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https://www.readbyqxmd.com/read/28065200/testing-the-start-triage-protocol-can-it-improve-the-ability-of-nonmedical-personnel-to-better-triage-patients-during-disasters-and-mass-casualties-incidents
#1
Stefano Badiali, Aimone Giugni, Lucia Marcis
OBJECTIVE: START (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether "last-minute" START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients. METHODS: In this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group)...
January 9, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28058292/monoclonal-antibodies-that-recognize-various-folding-states-of-pure-human-butyrylcholinesterase-can-immunopurify-butyrylcholinesterase-from-human-plasma-stored-at-elevated-temperatures
#2
Hong Peng, Thomas A Blake, Rudolph C Johnson, Alicia J Dafferner, Stephen Brimijoin, Oksana Lockridge
Human plasma to be analyzed for exposure to cholinesterase inhibitors is stored at 4 °C or lower to prevent denaturation of human butyrylcholinesterase (HuBChE), the biomarker of exposure. Currently published protocols immunopurify HuBChE using antibodies that bind native HuBChE before analysis by mass spectrometry. It is anticipated that the plasma collected from human casualties may be stored nonideally at elevated temperatures of up to 45 °C for days or maybe weeks. At 45 °C, the plasma loses 50% of its HuBChE activity in 8 days and 95% in 40 days...
December 31, 2016: ACS Omega
https://www.readbyqxmd.com/read/28041825/sodium-nitrite-and-sodium-thiosulfate-are-effective-against-acute-cyanide-poisoning-when-administered-by-intramuscular-injection
#3
Vikhyat S Bebarta, Matthew Brittain, Adriano Chan, Norma Garrett, David Yoon, Tanya Burney, David Mukai, Michael Babin, Renate B Pilz, Sari B Mahon, Matthew Brenner, Gerry R Boss
STUDY OBJECTIVE: The 2 antidotes for acute cyanide poisoning in the United States must be administered by intravenous injection. In the out-of-hospital setting, intravenous injection is not practical, particularly for mass casualties, and intramuscular injection would be preferred. The purpose of this study is to determine whether sodium nitrite and sodium thiosulfate are effective cyanide antidotes when administered by intramuscular injection. METHODS: We used a randomized, nonblinded, parallel-group study design in 3 mammalian models: cyanide gas inhalation in mice, with treatment postexposure; intravenous sodium cyanide infusion in rabbits, with severe hypotension as the trigger for treatment; and intravenous potassium cyanide infusion in pigs, with apnea as the trigger for treatment...
December 29, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28034667/adjunctive-hyperbaric-oxygen-therapy-in-severe-burns-experience-in-taiwan-formosa-water-park-dust-explosion-disaster
#4
I-Han Chiang, Shyi-Gen Chen, Kun-Lun Huang, Yu-Ching Chou, Niann-Tzyy Dai, Chung-Kan Peng
BACKGROUND: Despite major advances in therapeutic strategies for the management of patients with severe burns, significant morbidity and mortality is observed. Hyperbaric oxygen therapy (HBOT) increases the supply of oxygen to burn areas. The aim of this study was to determine whether HBOT is effective in the treatment of major thermal burns. METHODS: On June 27, 2015 in New Taipei, Taiwan, a mass casualty disaster occurred as fire erupted over a large crowd, injuring 499 people...
December 26, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28024651/dedicated-mass-casualty-incident-hospitals-an-overview
#5
J J Mark Haverkort, Mirjam B de Jong, Maurizio Foco, Daniele Gui, Masad Barhoum, Gila Hyams, Hany Bahouth, Michael Halberthal, Luke P H Leenen
INTRODUCTION: Hospitals worldwide are preparing for mass casualty incidents (MCIs). The Major Incident Hospital in the Netherlands was constructed 25 years ago as a dedicated hospital for situations wherein a sudden increase in medical surge capacity is mandated to handle an MCI. Over the years, more initiatives of dedicated MCIs have arisen. Herein, we compared the MCI facilities from three countries considering the reasons for construction and the functionality. METHODS: Three dedicated mass casualty hospitals and one hospital with a largely fortified structure were compared...
November 23, 2016: Injury
https://www.readbyqxmd.com/read/27964769/paramedic-application-of-a-triage-sieve-a-paper-based-exercise
#6
Glen Cuttance, Kathryn Dansie, Tim Rayner
: Introduction Triage is the systematic prioritization of casualties when there is an imbalance between the needs of these casualties and resource availability. The triage sieve is a recognized process for prioritizing casualties for treatment during mass-casualty incidents (MCIs). While the application of a triage sieve generally is well-accepted, the measurement of its accuracy has been somewhat limited. Obtaining reliable measures for triage sieve accuracy rates is viewed as a necessity for future development in this area...
December 14, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27957642/radiology-response-in-the-emergency-department-during-a-mass-casualty-incident-a-retrospective-study-of-the-two-terrorist-attacks-on-22-july-2011-in-norway
#7
Victoria Solveig Young, Heidi B Eggesbø, Christine Gaarder, Pål Aksel Næss, Tone Enden
OBJECTIVES: To describe the use of radiology in the emergency department (ED) in a trauma centre during a mass casualty incident, using a minimum acceptable care (MAC) strategy in which CT was restricted to potentially severe head injuries. METHODS: We retrospectively studied the initial use of imaging on patients triaged to the trauma centre following the twin terrorist attacks in Norway on 22 July 2011. RESULTS: Nine patients from the explosion and 15 from the shooting were included...
December 12, 2016: European Radiology
https://www.readbyqxmd.com/read/27907140/detection-of-acute-radiation-sickness-a-feasibility-study-in-non-human-primates-circulating-mirnas-for-triage-in-radiological-events
#8
Naresh Menon, Claude J Rogers, Agnes I Lukaszewicz, James Axtelle, Marshleen Yadav, Feifei Song, Arnab Chakravarti, Naduparambil K Jacob
Development of biomarkers capable of estimating absorbed dose is critical for effective triage of affected individuals after radiological events. Levels of cell-free circulating miRNAs in plasma were compared for dose-response analysis in non-human primates (NHP) exposed to lethal (6.5 Gy) and sub-lethal (1 and 3 Gy) doses over a 7 day period. The doses and test time points were selected to mimic triage needs in the event of a mass casualty radiological event. Changes in miRNA abundance in irradiated animals were compared to a non-irradiated cohort and a cohort experiencing acute inflammation response from exposure to lipopolysaccharide (LPS)...
2016: PloS One
https://www.readbyqxmd.com/read/27893288/analyzing-injury-severity-of-bus-passengers-with-different-movements
#9
Duo Li, Yifei Zhao, Qiang Bai, Bei Zhou, Hongbiao Ling
OBJECTIVE: Though public transport vehicles are rarely involved in mass casualty accidents, when they are, the number of injuries and fatalities is usually high because of large passenger capacity. Of the few studies that have been conducted on bus safety, the majority focused on vehicle safety features, road environmental factors, as well as driver characteristics. Nevertheless, few studies have attempted to investigate the underlying risk factors related to bus occupants. This paper presents an investigation aimed at identifying the risk factors affecting injury severity of bus passengers with different movements...
November 28, 2016: Traffic Injury Prevention
https://www.readbyqxmd.com/read/27890096/entrance-and-exit-wounds-of-high-velocity-bullet-an-autopsy-analysis-in-the-event-of-dispersing-the-mass-rally-in-bangkok-thailand-may-2010
#10
Vichan Peonim, Smith Srisont, Jitta Udnoon, Sompong Wongwichai, Arisa Thapon, Wisarn Worasuwannarak
Fatal mass casualties by high velocity bullets (HVBs) are rare events in peaceful countries. This study presents 27 forensic autopsy cases with 32 shots fired by 5.56×45mm. HVB (M-16 rifle bullets) during the dispersing the mass rally in Bangkok Thailand, May 2010. It was found that twenty-three (71.88%) typical entrance HVB wounds had round sizes less than the bullet diameters. Most entrance wounds had microtears but no collar abrasion since a HVB has a small streamlined spitzer tip and full metal jacket...
November 2016: Legal Medicine
https://www.readbyqxmd.com/read/27881470/modelling-primary-blast-lung-injury-current-capability-and-future-direction
#11
EDITORIAL
Timothy Scott, E Hulse, M Haque, E Kirkman, J Hardman, P Mahoney
Primary blast lung injury frequently complicates military conflict and terrorist attacks on civilian populations. The fact that it occurs in areas of conflict or unpredictable mass casualty events makes clinical study in human casualties implausible. Research in this field is therefore reliant on the use of some form of biological or non-biological surrogate model. This article briefly reviews the modelling work undertaken in this field until now and describes the rationale behind the generation of an in silico physiological model...
November 23, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27855268/hitting-a-moving-target-a-strategic-tool-for-analyzing-terrorist-threats
#12
Ken Coleman, Noriko Ishisoko, Milana Trounce, Kenneth Bernard
The subject of terrorism risk can be confusing for both the general public and for those responsible for protecting us from attack. Relatively minor terrorist threats are often conflated with much more serious ones, in part because it is hard to quantify either intent or technical ability to carry out an attack. Plotting threats on a "potential mass casualties" versus "ease of obtainment or production" matrix creates some order out of a seemingly endless array of worldwide threats, and it highlights those threats that are in need of more urgent attention...
November 2016: Health Security
https://www.readbyqxmd.com/read/27851235/1600-real-time-tracking-of-mass-casualty-incident-markers-in-a-search-and-rescue-training-simulation
#13
Kendall Park, Salman Ahmad, John Gillis, Prasad Calyam, Amy Cheng, Josiah Burchard, Kourtney Meiss, Luke Guerdan
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27833335/the-role-of-dentistry-in-disaster-management-and-victim-identification-an-overview-of-challenges-in-indo-nepal-scenario
#14
REVIEW
Shubha Ranjan Dutta, Purnima Singh, Deepak Passi, Don Varghese, Sarang Sharma
BACKGROUND: Recently, natural disasters and terrorist activities have been leading to mass casualty situations unexpectedly around the globe. In addition to the traditional emergency medical services centering around medically trained and paramedic personnel, dental practitioners having vital skills and attributes may be important in responding to a mass casualty situation. OBJECTIVE: This paper aims at discussing the role of dentists in disaster management and the role of forensic odontology in the disaster victim identification (DVI), its status in India and some suggestions to develop the plans for same...
December 2016: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/27825363/pre-hospital-management-of-mass-casualty-civilian-shootings-a-systematic-literature-review
#15
Conor D A Turner, David J Lockey, Marius Rehn
BACKGROUND: Mass casualty civilian shootings present an uncommon but recurring challenge to emergency services around the world and produce unique management demands. On the background of a rising threat of transnational terrorism worldwide, emergency response strategies are of critical importance. This study aims to systematically identify, describe and appraise the quality of indexed and non-indexed literature on the pre-hospital management of modern civilian mass shootings to guide future practice...
November 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27824239/emergency-clinical-networks-represent-a-real-opportunity-for-dealing-with-mass-casualty-events
#16
Adriano Peris
No abstract text is available yet for this article.
December 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27790383/mass-casualty-decontamination-guidance-and-psychosocial-aspects-of-cbrn-incident-management-a-review-and-synthesis
#17
Holly Carter, Richard Amlôt
INTRODUCTION: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents...
September 27, 2016: PLoS Currents
https://www.readbyqxmd.com/read/27790381/mass-casualty-decontamination-in-a-chemical-or-radiological-nuclear-incident-further-guiding-principles
#18
Holly Carter, Richard Amlôt, Richard Williams, G James Rubin, John Drury
This short report presents a response to an article written by Cibulsky et al. (2016). The paper by Cibulsky et al. presents a useful and timely overview of the evidence surrounding the technical and operational aspects of mass casualty decontamination. It identifies three priority targets for future research, the third of which is how casualties' needs can be met in ways that best support compliance with and effectiveness of casualty decontamination. While further investigation into behavioural, communication and privacy issues during mass decontamination is warranted, there is now a substantial body of research in this area which is not considered in detail in the succinct summary provided by Cibulsky et al...
September 15, 2016: PLoS Currents
https://www.readbyqxmd.com/read/27788698/a-pilot-study-examining-the-speed-and-accuracy-of-triage-for-simulated-disaster-patients-in-an-emergency-department-setting-comparison-of-a-computerized-version-of-canadian-triage-acuity-scale-ctas-and-simple-triage-and-rapid-treatment-start-methods
#19
Gwynn Curran-Sills, Jeffrey M Franc
OBJECTIVE: To compare emergency department triage nurses' time to triage and accuracy of a simulated mass casualty incident (MCI) population using a computerized version of CTAS or START systems. METHODS: This pilot study was a prospective trial using a convenience sample. A total of 20 ED triage nurses, 10 in each arm of the study, were recruited. The paper-based questionnaire contained nine simulated MCI vignettes. An expert panel arrived at consensuses on the wording of the vignettes and created a standard triage score from which to compare the study participants...
October 28, 2016: CJEM
https://www.readbyqxmd.com/read/27757716/simedis-a-discrete-event-simulation-model-for-testing-responses-to-mass-casualty-incidents
#20
Michel Debacker, Filip Van Utterbeeck, Christophe Ullrich, Erwin Dhondt, Ives Hubloue
It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion. No experimental studies regarding the effects of DMR interventions on the health outcomes of disaster survivors have been carried out. Traditional analytic methods cannot fully capture the flow of disaster victims through a complex disaster medical response system (DMRS)...
December 2016: Journal of Medical Systems
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