Trauma Teams and Their Use in Aircraft Disasters

1985 ◽  
Vol 1 (2) ◽  
pp. 142-143
Author(s):  
Leon D. Star ◽  
Louis R.M. DelGuercio ◽  
Louis C. Abelson
Keyword(s):  
New York ◽  
Road Traffic ◽  
Trauma Team ◽  
Time Of Day ◽  
Teaching Hospitals ◽  
Mass Casualties ◽  
Medical College ◽  
Access Road ◽  
Major Teaching ◽  
Trauma Teams

The concept of treating mass casualties in major disasters, particularly at or near airports, has gained considerable momentum in recent years (1). Major urban airports are almost without exception, plagued by access road traffic problems even under normal circumstances. Given a disaster within the confines of an airport, emergency equipment and medical support are found to be mired in a morass of sightseer and emergency service vehicles, compounding the congestion already present immeasurably (2).Evolving from experiences gained over the past 30 years in handling masses of casualties resulting from aircraft disasters, we at Kennedy Airport have developed a Mobile Emergency Hospital which now serves as the “workshop” for stabilizing large numbers of injuries prior to subsequent transfer to definitive hospitals. The keys to this plan are the Trauma Team support used in conjunction with the mobile hospitals.The ideal trauma team consists of 2 surgeons or trauma-trained physicians, one surgical nurse and one medical or 2 surgical technicians. These teams can be varied according to the immediate situation, time of day, available physicians, nurses and technicians. Anesthesiologists respond either individually or as members of some of the teams reporting directly to the operating units on arrival.For an efficient response plan to function, previous liaison must be established primarily with teaching hospitals with a surgical staff that includes surgery and trauma residents. The Kennedy plan has a working arrangement with the New York Medical College and 8 of its affiliated major teaching hospitals in Manhattan, as well as in the main campus at Valhalla, which maintains an associated Burn Center.

STATEMENT FROM COMMITTEE ON MEDICAL EDUCATION

PEDIATRICS ◽  
1958 ◽  
Vol 22 (3) ◽  
pp. 575-575
Keyword(s):  
New York ◽  
Medical Education ◽  
Primary Objective ◽  
Child Health Services ◽  
Teaching Hospitals ◽  
News Letter ◽  
Major Teaching ◽  
Part Time ◽  
Regional Basis ◽  
Academic Year

THE Executive Board of the Academy has approved a proposal made by the Committee on Medical Education for the establishment of postgraduate courses on a regional basis for Academy members. This decision was derived from the fact that, although in 1957 there were 53 postgraduate courses offered in the pediatric field the country over (J.A.M.A., 164:1811, 1957), 46 were primarily for physicians in general practice or part-time specialty practice. Six were offered for physicians interested in application of specialties to pediatrics, such as orthopedics, allergy, and dermatology, but only two were on clinical pediatrics. Of the courses in the specialties, two were given in New York City (one every Wednesday for 6 months, and the other for durations varying from 1 to 12 months). The Academy plans to conduct its postgraduate courses in conjunction with medical schools and major teaching hospitals co-operating with the Academy for this purpose. It is anticipated that 8 to 10 courses will be offered annually. These courses will cover general pediatric problems as well as specialty subjects in pediatrics, according to the demands of the membership. The courses will be arranged so they will in no way conflict with the Annual Meeting or the Spring Session of the Academy. For the academic year 1958-59, two courses are being arranged. Details of these, including content of programs and locations, will be circulated to the members of the Academy by the News Letter of the Academy from the Central Office. It is believed that Academy-sponsored postgraduate courses distributed over the country on a regional basis will greatly enhance the fulfillment of the primary objective of the Academy: to foster and promote better child health services for the children of this nation.

Airport Access Road Traffic Demand Estimation

2015 ◽  
Vol 764-765 ◽  
pp. 1356-1360
Author(s):  
Seong Ho Kim ◽  
Won Ho Suh ◽  
Jun Gin Kim
Keyword(s):  
Traffic Engineering ◽  
Road Traffic ◽  
Time Of Day ◽  
User Characteristics ◽  
Traffic Demand ◽  
Passenger Demand ◽  
Access Road ◽  
Traffic Volumes ◽  
Airport Access ◽  
Toll Plaza

For most traffic engineering studies, traffic flows are usually analyzed and evaluated on hourly basis. However few studies have been performed that estimate the number of traffic volumes made to an airport as a function of air passengers by time of day. The objective of this paper is to develop a mathematical model which forecasts hourly traffic volume by using hourly airport operation data along with airport user characteristics data. An analytical model was developed. This model can be used to (1) predict the number of vehicles queued at airport entrances intersection or toll plaza, (2) predict optimum toll lane staffing, and (3) analyze the level of congestion on the roadway for different levels of air passenger demand in future.

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

scholarly journals Assessing inequality, irregularity, and severity regarding road traffic safety during COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lei Lin ◽  
Feng Shi ◽  
Weizi Li
Keyword(s):  
New York ◽  
Los Angeles ◽  
Traffic Safety ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Human Mobility ◽  
Critical Conditions ◽  
Road Traffic Safety ◽  
Accident Data ◽  
The Impact

AbstractCOVID-19 has affected every sector of our society, among which human mobility is taking a dramatic change due to quarantine and social distancing. We investigate the impact of the pandemic and subsequent mobility changes on road traffic safety. Using traffic accident data from the city of Los Angeles and New York City, we find that the impact is not merely a blunt reduction in traffic and accidents; rather, (1) the proportion of accidents unexpectedly increases for “Hispanic” and “Male” groups; (2) the “hot spots” of accidents have shifted in both time and space and are likely moved from higher-income areas (e.g., Hollywood and Lower Manhattan) to lower-income areas (e.g., southern LA and southern Brooklyn); (3) the severity level of accidents decreases with the number of accidents regardless of transportation modes. Understanding those variations of traffic accidents not only sheds a light on the heterogeneous impact of COVID-19 across demographic and geographic factors, but also helps policymakers and planners design more effective safety policies and interventions during critical conditions such as the pandemic.

scholarly journals Controlling a Multicenter Outbreak Involving the New York/Japan Methicillin-ResistantStaphylococcus aureusClone

2007 ◽  
Vol 28 (7) ◽  
pp. 845-852 ◽  
Author(s):  
G. W. Coombs ◽  
H. Van Gessel ◽  
J. C. Pearson ◽  
M.-R. Godsell ◽  
F. G. O'Brien ◽  
...  
Keyword(s):  
Public Health ◽  
New York ◽  
Molecular Typing ◽  
Management Strategies ◽  
Research Unit ◽  
Management Policy ◽  
Teaching Hospitals ◽  
Term Care ◽  
Outbreak Management ◽  
Healthcare Facilities

Objective.To describe the control of an outbreak of infection and colonization with the New York/Japan methicillin-resistantStaphylococcus aureus(MRSA) clone in multiple healthcare facilities, and to demonstrate the importance of making an MRSA management policy involving molecular typing of MRSA into a statewide public health responsibility.Setting.A range of healthcare facilities, including 2 metropolitan teaching hospitals and a regional hospital, as well as several community hospitals and long-term care facilities in a nonmetropolitan healthcare region.Interventions.A comprehensive, statewide MRSA epidemiological investigation and management policy.Results.In May 2005, there were 3 isolates referred to the Western Australian Gram-Positive Bacteria Typing and Research Unit that were identified as the New York/Japan MRSA clone, a pandemic MRSA clone with the ability to spread and replace existing clones in a region. Subsequent investigation identified 28 additional cases of infection and/or colonization dating from 2002 onward, including 1 involving a colonized healthcare worker (HCW) who had previously been hospitalized overseas. Of the 31 isolates detected, 25 were linked epidemiologically and via molecular typing to the isolate recovered from the colonized HCW. Four isolates appeared to have been introduced separately from overseas. Although the isolate from the single remaining case patient was genetically indistinct from the isolates that spread within Western Australia, no specific epidemiological link could be established. The application of standard outbreak management strategies reduced further spread.Conclusions.The elimination of the New/York Japan MRSA clone in a healthcare region demonstrates the importance of incorporating MRSA management policy into statewide public health programs. The mainstays of such programs should include a comprehensive and effective outbreak identification and management policy (including pre-employment screening of HCWs, where applicable) and MRSA clone identification by multilocus sequence typing.

scholarly journals Characterizations of Clinical Isolates of Clostridium difficile by Toxin Genotypes and by Susceptibility to 12 Antimicrobial Agents, Including Fidaxomicin (OPT-80) and Rifaximin: a Multicenter Study in Taiwan

2012 ◽  
Vol 56 (7) ◽  
pp. 3943-3949 ◽  
Author(s):  
Chun-Hsing Liao ◽  
Wen-Chien Ko ◽  
Jang-Jih Lu ◽  
Po-Ren Hsueh
Keyword(s):  
Clostridium Difficile ◽  
Care Setting ◽  
Antimicrobial Agents ◽  
Teaching Hospitals ◽  
Binary Toxin ◽  
Content Type ◽  
Vancomycin Mics ◽  
Major Teaching ◽  
Southern Taiwan

ABSTRACTA total of 403 nonduplicate isolates ofClostridium difficilewere collected at three major teaching hospitals representing northern, central, and southern Taiwan from January 2005 to December 2010. Of these 403 isolates, 170 (42.2%) were presumed to be nontoxigenic due to the absence of genes for toxins A or B or binary toxin. The remaining 233 (57.8%) isolates carried toxin A and B genes, and 39 (16.7%) of these also had binary toxin genes. The MIC90of all isolates for fidaxomicin and rifaximin was 0.5 μg/ml (range, ≤0.015 to 0.5 μg/ml) and >128 μg/ml (range, ≤0.015 to >128 μg/ml), respectively. All isolates were susceptible to metronidazole (MIC90of 0.5 μg/ml; range, ≤0.03 to 4 μg/ml). Two isolates had reduced susceptibility to vancomycin (MICs, 4 μg/ml). Only 13.6% of isolates were susceptible to clindamycin (MIC of ≤2 μg/ml). Nonsusceptibility to moxifloxacin (n= 81, 20.1%) was accompanied by single or multiple mutations ingyrAandgyrBgenes in all but eight moxifloxacin-nonsusceptible isolates. Two previously unreportedgyrBmutations might independently confer resistance (MIC, 16 μg/ml), Ser416 to Ala and Glu466 to Lys. Moxifloxacin-resistant isolates were cross-resistant to ciprofloxacin and levofloxacin, but some moxifloxacin-nonsusceptible isolates remained susceptible to gemifloxacin or nemonoxacin at 0.5 μg/ml. This study found the diversity of toxigenic and nontoxigenic strains ofC. difficilein the health care setting in Taiwan. All isolates tested were susceptible to metronidazole and vancomycin. Fidaxomicin exhibited potentin vitroactivity against all isolates tested, while the more than 10% of Taiwanese isolates with rifaximin MICs of ≥128 μg/ml raises concerns.

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