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Medic Evacuation

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https://www.readbyqxmd.com/read/28437783/evacuation-of-a-tertiary-neonatal-centre-lessons-from-the-2016-kumamoto-earthquakes
#1
Osuke Iwata, Akihiko Kawase, Masanori Iwai, Kazuko Wada
BACKGROUND: Newborn infants hospitalised in the neonatal intensive care unit (NICU) are vulnerable to natural disasters. However, publications on evacuation from NICUs are sparse. The 2016 Kumamoto Earthquakes caused serious damage to Kumamoto City Hospital and its level III regional core NICU. Local/neighbour NICU teams and the disaster-communication team of a neonatal academic society cooperated to evacuate 38 newborn infants from the ward. OBJECTIVE: The aim of this paper was to highlight potential key factors to improve emergency NICU evacuation and coordination of hospital transportation following natural disasters...
April 25, 2017: Neonatology
https://www.readbyqxmd.com/read/28435989/aggressive-medical-management-of-acute-traumatic-subdural-hematomas-before-emergency-craniotomy-in-patients-presenting-with-bilateral-unreactive-pupils-a-cohort-study
#2
Arturo Chieregato, Alessandra Venditto, Emanuele Russo, Costanza Martino, Giovanni Bini
BACKGROUND: The outcome of patients with severe traumatic brain injury (TBI) and acute traumatic subdural hematoma (aSDH) admitted to the emergency room with bilaterally dilated, unreactive pupils (bilateral mydriasis) is notoriously poor. METHODS: Of 2074 TBI patients consecutively admitted to our facility between 1997 and 2012, 115 had a first CT scan with aSDH, unreactive bilateral mydriasis, and a Glasgow Coma Score of 3 or 4. Sixty-two patients were unoperated and died within hours or a few days...
April 24, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28427975/surgical-management-of-vertex-epidural-hematoma-technical-case-report-and-literature-review
#3
David T Fernandes-Cabral, Ali Kooshkabadi, Sandip S Panesar, Emrah Celtikci, Hamid Borghei-Razavi, Pinar Celtikci, Juan C Fernandez-Miranda
BACKGROUND: Vertex epidural hematoma (VEH) is an uncommon presentation of extra-axial hematomas. It can represent a surgical dilemma regarding when and how to operate, particularly considering the potential implication of the superior sagittal sinus (SSS). OBJECTIVE: Here, we illustrate the surgical technique for VEH as well as review of the existing literature. METHODS: A 60-year-old male sustained a ground level fall resulting in complete diastasis of the sagittal suture with underlying large VEH causing significant mass effect on the SSS and bi-hemispheric convexities...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28422911/do-vented-chest-seals-differ-in-efficacy-an-experimental-evaluation-using-a-swine-hemopneumothorax-model
#4
Bijan S Kheirabadi, Irasema B Terrazas, Nahir Miranda, Spc Amber N Voelker, Francoise Arnaud, Harold G Klemcke, Frank F Butler, Michael A Dubick
OBJECTIVE: Hemopneumothorax (HPTX) is the second leading cause of potentially preventable death among combat casualties. We investigated the ability of five FDA-approved non-occlusive chest seals (CSs) to seal a bleeding chest wound and prevent tension HPTX in a swine model. METHODS: Following instrumentation, an open chest wound was created in the left thorax of spontaneously air-breathing anesthetized pigs (n=26, 43 Kg). Autologous fresh blood (226 mL) was then infused into the pleural cavity to produce HPTX...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28411937/preparing-for-international-travel-and-global-medical-care
#5
REVIEW
Swaminatha V Mahadevan, Matthew C Strehlow
Thorough pretravel preparation and medical consultation can mitigate avoidable health and safety risks. A comprehensive pretravel medical consultation should include an individualized risk assessment, immunization review, and discussion of arthropod protective measures, malaria prophylaxis, traveler's diarrhea, and injury prevention. Travel with children and jet lag reduction require additional planning and prevention strategies; travel and evacuation insurance may prove essential when traveling to less resourced countries...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28410486/how-to-treat-ebola-virus-infections-a-lesson-from-the-field
#6
REVIEW
Sophie Duraffour, Denis Malvy, Daouda Sissoko
The reported case fatality ratios (CFR) of Ebola virus disease (EVD) have been as high as 90% in previous outbreaks. While the cumulative CFR among patients medically evacuated and treated in Western countries was inferior to 20%, it peaked to approximately 75% between September and December 2014 in West Africa, thereafter decreasing to less than 40% (May 2015) without current evidence of major virus mutations capable to alter virus pathogenicity over the course of the epidemic. Therefore, the observed diminution of CFR is likely to reflect improvement of EVD patient care...
April 11, 2017: Current Opinion in Virology
https://www.readbyqxmd.com/read/28409652/modeling-to-optimize-hospital-evacuation-planning-in-ems-systems
#7
Douglas R Bish, Hussein Tarhini, Roel Amara, Richard Zoraster, Nichole Bosson, Marianne Gausche-Hill
OBJECTIVE: To develop optimal hospital evacuation plans within a large urban EMS system using a novel evacuation planning model and a realistic hospital evacuation scenario, and to illustrate the ways in which a decision support model may be useful in evacuation planning. METHODS: An optimization model was used to produce detailed evacuation plans given the number and type of patients in the evacuating hospital, resource levels (teams to move patients, vehicles, and beds at other hospitals), and evacuation rules...
April 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28408272/successful-management-of-a-neck-hematoma-following-simulation-training
#8
Marie-Ève Bélanger, Issam Tanoubi, Mihai Georgescu, Roger Perron, Arnaud Robitaille, Marie-Pierre Charron, Pierre Drolet
Simulation-based education is gaining widespread acceptance in many medical specialties as an effective method to teach technical and non-technical skills. The ultimate goal of simulation is to improve health care and patient safety. Boet et al. [1] published a review on simulation-based crisis resources management (CRM) teaching, looking for evidence that it can lead to improved workplace practices and patient safety. Amongst hundreds of studies pertaining to CRM, he found only nine that were relevant, and only one that showed reduced mortality...
April 10, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28402415/single-versus-repeat-doses-of-misoprostol-for-treatment-of-early-pregnancy-loss-a-randomized-clinical-trial
#9
Yossi Mizrachi, Ann Dekalo, Ohad Gluck, Hadas Miremberg, Lotem Dafna, Ohad Feldstein, Eran Weiner, Jacob Bar, Ron Sagiv
STUDY QUESTION: Does repeat administration of misoprostol for early pregnancy loss increase the treatment success rate? SUMMARY ANSWER: Repeat administration of misoprostol does not increase the treatment success rate, and is associated with more analgesics use. WHAT IS KNOWN ALREADY: Misoprostol reduces the need for surgical evacuation and shortens the time to complete expulsion in patients with early pregnancy loss. However, the impact of repeat doses of misoprostol is not clear...
April 10, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28395673/rural-community-disaster-preparedness-and-risk-perception-in-trujillo-peru
#10
Matthew Stewart, Bridget Grahmann, Ariel Fillmore, L Scott Benson
Introduction Disasters will continue to occur throughout the world and it is the responsibility of the government, health care systems, and communities to adequately prepare for potential catastrophic scenarios. Unfortunately, low-and-middle-income countries (LMICs) are especially vulnerable following a disaster. By understanding disaster preparedness and risk perception, interventions can be developed to improve community preparedness and avoid unnecessary mortality and morbidity following a natural disaster...
April 11, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28382876/assessment-of-risks-posed-to-vad-patients-during-disasters
#11
Katherine J Davis, Genevieve O'Shea, Michael Beach
Ventricular assist devices (VADs) are an Advanced Life Support for patients with heart failure. These patients are particularly vulnerable in the event of a disaster. A hazard vulnerability analysis (HVA) was conducted to determine areas of susceptibility for these patients. Lack of electrical power, limited access to medications and anticoagulation, dehydration, extreme temperature and weather environments, conditions which predispose to infection, and evacuation transport are all identified circumstances that place these patients at an increased risk for harm and death...
April 6, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28355616/medical-evacuations-in-the-oil-and-gas-industry-a-retrospective-review-with-implications-for-future-evacuation-and-preventative-strategies%C3%A2
#12
Sharyn Toner, Derkje H Andrée Wiltens, Johannes Berg, Hector Williams, Susan Klein, Simon Marshall, Neil Nerwich, Ryan Copeland
BACKGROUND: Businesses increasingly conduct operations in remote areas where medical evacuation [Medevac(s)] carries more risk. Royal Dutch Shell developed a remote healthcare strategy whereby enhanced remote healthcare is made available to the patient through use of telemedicine and telemetry. To evaluate that strategy, a review of Medevacs of Shell International employees [i.e. expatriate employees (EEs) and frequent business travellers (FBTs)] was undertaken. METHOD: A retrospective review of Medevac data (period 2008-12) that were similar in operational constraints and population profile was conducted...
May 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28351055/comparison-of-the-induction-to-delivery-interval-in-terminations-of-pregnancy-with-or-without-dilapan-s%C3%A2
#13
Marie Vincienne, Olivia Anselem, Anne Gaelle Cordier, Camille Le Ray, Vassilis Tsatsaris, Alexandra Benachi, François Goffinet
OBJECTIVE: In France, terminations of pregnancy (TOP) for medical reasons beyond the second trimester use mifepristone and misoprostol. We sought to determine the effectiveness of Dilapan-S®, an osmotic cervical dilator, in shortening the induction-to-delivery interval (IDI). MATERIALS AND METHODS: This retrospective study of TOP in 2010-2012 compared the results from 2 hospitals with different TOP protocols starting at 16 weeks' gestation, one (164 women) with and one (106) without Dilapan-S®...
March 29, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28338467/somewhere-in-france-9-april-17-a-centenary-review-of-medical-arrangements-at-vimy-ridge
#14
Vivian McAlister
In April 1917, medical units of the 4 divisions of the Canadian Corps combined for the first time in support of a single action, the assault upon Vimy Ridge. Detailed planning, infrastructure development, information dissemination and rehearsal were features of preparations by the combat arms and medical elements of the Canadian Forces. Extraordinary coordination resulted in the rapid rescue and evacuation by Canadian medical services of 8000 casualties over 4 days. Characteristics of today's military medical services are evident in the work of the Canadian Army Medical Corps 100 years ago...
April 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28337701/ct-guided-drainage-of-pericardial-effusion-after-open-cardiac-surgery
#15
Nour-Eldin Abdelrehim Nour-Eldin, Mohammed Alsubhi, Tatjana Gruber-Rouh, Thomas J Vogl, Benjamin Kaltenbach, Hazem Hamed Soliman, Wael Eman Hassan, Sherif Maher Abolyazid, Nagy N Naguib
PURPOSE: This study was designed to evaluate the safety and efficacy of CT-guided drainage of the pericardial effusion in patients after cardiac surgery. MATERIALS AND METHODS: The study included 128 consecutive patients (82 males, 46 females; mean age 66.6 years, SD: 4.2) complicated by pericardial effusion or hemopericardium after cardiac surgeries between June 2008 and June 2016. The medical indication for therapeutic pericardiocentesis in all patients was hemodynamic instability caused by pericardial effusion...
March 23, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28336015/ten-years-of-en-route-critical-care-training
#16
Mathieu Boutonnet, Pierre Pasquier, Laurent Raynaud, Laurent Vitiello, Jérôme Bancarel, Sébastien Coste, Guillaume Pelée de Saint Maurice, Sylvain Ausset
OBJECTIVE: The French Military Health Service (FMHS) has developed a training program for medical evacuation (MEDEVAC) of critical care patients on fixed wing aircraft. METHODS: We conducted a 10-year retrospective analysis (2006-2015) of the data from the FMHS Academy. The number of trainees was listed according to the different courses and medical specialties. The number of MEDEVACs recorded during the period was described. RESULTS: Since 2006, the FMHS has developed training courses designed for MEDEVAC of critical care patients...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28325458/chronic-subdural-hematoma-icu-management
#17
REVIEW
Jeremy T Ragland, Kiwon Lee
Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly.Seizure prophylaxis treatment is reasonable...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28319267/risk-factors-associated-with-failure-of-treatment-for-cesarean-scar-pregnancy
#18
Ying-Cheng Chiang, Yi-An Tu, Jehn-Hsiahn Yang, Shin-Yu Lin, Chien-Nan Lee, Jin-Chung Shih
OBJECTIVE: To identify risk factors associated with treatment failure among women with cesarean scar pregnancy (CSP). METHODS: In a retrospective study, the medical records of patients with CSP treated at National Taiwan University Hospital, Taipei, Taiwan, from 1994 to 2015 were reviewed. The women were managed primarily with hysterotomy, evacuation, or methotrexate. Receiver operating characteristic (ROC) curve analysis and logistic regression analysis were used to evaluate the factors associated with treatment failure...
March 20, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28314862/epidemiology-and-prognosis-of-mild-traumatic-brain-injury-in-returning-soldiers-a-cohort-study
#19
Karen Schwab, Heidi P Terrio, Lisa A Brenner, Renee M Pazdan, Henry P McMillan, Margaret MacDonald, Sidney R Hinds, Ann I Scher
OBJECTIVE: Mild traumatic brain injury (mTBI; concussion) is common in returning service members yet limited definitive evidence exists on its prognosis. METHODS: Almost 25,000 non-medically evacuated soldiers returning from Afghanistan or Iraq to 2 military bases between 2009 and 2014 were screened for mTBI. We invited a random sample to participate in the present study, oversampling those screening positive, resulting in 557 mTBI cases and 1,010 controls, of whom 366 cases and 599 controls completed 3-month follow-up evaluations...
March 17, 2017: Neurology
https://www.readbyqxmd.com/read/28291484/post-traumatic-stress-symptoms-in-united-states-air-force-aeromedical-evacuation-nurses-and-technicians
#20
Julie M Swearingen, Tanya M Goodman, Wayne L Chappelle, William T Thompson
Critical Care Air Transport Teams (CCATT) are specialized military medical personnel who provide high-acuity care in an aeromedical environment. The rate of post-traumatic stress disorder (PTSD) symptoms was assessed in CCATT personnel and their rates were compared to general aeromedical evacuation (AE) personnel. As part of a computer-based occupational stress survey, 188 crew members (138 AE nurses and technicians, 50 CCATT nurses and respiratory therapists) completed the PTSD Checklist - Military Version...
March 2017: Military Medicine
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