Improving oxygen capacity at ITBP Referral Hospital during the second wave of COVID-19 infections in Greater Noida, India An operative targeted intervention

Due to factors that still remain under debate, both social and virological, the COVID-19 pandemic has continued to flare up in India, particularly in northern and western areas. This has led to an incidence of approximately 350,000 cases per day and a daily death toll of around 4,000 in the weeks between the 1st and 14th May 2021. The current pandemic is testing the adaptability of the oxygen distribution and consumption. Following India’s request for support, the EU Civil Protection Mechanism coordinated the response agreed by EU Member States providing shipments of oxygen and equipment. In this scenario, our Emergency Medical Team (EMT)-2, based in Italy, organized a cargo and a twelve member team of technicians and medical professionals with the main objective of installing a novel source of oxygen. The installation of a PSA oxygen plant provided the ITBP hospital in Greater Noida, India, with a sustainable solution to combat oxygen shortage in less than 48 hours. The supply of oxygen could not be deemed a successful intervention without a proper plan to guarantee the rational use of the source so additional training was carried out. Our EMT were among the first responders in mitigating this public health crisis.

PT EMT – Portuguese Emergency Medical Team Type 1 Relief Mission in Mozambique

Introduction:The tropical cyclone Idai hit Mozambique in the city of Beira on March 15, 2019. During the following days, the Portuguese Emergency Medical Team (PT EMT) and its infrastructure deployed to Mozambique with the mission of helping local people and collaborating with the authorities.Methods:Data analyzed were collected in the period of the deployment, from April 1-April 30, 2019. All patients admitted to PT EMT were registered through the Clinical Record of PT EMT.Results:In total, 1,662 patients were admitted to PT EMT during the 30-day mission. The five most prevalent diagnoses were: 61.49% classified with “code 29” (which corresponds to “other unspecified diagnoses”), 9.15% of cases of skin disease, 8.90% of minor injuries, 6.74% of acute respiratory infection, and 3.19% of obstetric/genecology complications.Discussion and Challenges:An important challenge identified was the need for a robust and effective network for transporting patients, allowing transfers between EMTs, enabling a true network response in the provision of care to disaster victims.Conclusions:The benefit of the deployment of PT EMT in Mozambique after Cyclone Idai was in line with the EMT initiative standards, allowing a direct delivery of care to the affected Mozambican population and support to the local health authorities.

Development and Validation of the Perceived Stress Scale in Emergency Medical Teams During the Epidemic of COVID-19

BackgroundDuring the epidemic of COVID-19 of China, the emergency medical teams are facing serious stress in the front-line. As far as we know, there are no studies to test the applicability and measurement properties of the 10-item Chinese perceived stress scale (CPSS-10) in the emergency medical team.MethodsFrom March 17 to 27, 2020, an online survey was conducted on the emergency medical teams of Liaoning Province who supporting Wuhan. The CPSS-10 was used to measure the stress of medical workers. Classical test theory (CTT), bifactor model and multidimensional graded response model (MGRM) were used to analyze the measurement characteristics and differential item functioning (DIF) of CPSS-10.ResultsThe Cronbach's alpha coefficient of CPSS-10 was 0.86. Bifactor model confirmed that CPSS-10 was a two-factor structure. MGRM showed ordered response categories of K10. Item 8 could distinguish individual stress, but the slope of this item was very large (slope is 7.97, which was higher than 4), showing local dependence. There was a significant age DIF, but no DIF in gender. After removing the items 2, 5, and 8, the CPSS-7 showed high reliability, without DIF of age and gender, and there was no local dependence.ConclusionsMGRM could provide useful measurement information about CPSS-10 and CPSS-7. MGRM found that CPSS-10 did not fully conform to the item response theory (IRT). CPSS-7 had proved to be a more effective and reliable tool for assessing the perceived stress of emergency medical team.

Health Protection of CT Radiographers During the Outbreak of COVID-19: Application of Automatic Positioning Technology for Relocatable CT in the Fang Cang Hospital

Background: To investigate the value of automatic positioning technology in improving the protection of radiographers in the relocatable CT room of a Fang Cang hospital during the outbreak of coronavirus disease 2019 (COVID-19).Methods: The National Emergency Medical Team of our hospital assumed command of Wuchang Fang Cang Hospital and treated confirmed COVID-19 patients with mild symptoms. Relocatable CT was used to examine patients in this hospital. Automatic positioning technology was applied to avoid close contact between medical staff and patients and to protect medical staff more effectively.Results: Seven hundred lung CT scans acquired from 269 patients were completed from February 17 to 26, 2020 with automatic positioning technology for relocatable CT in a Fang Cang hospital. All scans were conducted successfully using automatic positioning technology. All patients entered the scanning room from a separate door. All the position lines were accurate, and all images met the requirement for diagnosis of COVID-19, with satisfied quality. None of our medical staff had any close contact with patients.Conclusion: Automatic positioning technology applied to relocatable CT can minimize the close contact between technologists and patients and effectively improve the protection of medical staff without sacrificing image quality.

Enhancing Military Field Hospitals: World Health Organization Emergency Medical Team Verification

ABSTRACT Despite the significant investment in the U.S. and partner nation military field hospital capability, the DoD has not pursued WHO Emergency Medical Team verification. Doing so would reinforce the DoD as an international leader, uphold the DoD as a partner of choice for response when requested, and enable the DoD to assist other nations in achieving the same.

Brugada syndrome detected at the prehospital level

Introduction/Objective Brugada syndrome (BS) is becoming less of a mystery and more of a challenge for early recognition and treatment. We are presenting the case of a patient with Brugada syndrome recognized at the prehospital level. Case report The Emergency Medical Team (EMT) treated a 23-year-old Syrian native, who had fallen ill in a public place. He declared that he had experienced chest pain, 7/10 in strength, and weakness on the left side of his body followed by a short-term collapse some 20 minutes earlier. After that, he felt weak, languid, very tired and had neck pain. As declared by witnesses, he did not lose consciousness, but was confused, pale, covered with sweat and was breathing rapidly. All this happened after a prolonged quick-paced walk in high air humidity conditions. He declared that he hadn't had similar episodes before, nor had he had significant injuries, allergies or chronic diseases. There was no sudden cardiac death history in his family. Upon examination, he was conscious, afebrile, eupnoeic (18 breaths per minute) with normal heart frequency (70 per minute), blood pressure of 120/90 mmHg and blood oxygen saturation level of 100%. His heart and breath sounds were normal. All other physical examination findings were normal as well. ECG: sinus rhythm, 70 beats per minute, saddleback ST-segment elevation > 1mm in V2. An IV line was inserted and an ECG monitor placed. He was transported to the hospital with the diagnosis of having collapsed and a suspected Brugada syndrome. After short observation and a repeated ECG recording, the Brugada syndrome type II diagnosis was confirmed. Conclusion The Emergency Medical Team doctor must recognize the ECG pattern of this disease, apply necessary CPR measures including early defibrillation if needed, and closely monitor the ECG and vital signs of the patient during transport.

EMOTIONAL PROBLEMS AND SLEEP DISTURBANCES IN PARAMEDICS IN THE ERA OF THE COVID-19 PANDEMIC

Infectious diseases have accompanied mankind for centuries, and the effects of their dramatic course are felt on many levels of everyday life. The COVID-19 pandemic caused by SARS-CoV-2 virus infection carries a tremendous psychological burden for both those infected and health care workers. Particularly vulnerable to psychological strain are paramedics who have direct contact with and caring for patients infected with coronavirus. From a review of the literature, it is known that Emergency Medical Team members, as a result of the stress experienced during a pandemic, manifest symptoms such as depression, anxiety, and sleep disturbances. In order to limit the adverse impact of the pandemic on the mental condition of this professional group, it is necessary to create appropriate conditions for solitary rest, relaxation and satisfaction of basic needs such as: food, sleep and protective clothing. An important role is also played by unrestricted access to psychological support in the broad sense of the word and often also to psychiatric care.

The Beirut blast 2020: Lessons learned from the Swiss Emergency Medical Team specialized “Mother & Child”

On August 4, 2020, Beirut was hit by a devastating explosion leading to mass casualties: thousands were injured and there were significant damages to residences, offices, and health structures. The Emergency Medical Team (EMT) specialized “Mother and Child” was deployed by the Swiss Humanitarian Aid in order to support local health facilities, empower local health professionals to resume clinical activities and ensure access, and continuity of patient care in particular in the fields of gynecology-obstetrics and pediatrics. This communication presents the particularities of an EMT deployment in an urban area of an upper middle-income country with some recommendations for such settings.

Medical Practice Differences Among Internal Medicine Fellows During in-hospital Emergency Department 24-hour Shifts

Background There are limited data which show how Emergency Department (ED)-specific knowledge and skills are acquired throughout the internal medicine fellowship, especially during 24-hour shifts. The aim of the study was to assess the differences in medical practice between fellows among different fellowship-years in ED settings. Methods We conducted a cross-sectional, retrospective study at a large university hospital using data on every ED examination done during 2016. All data were taken from the hospital information system. We compared 1st-year fellows with all older fellows, as well as 5th-year fellows with all younger fellows. Results In 2016, 55 fellows had ≥ 15 24-hour shifts with 3 attending fellows during one shift. A total of 19’916 patients were examined by attending fellows in the ED. When compared to 2nd-year fellows, 1st-year fellows examined more patients brought to ED by out-of-hospital emergency medical team and had significantly higher share of examined patients per 24-hour shift with lower length of stay. When compared to 5th-year fellows, 1st-year fellows examined older patients, but had lower share of examined patients during one 24-hour shift and participated in fewer CPR cases. When compared to younger fellows, 5th-year fellows participated in more CPR cases and had higher proportion of patients admitted to hospital. Conclusion To our knowledge, this is the first report on the ED medical practice differences among fellows of different fellowship-year. When compared to other fellows, 1st-year fellows participated less in CPR cases, but were faster in providing medical care in ED. 5th-year fellows had the highest proportion of patients admitted to hospital and more CPR cases.