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At least 145 records · Page 8Linked to original sources

[The toxicological problems of disaster medicine in the Navy Fleet].

From position of the uniform concept of the accident medicine the problems of toxicological supply of the ships of MNF are considered. Peculiarities of chemical accidents in the ship conditions are marked. The question about principles of harmful chemical substances regulating, forming air environment of ship living quarters is discussed. The prospects of practical use of antidotal means, intended for protection of personnel from toxic action of carbon dioxide and chemical combinations, causing development of toxic edema of lungs are given.

Accidents↗

Diagnostic radiology in disaster medicine: implications for design, planning and organization of X-ray departments.

Diagnostic radiology plays an important role in the evaluation of disaster casualties; these are referred to X-ray departments, shortly after their arrival at hospital, in large numbers, frequently overwhelming facilities and resources of the department. The study of relevant literature and the experience of the authors suggest that there are implications for design, planning and organization of X-ray departments to be considered in disaster-prone areas. Departments should be sited as near as possible to triage areas, on the same floor, with broad, unobstructed passages. There should be provision for easy passage of equipment and trolleys through doors and corridors and large circulation areas, working rooms and waiting spaces with plugs, for electricity, piped oxygen and suction and devices for hanging infusion sets. Two entrances to the department would enable one-way flow through the department. All work should be done in the department and examinations performed with mobile units avoided. A radiologist at the entrance to the department and a control post at the exit ensure adequate processing of casualties. Interpretation and reporting should be done by assigned radiologists dictating directly to typists; films and reports should accompany casualties.

Disaster Planning↗

[The prospects for using extracorporeal detoxication methods in disaster medicine].

A lot of specific injuries caused by catastrophes provoke endogenic intoxication. In this situation the application of extracorporal detoxication methods will be conditioned by pathogenetical mechanisms of their action. There are indications for ED management in mechanical injuries, prolonged squeezing effects, thermal injuries, acute poisoning, irradiation injuries, acute infectious diseases, acute reactivity state. The experience of 163 operations on 111 wounded in catastrophes proves the worth-while character of work in this sphere. 10 variants of extracorporal operations including combined methods were applied.

Accidents↗

[The triage in disaster medicine: analysis of a practical exercise].

BACKGROUND: The triage is a procedure for casualties classification using some criteria (severity, survival, therapeutical delay, etc.) which is basic for the preparedness of health personnel in event of disaster. Even being a basic procedure, its teaching and training is not enough extended among health personnel. The goal of this study was assess the efficacy of teaching triage procedures in terms of its capability to carry out the examination and classification of massive casualties under different conditions of environmental difficulties. METHODS: 25 couples of health professionals (doctor and nurse) were trained during 90 minutes on triage procedures and them aleatory located at 3 groups with 12 simulated casualties at each group corresponding to 3 different levels of environmental difficulties. They were asked to perform the triage and complete the information contained at the triage card. This information was analyzed in order to see and compare the results of each group. RESULTS: All the health professionals showed high correlations between observed and expected responses for the evacuation priority variable. However, only the group of less environmental difficulty showed a significative statistical correlation (p = 0.03). No significative statistical differences were found on the diagnostic classification but the adjust level was poor for the high environmental difficulties group. CONCLUSIONS: Acceptable levels of efficacy on triage procedures can be obtained using a single teaching session of theoretical contents plus a practical exercise, specially for the casualties prioritization. On the other hand, environmental conditions looks as a variable influencing the efficacy of other acceptable results expected on this kind of technic perhaps requiring further training.

Disaster Planning↗

Impact of mobile clinical analyzers on disaster medicine: a lesson from crush syndrome in the 1995 Hanshin-Awaji earthquake.

The Great Hanshin-Awaji earthquake caused many people to develop crush syndrome. Analysis of these patients revealed that the severity is not related to their hemodynamics but to hematocrit, base deficits, and potassium concentrations soon after their extrications. In the disaster site, these parameters can only be measured using whole-blood samples by mobile instruments. The present study was made to evaluate the possibility of uses of a mobile measuring device, ABL77, for the triage of crush syndrome patients in disaster sites. Heparin-added blood samples and serum samples were collected from patients admitted to Senshu Critical Care Medical Center. Blood gases, electrolytes, and hematocrit of the heparin-added blood samples were measured using ABL77 and compared with those measured using the stationary device ABL725. Potassium concentrations of the heparin-added blood samples measured by the ABL77 were compared with those of the serum samples measured by the stationary EA06T. Significant correlations were observed between the measurements. We conclude that the ABL77 was satisfactorily compatible with stationary devices in the hospital. Medical institutions should have simplified, mobile measuring devices as a precaution against disasters, so that they can get ready to take appropriate action promptly.

Ambulances↗

[Disaster medicine].

The authors have reviewed the concept of catastrophe from the health care stand-point as well as, that concerning medicine in catastrophies. The basic outlines for planning adequate health care when a massive number of victims have to be attended are pointed-out as well as, the prevention means for possible flare ups of transmissible diseases.

Accidents↗

[Collective oxygen therapy and disaster medicine].

The distribution of oxygen to many victims can be necessary all along the medical help chain: operations of extraction, stand up, recovery, transport, life supporting care, surviving and transportation in mobile processing formations installed to proximity of the site, evacuations by road or by fly. Moreover, hospital in situation of crisis has an increased oxygen consumption (especially for ventilators). An estimable need calculation, a census of stocking and distribution ways have to allow to adapt resources to needs. Proposed solutions are the strengthening of vehicles in oxygen tanks, utilization of liquid oxygen tanks in large mobile formations and particular procedures to supply hospital crisis situation.

Administration, Inhalation↗

Methodological aspects of the medical examination of special contingents in the All-Russian Service of Disaster Medicine.

The tasks required for the preservation of the health of rescuers can be accomplished with the creation of a system for medical examinations and rehabilitation that functions with commonly used methodological and organizational principles. Absence of such a common methodological platform often results in the disqualification of members of the special contingent and a mistake in the evaluation process that gives birth to serious medical and social problems. The specific character of the rescuers' activities during conditions associated with extraordinary situations necessitates the development of criteria-based evaluation systems for determining the prognosis, and the clinical, diagnostic, normative, and legal, medical, and social criteria that include methodological approaches that define the criteria to be used in the examinations. We propose that the concept of the professional health examinations becomes the methodological basis used for the medical examinations and rehabilitation of the rescuers.

Disasters↗

The Bhopal tragedy--what has Swedish disaster medicine planning learned from it?

On December 3, 1984, a leak of methylisocyanate (MIC) from a chemical plant in Bhopal, India, affected 150,000 to 200,000 people. More than 10,000 people were severely injured and approximately 2,500 died. In this article a survey of symptoms, treatment, and rescue work is given. On the basis of this, we discuss ways to help reduce the effects of a major release of an irritant gas. People living in the vicinity of potential health hazards need information on how to behave in case of accidents. Rescue workers and medical personnel must be trained to operate under "toxic conditions." There must be planning for treatment of thousands of patients at the same time, a circumstance that will often require temporary "satellite hospitals" to be opened. As symptoms and injuries are of the same kind, even if the magnitude and the effect may differ, treatment can, in many ways, be standardized. Therefore members of the health care team, irrespective of their daily different specialty fields, can work with the most urgent missions.

Accidents, Occupational↗