First Aid Stations Research Articles

The Brugada syndrome: a complex cardiological problem in the experience of the specialist in internal medicine

BACKGROUND Brugada syndrome, a disease burdened by elevated risk of sudden unexpected cardiac death, often affects young aged subjects that have structurally healthy heart. The diagnostic itinerary is complex: anamnesis, ECG, pharmacological test and electrophysiological study. Its phenotypes are three. METHOD We have identified 13 cases (10 men and 3 women), 12 estimated at the Cardiological Outpatients' Department and 1 at the First-aid Station. RESULTS 2 cases belonged to phenotype 1, 4 cases to phenotype 2 and 7 cases to phenotype 3. CONCLUSIONS Our work of specialists in internal medicine, toward this syndrome, is: an accurate anamnesis, a correct interpretation of ECG, fast sending of high risk cases to advanced level cardiological competences, a selection of cases to submit to pharmacological test, to address middle risk patients to cardiological competences, offering our cooperation in the follow-up.

Effect of Military Conflicts on the Formation of Emergency Medical Services Systems Worldwide

This article briefly reviews the evolution of medical support during wars and conflicts from ancient to modern times and discusses the effect warfare has had on the development of civilian health care and emergency medical services (EMS). Medical breakthroughs and discoveries made of necessity during military conflicts have developed into new paradigms of medical care, including novel programs of triage and health assessment, emergency battlefield treatment and stabilization, anesthesia, and other surgical and emergency procedures. The critical role of organizations that provide proper emergency care to help the sick and injured both on the battlefield and in the civilian world is also highlighted.

Assessing current state of nursing in Mari El Republic and developing approaches for its improvement

Aim. Improving the nursing management based on a comprehensive socio-hygienic assessment. Methods. Analytical, statistical, retrospective and prospective analysis, data copying, opinion poll. Results. Positive changes in nursing service development in Mari El Republic were revealed during the period from 2000 to 2011. By January, 1, 2012, 7458 nurses with secondary medical education were employed in 50 medical institutions run by Ministry of Healthcare and in 306 village first-aid stations. The majority were certified and had a qualifying category - 97% and 67% respectively. The average value of nursing provision was 107.1 nurses per 10 000 of population, staffing - 95.5%, staffing based of the number of employed nurses - 72%. Ratio of job combining among nursing staff was 1.3, the «doctor-nurse» ratio was 1:3.6. Recently a tendency of nursing personnel outflow from nursing practice was revealed in the region. Since 2000 the number of working nursing specialists decreased by 380. The share of «young» specialists was only 7.9% of all the employed nurses, the share of nursing staff of pre-retirement and retirement age was 19%. Conclusion. According to the forecast data for the near-term outlook it is possible to expect decrease of nursing staff rates in the region. The creation of «nursing service management school» may solve the problem.

Needs for disaster medicine: lessons from the field of the Great East Japan Earthquake

The Great East Japan Earthquake, which occurred in Tohoku, Japan on 11 March 2011, was followed by a devastating tsunami and damage to nuclear power plants that resulted in radiation leakage. The medical care, equipment and communication needs of four Disaster Medical Assistance Teams (DMAT) during four missions are discussed. DMATs are medically trained mobile teams used in the acute phase of disasters. The DMATs conducted four missions in devastated areas from the day of the earthquake to day 10. The first and second missions were to triage, resuscitate and treat trauma victims in Tokyo and Miyagi, respectively. The third mission was to conduct emergency medicine and primary care in Iwate. The fourth was to assist with the evacuation and screening of inpatients with radiation exposure in Fukushima. Triage, resuscitation and trauma expertise and equipment were required in Missions 1 and 2. Emergency medicine in hospitals and primary care in first-aid stations and evacuation areas were required for Mission 3. In Mission 4, the DMAT assisted with evacuation by ambulances and buses and screened people for radiation exposure. Only land phones and transceivers were available for Missions 1 to 3 although they were ineffective for urgent purposes. These DMAT missions showed that there are new needs for DMATs in primary care, radiation screening and evacuation after the acute phase of a disaster. Alternative methods for communication infrastructure post-disaster need to be investigated with telecommunication experts.

1P1-P23 車輪型階段昇降機構の試作と実験(サーチ&レスキューロボット・メカトロニクス)

A Sarin gas attack occurred in the Tokyo subway system on March 20, 1995. This fatal gas attack sickened many passengers. Since the disaster broke out underground, the main job of the rescue personnel was to transport victims on stretchers to a first-aid station above the ground. Therefore, we researched the development of a rescue support stretcher system for handling heavy casualties in underground areas or at stations in a quick and effective manner. The stretcher system is expected to help firefighters achieve efficient rescue operations. In this paper, we introduce a new stair-climbing mechanism. We also compare the effectiveness of our proposed system with the past system.

General practitioners� experience at �med� first-aid station of �F. Spaziani� Hospital in Frosinone: data analysis and outlooks

General practitioners� experience at �med� first-aid station of �F. Spaziani� Hospital in Frosinone: data analysis and outlooks

Fighting for Fame: The ‘Heroines of Pervyse’ and the Disputed Construction of a Public Image

: This investigative analysis bases itself on an array of documentary material from the archives of the Imperial War Museum in its effort to recover the intricate story behind the two British volunteer nurses who made their name during the First World War with the first-aid station they set up in Pervyse, a mere stone's throw away from the Belgian firing line. The essay juxtaposes a variety of documentary sources—the unpublished diaries of the two women, Geraldine Mitton's reconstruction of the story out of the nurses' journals and letters in The Cellar-House of Pervyse (1916), and two photograph albums, ‘The Women of Pervyse’, bequeathed to the Imperial War Museum—in a quest to understand how the two nurses came to acquire their status of national heroines. Sifting through the source material, this investigation reveals the numerous inconsistencies and gaps that exist between the published and the unpublished accounts of the dressing station, whose true genesis is obscured by several competing narratives. A close reading of Mitton's account and the photographic portraitures discloses that neither of these documents ought to be taken at their face value. They need to be understood as valuable tools in the nurses' own battle for authority, public recognition and their opportunity to feature as genuine protagonists in the arena of war.

Burning Man 2011: Mass Gathering Medical Care in an Austere Environment

Introduction. Burning Man is a large weeklong outdoor arts festival held annually in the rugged and austere Black Rock Desert in northern Nevada. The 2011 event presented several unusual challenges in terms of emergency medical services (EMS) and medical care provision. Objective. This paper details the planning and subsequent emergency medical care for Burning Man 2011. Methods. This was a retrospective, observational review of the preparation, management, and medical care at Burning Man 2011. Results. Attendance at Burning Man 2011 was 53,735. Of these attendees, 2,307 were treated in the field hospital. While most patients had minor injuries, 33 were subsequently transported to a hospital (28 by ambulance and five by helicopter). The most common conditions treated were soft-tissue injuries, dehydration, eye problems, and urinary tract infections. There was one death (subarachnoid hemorrhage) and one patient in cardiac arrest (thoracic aortic dissection) who was successfully resuscitated and transferred. Burning Man 2011 presented numerous challenges in provision of EMS and medical care because of attendance size, the austere environment, and significant distance (150 miles) to definitive medical care. EMS operations included six dedicated ambulances, three quick-response vehicles, two first-aid stations, and a physician-staffed field hospital. The hospital had limited diagnostic capabilities (e.g., x-ray, ultrasound, basic laboratory analysis) and a limited formulary. We found that the use of physicians was necessary because much of the care provided was beyond the scope of paramedics. Conclusions. We describe the preparation and medical care for a large outdoor mass-gathering event held in a remote and austere environment. We met the stated goals of providing needed medical care while minimizing the need to transport attendees offsite for additional care. Our experience with Burning Man 2011 may aid planners with similar events.

Medical Care at Mass Gatherings: Emergency Medical Services at Large-Scale Rave Events

The objective of this study was to develop comprehensive guidelines for medical care during mass gatherings based on the experience of providing medical support during rave parties. Study design was a prospective, observational study of self-referred patients who reported to First Aid Stations (FASs) during Dutch rave parties. All users of medical care were registered on an existing standard questionnaire. Health problems were categorized as medical, trauma, psychological, or miscellaneous. Severity was assessed based on the Emergency Severity Index. Qualified nurses, paramedics, and doctors conducted the study after training in the use of the study questionnaire. Total number of visitors was reported by type of event. During the 2006-2010 study period, 7,089 persons presented to FASs for medical aid during rave parties. Most of the problems (91.1%) were categorized as medical or trauma, and classified as mild. The most common medical complaints were general unwell-being, nausea, dizziness, and vomiting. Contusions, strains and sprains, wounds, lacerations, and blisters were the most common traumas. A small portion (2.4%) of the emergency aid was classified as moderate (professional medical care required), including two cases (0.03%) that were considered life-threatening. Hospital admission occurred in 2.2% of the patients. Fewer than half of all patients presenting for aid were transported by ambulance. More than a quarter of all cases (27.4%) were related to recreational drugs. During a five-year field research period at rave dance parties, most presentations on-site for medical evaluation were for mild conditions. A medical team of six healthcare workers for every 10,000 rave party visitors is recommended. On-site medical staff should consist primarily of first aid providers, along with nurses who have event-specific training on advanced life support, event-specific injuries and incidents, health education related to self-care deficits, interventions for psychological distress, infection control, and disaster medicine. Protocols should be available for treating common injuries and other minor medical problems, and for registration, triage, environmental surveillance and catastrophe management and response.

Substance-related health problems during rave parties in The Netherlands (1997-2008).

The objective of this study was to describe a 12-year (1997–2008) observation of substance-related incidents occurring at rave parties in the Netherlands, including length of visits to first-aid stations, substances used, and severity of the incidents. During rave parties, specifically trained medical and paramedical personnel staffed first aid stations. Visitors were diagnosed and treated, and their data were recorded using standardized methods. During the 12-year period with 249 rave parties involving about 3,800,000 visitors, 27,897 people visited a first aid station, of whom 10,100 reported having a substance-related problem. The mean age of these people was 22.3+/−5.4 years; 52.4% of them were male. Most (66.7%) substance-related problems were associated with ecstasy or alcohol use or both. Among 10,100 substance-related cases, 515 required professional medical care, and 16 of these cases were life threatening. People with a substance-related problem stayed 20 min at the first aid station, which was significantly longer than the 5 min that those without a substance-related health problem stayed. These unique data from the Netherlands identify a variety of acute health problems related to the use of alcohol, amphetamines, cannabis, cocaine, ecstasy, and GHB. Although most problems were minor, people using GHB more often required professional medical care those using the other substances. We recommended adherence to harm and risk reduction policy, and the use of first aid stations with specially trained staff for both minor and serious incidents.

The bangover that did not stop: case report of neck weakness after headbanging at a rock concert, with later neck pain and upper limb paraesthesia

A case is discussed of a 16-year-old girl attending a concert who presented at the first-aid station complaining of being unable to keep her head upright. There were no specific therapeutic interventions and recovery from the injury took its natural course. However, she still suffered symptoms 4 years later. Unfortunately, there is no validated diagnosis to explain this combination of symptoms including dysfunctions in cognition (concentration problems), nerve and muscle tissue (tingling and weakness).

Tuberculosis morbidity among Moscow healthcare workers in 1995-2008

The paper characterizes tuberculosis morbidity among the healthcare workers of Moscow versus its adult population. Its considerable rise has been established. Occupational factors and tuberculosis risk groups have been determined in this professional category. Tuberculosis facilities, forensic medical examination bureaus, first-aid stations, hospital departments of morbid anatomy, and clinical and postmortem laboratories have been found to be of high epidemiological importance in determining the incidence of tuberculosis among Moscow healthcare workers. Its further studies and development of present-day programs to prevent nosocomial tuberculosis among the staff of health care facilities are needed.

1A2-B26 階段昇降機構を付加した救助支援型担架システムの開発 : 第3報 小型軽量化の効果に対する実験的検証

A sarin gas incident occurred in the Tokyo subway system on March 20, 1995. This fatal gas attack caused sicknesses to many passengers. Since the disaster broke out under the ground, the main job of rescue personnel was to transport victims on stretchers to a first-aid station on the ground. So, we research and development the rescue support stretcher robot for a heavy casualty disaster in underground areas or at stations can be handled in a quick, effective manner. The stretcher robot is expected to help firefighters achieve efficient rescue operations. In this paper, we introduce the rescue support stretcher system for going up and down the stairs. And, we propose the technique of smaller and lighter system. Finally, we examined the effectiveness of the robot by the experiment.

Emergency medical service for the Beijing Olympic Games and its outcome

Emergency Medical Service (EMS) of Beijing Olympic Games needs to cover not only all the venues of the Olympic and Paralympic Games, but also emergency medical service for citizens at large and other emergency events. To this end, Beijing Emergency Medical Center made efficient preparations for the Olympic Games, namely upgraded dispatch system, first-aid stations, ambulances and equipment, and volunteer recruitment among others. Thanks to such efforts made, the EMS successfully served the Beijing Olympic Games and citizens at large. Furthermore, the Beijing Olympic Games promoted the development of the Beijing EMS system. Key words: Olympic Games; Paralympic Games; Emergency Medical Service (EMS); Beijing

1A2-H05 階段昇降機構を付加した救助支援型担架システムの開発

A sarin gas incident occurred in the Tokyo subway system on March 20, 1995. This fatal gas attack caused sicknesses to many passengers. Since the disaster broke out under the ground, the main job of rescue personnel was to transport victims on stretchers to a first-aid station on the ground. So, we research and development the rescue support stretcher robot for a heavy casualty disaster in underground areas or at stations can be handled in a quick, effective manner. The stretcher robot is expected to help firelighters achieve efficient rescue operations, hi this paper, we discuss the mechanism for going up and down the stairs. And, we show the produced stretcher system with stair-climbing.

Injury Patterns and Levels of Care at a Marathon

Marathons pose many challenges to event planners. The medical services needed at such events have not received extensive coverage in the literature. The objective of this study was to document injury patterns and medical usage at a category III mass gathering (a marathon), with the goal of helping event planners organize medical resources for large public gatherings. Prospectively obtained medical care reports from the five first-aid stations set up along the marathon route were reviewed. Primary and secondary reasons for seeking medical care were categorized. Weather data were obtained, and ambient temperature was recorded. The numbers of finishers were as follows: 4,837 in the marathon (3,099 males, 1,738 females), 814 in the 5K race (362 males, 452 females), and 393 teams in the four-person relay (1,572). Two hundred fifty-one runners sought medical care. The day's temperatures ranged from 39 to 73 degrees F (mean, 56 degrees F). The primary reasons for seeking medical were medication request (26%), musculoskeletal injuries (18%), dehydration (14%), and dermal injuries (11%). Secondary reasons were musculoskeletal injuries (34%), dizziness (19%), dermal injuries (11%), and headaches (9%). Treatment times ranged from 3 to 25.5 minutes and lengthened as the day progressed. Two-thirds of those who sought medical care did so at the end of the race. The majority of runners who sought medical attention had not run a marathon before. Marathon planners should allocate medical resources in favor of the halfway point and the final first-aid station. Resources and medical staff should be moved from the earlier tents to further augment the later first-aid stations before the majority of racers reach the middle- and later-distance stations.

Applying Software Product Line Technology to Simulation Modeling of Emergency Response Facility

This paper proposes an effective, reusable solution for modeling and simulation. The approach is to develop a Software Product Line (SPL) architecture that explicitly captures the commonality and variability in a family of similar simulation systems. First responders and incident management personnel need better training resources to prepare for possible catastrophic events, including natural disasters and terrorist attacks. Live exercises are often very expensive to organize and conduct. With modeling and simulation technology, simulation-based exercise and training models could be developed. The SPL technology enables the simulation system to easily adapt to multiple contexts and allows the simulation system to reconfigure quickly. SPL models can be developed at different levels of scope and depth to suit the emergency responder's needs. By reusing the system requirement analysis, software architectures, and design, the development time is shorter, the development cost is lower, and the quality is easily maintained. This paper focuses on the application of SPL technology to simulation systems of emergency facilities, such as hospital emergency rooms, on-site emergency triage stations, decontamination stations, first-aid stations, and ambulances. The paper also introduces a prototype simulation of the SPL member system – a hospital emergency room simulation system that has been developed at the National Institute of Standards and Technology. The detailed modeling of a family of emergency response facility simulation systems is performed based on the Product Line Unified Modeling Language (UML)-based Software engineering (PLUS) method.

A distributed and interoperable system for out-of-hours health care

In Italy, at nights and weekends, there is an out-of-hours service called the Continuity Healthcare Service (CHS) which provides for urgent, non-emergency health-care needs. The CHS manages the following typical requests: information on health-care services, support and assistance, prescriptions, various kinds of clinical advice, urgent care problems, general practitioners’ visits and suspected emergencies which require immediate evaluation. A distributed and interoperable system (DAISIES) was proposed to manage the entire CHS process for each health district, with particular emphasis on health assistance, medical support and urgent care problems. The DAISIES system is now being implemented in a health district in the northern part of Milan, with the implementation of a service call-centre and some first-aid stations. Experience to date shows that it is possible to implement a technology-based model for the organization and the management of an out-of-hours health service, with particular emphasis on health assistance, medical support and urgent care problems.

The Incidence of Sickness/trauma in Spectators of Professional Baseball at the Meiji Jingu Baseball Stadium

The Meiji Jingu Baseball Stadium attracts a large number of spectators in the Tokyo metropolitan area. To clarify the demand for medical care at a public ballpark, we analyzed following two types of medical records maintained at the stadium: (1) "Report of Aid": a record of patients visiting the first-aid station in 2003 season and (2) "Report of Accidents": a record of patients referred to clinics/hospitals between 1996 and 2003 season. (1) In 2003, approximately 1,582,000 spectators watched 67 professional baseball games (60 night games). Of the 247 spectators received medical care at the first-aid station (3.7 persons per game, 1/6,405 spectators), 128 (51.8%) had trauma and 109 (44.1%) had illness. The incidence of trauma was relatively higher before the start and near the end of the night games. The risk of becoming sick/wounded per spectator or the number of the sick/wounded per game differed depending on the participating sports teams. (2) Ninety-three spectators referred to clinics/hospitals during the 8-year period from 1996 to 2003, of which 57 were transferred by ambulance. Direct ball injury accounted for 65 (69.9%) cases of trauma, followed by stumbling/falls (18 cases, 19.4%). Twenty patients were diagnosed to have fractures at the clinics/hospitals. Intrinsic cardiopulmonary arrest occurred in one spectator. Trauma due to direct ball injury accounted for the largest number of wounded patients referred to clinics/hospitals. Treatment to patients at the first-aid station in the stadium may optimize the frequency of hospital visits. Records of medical care are effective to analyze the demand for medical preparedness.

Pain and ethnicity - results of a survey at three internal/gynecological first-aid stations in Berlin

How high is the pain pressure in everyday life of German vs. not German patients, with which troubles do they come to the emergency room, how intense is their pain, how long is it lasting, how many pain areas are named? GROUP OF PATIENTS/METHODS: The study "Utilization of clinical emergency rooms by German patients and migrants" was carried out at first-aid stations of three Berlin hospitals in municipal districts with a high share of foreigners in the population in the form of standardized interviews on following topics: roads to have access to the emergency room, perception and interpretation of pain/troubles, expectations from the first-aid station, further medical care, chronical diseases, self-help measures, social data, migration aspects. An everyday life pressure because of headache and rheumatic pains was named significant more often by migrants of Turkish extraction than by the German women asked. In the age-group 50-65 years the migrants chose significant higher scale values to characterize their pain intensity. Migrants named all in all clearly more pain areas than German patients. The share of patients with pain persisting more than three days was 36.1 % in German women, 45.5 % in migrants of Turkish origin, 45.8 % in women of other ethnicity. Pain interpretation as well as pain expression are socio-culturally conditioned. Differences between migrants and native patients should lead to take more into consideration the concrete life situation and specific strain in the patients' treatment.