infection.

Adolescent↗