bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-Level Carbon-Monoxide Poisoning: Inability of Neuropsychological Testing to Identify Patients Who Benefit from Hyperbaric Oxygen Therapy
Authors: Rottman Steven J. , Kaser-Boyd Nancy , Cannis Timothy , Alexander John 
Published: July 2016

AbstractIntroduction:Although major sequelae of carbon-monoxide (CO) poisoning and its treatment with hyperbaric oxygen (HBO) are well-documented, a syndrome of low-level CO poisoning has received relatively little attention. Subtle symptoms of poor concentration, language difficulty, problems with calculations, and memory loss were noted after an acute exposure of 131 dormitory residents to low levels of CO. The CO Neuropsychological Screening Battery (CONSB), a series of tests reported by others as useful to identify victims of CO poisoning, was performed on a subset of 46 victims. It was hypothesized that their test scores would improve after treatment with HBO.Methods:Testing was performed both before and after HBO on 35 CO-exposed victims. A control group of 20 students residing on the same college campus, but not involved with the CO incident, also were tested on two separate occasions to assess the ability of the test to identify selectively victims of low-level CO poisoning, as well as to evaluate its validity when administered serially.Results:Both CO-exposed and control subjects demonstrated significant performance improvement when completing the testing for the second time. In addition, the baseline test scores were not significantly different for either the CO-exposed or the control groups. Nonetheless, all CO-exposed victims reported immediate subjective improvement of their symptoms after HBO therapy.Conclusion:These observations and a review of the literature suggest that there might exist a syndrome of subtle neurological disturbances in victims of low-level CO poisoning. Whether this is permanent or might regress spontaneously over time is unknown. As a diagnostic adjunct, the CONSB does not appear to be as useful in low-level CO poisoning.
Human Health Concerns from Pet Ownership After a Tornado
Authors: Heath Sebastian E. , Champion Max 
Published: July 2016

AbstractIntroduction:Although 50% to 60% of North American households own pets and many of these pets are considered family members, there is little information on the impact pet ownership on pet-owning families affected by disasters.Methods:This case report describes some of the effects of a tornado on 17 families whose dwellings were destroyed. The setting was a typical urban trailer park.Results:After a tornado at the Sagamore Village Trailer Park in north central Indiana, 104 families were evacuated. Seventeen (16.3%) of these families owned pets. For 14 families (13.5%), pet ownership had an important impact on the families' recovery from the tornado. Public- and mental-health concerns that arose from pet ownership included failure to evacuate a dangerous site, attempts to re-enter a dangerous site, separation anxiety leading to psychosomatic disturbances, and the need for additional animal care.Conclusions:In urban disasters, the behaviors of families with a human-animal bond are likely to pose a significant risk to their own and others' health and safety in urban disasters. In this small study of families affected by a tornado, the most prominent public-health concerns were failure to evacuate because of a pet and attempts of re-entry to save a pet; the most common mental-health concerns resulted from separation anxiety from a pet and refusal to accept medical treatment until a pet's well-being can be assured. These are thought to be typical issues that will arise out of the human-animal bond in urban disaster situations and differ considerably from traditional public-health concerns over dog bites, spread of zoonotic diseases, and human food contamination. Medical disaster preparedness planning should consider the substantial effects that the human-animal bond is likely to have on human recovery from large-scale urban disasters.
The 1994 Northridge Earthquake Disaster Response: The Local Emergency Medical Services Agency Experience
Authors: Stratton Samuel J. , Hastings Virginia Price , Isbell Darlene , Celentano John , Ascarrunz Miguel , Gunter Carol S. , Betance Joe 
Published: July 2016

AbstractIntroduction:This paper describes the 1994 Northridge earthquake experience of the local emergency medical services (EMS) agency. Discussed are means that should improve future local agency disaster responses.Methods:Data reported are descriptive and were collected from multiple independent sources, and can be reviewed publicly and confirmed. Validated data collected during the disaster by the Local EMS Agency also are reported.Results:The experience of the Los Angeles County EMS Agency was similar to that of earthquake disasters previously reported. Communication systems, water, food, shelter, sanitation means, power sources, and medical supplies were resources needed early in the disaster. Urban Search and Rescue Teams and Disaster Medical Assistance Teams were important elements in the response to the Northridge earthquake. The acute phase of the disaster ended within 48 to 72 hours and public health then became the predominant health-care issue. Locating community food and water supplies near shelters, providing transportation to medical care, and public-health visits to shelter locations helped prevent the development of long-term park encampments. An incident command system for the field, hospitals, and government responders was necessary for an organized response to the disaster.Conclusion:Disaster preparedness, multiple forms of reliable communication, rapid mobilization of resources, and knowledge of available state and federal resources are necessary for a disaster response by a local EMS agency.
Emergency Medical Vehicle Collisions in an Urban System
Authors: Biggers William A. , Zachariah Brian S. , Pepe Paul E. 
Published: July 2016

AbstractIntroduction:Emergency medical services collisions (EMVCs) are a largely unexplored area of emergency medical services (EMS) research. Factors that might contribute to an EMVC are numerous and include use of warning lights and siren (WL&S). Few of these factors have been evaluated scientifically. Similarly, the incidence and severity of EMVCs is poorly documented in the literature. This study sought to define the incidence and severity of, and where possible, identify any contributing factors to EMVCs in a large urban system.Methods:Retrospective study of all collisions involving vehicles assigned to the EMS Division of the Houston Fire Department in calendar year 1993. Fifty-one ambulances were operational 24 hours per day during calendar year 1993. Houston EMS received 150,000 requests for assistance, made 180,000 vehicular responses, and accrued 2,651,760 miles in 1993.Results:Eighty-six EMVCs were identified during the study period. The gross incidence rate was therefore 3.2 EMVC/100,000 miles driven or 4.8 collisions/10,000 responses. Of the 86 EMVCs, 74 (86%) files were complete and available for evaluation. Major collisions, determined according to injuries or vehicular damage, accounted for 10.8% of all EMVCs. There were 17 persons transported to hospitals from EMS collisions, yielding an injury incidence of 0.64 injuries/100,000 miles driven or 0.94 injuries/10,000 responses. There were no fatalities. The majority of collisions (85.1%) occurred at some site other than an intersection. There was no statistical association between occurrence at an intersection and severity, day versus night, weekend versus weekday, presence or absence of precipitation, or use of WL&S versus severity of collision. Drivers with a history of previous EMVCs were involved in 33% of all collisions. The presence of prior EMVCs was associated (p < 0.001) with the number of persons transported from the collision to a local hospital. Five drivers, all with previous EMVCs, accounted for 88.2% (15/17) of all injuries.Conclusions:A few drivers with previous EMVCs account for a disproportionate number of EMVCs and nearly 90% of all injuries. This risk factor—history of previous EMVC—has not been reported in the EMS literature. It is postulated that this factor ultimately will prove to be the major determinant of EMVCs. Data collection of EMS collisions needs to be standardized and a proposed collection tool is provided.
Carbon Monoxide and Nonquantitative Carbon Dioxide Detection
Authors: Petroianu Georg , Maleck Wolfgang , Bergler Wolfgang , Ruefer Roderich 
Published: July 2016

AbstractIntroduction:The capnometric demonstration of end-tidal carbon dioxide (CO2) is a reliable method of differentiating between a correct endotracheal tube position and an accidental misplacement of the tube into the esophagus. Recently, several CO2detectors have been introduced for monitoring end-tidal CO2in the “out-of-hospital” setting, where quantitative capnometry with capnography is not yet available.Hypothesis:These devices are not influenced by carbon monoxide (CO) present in lethal concentration.Methods:A heated (37°C) 2.3 L reservoir bag filled one-third full with water (representing the stomach in esophageal misintubation) was machine ventilated (tidal volume: 450 ml; frequency: 16/min) with the following mixtures for three minutes each: 1) 95% O2, 5% CO; 2) 45% O25% CO, 50% N2O; and 3) 44% O25% CO, 50% N2O, 1% halothane. The presence of end-tidal CO2was monitored with each of the following devices: 1) MiniCAP™ III CO2Detector; 2) StatCAP™ CO2Detector; 3) EasyCAP™ CO2Detector; PediCAP™ CO2Detector; and 5) Colibri™ CO2Detector.Results:In none of the cases was the presence of CO2signaled by the detector.Conclusion:The presence of 5% CO does not interfere with infrared spectrometry detection (MiniCAP™ and StatCAP™) or chemical detection (EasyCAP™, PediCAP™, and Colibri™) of CO2. The devices can be used safely in patients with CO poisoning for monitoring of endotracheal tube position.
Integrating Reproductive Health into Emergency Response Assessments and Primary Health Care
Authors: Goodyear Lorelei , Hynes Michelle 
Published: July 2016

AbstractWar-affected populations often are displaced for years. When primary health care is focused on the acute conditions that often present in the emergency phase of a complex emergency, insufficient attention often is directed towards other evolving needs of the population. Their reproductive health, psychosocial health, and problems with chronic diseases may be overlooked even after the situation stabilizes.This article examines currently available resources for conducting rapid assessments of health needs and services during complex emergencies. Their respective strengths and weaknesses are discussed, particularly for assessing a population's reproductive health needs, and for fostering the integration of reproductive health and primary health-care services, and for designing health services delivery.When more specific indicators are included in a needs assessment tool, the likelihood that the assessment results will influence the design and scope of the health program is increased. Needs assessments for primary health care that incorporate reproductive health indicators will assist health officials to integrate these services, and thus, use staff and facilities more efficiently, and will highlight areas of opportunity for providing services.
Post-War Kosovo: Part 1. Assessment of Prehospital Emergency Services
Authors: Vanier Vance K. , VanRooyen Michael J. , Lis Julian , Eliades M. James 
Published: July 2016

AbstractThe United Nations Mission in Kosovo (UNMIK) designated that the World Health Organization (WHO) develop health policy to assist in the recovery and rehabilitation of the post-war health system of Kosovo. As a critical part of the pre-policy evaluation, an assessment of current prehospital medical services was performed. This assessment identified a basic healthcare infrastructure upon which additional prehospital capabilities can be built, especially in communications, staffing, equipment, and transport services. To serve Kosovo properly in the future, it is recommended that capacity building must include the parallel development of emergency departments and specialty-trained physicians.
Post-War Kosovo: Part 2. Assessment of Emergency Medicine Leadership Development Strategy
Authors: Eliades M. James , Lis Julian , Barbosa Joilo , VanRooyen Michael J. 
Published: July 2016

AbstractSince the return of the refugee population to Kosovo, attempts at development of an emergency medical system in Kosovo have met with varied success, and have been hampered by unforeseen barriers. These barriers have been exacerbated by the lack of detailed health system assessments. A multimodal approach of data collection and analysis was used to identify potential barriers, and determine the appropriate level of intervention for emergency medicine (EM) development in Kosovo. The four step, multi-modal, data collection tool utilized: 1) demographic and health systems data; 2) focus group discussions with health-care workers; 3) individual interviews with key individuals in EM development; and 4) Q-Analysis of the attitudes and opinions of EM leaders.Results indicated that Emergency Medicine in Kosovo is under-developed. This method of combined quantitative and qualitative analysis identified a number of developmental needs in the Kosovar health system. There has been litde formal training, the EMS system lacks organization, equipment, and a reliable communication system, and centralized emergency centers, other than the center at Prishtina Hospital, are inadequate. Group discussions and interviews support the desire by Kosovar health-care workers to establish EM, and highlight a number of concerns. A Q-methodology analysis of the attitudes of potential leaders in the field, supported these concerns and identified two attitudinal groups with deeper insights into their opinions on the development of such a system.This study suggests that a multi-modal assessment of health systems can provide important information about the need for emergency health system improvements in Kosovo. This methodology may serve as a model for future, system-wide assessments in post-conflict health system reconstruction.
Emergency Care Delivery Research: Methodological Considerations
Authors: Pozen Michael 
Published: July 2016

Methodological considerations should be discussed within the context of emergency medical services (EMS) and disaster research. The fast pace and the information explosion of the society in which we live open new opportunities for epidemiological research and evaluation of care in disasters. The many methodological considerations necessary to generate useful and valid research is the topic of this article.I would like to discuss four major issues which raise a series of questions and suggest a variety of alternatives. The four major areas are: (l) the taxonomy required to do this type of research; (2) the elements of care; (3) comparative samples; and (4) planned as opposed to unplanned disasters.
Experience in Teaching CPR in the USA and in Europe
Authors: Laerdal Tore 
Published: July 2016

For more than 20 years, our company has had the pleasure of working closely with medical authorities and active first aid organizations in many countries for the teaching and practice of life-support. The access thus gained by experience in the field permits me to present the following status report of CPR teaching of the populations in North America and Western Europe.HistoryBefore 1960, little or no life-supporting treatment was given to the seriously injured or acutely ill prior to arrival at the hospital. First aid was largely limited to dressing wounds and splinting broken limbs. The ambulance at that time merely served as a means of fast transportation.
Early PEEP Ventilation in Fresh- and Seawater Asphyxiation
Authors: Dick W. F. , Schindewolf K.-H. , Ohmann Ch. 
Published: July 2016

Recent case reports have shown that persistent hypoxia after the resuscitation of nearly-drowned patients is a major problem. PEEP ventilation could be successfully applied in such a condition. After PEEP valves for manually operated resuscitators became available, the question arose of how beneficial the immediate application of positive end expiratory pressure of 5 cm H2O would be for lungs damaged by either seawater or fresh water. This question was examined by means of standardized animal experiments.Material and MethodsIn four test groups comprising 34 randomly selected young pigs, either 25 ml fresh water/kg body weight, or else 12.5 ml salt water/kg body weight, were instilled by way of an endotracheal tube. This was followed by a period of apnea lasting 4 min and subsequent ventilation with 100% oxygen for a 2 hour period. The 32 animals which survived the first part of the experiment were then subjected to either PEEP or ZEEP ventilation therapy without further medication.
‘Solfire’ VIII Marine Disaster Exercise
Authors: Sleet Rodger 
Published: July 2016

The Solent is that stretch of seaway separating the Hampshire Dorset coast from the Isle of Wight. It is one of the busiest sea routes in the United Kingdom. Approximately 134 shipping movements take place weekly into the Docks and Naval Base at Portsmouth, the Docks and Ocean Terminal in Southampton and the nearby Esso Oil Refinery. During the height of the summer season there are numerous local Ferry Services to and from the mainland and the Isle of Wight, which is a popular summer resort, and at weekends as many as 35,000 pleasure craft may be afloat. Major collision is rare and reflects the high standard of seamanship, local pilotage and strict port control, but the possibility of disaster is ever present in such a congested seaway.To meet this eventuality the Solent and Southampton Water Marine Emergency Plan was developed from preexisting Southampton and Portsmouth schemes in the early 1960's. Since that time it has been put into action on three occasions for episodes of fire at sea, with good effect.
Physicians for the Prevention of Nuclear War
Authors: Negovsky Vladimir A. 
Published: July 2016

First of all, I would like to express gratitude on behalf of academician Eugeni I. Chazov, who was kindly invited by Professor Safar to attend this Congress. Unfortunately, some circumstances connected with work prevented Dr. Chazov's attending. Most of you are probably informed about his attitude toward the movement known as Physicians for Nuclear Disarmament. In 1981, Dr. Chazov delivered his paper at the First Congress of International Physicians for the Prevention of Nuclear War (IPPNW), held in Airlie, Virginia, USA. The Academy of Medical Sciences of the USSR has established a special Council to help guide this disaster prevention movement among Soviet physicians. Academician Chazov is the chairman of this Council.In May 1981, our central newspaper,Pravda, published an appeal to the scientists of the world, signed by many prominent Soviet scientists, Lenin and State Prize winners of the USSR, and Nobel Prize winners, calling upon their colleagues and urging all scientific workers to do everything possible to avert the danger of nuclear war. Professor Chazov was among those who signed.
A Study of the Johnstown Floods
Authors: Layton Thomas R. , Elhauge Einer R. 
Published: July 2016

In order to analyze the cause, effect and relief efforts of the Johnstown floods of 1889,1936, and 1977, existing literature, journalistic accounts, and official documents concerning the floods were investigated.At 4:00 PM on May 31, 1889, the South Fork Dam burst, releasing 60 million tons of water into the Conemaugh Valley. The flood destroyed Johnstown and the surrounding communities within a few minutes. The official totals were 2209 persons killed, 30,000 homeless, and 17.2 million dollars property damage. From Sang Hollow, a community four miles from Johnstown, the first description of the disastrous flood was sent to Pittsburgh by telegraph about two hours after the catastrophe. Several journalists set out by train for Johnstown immediately. A fire started in the flood debris and burned throughout the night. By morning rescue squads of survivors were trying to get through to those still marooned and to identify the dead.
Resuscitation of Victims of Cholera, Plague and Rabies in South Africa
Authors: Holloway Alison M. 
Published: July 2016

Cholera, which was unknown in Africa south of the Sahara, became an identifiable disease in South Africa in 1919. In the 1970's, 5 cases were diagnosed in people coming into South Africa from countries to the north. Instructions regarding Cholera surveillance were circulated in 1979 following an outbreak in Maputo. There was no evidence of any case of cholera acquired in South Africa before September 1980. Within 12 days, there were 23 proven cases ofVibrio cholera, El Tor biotype, among Africans who obtained drinking water from an irrigation canal off the Crocodile River midway between Nelspruit and Kaapmuiden. Five hundred forty-six cases had been identified by the end of February 1981 and more are expected.On 13 October 1980, a team of health officials collected at Nelspruit to coordinate measures to contain the epidemic. They included chlorination of the irrigation canal, water surveillance of local rivers by sampling or leaving Moore pads in situ, increasing the number of staff and strengthening equipment at local laboratories, educating local medical and nursing staff in patient management and providing adequate stocks of intravenous fluids and tetracycline. Patients' contacts were traced, their homes inspected, their water supply sources and means of sewage disposal checked and the public educated in cholera prevention. There were regular press statements, radio talks, television programs and the broadcasting of educational leaflets to warn the population to take precautions. It was decided not to hold a mass immunization campaign nor to administer preventive antibiotics.
09. The Impact of Paramedics on Prehospital Cardiac Arrests in a Rural Community
Authors: Mace Sharon E. , Kriegsman William 
Published: July 2016

Hypothesis: Do paramedics influence the outcome of out of hospital cardiac arrests in a rural setting?Methods: Retrospective analysis of cardio-respiratory arrests of ALS-EMS system in rural Southeastern Alaska for 9 years. There were two patient groups treated by EMT-III or paramedics. EMT-III vs. paramedics differ in training/experience but not technical skills. Statistical analyses were done by chi square.Results: Thirty-seven patients (52%) were treated by paramedics, thirty-four (48%) by EMT-III. Demographics/CPR variables for the groups were not significantly different. Comparing paramedics vs. EMT-III: successful ET placement (87% vs. 62%, p <0.02), successful IV placement (87% vs. 62%, p <0.02), return of spontaneous circulation (ROSC) 46% (17/37 pts.) vs. 18% (6/34 pts.) (p = 0.01), ICU admission 38% (14/37) vs. 15% (5/34) (p = 0.03), hospital discharge 20% (7/35) vs. 9% (3/34) (p = NS). There was no correlation between successful ET placement or IV insertion and outcome.