Ten Myths about Medical Emergencies and Medical Kits

2021 ◽  
Vol 9 (1) ◽  
pp. 23-33 ◽  
Author(s):  
Seth C. Hawkins ◽  
R. Bryan Simon

ABSTRACTWilderness medicine is plagued by myths and dogmatic teachings not supported by evidence. This article focuses particularly on those teachings and tools that would be most likely used in archaeological fieldwork. It lays out 10 of the most common and concerning myths taught in wilderness medicine and wilderness emergency medical services, both in terms of first aid and preparation of medical kits. The myths described are provide a structure for the main purpose of the article: to explain interventions and medical kit contents that are more evidence based and supported by modern understandings of wilderness medicine and fieldwork risk management. The list of top 10 myths includes (1) the use of medications other than epinephrine for anaphylaxis and (2) the availability and proper use of epinephrine auto-injectors, (3) the use of suction devices and tourniquets for snakebites, (4) the use of spinal immobilization for neck injuries, (5) the identification and treatment of heat illnesses, (6) the use of CPR in remote areas, (7) the appropriateness of dislocation reduction in remote areas, (8) the use and choice of tourniquets for arterial bleeding, (9) the initial definition and management of drowning patients, and (10) wound management myths.

Author(s):  
Sarah R. Anderson ◽  
James Moore ◽  
Sarah R. Anderson ◽  
Jon Dallimore ◽  
Claire Davies ◽  
...  

Joining an expedition - Role of the expedition medical officer - Creating expedition teams - Immunization - Medical kits and supplies - Medical and first-aid training - Medical screening - Advising those with common pre-existing conditions - The older traveller - Child health in remote areas - Risk management - Medical insurance - Legal liabilities and professional insurance


Author(s):  
Sarah R. Anderson ◽  
James Moore ◽  
Sarah R. Anderson ◽  
Jon Dallimore ◽  
Claire Davies ◽  
...  

Joining an expedition - Role of the expedition medical officer - Creating expedition teams - Immunization - Medical kits and supplies - Medical and first-aid training - Medical screening - Advising those with common pre-existing conditions - The older traveller - Child health in remote areas - Risk management - Medical insurance - Legal liabilities and professional insurance


2021 ◽  
Vol 9 (1) ◽  
pp. 49-55
Author(s):  
Seth C. Hawkins ◽  
Corey Winstead

AbstractWilderness medicine classes are widely available to archaeologists and field scientists, but because wilderness medicine is an unregulated field, knowing what the various courses and products mean can be difficult. Based on the education chapter in the recently published textbook Wilderness EMS, this article—written by same two authors as the book—explores a number of topics relevant for the field scientist, program director, or administrator seeking to obtain wilderness medicine training for archaeologists. The article first explores the history of wilderness medicine products and certificates available to interested parties. It then differentiates between the various products available today along with their benefits and limitations for the end user. Products and trainings described include certifications (including Wilderness First Aid [WFA], Wilderness Advanced First Aid [WAFA], Advanced Wilderness First Aid [AWFA], and Wilderness First Responder [WFR]), as well as single use or continuing education trainings (including Stop the Bleed, CPR, conference courses, and field schools). Particular attention is paid to the specific and actionable needs of a field scientist in remote areas.


Author(s):  
Kevin K. C. Hung ◽  
Sonoe Mashino ◽  
Emily Y. Y. Chan ◽  
Makiko K. MacDermot ◽  
Satchit Balsari ◽  
...  

The Sendai Framework for Disaster Risk Reduction 2015–2030 placed human health at the centre of disaster risk reduction, calling for the global community to enhance local and national health emergency and disaster risk management (Health EDRM). The Health EDRM Framework, published in 2019, describes the functions required for comprehensive disaster risk management across prevention, preparedness, readiness, response, and recovery to improve the resilience and health security of communities, countries, and health systems. Evidence-based Health EDRM workforce development is vital. However, there are still significant gaps in the evidence identifying common competencies for training and education programmes, and the clarification of strategies for workforce retention, motivation, deployment, and coordination. Initiated in June 2020, this project includes literature reviews, case studies, and an expert consensus (modified Delphi) study. Literature reviews in English, Japanese, and Chinese aim to identify research gaps and explore core competencies for Health EDRM workforce training. Thirteen Health EDRM related case studies from six WHO regions will illustrate best practices (and pitfalls) and inform the consensus study. Consensus will be sought from global experts in emergency and disaster medicine, nursing, public health and related disciplines. Recommendations for developing effective health workforce strategies for low- and middle-income countries and high-income countries will then be disseminated.


2021 ◽  
Author(s):  
Laura Martinengo ◽  
Anne-Claire Stona ◽  
Konstadina Griva ◽  
Paola Dazzan ◽  
Carmine Maria Pariante ◽  
...  

BACKGROUND Mental health disorders affect one in ten people globally, of which around 300 million are affected by depression. At least half of affected people remain untreated. Cognitive behavioral therapy (CBT) is an effective treatment but access to specialized providers, habitually challenging, has worsened with COVID-19. Internet-based CBT (iCBT) is effective and a feasible strategy to increase access to treatment for people with depression. Mental health apps may further assist in facilitating self-management for people affected by depression but accessing the right app might be cumbersome given the large number and wide variety of apps offered by public app marketplaces. OBJECTIVE To systematically assess features, functionality, data security and congruence with evidence of self-guided CBT-based apps available in major app stores, suitable for users suffering from depression. METHODS A systematic assessment of self-guided CBT-based apps available in Google Play and Apple’s App Store was conducted. Apps launched or updated since August 2018 were identified through a systematic search in 42matters using CBT-related terms. Apps meeting inclusion criteria were downloaded and assessed using a Samsung Galaxy J7 Pro (Android 9) and iPhone 7 (iOS 13.3.1). Apps were appraised using a 182-question checklist developed by the research team, comprising apps’ general characteristics, CBT-related features, including six evidence-based CBT techniques as informed by a CBT manual, CBT competences framework and a literature review of iCBT clinical trial protocols (psychoeducation, behavioral activation, cognitive restructuring, problem solving, relaxation, and exposure for comorbid anxiety), and technical aspects and quality assurance. Results were reported as a narrative review, using descriptive statistics. RESULTS The initial search yielded 3006 apps, of which 98 apps met inclusion criteria and were systematically assessed. There were 20 wellbeing apps, 65 mental health apps and 13 depression apps. Twenty-eight apps offered at least four evidence-based CBT techniques, particularly depression apps. Cognitive restructuring was the most common technique, offered by 77/98 apps. Only a third of apps offered suicide- risk management resources while less than 20% of apps offered COVID-19-related information. Most apps included a privacy policy, but only a third of apps presented it before account creation. Eighty percent of privacy policies stated sharing data with third party service providers. Half of app development teams included academic institutions or healthcare providers. CONCLUSIONS Only few self-guided CBT-based apps offer comprehensive CBT programs or suicide risk management resources. Sharing of users’ data is widespread, highlighting shortcomings in the health app market governance. To fulfill their potential, self-guided CBT-based apps should follow evidence-based clinical guidelines, be patient-centered and enhance users’ data security. CLINICALTRIAL NA


2008 ◽  
Vol 23 (6) ◽  
pp. 530-536 ◽  
Author(s):  
Colin J. Ireland ◽  
Kathryn M. Zeitz ◽  
Franklin H.G. Bridgewater

AbstractIntroduction:Research on skill acquisition and retention in the prehospital setting has focused primarily on resuscitation and defibrillation. Investigation into other first aid skills is required in order to validate practices and support training regimes. No studies have investigated competency using an extrication cervical collar for cervical spine immobilization.Objective:This study was conducted to confirm that a group of first responders could acquire and maintain competency in the application of an extrication cervical collar over a 12-month period.Methods:Participants attended a standardized training session that addressed the theory of application of an extrication cervical collar followed by hands-on practice. The training was presented by the same instructor and covered the nine key elements necessary in order to be deemed competent in extraction cervical collar application. Following the practical session, the competency of the participants was assessed. Participants were requested not to practice the skill during the 12-month period. Following the 12-month period, their skills were re-assessed by the same assessor.Results:Of the 64 subjects who participated in the study, 100% were competent after the initial first assessment. Forty-one participants (64%) were available for the second assessment (12 months later); of these, 25 (61%) maintained competence.Conclusions:Although the sample size was small, this research demonstrates that first responders are able to acquire competence in applying an extrication cervical collar. However, skill retention in the absence of usage or re-training is poor. Larger studies should be conducted to validate these results. In addition, there is a need for research on the clinical practice and outcomes associated with spinal immobilization in the prehospital setting.


Author(s):  
Vincenzo Gullà ◽  
Corrado Cancellotti

Emergency events are always very critical to manage as in most cases there is a human life risk. Such events could become even more serious when occurring in remote areas not equipped with adequate healthcare facilities, able to manage life risk. This is the case in many rural geographical areas. In such scenarios telemedicine can play a very important and determinant role. This is mainly the basis of the experience described in the following chapter about telemedicine application in a small hospital located in the town of Branca, near Gubbio Italy. The first aid department, responsible for emergency support in a territory where distances between houses and hospital is quite important and the lack of healthcare structures and speedways connections makes it even more difficult, has decided to use telemedicine solutions to face the emergency events. The experience has shown how the use of Videocommunication based telemedicine systems has improved the service and what procedural impact the adoption of such technology has required. A brief description of the experience and highlights of the service still under experimentation will be shown in the following.


Part 1. General principles of first aid for nurses outside the emergency department environment Medical emergencies 1025 General principles of first aid for nurses 1026 Priorities when faced with an emergency situation 1028 Care of the unconscious patient (both within and outside the hospital environment) ...


2017 ◽  
Vol 51 (2) ◽  
pp. 76-88 ◽  
Author(s):  
Eugene Georgiades ◽  
Daniel Kluza

AbstractVessel biofouling is a significant pathway for the introduction of nonindigenous marine species (NIMS). New Zealand is the first nation to regulate the vessel biofouling pathway, with controls scheduled to come into force in May 2018. The Craft Risk Management Standard (CRMS): Biofouling on Vessels Arriving to New Zealand specifies the hull fouling thresholds that vessels must meet; and here, we present the evidence-based decisions that underpin these thresholds.Under the CRMS, a vessel must arrive in New Zealand with a “clean hull,” the thresholds for which are governed by the intended duration of a vessel's stay in New Zealand. For example, long-stay (≥21 days) vessels must meet a more stringent standard of hull cleanliness due to the increased likelihood of release and establishment of NIMS. While setting a clean hull threshold at “slime layer only” can be tractable when vessels operate within the specifications of antifouling coatings, incidental amounts of macrofouling can establish even under the best management practices. Because of such instances, the thresholds within the CRMS were designed to allow for the presence of some macrofouling species, albeit with restrictions to minimize biosecurity risk. These thresholds are intended to limit species richness and to prevent successful reproduction and settlement of the allowed taxonomic groups while considering the practicality and feasibility of implementation.The difficulties of managing biofouling on different areas of the hull are acknowledged within these thresholds. For example, a greater tolerance of macrofouling has been allowed for niche areas due to the difficulties in preventing biofouling on these areas.


2019 ◽  
Vol 28 (Sup7) ◽  
pp. S4-S13 ◽  
Author(s):  
Janet L. Kuhnke ◽  
David Keast ◽  
Sue Rosenthal ◽  
Robyn Jones Evans

Objective: This study examined the perspectives of health professionals on the barriers and solutions to delivery of patient-focused wound management and outcomes. Methods: A qualitative, descriptive study design was used. Participants were health-care managers, clinical leaders, nurses and allied health members who are part of wound care services. Open-ended surveys were distributed to participants in a series of learning workshops, and data analysed to identify leading themes. Results: A total of 261 participants took part and 194 surveys were returned (response rate: 74%). From the analysis five themes emerged: patient/family wound-related education; health professional wound-related education; implementation of evidence-based wound care and dissemination of evidence-based wound information across professions and contexts; teamwork and respectful communication within teams; and a higher value and priority placed on wound care through collaborative teams by managers, leaders and policymakers. Conclusion: Findings suggest that ongoing, system-wide education is needed to improve prevention, assessment, treatment and management of four wound types: venous leg ulcer (VLU), diabetic foot ulcer (DFU), pressure ulcer (PU) and surgical wounds. Health professionals are committed to delivering best practice in wound care. Participants identified that effective patient-focused, evidence-based wound care involves having a health-care system with a clear mandate to ensure wound care is a priority. A high value placed on wound care by managers and clinical leadership could transform the present systems. Additionally, effective and widespread dissemination of evidenced-informed practice information is crucial to positive patient outcomes. Education and team commitment for consistent and respectful communication would improve care delivery.


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