Oral trauma and dental emergency management recommendations of first-aid textbooks and manuals

Objective: To assess disaster planning of local Offices of Emergency Management (OEM) with respect to people with disabilities (PWD).Design: A cross-sectional study of local OEM from Federal Emergency Management Agency (FEMA) Region 9 (N = 61) was conducted using an internet-based survey. The primary outcome was the adoption of emergency management recommendations by the Department of Justice (DOJ) and FEMA in applying Title II of the Americans with Disabilities Act (ADA). Results: OEM implementation of ADA requirements was generally suboptimal. While 63 percent reported that plans addressed the needs of PWD, only 41 percent reported detailed operating procedures for PWD. Training of staff to ensure that they were knowledgeable on the ADA requirements for inclusivity was rarely conducted. While accessible shelters and transportation were often identified, accessible communication strategies, including emergency notifications, were often lacking; only 28 percent of OEMs reported availability of sign language interpreters at shelters. Shelters often allowed service animal access (62 percent), but fewer allowed access to personal assistants (39 percent). Engagement of the disability community, from plan development to community drills, was uncommon. While more than half (59 percent) of OEM felt clear about their responsibilities in providing equal access to PWD, only 23 percent reported having qualified staff and other resources necessary in order to meet those responsibilities. Participants cited the need for more training on the ADA requirements in order to better meet the needs of PWD. Conclusion: Strategies for improvement to assure inclusiveness of PWD in all phases of emergency management are needed.

Download Full-text

First Aid and Emergency Management in Orthopedic Injuries

10.5005/jp/books/11565 ◽

2012 ◽

Cited By ~ 2

Keyword(s):

Emergency Management ◽

First Aid ◽

Orthopedic Injuries

Download Full-text

Intrathecal Baclofen Therapy—Practical Approach: Clinical Benefits and Complication Management

Journal of Child Neurology ◽

10.1177/0883073818785074 ◽

2018 ◽

Vol 33 (11) ◽

pp. 734-741 ◽

Cited By ~ 5

Author(s):

Gidon Winter ◽

Liana Beni-Adani ◽

Hilla Ben-Pazi

Keyword(s):

Emergency Management ◽

Health Care Professionals ◽

Intrathecal Baclofen ◽

Intrathecal Baclofen Therapy ◽

Management Measures ◽

Children With Cerebral Palsy ◽

Clinical Benefits ◽

Invasive Device ◽

Management Recommendations ◽

A Current

Intrathecal baclofen is an expanding accepted treatment for children with cerebral palsy and other causes of spasticity and dystonia. The aims of this review are therefore to (1) delineate the clinical benefits of intrathecal baclofen therapy in pediatric spasticity and dystonia and (2) increase awareness of the potential complications and emergency management measures of intrathecal baclofen therapy. A current literature review demonstrates the benefits and complications of this minimally invasive device. Practical guides for recognizing acute conditions and management recommendations are included. Intrathecal baclofen is increasingly being used to help individuals attain realistic functional goals. Therefore, families and health care professionals should be aware of potential complications, symptoms, and emergency management.

Download Full-text

Pre-hospital care: Data profile from traumatic brain injury registry

Romanian Neurosurgery ◽

10.1515/romneu-2017-0055 ◽

2017 ◽

Vol 31 (3) ◽

pp. 339-343

Author(s):

Ranjan Kumar Jena ◽

Amit Agrawal ◽

M. Ashok ◽

B.V. Subrahmanyam

Keyword(s):

Emergency Management ◽

Hospital Care ◽

Trauma Registry ◽

Data Entry ◽

First Aid ◽

Trauma Unit ◽

Rural And Urban ◽

Ground Ambulance ◽

Mode Of Transportation ◽

Larger Sample

Abstract Introduction: There are multiple factors from injury spot till patient reach trauma unit, which affect their outcome. The literature of same from developing country is mere. The present study investigates primary care, mode of transportation and emergency management among TBI patients visiting a tertiary institute. Methods: The data of 337 patients was selected from a trauma registry. The data of TBI patients visiting emergency were entered in standard computer interface after obtaining their consent. The standard proforma was developed by FileMaker Pro Advanced 13 (Copyright © 1994-2015, FileMaker, Inc) and web data entry interface Drupal CMS. Data was analyzed using Stats Direct version 3.0.150. Results: Seventy five percent of patients were from rural setup. About 67% of patients visiting emergency had undergone first aid from both rural and urban setup. Forty percent of patients came directly, only about 5% were referred from other hospitals. Majority of patients were accompanied by relatives (87%) followed by spouse (8.6%). Non ambulance mode (31%) was more than ground ambulance (25%) to reach emergency setup. Emergency management of airway, breathing and circulation was significant with outcome at discharge (p<0.001). Conclusion: The study reports that majority of patients had undergone first aid before reaching trauma unit. Non ambulance mode of transportation is more. The study emphasis for detail study on pre hospital care variables with larger sample size.

Download Full-text

Use of a Smartphone Platform to Help With Emergency Management of Acute Ischemic Stroke: Observational Study

JMIR mhealth and uhealth ◽

10.2196/25488 ◽

2021 ◽

Vol 9 (2) ◽

pp. e25488

Author(s):

Yiqun Wu ◽

Fei Chen ◽

Haiqing Song ◽

Wuwei Feng ◽

Jinping Sun ◽

...

Keyword(s):

Ischemic Stroke ◽

Emergency Management ◽

Acute Ischemic Stroke ◽

Health Management ◽

Digital Health ◽

First Aid ◽

Mobile Technologies ◽

Tissue Type ◽

Management Processes ◽

Clinical Records

Background To improve the outcomes of acute ischemic stroke (AIS), timely thrombolytic therapy is crucial. Series strategies were recommended to reduce door-to-needle (DTN) time for AIS. Mobile technologies are feasible and have been used in stroke management for various purposes. However, the use of smartphone platforms that integrate series strategies through the entire first aid process to improve emergency management of AIS remains to be verified. Objective This study aims to describe the utility and application of a smartphone platform in the emergency management of AIS and report the DTN time for patients with AIS during its 2-year application period. Our results are relevant to digital health management. Methods A smartphone platform named “Green” was developed to incorporate the field assessment, hospital recommendation, prehospital notification, real-time communication, clinical records creation, key time-stamping, and quality control to streamline and standardize overall AIS emergency management processes. The emergency medical system (EMS) and all the emergency departments in Beijing have used this platform since 2018. From January 1, 2018, to December 31, 2019, 8457 patients diagnosed with AIS received intravenous tissue-type plasminogen activator therapy. The median DTN time and the proportions of patients with DTN times of ≤60 minutes and ≤45 minutes were reported. Results During the 2-year application period of this platform, the median DTN time was 45 minutes, and the proportions of patients with DTN times of ≤60 minutes and ≤45 minutes were 74.6% and 50.5%, respectively. The median DTN time was significantly reduced from 50 minutes in 2018 to 42 minutes in 2019 (P<.001). The proportions of patients with DTN times of ≤60 minutes and ≤45 minutes increased from 66.1% and 40.7%, respectively, in 2018 to 80.7% and 57.3%, respectively, in 2019 (both P<.001). Sustained improvement in DTN time was seen during all the observed months. The improvement occurred across all facilities, and the variations among hospitals also decreased. The median DTN time for patients transferred by ambulances (43 minutes) was significantly shorter than those who reached hospitals by themselves (47 minutes; P<.001). Conclusions Sustained reductions in DTN time reflected the improvement in AIS emergency management processes. The use of a smartphone platform integrating recommended strategies throughout all first aid stages is a practical way to help the emergency management of AIS.

Download Full-text

Use of a Smartphone Platform to Help With Emergency Management of Acute Ischemic Stroke: Observational Study (Preprint)

10.2196/preprints.25488 ◽

2020 ◽

Author(s):

Yiqun Wu ◽

Fei Chen ◽

Haiqing Song ◽

Wuwei Feng ◽

Jinping Sun ◽

...

Keyword(s):

Ischemic Stroke ◽

Emergency Management ◽

Acute Ischemic Stroke ◽

Health Management ◽

Digital Health ◽

First Aid ◽

Mobile Technologies ◽

Tissue Type ◽

Management Processes ◽

Clinical Records

BACKGROUND To improve the outcomes of acute ischemic stroke (AIS), timely thrombolytic therapy is crucial. Series strategies were recommended to reduce door-to-needle (DTN) time for AIS. Mobile technologies are feasible and have been used in stroke management for various purposes. However, the use of smartphone platforms that integrate series strategies through the entire first aid process to improve emergency management of AIS remains to be verified. OBJECTIVE This study aims to describe the utility and application of a smartphone platform in the emergency management of AIS and report the DTN time for patients with AIS during its 2-year application period. Our results are relevant to digital health management. METHODS A smartphone platform named “Green” was developed to incorporate the field assessment, hospital recommendation, prehospital notification, real-time communication, clinical records creation, key time-stamping, and quality control to streamline and standardize overall AIS emergency management processes. The emergency medical system (EMS) and all the emergency departments in Beijing have used this platform since 2018. From January 1, 2018, to December 31, 2019, 8457 patients diagnosed with AIS received intravenous tissue-type plasminogen activator therapy. The median DTN time and the proportions of patients with DTN times of ≤60 minutes and ≤45 minutes were reported. RESULTS During the 2-year application period of this platform, the median DTN time was 45 minutes, and the proportions of patients with DTN times of ≤60 minutes and ≤45 minutes were 74.6% and 50.5%, respectively. The median DTN time was significantly reduced from 50 minutes in 2018 to 42 minutes in 2019 (P<.001). The proportions of patients with DTN times of ≤60 minutes and ≤45 minutes increased from 66.1% and 40.7%, respectively, in 2018 to 80.7% and 57.3%, respectively, in 2019 (both P<.001). Sustained improvement in DTN time was seen during all the observed months. The improvement occurred across all facilities, and the variations among hospitals also decreased. The median DTN time for patients transferred by ambulances (43 minutes) was significantly shorter than those who reached hospitals by themselves (47 minutes; P<.001). CONCLUSIONS Sustained reductions in DTN time reflected the improvement in AIS emergency management processes. The use of a smartphone platform integrating recommended strategies throughout all first aid stages is a practical way to help the emergency management of AIS.

Download Full-text

First Aid Management of Hypothermia and Cold Injuries

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19002887 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s132-s132

Author(s):

Rowena Christiansen

Keyword(s):

Literature Review ◽

Expert Opinion ◽

Key Management ◽

Best Practice ◽

First Aid ◽

Accidental Hypothermia ◽

Cold Environments ◽

Randomized Controlled ◽

Practice Recommendations ◽

Management Recommendations

Introduction:Best practice first aid management of accidental hypothermia and cold injuries in the prehospital setting is relevant for disaster management in cold environments as well as for wilderness and expedition medicine, and space medicine. In the Australasian context, guidance is currently taken from the Australian Resuscitation Council (“ARC”) Guidelines dealing with these issues.Aim:To review and update the recommendations of the ARC Guideline 9.3.3 Hypothermia: First-Aid Management (February 2009) and ARC Guideline 9.3.6 Cold Injury (March 2000).Method: The review is being undertaken through a combination of a focused literature review and expert opinion. Through the author’s membership of the International Commission for Alpine Rescue (“ICAR”) Alpine Emergency Medicine Commission, two northern-hemisphere experts on hypothermia have reviewed the guidelines and provided commentary and recommendations.Results:Much of the literature around accidental hypothermia and cold injuries (including frostbite, frostnip, and chilblains), relies on expert opinion and case studies. There are relatively few randomized controlled trials, and these are often confined to the laboratory setting. As a result, there is a heavier reliance on expert opinion than in any other areas of medicine.Discussion:This presentation will summarize the current best practice recommendations for the first aid management of accidental hypothermia and cold injuries through combining the existing ARC Guidelines with key advances identified through the literature review, and the key management recommendations stemming from expert opinion. This will provide attendees with a cohesive set of clinical practice recommendations which can be used in the field.

Download Full-text

An Unexpected Case of Black Mamba (Dendroaspis polylepis) Bite in Switzerland

Case Reports in Critical Care ◽

10.1155/2017/5021924 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Verena Quarch ◽

Lukas Brander ◽

Luca Cioccari

Keyword(s):

Critical Care ◽

Emergency Management ◽

Continuous Monitoring ◽

Unusual Case ◽

Clinical Course ◽

First Aid ◽

Adequate Ventilation ◽

Snake Bites ◽

The World ◽

Pressure Immobilization

Mambas (genusDendroaspis) are among the most feared venomous African snakes. Without medical treatment, mamba bites are frequently fatal. First-aid treatment includes lymphatic retardation with the pressure immobilization technique. Medical management comprises continuous monitoring, securing patency of the airway, ensuring adequate ventilation, symptomatic measures, and administration of specific antivenin. We report an unusual case of a snake breeder bitten by a black mamba in Switzerland, report the clinical course, and review the lifesaving emergency management of mamba bites. This case highlights the importance of early antivenin administration and suggests that emergency and critical care physicians as well as first responders all around the world should be familiar with clinical toxinology of exotic snake bites as well as with the logistics to most rapidly make the specific antivenin available.

Download Full-text