Controversial Aspects of PEEP Ventilation in Emergency Medicine

Controlled mechanical ventilation using positive and expiratory pressure (PEEP) is a well-established therapeutic measure in intensive care. Its early application has been shown to markedly decrease morbidity and mortality, especially in polytraumatized patients with an acute respiratory distresss syndrome. It therefore seems reasonable to use positive end expiratory pressure as early as possible in the clinical treatment of emergency patients before extensive pulmonary changes have had time to develop completely.

Disaster Triage by Advanced Emergency Medical Technicians

Many disaster plans are based on the presence of a physician at the scene to perform triage. This requirement originated when there were no trained paramedical personnel in the field and may actually delay care in rural areas where a physician may not be readily available or may be the only physician at the hospital.It is our hypothesis that properly trained Advanced Emergency Medical Technicians (AEMT's) may serve as triage officers for rural disasters with little difference, and perhaps improvement, in the outcomes of medical care. AEMT's are among the first responders to arrive at scenes of accidents and often triage from three to five trauma patients in multiple victim accidents on the highway. They are on duty, available and strategically located both day and night. The AEMT's are familiar with working under field conditions, i.e. at night by headlight, in rain, snow, and darkness, and know extrication procedures. They are aware of environmental hazards. They have radio and telemetry communication with a physician when needed.

Earthquake Prediction

Every new earthquake disaster revives the idea of earthquake prediction, the idea which was considered a few decades ago as a fantasy scientific endeavor. However, recent technical and scientific developments, as well as some social and economic pressures, have created a quite different atmosphere. Earthquake prediction has become a serious scientific activity combining the efforts and results of many disciplines, particularly those of the earth sciences. The principal purpose of earthquake prediction is to reduce the vulnerability of the population living within an earthquake prone region. For this reason, scientific disciplines other than seismology and geology are also involved; they include those dealing with various aspects of human response and environment.