Editorial: Military-Civilian Collaboration in Disaster Medicine

1985 ◽  
Vol 1 (1) ◽  
pp. 4-4 ◽  
Author(s):  
Peter Safar
Keyword(s):  
Editorial Comment ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Military Medicine ◽  
Disaster Medicine ◽  
Nuclear War ◽  
World Regions ◽  
Emergency Medical ◽  
Life Saving ◽  
Mass Disasters

This is an editorial comment for Volume 1, Number 1. Medical disasters are “events in which the number of acutely ill or injured persons exceeds the capacity of the local emergency medical services (EMS) system to provide basic and advanced medical care according to prevalent regional standards.” There are multi-casualty incidents, such as transportation accidents, in which the local EMS system is overwhelmed; mass disasters, such as major earthquakes and wars, in which the local EMS system is severely damaged; and endemic disasters, such as combinations of famine, epidemics and revolutions which often occur in world regions without EMS systems. Nuclear war has become recognized as the “ultimate disaster” which is beyond disaster medicine systems' capacities to save lives. Military medicine, however, which is organized for “conventional” war, offers the maximal life-saving potential for mass disasters in peace time.

The New “Journal of the World Association for Emergency and Disaster Medicine” (J. Waedm)

1985 ◽  
Vol 1 (3) ◽  
pp. 207-207
Author(s):  
Peter Safar
Keyword(s):  
Critical Care ◽  
Life Support ◽  
Military Medicine ◽  
International Communication ◽  
Disaster Medicine ◽  
Red Cross ◽  
Emergency Medical ◽  
World Association ◽  
The World ◽  
Mass Disasters

This new Journal, starting with volume 1, number 1, Spring 1985, is an official publication of the World Association for Emergency and Disaster Medicine (WAEDM), formerly called the Club of Mainz. The Journal is cosponsored by the League of Red Cross and Red Crescent Societies (LRCS). The Journal is owned and published by the WAEDM. There will be 4 Journal numbers per year, plus an occasional supplement.We initiated this Journal and its predecessor (see below) because existing journals on disasters focus on sociologic and epidemiologic topics, and more on aid to uninjured survivors and rehabilitation of disaster-stricken regions, than on the resuscitation and life support of severely injured victims. Disaster medicine is not yet a science, and thus based primarily on anecdotal reports. It is in need of international communication and the acquisition of quantifiable facts. The Journal will help meet these needs by examining the potentials of resuscitation, emergency medical care and critical care (intensive care) medicine for everyday Emergency Medical Services (EMS) and for disaster medicine. The disasters to consider range from multi-casualty incidents to mass disasters and endemic disasters. Other organizations emphasize response to mass disasters after days or weeks; the WAEDM emphasizes response within minutes to hours. This Journal will benefit medical and nonmedical members of the WAEDM and the LRCS, as well as non-member specialists in anesthesiology, critical care medicine, cardiology, emergency medicine, epidemiology, forensic medicine, government medicine, infectious diseases, military medicine, nuclear medicine, nutrition, pathology, public health, resuscitology, surgery, toxicology, and traumatology.

Directions for improving the organization of emergency medical services, specialized medical care and medical evacuation in federal subject of Russia

2019 ◽  
Vol 2019 (3) ◽  
pp. 70-74
Author(s):  
Сергей Багненко ◽  
Sergey Bagnenko ◽  
Ильдар Миннулин ◽  
Il'dar Minnulin ◽  
Александр Мирошниченко ◽  
...  
Keyword(s):  
Health System ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Medical Information ◽  
Disaster Medicine ◽  
Medical Services ◽  
Medical Information Systems ◽  
Federal Subject ◽  
Medical Evacuation ◽  
Emergency Medical

The article presents main directions for improving the organization of emergency medical services (EMS), specialized medical care and medical evacuation in federal subject of Russia. These directions of development include: the formation of three-tier health system in federal subject of Russia, the integration of ambulance stations and territorial disaster medicine centres, the creation of EMS regional dispatch centres, the development of emergency departments, the modernization of medical information systems for EMS.

Resuscitation Potentials in Mass Disasters

1986 ◽  
Vol 2 (1-4) ◽  
pp. 34-47 ◽  
Author(s):  
Peter Safar
Keyword(s):  
Infectious Diseases ◽  
Emergency Medical Services ◽  
Medical System ◽  
Medical Services ◽  
Nuclear Accidents ◽  
Industrial Accidents ◽  
Emergency Medical ◽  
Mass Disasters ◽  
Political Economic ◽  
National Disaster

Mass disastersare events which overwhelm, damage or destroy local Emergency Medical Services (EMS) systems, and therefore need the response of a State or National Disaster Medical System (NDMS). Natural mass disasters include major earthquakes, floods, hurricanes and fires. Manmade mass disasters include major fires, industrial accidents, wars, and nuclear accidents. Mass disasters must be distinguished from “multicasualty incidents” (MCI), such as major transportation accidents, which the local EMS system should be able to handle, if necessary, with the assistance of surrounding (regional) EMS systems. Endemic-epidemic disasters (e.g., droughts, famines, infectious diseases, and refugee problems) are catastrophes which deserve separate considerations, as they require ongoing political-economic solutions.

The emergency medical system

2021 ◽  
pp. 65-75
Author(s):  
Olivier Hoogmartens ◽  
Michiel Stiers ◽  
Koen Bronselaer ◽  
Marc Sabbe
Keyword(s):  
Medical Care ◽  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Tertiary Care ◽  
Medical Services ◽  
High Quality ◽  
Emergency Medical ◽  
High Quality Medical Care ◽  
The Moment

The mission of the emergency medical services is to promote and support a system that provides timely, professional and state-of-the art emergency medical care, including ambulance services, to anyone who is victim of a sudden injury or illness, at any time and any location. A medical emergency has five different phases, namely: population awareness and behaviour, occurrence of the problem and its detection, alarming of trained responders and help rendered by bystanders and trained pre-hospital providers, transport to the nearest or most appropriate hospital, and, if necessary, admission or transfer to a tertiary care centre which provides a high degree of subspecialty expertise. In order to meet these goals, emergency medical services must work aligned with local, state officials; with fire and rescue departments; with other ambulance providers, hospitals, and other agencies to foster a high performance network. The term emergency medical service evolved to reflect a change from a straightforward system of ambulances providing nothing but transportation, to a complex network in which high-quality medical care is given from the moment the call is received, on-scene with the patient and during transportation. Medical supervision and/or participation of emergency medicine physicians (EP) in the emergency medical service systems contributes to the quality of medical care. This emergency medical services network must be capable to respond instantly and to maintain efficacy around the clock, with well-trained, well-equipped personnel linked through a strong communication system. Research plays a pivotal role in defining necessary resources and in continuously improving the delivery of high-quality care. This chapter gives an overview of the different aspects of emergency medical services and calls for high quality research in pre-hospital emergency care in a true partnership between cardiologists and emergency physicians.

Emergency Medical Services Response to Active Shooter Incidents: Provider Comfort Level and Attitudes Before and After Participation in a Focused Response Training Program

2014 ◽  
Vol 29 (4) ◽  
pp. 350-357 ◽  
Author(s):  
Jerrilyn Jones ◽  
Ricky Kue ◽  
Patricia Mitchell ◽  
Sgt. Gary Eblan ◽  
K. Sophia Dyer
Keyword(s):  
Law Enforcement ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Training Program ◽  
Comfort Level ◽  
Medical Services ◽  
Active Shooter ◽  
Response Training ◽  
Emergency Medical ◽  
Before And After

AbstractIntroductionEmergency Medical Services (EMS) routinely stage in a secure area in response to active shooter incidents until the scene is declared safe by law enforcement. Due to the time-sensitive nature of injuries at these incidents, some EMS systems have adopted response tactics utilizing law enforcement protection to expedite life-saving medical care.ObjectiveDescribe EMS provider perceptions of preparedness, adequacy of training, and general attitudes toward active shooter incident response after completing a tactical awareness training program.MethodsAn unmatched, anonymous, closed-format survey utilizing a five-point Likert scale was distributed to participating EMS providers before and after a focused training session on joint EMS/police active shooter rescue team response. Descriptive statistics were used to compare survey results. Secondary analysis of responses based on prior military or tactical medicine training was performed using a chi-squared analysis.ResultsTwo hundred fifty-six providers participated with 88% (225/256) pretraining and 88% (224/256) post-training surveys completed. Post-training, provider agreement that they felt adequately prepared to respond to an active shooter incident changed from 41% (92/225) to 89% (199/224), while agreement they felt adequately trained to provide medical care during an active shooter incident changed from 36% (82/225) to 87% (194/224). Post-training provider agreement that they should never enter a building with an active shooter changed from 73% (165/225) to 61% (137/224). Among the pretraining surveys, significantly more providers without prior military or tactical experience agreed they should never enter a building with an active shooter until the scene was declared safe (78% vs 50%, P = .002), while significantly more providers with prior experience felt both adequately trained to provide medical care in an active shooter environment (56% vs 31%, P = .007) and comfortable working jointly with law enforcement within a building if a shooter were still inside (76% vs 56%, P = .014). There was no difference in response to these questions in the post-training survey.ConclusionsAttitudes and perceptions regarding EMS active shooter incident response appear to change among providers after participation in a focused active shooter response training program. Further studies are needed to determine if these changes are significant and whether early EMS response during an active shooter incident improves patient outcomes.JonesJ, KueR, MitchellP, EblanG, DyerKS. Emergency Medical Services response to active shooter incidents: provider comfort level and attitudes before and after participation in a focused response training program. Prehosp Disaster Med. 2014;29(4):1-7.

An Analysis of Prehospital Mortality in an Earthquake

1994 ◽  
Vol 9 (2) ◽  
pp. 107-117 ◽  
Author(s):  
Ernesto A. Pretto ◽  
Derek C. Angus ◽  
Joel I. Abrams ◽  
Bern Shen ◽  
Richard Bissell ◽  
...  
Keyword(s):  
Costa Rica ◽  
Medical Care ◽  
Cause Of Death ◽  
Crush Injury ◽  
Emergency Medical Care ◽  
Principal Mechanism ◽  
Medical Response ◽  
Emergency Medical ◽  
Life Saving ◽  
Prehospital Emergency

AbstractIntroduction:Anecdotal observations about prehospital emergency medical care in major natural and human-made disasters, such as earthquakes, have suggested that some injured victims survive the initial impact, but eventually die because of a delay in the application of life-saving medical therapy.Methods:A multidisciplinary, retrospective structured interview methodology to investigate injury risk factors, and causes and circumstances of prehospital death after major disasters was developed. In this study, a team of United States researchers and Costa Rican health officials conducted a survey of lay survivors and health care professionals who participated in the emergency medical response to the earthquake in Costa Rica on 22 April 1991.Results:Fifty-four deaths occurred prior to hospitatization (crude death rate = 0.4/1,000 population). Seventeen percent of these deaths (9/54) were of casualties who survived the initial impact but died at the scene or during transport. Twenty-two percent (2/9) were judged preventable if earlier emergency medical care had been available. Most injuries and deaths occurred in victims who were inside wooden buildings (p <.O1) as opposed to other building types or were pinned by rubble from building collapse. Autopsies performed on a sample of victims showed crush injury to be the predominant cause of death.Conclusions:A substantial proportion of earthquake mortality in Costa Rica was protracted. Crush injury was the principal mechanism of injury and cause of death. The rapid institution of enhanced prehospital emergency medical services may be associated with a significant life- saving potential in these events.

Disaster medicine and response: Optimizing life-saving potential

2018 ◽  
Vol 13 (4) ◽  
pp. 253-264 ◽  
Author(s):  
Mehmet Sukru Sever, MD ◽  
Giuseppe Remuzzi, MD ◽  
Raymond Vanholder, MD
Keyword(s):  
Disaster Medicine ◽  
Regional Hospital ◽  
Medical Problems ◽  
Basic Principles ◽  
Demand And Supply ◽  
Medical Interventions ◽  
Medical Response ◽  
Life Saving ◽  
Routine Medical Practice ◽  
Mass Disasters

Background: Natural and technological mass disasters strike densely populated areas on a regular basis, causing ever growing numbers of deaths and injured, economical losses, social problems, and damage to the environment.Objective of the review: This review aims to provide a comprehensive idea about the spectrum of main problems, essentially presenting a number of basic principles to save as many lives as possible after natural and man-made mega disasters.Discussion: Medical problems following disasters may be acute, acute-on-chronic, or chronic; they appear from the disaster period up till long thereafter. All these problems may be nonspecific, or specific for particular disaster types. Decreasing death toll after mass disasters can be accomplished by preparations before, and effective medical response after disasters. These interventions should be considered at both national/governmental and regional/hospital levels. Disaster medicine, the art and science of providing healthcare to the victims, differs significantly from routine medical practice because of disparities between demand and supply of rescue and healthcare, the need for unusual medical interventions, and the occurrence of ethical and legal dilemmas.Conclusions: Adherence to the principles of disaster medicine, is vital to minimize the extent of medical, logistic, ethical, and legal problems, and saving as many lives as possible.

scholarly journals The Epidemiology of Emergency Medical Services Use by Children: An Analysis of the National Hospital Ambulatory Medical Care Survey

2008 ◽  
Vol 12 (3) ◽  
pp. 269-276 ◽  
Author(s):  
Manish N. Shah ◽  
Jeremy T. Cushman ◽  
Colleen O. Davis ◽  
Jeffrey J. Bazarian ◽  
Peggy Auinger ◽  
...  
Keyword(s):  
Medical Care ◽  
Emergency Medical Services ◽  
Medical Services ◽  
National Hospital ◽  
Emergency Medical ◽  
Care Survey ◽  
Ambulatory Medical Care ◽  
Services Use

scholarly journals EMERGENCY MEDICINE: PROBLEMS OF VIOLENCE AND SAFETY AT WORK

2019 ◽  
Vol 7 (4) ◽  
pp. 351-357
Author(s):  
Yu. V. Shkatula ◽  
Y. O. Badion ◽  
M. V. Novikov ◽  
Ya. V. Khyzhnia
Keyword(s):  
Medical Care ◽  
Close Contact ◽  
Medical Personnel ◽  
Disaster Medicine ◽  
Third Parties ◽  
Emergency Medical Care ◽  
Medical Worker ◽  
Emergency Medical ◽  
Emergency Medical Personnel ◽  
Victims Of Violence

The work of medical workers is associated with constant psycho-emotional stress, which is caused by close contact with human suffering, the need to make immediate decisions, uncomfortable conditions of the pre-hospital stage and cases of aggressive and violent actions by patients or third parties. Statistics show that 54 to 84.8 % of medical workers have become victims of verbal or physical aggression annually. In 2013-2017, 543 crimes against life and health of medical workers on duty were registered in Ukraine. The purpose of the research was to study the causes, nature and risk factors of violent actions against emergency medical personnel with finding the ways to normalize the situation. Material and methods. An anonymous non-personified survey was conducted among 127 workers of the Sumy Regional Centre for Emergency Medical Care and Disaster Medicine. A modified questionnaire “Violence and aggression in the Health Service” (B. Mullan, F. Badger, 2007) was used in the study. It has been established that 74.8 % of emergency medical care and disaster medicine personnel were victims of violence caused by patients, their relatives or friends. Most often, the reasons for aggressive behaviour of the patient or third parties were the time of waiting for a medical worker and the suspicion of incompetence. According to the results of the survey, 35.43 % of employees believe that it is possible to improve the situation by completing and forming ambulance teams of a mixed type. Almost a third of the surveyed medical workers (24.41 %) indicated the need to provide personal protective equipment, another 14.96 % of respondents wanted better legal support and assistance. The authors come to the conclusion that it is necessary to solve the problem of the safety of a medical worker during an emergency call at the state legislative level. Particular attention should be paid to the further improvement of legal assistance, as well as to the development of measures to prevent violence.

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