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https://www.readbyqxmd.com/read/28102530/surgeon-preparedness-for-mass-casualty-events-adapting-essential-military-surgical-lessons-for-the-home-front
#1
Kyle N Remick, Stacy Shackelford, John S Oh, Jason M Seery, Daniel Grabo, John Chovanes, Kirby R Gross, Shawn C Nessen, Nigel Rm Tai, Rory F Rickard, Eric Elster, C W Schwab
Military surgeons have gained familiarity and experience with mass casualty events (MCEs) as a matter of routine over the course of the last two conflicts in Afghanistan and Iraq. Over the same period of time, civilian surgeons have increasingly faced complex MCEs on the home front. Our objective is to summarize and adapt these combat surgery lessons to enhance civilian surgeon preparedness for complex MCEs on the home front. The authors describe the unique lessons learned from combat surgery over the course of the wars in Afghanistan and Iraq and adapt these lessons to enhance civilian surgical readiness for a MCE on the home front...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28096062/combat-casualty-care-improvement-a-quality-process
#2
EDITORIAL
Jean-Pierre Tourtier
No abstract text is available yet for this article.
January 13, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28071950/reporting-individual-surgeon-outcomes-does-not-lead-to-risk-aversion-in-abdominal-aortic-aneurysm-surgery
#3
A Saratzis, A Thatcher, M F Bath, D A Sidloff, M J Bown, J Shakespeare, R D Sayers, C Imray
INTRODUCTION Reporting surgeons' outcomes has recently been introduced in the UK. This has the potential to result in surgeons becoming risk averse. The aim of this study was to investigate whether reporting outcomes for abdominal aortic aneurysm (AAA) surgery impacts on the number and risk profile (level of fitness) of patients offered elective treatment. METHODS Publically available National Vascular Registry data were used to compare the number of AAAs treated in those centres across the UK that reported outcomes for the periods 2008-2012, 2009-2013 and 2010-2014...
January 10, 2017: Annals of the Royal College of Surgeons of England
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
#4
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/28062529/a-mixed-reality-simulator-concept-for-future-medical-emergency-response-team-training
#5
Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
January 6, 2017: Journal of the Royal Army Medical Corps
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
#6
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/28044383/alcohol-use-among-fatally-injured-victims-in-s%C3%A3-o-paulo-brazil-bridging-the-gap-between-research-and-health-services-in-developing-countries
#7
Gabriel Andreuccetti, Vilma Leyton, Nikolas P Lemos, Ivan Dieb Miziara, Yu Ye, Juliana Takitane, Daniel Romero Munoz, Arthur L Reingold, Cheryl J Cherpitel, Heraclito Barbosa de Carvalho
BACKGROUND AND AIMS: Most studies reporting alcohol use among fatally injured victims are subject to bias, particularly those related to sample selection and to absence of injury context data. We developed a research method to estimate the prevalence of alcohol consumption and test correlates of alcohol use prior to fatal injuries. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional study based on a probability sample of fatally injured adult victims (n = 365) autopsied in São Paulo, Brazil...
November 6, 2016: Addiction
https://www.readbyqxmd.com/read/28043499/complex-emergencies-in-the-eastern-mediterranean-region-impact-on-tuberculosis-control
#8
Akihiro Seita
OBJECTIVE/BACKGROUND: The Eastern Mediterranean Region (EMR) has witnessed the largest refugee crisis in history. Overall, 70% of the global refugee populations are from Palestine, Syria, Afghanistan, or Somalia. We reviewed the possible impact of such crisis on the tuberculosis situation in EMR. METHODS: We used the available data and information from the World Health Organization and other international and national institutions. RESULTS: Overall, 15 out of 22 countries in the EMR are either engulfed in complex emergencies (10 countries) or suffering from their neighbors' complex emergencies (7 countries), whereas two countries suffer from both...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043298/-investigation-on-events-of-bus-on-fire-in-6-years-in-the-mainland-of-china
#9
X G Wang, Y Liu, Y Cen, P Wu, H L Zhou, C M Han
Objective: To retrospectively analyze the characteristics of events of bus on fire in 6 years in the mainland of China. Methods: Events of bus on fire happened between January 2009 and December 2014 were retrieved through Baidu search engine, Chinese Journals Full-text Database, and PubMed database in the search strategy with " bus" and " fire" or " arson" as keywords combined with the name of provinces, autonomous regions, and municipalities of the mainland of China. The occurrence time, region, cause of fire, casualties of each event were recorded, and the correlative analysis was conducted...
December 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28043178/towards-clinical-development-of-a-pfs48-45-based-transmission-blocking-malaria-vaccine
#10
Michael Theisen, Matthijs M Jore, Robert Sauerwein
Malaria is a devastating vector-borne disease caused by the Plasmodium parasite, resulting in almost 0.5 million casualties per year. The parasite has a complex life-cycle that includes asexual replication in human red blood cells, causing symptomatic malaria, and sexual stages which are essential for the transmission to the mosquito vector. A vaccine targeting the sexual stages of the parasite and thus blocking transmission will be instrumental for the eradication of malaria. One of the leading transmission blocking vaccine candidates is the sexual stage antigen Pfs48/45...
January 3, 2017: Expert Review of Vaccines
https://www.readbyqxmd.com/read/28041825/sodium-nitrite-and-sodium-thiosulfate-are-effective-against-acute-cyanide-poisoning-when-administered-by-intramuscular-injection
#11
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/28041751/a-comparison-of-suicidal-behavior-by-burns-five-years-before-and-five-years-after-the-2011-tunisian-revolution
#12
Mehdi Ben Khelil, Amine Zgarni, Mounir Ben Mohamed, Mohamed Allouche, Anis Benzarti, Ahmed Banasr, Moncef Hamdoun
INTRODUCTION: In Tunisia, the phenomenon of self-immolation has increased dramatically since the self-burn of Mohamed Bouazizi which occurred on 17 December 2010. The aim of our study was to compare the casualties' profile of suicide by self-immolation before and after the Tunisian Revolution over a period of 10 years (2006-2015). METHODS: We conducted a retrospective review including all the cases of self-immolation suicides that occurred in Northern Tunisia five years before and five years after the January 2011 Revolution...
December 29, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28040361/experience-of-distributing-499-burn-casualties-of-the-june-28-2015-formosa-color-dust-explosion-in-taiwan
#13
Tsung-Hsi Wang, Wei-Siang Jhao, Yu-Hua Yeh, Christy Pu
OBJECTIVE: To describe the experience of distributing 499 burn casualties of an unexpected event and determine whether patient transfer is associated with patient outcomes measured 2 weeks after the incident. METHODS: All 499 patients injured in the event were included. For the 138 patients transferred to other hospitals after primary distribution, we evaluated whether the transfers were associated with patient severity. Furthermore, we used multinomial logistic regression to investigate the association of patient transfer with patient outcomes after controlling for age, gender, total burn surface area (TBSA), final hospital level, wound infection, and patient pneumonia...
December 28, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28034667/adjunctive-hyperbaric-oxygen-therapy-in-severe-burns-experience-in-taiwan-formosa-water-park-dust-explosion-disaster
#14
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/28029497/active-numerical-model-of-human-body-for-reconstruction-of-falls-from-height
#15
Marcin Milanowicz, Krzysztof Kędzior
Falls from height constitute the largest group of incidents out of approximately 90,000 occupational accidents occurring each year in Poland. Reconstruction of the exact course of a fall from height is generally difficult due to lack of sufficient information from the accident scene. This usually results in several contradictory versions of an incident and impedes, for example, determination of the liability in a judicial process. In similar situations, in many areas of human activity, researchers apply numerical simulation...
October 21, 2016: Forensic Science International
https://www.readbyqxmd.com/read/28029474/hypertension-after-injury-among-burned-combat-veterans-a-retrospective-cohort-study
#16
Ian J Stewart, Jonathan A Sosnov, Brian D Snow, Augen Batou, Jeffrey T Howard, Jud C Janak, Mary Bollinger, Kevin K Chung
BACKGROUND: The long-term health effects of burn are poorly understood. We sought to evaluate the relationship between burn and the subsequent development of hypertension. METHODS: Retrospective cohort study of patients admitted to our burn center from 2003 to 2010. Data collected included demographic variables, burn size, injury severity score, presence of inhalation injury, serum creatinine, need for renal replacement therapy, as well as days spent in the hospital, in the intensive care unit and on mechanical ventilation...
October 28, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28025382/mortality-reduction-by-post-dilution-online-haemodiafiltration-a-cause-specific-analysis
#17
Menso J Nubé, Sanne A E Peters, Peter J Blankestijn, Bernard Canaud, Andrew Davenport, Muriel P C Grooteman, Gulay Asci, Francesco Locatelli, Francisco Maduell, Marion Morena, Ercan Ok, Ferran Torres, Michiel L Bots
BACKGROUND: From an individual participant data (IPD) meta-analysis from four randomized controlled trials comparing haemodialysis (HD) with post-dilution online-haemodiafiltration (ol-HDF), previously it appeared that HDF decreases all-cause mortality by 14% (95% confidence interval 25; 1) and fatal cardiovascular disease (CVD) by 23% (39; 3). Significant differences were not found for fatal infections and sudden death. So far, it is unclear, however, whether the reduced mortality risk of HDF is only due to a decrease in CVD events and if so, which CVD in particular is prevented, if compared with HD...
December 26, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28024651/dedicated-mass-casualty-incident-hospitals-an-overview
#18
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/28019001/characteristics-of-road-traffic-accident-casualties-admitted-to-a-tertiary-care-hospital-in-sri-lanka
#19
Dinesh M Fernando, Sampath U Tennakoon, Achini N Samaranayake, Medhani Wickramasinghe
The mortality and morbidity of road traffic accidents (RTA) is increasing in the South Asian region, including Sri Lanka. Therefore, the demographic factors, types of vehicles involved, and the severity of injuries sustained in RTA was studied. Age, gender, and details of the incident of all patients admitted to hospital following a RTA, between January 2007 and August 2012, were obtained by interview. Following a medico-legal examination, the type and severity of injuries was categorized as, non-grievous, grievous, endangering life or fatal in the ordinary course of nature...
December 26, 2016: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28003301/safety-and-feasibility-of-sublingual-microcirculation-assessment-in-the-emergency-department-for-civilian-and-military-patients-with-traumatic-haemorrhagic-shock-a-prospective-cohort-study
#20
David N Naumann, Clare Mellis, Iain M Smith, Jasna Mamuza, Imogen Skene, Tim Harris, Mark J Midwinter, Sam D Hutchings
OBJECTIVES: Sublingual microcirculatory monitoring for traumatic haemorrhagic shock (THS) may predict clinical outcomes better than traditional blood pressure and cardiac output, but is not usually performed until the patient reaches the intensive care unit (ICU), missing earlier data of potential importance. This pilot study assessed for the first time the feasibility and safety of sublingual video-microscopy for THS in the emergency department (ED), and whether it yields useable data for analysis...
December 21, 2016: BMJ Open
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