bluuebunny/crossref_metadata_2025_split huggingface dataset:
KAMEDO Report No. 79 Train Accident in Germany, 1998
Authors: Iselius Lennart , Nilsson Per-Åke , Riddez Louis 
Published: August 2016

AbstractA train traveling at 200 kilometers per hour carrying 300 passengers crashed into a bridge. At leaset 85 doctors and 1,889 persons were involved in the emergency response. A total of 101 persons were killed, 108 were injured, and 87 were transported to a hospital (27 by helicopter; 60 by land ambulance). Eighty percent of the severely injured were trasported to a hosptial within two hours of the crash. Coordination of the activities of the hoards of responders was an issue, as was the lack of a formal organization to provide psychosocial support. Preparedness plans should include management of the dead and for the provision of psychosocial support.
Frequency of Post-Traumatic Stress Disorder among Relief Force Workers after the Tsunami in Asia: Do Rescuers Become Victims?
Authors: Armagan Erol , Engindeniz Zulfi , Devay Ali Onder , Erdur Bulent , Ozcakir Alis 
Published: August 2016

AbstractObjective:The objective of this study was to evaluate the frequency of posttraumatic stress disorder (PTSD) among the participants of the Turkish Red Crescent Disaster Relief Team after the Tsunami in Asia.Methods:The Clinician Administered PTSD Scale-1 (CAPS-1) was administered to 33 of 36 team members one month after their Disaster Relief Team duty. Along with the CAPS-1 interview, demographic features, profession, previous professional experience, previous experience with traumatic events and disasters also were recorded. To be classified as present, a symptom must have a frequency score of “1” and an intensity score of “2” at the CAPS-1 interview. For a diagnosis of PTSD, at least one re-experiencing, three avoidance and numbing, and two increased arousal symptoms should be present.Results:The PTSD was diagnosed in eight of the 33 (24.2%) participants. No significant difference was detected in the distribution of PTSD diagnosis according to gender, age, profession, professional experience, previous disaster experience, and/or previous experience of traumatic events. However, the severity of PTSD symptoms as measured by the CAPS-1 score was significantly higher in women, nurses, and participants with <3 previous disaster duty experiences.Conclusion:Post-traumatic stress disorder is prevalent within disaster teams and healthcare workers, and measures should be taken to prevent PTSD within this group.
Changes in Level of Consciousness and Association with Hyperglycemia as Tool for Predicting and Preventing Re-bleeding after Spontaneous Subarachnoid Hemorrhage
Authors: Kitsuta Yoichi , Suzuki Noriyuki , Sugiyama Mitsugi , Yamamoto Isao 
Published: August 2016

AbstractIntroduction:It is crucial to predict and prevent re-bleeding from ruptured intracranial aneurysms in patients with subarachnoid hemorrhage (SAH). During the prehospital period and on arrival to the hospital, blood glucose and serum potassium levels, as well as changes in levels of consciousness were assessed in patients in the acute stage of spontaneous subarachnoid hemorrhage. These assessments were analyzed as possible risk factors for re-bleeding and as potential contributors to the prevention of re-bleeding, both in prehospital care and after hospital admission.Methods:Upon the arrival of 202 patients with spontaneous subarachnoid hemorrhage, the following indications were examined retrospectively: (1) presence/absence of re-bleeding; (2) time interval between the onset of SAH and re-bleeding; (3) level of consciousness using the Glasgow Coma Scale (GCS) score before and on arrival; (4) amount and distribution of subarachnoid blood using Fisher's Computerized Tomography Classification; (5) blood pressure; (6) blood glucose concentration; and (7) serum potassium concentration. The patients were hospitalized in the Yokohama City University Critical Care and Emergency Center (Yokohama, Japan) between January 1991 and December 2000. The re-bleeding rate was analyzed using the chi-square ([X]2 test, and the averages and standard deviations of hematological data were compared using the Mann-Whitney U-test. The level of statistical significance was set at p <0.05.Results:The overall re-bleeding rate was 20.8%. Among 119 patients with a GCS score of 3–7 before arrival, 42 (35.3%) had re-bleeding, but none of the 83 patients with a GCS score of 8–15 before arrival had re-bleeding. Of 105 patients with a GCS score of 13–15 on arrival, 14 (51.8%) of 27 patients whose consciousness level was a GCS score of 3–7 before arrival experienced re-bleeding. The re-bleeding rate of this group was high. Moreover, this rebleeding group had a significantly higher blood glucose concentration than did the patients whose GCS score was 13–15 both before and on arrival. Between the patients with or without re-bleeding, there was no significant difference in the blood pressure on arrival or in distribution according to Fisher's Computerized Tomography ClassificationConclusion:Since the re-bleeding rate is high in patients who have hyperglycemia and a history of a level of consciousness as low as a GCS score of 3–7, a detailed assessment of level of consciousness and blood glucose tests performed on arrival provide important information that will contribute to predicting and preventing re-bleeding. This may be extended to the prehospital phase, because blood glucose tests are simple and safe when performed by paramedics.
Medical Support for Emergency Relief Workers After Typhoon Sudal in Yap, Micronesia
Authors: Partridge Robert , King Kevin , Proano Lawrence 
Published: August 2016

AbstractIntroduction:On 09 April 2004, Typhoon Sudal struck the Island of Yap in the Federated States of Micronesia (FSM). Over 90% of homes, public utilities, and public property were damaged or destroyed. Nearly 10% of the population was displaced to shelters, and the majority of the population was without drinking water or power. United States disaster workers were deployed to Yap for three months to assist in the recovery and relief efforts.Objective:The objective of this study was to evaluate the acute healthcare needs of the US disaster relief population serving in a remote setting with limited medical resources.Methods:A retrospective chart review of all disaster relief workers presenting to an emergency clinic in Yap during the disaster relief effort from April 2004–July 2004 was performed. Investigators extracted demographic data, chief complaints, medical histories, medical management, disposition, and outcome data from the clinic charts.Results:Together, the 60 disaster workers present on Yap during the relief effort made 163 patient contacts in the disaster emergency clinic. A total of 92% of patient contacts were for minor medical complaints or minor trauma, 13% were for upper-respiratory infections, 9% were for gastrointestinal illness, and 9% were for dermatological problems. Eight percent of visits were for serious medical problems or trauma. Life-threatening illnesses or injuries did not occur.Conclusions:Disaster relief workers on Yap frequently utilized the disaster relief clinic. In general, disaster workers remained healthy during the relief effort in Yap, and most injuries and illnesses were minor. On-site medical providers resulted in rapid care and stabilization, and after treatment, disaster workers were able to return to duty.
Anti-personnel Landmine Injuries during Peace: Experience in a European Country
Authors: Papadakis Stamatios A. , Babourda Eleni C. , Mitsitskas Thomas C. , Markakidis Sotirios , Bachtis Costas , Koukouvis Dimitrios , Tentes Apostolos A. 
Published: August 2016

AbstractIntroduction:The purpose of this study is to report the incidence of landmine injuries during peacetime in a European country.Methods:Forty victims of landmine explosions were admitted to Didimoticho General Hospital in Greece, from December 1988 to March 2003. A total of 19 people survived (47.5%) these events; all of the others were dead upon admission to the hospital. All of the victims were men, either suspected smugglers or migrants entering the country illegally, with an aver- age of 30 years (range: 15–56 years).Results:Most victims presented in groups, with multiple traumatic injuries, including lower extremity wounds. The mortality rate in the minefield prior to hospital admission was 52.5%, and the amputation rate for the survivors was 37%. There were no deaths of the patients admitted to the hospital.Conclusions:Landmines cause highenergy injuries with high mortality and amputation rates. Illegal migrants are the main victims of landmine explosions in Greece.
Reanimation Unit Experience of a Second-Level Hospital in Mexico City
Authors: Loria-Castellanos Jorge , Rocha-Luna Juan Manuel , Márquez-Ávila Guadalupe 
Published: August 2016

AbstractObjectives:The objectives of this study were to determine the clinical characteristics of patients who presented to the Reanimation Unit (RU) of a second-level hospital during one year, and the number and type of emergency procedures performed.Methods:A cross-sectional study was designed that enrolled all patients >15 years of age who presented to the RU from 01 January through 31 December 2003. The age, gender, diagnosis, site of origin, and disposition of each patient was recorded, as well as the distribution by time of day, the number and type of emergency procedures performed, complications, and mortality rate.Results:Of the 3,741 patients enrolled in the study, 57.0% were male; predominantly 41–50 years old (20%). Most patients presented to the RU from their homes during the afternoon.There were 60 different admission diagnoses: more of the emergencies were for medical than for traumatic emergencies. The predominant pathologies were bronchospasm, hypertensive crisis, and upper gastrointestinal bleeding. Initially, patients either were admitted to the observation unit, the consulting office for the emergency department, or the intensive care unit. There were a total of 2,753 emergency procedures performed: orotracheal intubations were the most common, followed by installation of a catheter into the central venous circulation. Of all of the patients admitted to the RU, 31% were not insured.Conclusions:There exists a remarkable combination between medical and traumatic emergencies, which is not encountered frequently in other second level-hospitals in Mexico City. A high proportion of the patients who received medical attention were not insured and there were a large number of emergency invasive procedures performed.
Using Innovative Simulation Modalities for Civilian-based, Chemical, Biological, Radiological, Nuclear, and Explosive Training in the Acute Management of Terrorist Victims: A Pilot Study
Authors: Subbarao Italo , Bond William F. , Johnson Christopher , Hsu Edbert B. , Wasser Thomas E. 
Published: August 2016

AbstractObjectives:Chemical, biological, radiological, nuclear, and explosive (CBRNE) incidents are low frequency, high impact events that require specialized train-ing outside of usual clinical practice. Educational modalities must recreate these clinical scenarios in order to provide realistic first responder/receiver training.Methods:High fidelity, mannequin-based (HFMB) simulation and video clinical vignettes were used to create a simulation-based CBRNE course directed at the recognition, triage, and resuscitation of contaminated victims. The course participants, who consisted of first responders and receivers, were evaluated using a 43-question pre- and post-test that employed 12 video clinical vignettes as scenarios for the test questions. The results of the pre-test were analyzed according to the various medical training backgrounds of the participants to identify differences in baseline performance. A Scheffe posthoc test and an ANOVA were used to determine differences between the medical training backgrounds of the participants. For those participants who completed both the pre-course and post-course test, the results were compared using a paired Student's t-test.Results:A total of 54 first responders/receivers including physicians, nurses, and paramedics completed the course. Pre-course and post-course test results are listed by learner category. For all participants who took the pre-course test (n = 67), the mean value of the test scores was 53.5 ±12.7%. For all participants who took the post-course test (n = 54), the mean value of the test scores was 78.3 ±10.9%. The change in score for those who took both the pre- and post-test (n = 54) achieved statistical significance at all levels of learner.Conclusions:The results suggest that video clinical vignettes and HFMB simulation are effective methods of CBRNE training and evaluation. Future studies should be conducted to determine the educational and cost-effectiveness of the use of these modalities.
Medical Support during the European Union Summit in Gothenburg, Sweden, June 2001
Authors: Johnsson Kristina M.C. , Örtenwall Per A. , Kivi Anne-Lii H. , Hedelin Annika H.E. 
Published: August 2016

AbstractIntroduction:Several factors are important for the number and severity of medical emergencies during mass-gatherings. The risk of violence, the size and mobility of the crowd, the type of event, weather, and duration of the event all influence the outcome. During the European Union (EU) Summit, from 15–16 June 2001 in Gothenburg, Sweden, approximately 50,000 people participated in 43 protest marches, some which included 15,000 participants. Clashes between police and the protesters occurred.Objective:The objective of this study was to analyze the amount and character of injuries as well as the medical complaints in relation to the EU Summit. In addition, the aim of this study was to describe the organization and function of the healthcare services provided during the meeting.Methods:This study is based on the medical records of patients presenting with injuries and other types of medical emergencies at the healthcare stations during the Summit.Results:In total, 143 patients sought medical care. Fifty-three (37.1%) were police officers. Most patients had minor complaints, but a few were seriously injured.The Patient Presentation Rate (PPR) was 2.7. Nine victims were hospitalized as high priority.Conclusion:The PPR for the EU Summit was 2.7, which is in the same range as previously reported from other mass-gatherings.
Impact of London's Terrorist Attacks on a Major Trauma Center in London
Authors: Mohammed Aso B. , Mann Haroon A. , Nawabi Danyal H. , Goodier Davis W. , Ang Swee C. 
Published: August 2016

AbstractDuring the morning rush hour on Thursday, 07 July 2005, a series of four bombs exploded, affecting London's public transport system.These terrorist attacks killed 52 people and injured >700.A majorincident was declared, and the Royal London Hospital (RLH) was a primary receiving hospital.A total of 194 patients presented to the RLH.Twenty-seven patients required admission. A total of 11 amputations were performed on eight patients. One patient died intra-operatively.Another patient died on Day 6 due to complications related to a head injury.Coordination is vital to the implementation of the hospital's Major Incident Plan in such an emergency. Subsequent internal reviews of the response of the RLH on 07 July 2005 highlighted problems with communication and documentation, as well as the need for extra staffing.These areas should be improved for the management of future major incidents.
Percutaneous Transtracheal Ventilation: Resuscitation Bags Do Not Provide Adequate Ventilation
Authors: Hooker Edmond A. , Danzl Daniel F. , O'Brien Daniel , Presley Michael , Whitaker Ginger , Sharp M. Keith 
Published: August 2016

AbstractIntroduction:Percutaneous, transtracheal jet ventilation (percutaneous transtracheal jet ventilation) is an effective way to ventilate both adults and children. However, some authors suggest that a resuscitation bag can be utilized to ventilate through a cannula placed into the trachea.Hypothesis:Percutaneous transtracheal ventilation (percutaneous transtracheal ventilation) through a 14-gauge catheter is ineffective when attempted using a resuscitation bag.Methods:Eight insufflation methods were studied. A 14-gauge intravenous catheter was attached to an adult resuscitation bag, a pediatric resuscitation bag, wall-source (wall) oxygen, portable-tank oxygen with a regulator, and a jet ventilator (JV) at two flow rates. The resuscitation bags were connected to the 14-gauge catheter using a 7 mm adult endotracheal tube adaptor connected to a 3 cc syringe barrel. The wall and tank oxygen were connected to he 14-gauge catheter using a three-way stopcock. The wall oxygen was tested with the regulator set at 15 liters per minute (LPM) and with the regulator wide open. The tank was tested with the regulator set at 15 and 25 LPM. The JV was connected directly to the 14-gauge catheter using JV tubing supplied by the manufacturer. Flow was measured using an Ohmeda 5420 Volume Monitor. A total of 30 measurements were taken, each during four seconds of insufflation, and the results averaged (milliliters (ml) per second (sec)) for each device.Results:Flow rates obtained using both resuscitation bags, tank oxygen, and regulated wall oxygen were extremely low (adult 215 ±20 ml/sec; pediatric 195 ±19 ml/sec; tank 358 ±13 ml/sec; wall at 15 l/min 346 ±20 ml/sec). Flow rates of 1,394 ±13 ml were obtained using wall oxygen with the regulator wide open. Using the JV with the regulator set at 50 pounds per square inch (psi), a flow rate of 1,759 ±40 was obtained.These were the only two methods that produced flow rates high enough to provide an adequate tidal volume to an adult.Conclusions:Resuscitation bags should not be used to ventilate adult patients through a 14-gauge, transtracheal catheter. Jet ventilation is needed when percutaneous transtracheal ventilation is attempted. If jet ventilation is attempted using oxygen supply tubing, it must be connected to an unregulated oxygen source of at least 50 psi.
Seen but Not Heard: Injuries and Deaths from Landmines and Unexploded Ordnance in Chechnya, 1994–2005
Authors: Bilukha Oleg O. , Brennan Muireann , Anderson Mark , Tsitsaev Zaur , Murtazaeva Eliza , Ibragimov Ramzan 
Published: August 2016

AbstractIntroduction:Due to more than a decade of armed conflict and civil unrest, Chechnya is among the regions most affected by landmines and unexploded ordnance worldwide.Hypothesis:The study was performed to assess the magnitude of injuries and deaths due to landmines and unexploded ordnance in Chechnya between 1994 and 2005 and to describe epidemiologic patterns and risk factors for these events.Methods:Surveillance data that included 3,021 civilian non-combatants injured by landmines and unexploded ordnance in Chechnya during 1994–2005 were analyzed. Local non-governmental organizations in collaboration with the United Nations Children's Fund conducted victim data collection using trained staff to interview victims or their families. Surveillance data were used to describe injury trends, victim demographics, injury types, risk behaviors, and types of explosives related to landmine and unexploded ordnance events.Results:The largest number of injuries occurred in 2000 (716, injury rate 6.6 per 10,000) and 2001 (640, injury rate 5.9 per 10,000). One-quarter of all victims were younger than 18 years, and 19% were females. The case-fatality rate was 23%. Approximately 40% of victims were injured by landmines, 30% by unexploded ordnance, and 7% by booby traps. A large proportion of children and adults were injured while traveling or performing activities of economic necessity; 29% of children were injured while tampering with explosives or playing in a contaminated area. The proportion of victims with lower limb amputations was similar among children and adults (14% and 17%, respectively), whereas the proportion of victims with upper limb amputations was three times higher in children than in adults (12% and 4%, respectively). Most accidents that occurred while the victim was traveling or performing activities of economic necessity were caused by landmines, while most accidents that occurred while the victim was playing near an explosive device or tampering with it were caused by unexploded ordnance.Conclusions:Civilians in Chechnya experienced the highest rates of injury from landmines and unexploded ordnance ever documented, 10 times higher than injury rates reported from such highly affected countries as Afghanistan, Angola, or Cambodia. Urgent efforts to identify, mark, and clear mined areas and/or areas contaminated with unexploded ordnance are needed to prevent further civilian injuries and deaths.
Hospital Strategic Preparedness Planning: The New Imperative
Authors: Ginter Peter M. , Duncan W. Jack , Abdolrasulnia Maziar 
Published: August 2016

AbstractStrategic preparedness planning is an important new imperative for many hospitals. Strategic preparedness planning goes beyond traditional product/ market strategic planning by focusing on disaster prevention, containment, and response roles. Hospitals, because of their unique mission, size, complexity, the types of materials they handle, and the types of patients they encounter, are especially vulnerable to natural and human-initiated disasters. In addition, when disasters occur, hospitals must develop well-conceived first responder (receiver) strategies. This paper argues the case for strategic preparedness planning for hospitals and proposes a process for this relatively new and much needed type of planning.
Ability of Regional Hospitals to Meet Projected Avian Flu Pandemic Surge Capacity Requirements
Authors: Ten Eyck Raymond P. 
Published: August 2016

AbstractIntroduction:Hospital surge capacity is a crucial part of community disaster preparedness planning, which focuses on the requirements for additional beds, equipment, personnel, and special capabilities.The scope and urgency of these requirements must be balanced with a practical approach addressing cost and space concerns. Renewed concerns for infectious disease threats, particularly from a potential avian flu pandemic perspective, have emphasized the need to be prepared for a prolonged surge that could last six to eight weeks.Null Hypothesis:The surge capacity that realistically would be generated by the cumulative Greater Dayton Area Hospital Association (GDAHA) plan is sufficient to meet the demands of an avian influenza pandemic as predicted by the [US] Centers for Disease Control and Prevention (CDC) models.Methods:Using a standardized data form, surge response plans for each hospital in the GDAHA were assessed.The cumulative results were compared to the demand projected for an avian influenza pandemic using the CDC's FluAid and FluSurge models.Results:The cumulative GDAHA capacity is sufficient to meet the projected demand for bed space, intensive care unit beds, ventilators, morgue space, and initial personal protective equipment (PPE) use. There is a shortage of negative pressure rooms, some basic equipment, and neuraminidase inhibitors. Many facilities lack a complete set of written surge policies, including screening plans to segregate contaminated patients and staff prior to entering the hospital. Few hospitals have agreements with nursing homes or home healthcare agencies to provide care for patients discharged in order to clear surge beds. If some of the assumptions in the CDC's models are changed to match the morbidity and mortality rates reported from the 1918 pandemic, the surge capacity of GDAHA facilities would not meet the projected demand.Conclusions:The GDAHA hospitals should test their regional distributors' ability to resupply PPE for multiple facilities simultaneously. Facilities should retrofit current air exchange systems to increase the number of potential negative pressure rooms and include such designs in all future construction. Neuraminidase inhibitor supplies should be increased to provide treatment for healthcare workers exposed in the course of their duties. Each hospital should have a complete set of policies to address the special considerations for a prolonged surge. Additional capacity is required to meet the predicted demands of a threat similar to the 1918 pandemic.