Report on the Feasibility of Establishing a National Research and Information Center for Emergency and Disaster Medical Services (1967) / Chapter Skim
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Pages 43-63
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From page 43... ...
to record a higher emergency department census than admission rate (101) Although intramural emergencies and deaths, which necessitate immediate procedures and management, are frequently discussed by professional staff committees or during conferences, they are not coordinated for hospital emergency services or for the benefit of all specialties.
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From page 45... ...
Surprisingly, no concepts have vacillated more than those of wound care and treatment as related to trauma (83,111) .Insufficient attention has been directed toward debridement and closure (debridement with closure, debridement without closure)
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ee ee ee = eS
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From page 47... ...
Unfortunately, however, the hospital has not been recognized by community authorities as the focal point of a coordinated emergency medical service. Most communities are unaware that the hospital has the capability of actually supervising one of the major aspects of catastrophe.
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From page 49... ...
emergency communication system utilized by police departments, fire departments, departments of parks, taxi companies, construction companies, and the like. Most are still handled by telephone and controlling bodies have resisted the establishment of medical communication, except that intended solely for use in a national disaster.
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From page 51... ...
for paging the individual directly, such as "Bell Boy," 'Multitone," and "Walkie-Talkies." The direct dialing system has also developed a problem for small communi- ties, because the "town operator'' who previously gave advice and communi- cation assistance has been replaced by a central or regional operator in a large city or town that may be 100 or more miles away. Ambulance-type vehicles that are radio-equipped usually are dual-purpose units that belong to city governments and are related more to the nonmedi- cal aspects of daily emergencies.- Commercial ambulances with inter- vehicular communication and dispatching centers with radio systems utilize their equipment to carry on the business of dispatching and not to facili- tate emergency services (Appendix B)
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From page 53... ...
If it is considered that adequate equipment is available, enough radio- frequencies should be reserved, and existing regulations altered if insuf- ficient to ensure coordination of two-way communication between hospitals, ambulances, and the sites of disasters. The medical profession could well develop a formula for its needs, and request industry and government to provide the equipment and means to install local facilities with appropriate provisions to coordinate each with regional, state, and national facilities in order to cope with disasters of any magnitude.
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ciation published a guide for industry to develop disaster medical serv- ices (69)
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Adequate identification of emergency facilities has never been more important. The upsurge of patients who utilize the emergency depart- ments of general hospitals has been fully documented in recent years.
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wheel of the automobile, or even due to mechanical failure of the vehicle? " "Does the alcohol level of an injured person have a significant effect on the ultimate results of treatment?
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current research in trauma and documentation of contemporary emergency medical services must evolve. The Task Force, however, feels it is also within its franchise to suggest and recommend areas of investigation which are necessarily broad in char- acter but directly pertinent to the intent of the center, i.e., to improve emergency medicine.
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From page 63... ...
More attention is being paid to the clinical management of hypovolemic shock, with consideration of new plasma expanders (e.g., hydroxyethyl starch) and the treatment of metabolic acidosis with THAM and low-molecular- weight dextran.
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