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PubMedDate not supplied

[The use of hypertonic sodium chloride solutions in resuscitation, intensive therapy and disaster medicine].

The review of Russian and foreign literature published in 1939 to 1993 has demonstrated possible use of small doses of isotonic salt solution for prompt correction of hemodynamic parameters in severe traumas, massive blood loss, most severe stages of shock and critical conditions. The best effect can be achieved with the use of isotonic salt solutions in combination with hyperoncotic solutions (sodium chloride and low molecular weight dextran). The principal mechanism of action is attraction of the liquid from the interstitial spaces into the vascular bed, stimulation of vascular osmoreceptors and neurogenic reflex mechanisms. High efficacy, simplicity and acceptability of the technique make it possible to recommend it for the use at prehospital stage, immediately on the spot of the accident, during transportation and at hospital stage when there are numerous patients with severe traumas and shortage of infusion-transfusion media.

Animals↗
PubMed1998

[The use of air-plasma flows in military field surgery and disaster medicine].

Plasma currents of high energy are considered to be very promising in the surgical treatment of modern pathology. The scientists of this country have constructed a portable field surgery apparatus in which a heated atmospheric air assumes a form of a high-temperature thin jet used like a surgeon's scalpel. Experiments and clinical tests proved the efficacy of this microplasmotron that can destroy and coagulate body tissue when treating it with plasma. This new method has, besides hemostatic action, some noticeable antimicrobic effect that leads to acceleration of tissue granulation and wound healing. In specialized and skilled medicare this progressive and priority method should be applied for initial surgical wound treatment, secondary hemorrhage arrests and surgical interventions when a high risk of infection spreading is involved.

Air↗
PubMed1992

Organization of veterinary public health in the United States of America and Canada.

Veterinarians in the United States of America and Canada are involved in a variety of activities which contribute to improving human health and well-being. Some of these activities can be considered as a part of veterinary public health (VPH), including: zoonoses control, food safety, environmental protection, comparative medicine, disaster medicine and animal welfare. Both countries have federal systems, and their VPH activities are dependent on close interaction between health and agricultural agencies at the national, state or provincial, and local levels. In addition to governmental agencies, other entities such as academic institutions and various professional associations are also important contributors to VPH activities in the two countries.

Animal Welfare↗
PubMed1999

Emergency medicine in Singapore: past, present, and future.

What began in 1948 as a "Casualty and Outpatient Service" at the Singapore General Hospital grew into the first 24-hour emergency unit in 1964 and has since expanded to the current emergency departments of the 6 public hospitals providing acute 24-hour accident and emergency services with an annual patient load of up to 540,000. In 1984, emergency medicine was recognized as a distinct medical specialty by the Ministry of Health. Five years later, structured academic postgraduate training programs were introduced. In 1990, a specialist training committee for emergency medicine was appointed to oversee the development of advanced training in emergency medicine locally. Seven areas of subspecialization have since been identified and are in various stages of development: emergency cardiac care, emergency trauma care, emergency toxicology, prehospital emergency care, pediatric emergency medicine, disaster medicine, and observation medicine. The achievements in emergency medicine in Singapore can help to provide a model for the future development of emergency medicine in other similar environments.

Emergency Medical Services↗
PubMed2005

Worldwide disaster medical response: an historical perspective.

OBJECTIVE: Disaster medicine and disaster medical response is a complex and evolving field that has existed for millennia. The objective of this article is to provide a brief review of significant milestones in the history of disaster medicine with emphasis on applicability to present and future structures for disaster medical response. RESULTS: Disaster medical response is an historically necessary function in any society. These range from response to natural disasters, to the ravages of warfare, and most recently, to medical response after terrorist acts. Our current disaster response systems are largely predicated on military models derived over the last 200 yrs. Their hallmark is a structured and graded response system based on numbers of casualties. In general, all of these assume that there is an identifiable "ground zero" and then proceed with echelons of casualty retrieval and care that proceeds rearward to a hospital(s). In a civil response setting, most civilian models of disaster medical response similarly follow this military model. This historical approach may not be applicable to some threats such as bioterrorism. A "new" model of disaster medical response for this type of threat is still evolving. Using history to guide our future education and planning efforts is discussed. CONCLUSION: We can learn much from an historical perspective that is still applicable to many current disaster medical threats. However, a new response model may be needed to address the threats of bioterrorism.

Disaster Planning↗
PubMed2000

[Teaching medicine of disasters in the Military Academy of Medicine].

In the article the author's teaching programme of The Medical Military Academy of Łódź was presented. The programme is executed in an interdisciplinary way on each year of the studies, in full time of 80 hours of lectures: 30 hours of theory and 50 hours of practice. The programme takes into consideration the gradation of difficulty. In the teaching process particular emphasis is placed on the standards of proceedings in cases of life threat.

Curriculum↗
PubMedDate not supplied

Training of disaster managers at a masters degree level: from emergency care to managerial control.

The world has faced huge disasters over the last few decades and concerns have been expressed by nearly all international agencies involved that there is a scarcity of managerial skills to deal with the mitigation and management of disasters. Disaster risks are also on the increase throughout Africa and Southern Africa because of changes in the development process, settlement patterns and conflicts in the region. Emergency physicians are but one important resource in dealing with disasters. The need for a comprehensive multisectoral approach to disasters and more importantly to deal with its mitigation is becoming increasingly evident, especially in developing countries. Hence, the need for specially trained professionals in disaster management. In an effort to improve national, regional and continental capacity, and in support of the South African Disaster Management Act, the University of the Witwatersrand, Johannesburg, South Africa, has developed a Master of Public Health degree in Disaster Management. The MPH is aimed at preparing professionals from health and allied fields to play leadership roles in the management, improvement and evaluation of health and the health-care system. Emergency physicians have an important role to play in the development of disaster medicine and disaster management programmes and it is important that they engage in this activity, collaborating with colleagues of various other disciplines as appropriate. The following paper outlines the background to the programme and the current programme.

Biometry↗
PubMed1995

[When a disaster is a fact. Kamedo analyses how the help was functioning].

Kamedo (Organizing Committee for Disaster Medicine Studies) has for over 30 years compiled information on disasters in Sweden and abroad, analysed the data and published the results. The Kamedo reports supply knowledge and experience in the field of disaster medicine and form a basis for disaster medicine planning, education and research. Over 60 reports have been published so far, since 1980 including summaries in English. These summaries can be obtained from Kamedo, Swedish National Board of Health and Welfare (Socialstyrelsen), S-106 30 Stockholm, Sweden (fax +46 8 783 3287).

Disaster Planning↗
PubMedDate not supplied

Beginning, growth, and transition.

This is what has happened and is happening. For those offended along the way, I apologize--but try us now. Prehospital and Disaster Medicine no longer is an experiment to see if a Journal of this ilk can be a success. It is. The experiment is over. Prehospital and Disaster Medicine is here to stay. Clearly, it meets many of the needs of a broadly based audience, and could meet needs of those who still are not participating in this exciting and enriching endeavor. I am grateful for the support of each of you, for that of the sponsoring organizations, and to the advertisers and publisher. A new phase has begun. The state of the Journal is dynamic, and it will continue to improve. It only can better meet your needs if you participate with us in its evolution. As always, your input is requested. Our aim is to provide you with the very best, and only with your continued input and support can we continue to build the medical disciplines of prehospital and disaster medicine.

Emergency Medicine↗
PubMedDate not supplied

Non-institutional sources of assistance following a disaster: potential triage and treatment capabilities of neighborhood-based preparedness organizations.

The following paper presents an argument for enhancing and encouraging the development of neighborhood-based disaster preparedness organizations, particularly as a potential medical triage and treatment resource following a disaster. First, the research context for the utility of non-institutional sources of post-diaster assistance is outlined, followed by the more specific instance of medical triage and treatment. An emerging model of community disaster preparedness training is described, noting the modules that address disaster medicine. Positive contributions and limitations are addressed looking to disaster and non-disaster experiences. While the potential for non-traditional resources to aid immediate post-disaster response is becoming both more common and more accepted, there are a number of recommendations that would improve the usefulness and value, including: 1) integration with existing emergency care infrastructure; 2) standardization of training; 3) use of coordinated drills between public safety organizations, hospitals, and voluntary sectors; and 4) dedication of more funding to assist in the creation and maintenance of programs. Because of the relative infancy of these community-based programs, and the infrequency of large-scale disasters, there is little, if any, pre-post research that can demonstrate a measured impact on response. More pre-disaster baseline data-gathering efforts are needed, combined with post-disaster evaluative research to understand the utility of these non-traditional resources in terms of overall response, and in particular the ability to assist in areas of disaster medicine practice. One also expects that under these kinds of [disaster] conditions, family members, fellow employees, and neighbors will spontaneously try to help each other. This was the case following the Mexico City earthquake where untrained, spontaneous volunteers saved 800 people. However, 100 people lost their lives while attempting to save others. This is a high price to pay and is preventable through training.

Community Participation↗
PubMedDate not supplied

Educational and training systems in Sweden for prehospital response to acts of terrorism.

Sweden has a long tradition in planning for disaster situations in which the National Board of Health and Welfare has a key responsibilty within the health sector. One important part of this disaster preparedness is education and training. Since 11 September 2001, much focus has been placed on the acts of terrorism with special reference to the effects of the use of chemical, biological, or nuclear/radiological (CBNR) agents. In the health sector, the preparedness for such situations is much the same as for other castastrophic events. The National Board of Health and Welfare of Sweden is a national authority under the government, and one of its responsibilities is planning and the provision of supplies for health and medical services, environmental health, and social services in case of war or crises. "Joint Central Disaster Committees" in each County Council/Region in the country are responsible for overseeing major incident planning for their respective counties/regions. The "Disaster Committee" is responsible for ensuring that: (1) plans are established and revised; (2) all personnel involved in planning receive adequate information and training; (3) equipment and supplies are available; and (4) maintenance arrangements are in place. Sweden adopts a "Total Defense" strategy, which means that it places a high value in preparing for peacetime and wartime major incidents. The Swedish Emergency Management Agency coordinates the civilian Total Defense strategy, and provides funding to the relevant responsible authority to this end. The National Board of Health and Welfare takes responsibility in this process. In this area, the main activities of the National Board of Health and Welfare are: (1) the establishment of national guidelines and supervision of standards in emergency and disaster medicine, social welfare, public health, and prevention of infectious diseases; (2) the introduction of new principles, standards, and equipment; (3) the conducting education and training programmes; and (4) the provision of financial support. The budget for National Board of Health and Welfare in this area is approximately 160 million SEK (US dollar 18 million). The National Board of Health and Welfare also provides funding to the County Councils/Regions for the training of healthcare professionals in disaster medicine and crises management by arranging (and financing) courses primarily for teachers and by providing financial support to the County Councils/Regions for providing their own educational and training programmes. The National Board of Health and Welfare provides funding of approximately 20 million SEK (US dollar 2.4 million) to the County Councils/Regions for this training of healthcare professionals in disaster medicine and crises.

Delivery of Health Care↗
PubMed1994

Major incident planning in South East Thames Region: a survey of medical staff awareness and training.

In order to assess awareness and training of medical staff in major incident planning and disaster medicine, a telephone survey was conducted throughout South East Thames Region. Duty consultants and trainees in anaesthesia, general surgery and orthopaedic surgery from a total of 17 hospitals in the region were included. Accident and emergency (A&E) consultants were also interviewed in order to assess administrative aspects of major incident planning. It was found that major incident plans were updated regularly in all the hospitals that were surveyed. Training exercises had been held in 88% of hospitals and the majority had tested communications only. All consultants and 77% of trainees knew that their hospital had a major incident plan. However, only 39% of trainees had been given any major incident plan related literature and less than a third of all staff had attended a major incident plan orientation session. Over half of all staff expressed confidence in their personal training in disaster medicine, but few had received relevant tuition. Of all non-A&E personnel, 5% had attended an Advanced Trauma Life Support (ATLS) provider course. We conclude that major incident plans are in place and are updated in all the hospitals surveyed. However, all staff lack training in clinical and administrative aspects of major incident planning and disaster medicine. Recommendations to improve this situation are made.

Awareness↗