ABSTRACT
Most extreme heat studies relate outdoor weather conditions to human morbidity and mortality. In developed nations, individuals spend ~90% of their time indoors. This pilot study investigated the indoor environments of people receiving emergency medical care in New York City, NY, U.S., from July to August 2013. The first objective was to determine the relative influence of outdoor conditions as well as patient characteristics and neighborhood sociodemographics on indoor temperature and specific humidity (N = 764). The second objective was to determine whether cardiovascular or respiratory cases experience hotter and more humid indoor conditions as compared to controls. Paramedics carried portable sensors into buildings where patients received care to passively monitor indoor temperature and humidity. The case-control study compared 338 respiratory cases, 291 cardiovascular cases, and 471 controls. Intuitively, warmer and sunnier outdoor conditions increased indoor temperatures. Older patients who received emergency care tended to occupy warmer buildings. Indoor-specific humidity levels quickly adjusted to outdoor conditions. Indoor heat and humidity exposure above a 26 °C threshold increased (OR: 1.63, 95% CI: 0.98-2.68, P = 0.056), but not significantly, the proportion of respiratory cases. Indoor heat exposures were similar between cardiovascular cases and controls.
Subject(s)
Air Pollution, Indoor/adverse effects , Cardiovascular Diseases/etiology , Environmental Exposure/adverse effects , Hot Temperature/adverse effects , Respiratory Distress Syndrome/etiology , Seasons , Adult , Case-Control Studies , Emergency Medical Services/statistics & numerical data , Female , Housing , Humans , Humidity/adverse effects , Male , Middle Aged , New York City , Pilot Projects , WeatherSubject(s)
Emergency Treatment , Stroke/therapy , Aged , Humans , Male , Stroke/complications , Stroke/physiopathology , United StatesABSTRACT
This past August the American Heart Association (AHA) released a major revision of its recommendations for emergency cardiovascular care (ECC). The 2000 guidelines simplify CPR techniques for the layperson and strongly promote the use of community early defibrillation. What repercussions can we expect from these changes? We asked five experts to join a roundtable discussion of the BLS aspects of these new guidelines. Their conversation follows.
Subject(s)
Cardiopulmonary Resuscitation/standards , Emergency Treatment/standards , Guidelines as Topic , Electric Countershock , Emergency Treatment/methods , Humans , United StatesSubject(s)
Chest Pain/diagnosis , Emergency Medical Services , Emergency Treatment , Adult , Humans , Male , Physical Examination , Triage , United StatesABSTRACT
Ciguatera fish poisoning has been responsible for as many as half of all food poisonings in the United States due to fish. Because the initial symptoms often include gastrointestinal symptoms, such as nausea, vomiting, diarrhea, and abdominal pain, patients may be discharged from the Emergency Department with a diagnosis of "acute gastroenteritis," only to return soon thereafter. This is a case report of such a patient who was evaluated and discharged only to subsequently return because of worsening of symptoms.
Subject(s)
Ciguatera Poisoning , Foodborne Diseases/etiology , Acute Disease , Adult , Animals , Fishes , Gastroenteritis/diagnosis , Gastroenteritis/etiology , Humans , MaleABSTRACT
OBJECTIVE: To determine the utility of air medical transport in a large urban environment. METHODS: The authors conducted a retrospective analysis of all air medical transports of patients in the Fire Department of the City of New York EMS (emergency medical services) Command for the period of January 1, 1996, to December 31, 1999. These data were evaluated for frequency of air medical transport, patient condition at time of flight, and necessity of air evacuation. RESULTS: During the study period, some form of air medical transport was used 182 times. Of this number, 32 were for transports of patients from a scene of an incident to a hospital within New York City; 18 for interfacility transport of patients from a hospital facility within New York City to another facility within New York City; 122 for interfacility transfers of patients from medical facilities outside of the New York City area to a facility in New York City; and ten for transport of patients from New York City medical facilities to facilities out of the area. CONCLUSION: The Fire Department of the City of New York EMS Command utilizes air medical evacuation for patient transports very infrequently. The parameters of New York City's large urban environment may not be conducive to air medical transport. These data seem to be consistent with experiences of other large urban cities.
Subject(s)
Air Ambulances/statistics & numerical data , Transportation of Patients/statistics & numerical data , Urban Health Services/statistics & numerical data , Utilization Review , Accidents, Aviation/statistics & numerical data , Air Ambulances/organization & administration , Catchment Area, Health , Guidelines as Topic , Humans , New York City/epidemiology , Outcome Assessment, Health Care , Patient Transfer/statistics & numerical data , Retrospective Studies , SafetySubject(s)
Ciguatera Poisoning , Emergency Treatment , Food Contamination/analysis , Food Microbiology , Adult , Enterobacteriaceae , Humans , Male , Quality ControlSubject(s)
Emergency Medicine , Physician-Patient Relations , Adult , Female , Humans , Stereotyping , Substance Abuse, IntravenousABSTRACT
The authors have measured the power and endurable grip strength by five times repetition at five second intervals on post-office clerks (indoor service and outdoor service) and the personnel of harbor construction office (office workers and crew of dredger). The results are as follows: 1) Grip strength (power: higher value either at the first or the second grip) has negative correlation with age. 2) Endurable grip strength (endurance: subtract lower value either at the fourth or fifth grip from the grip strength) of the indoor mail clerks and office workers has no correlation with age, but that of the others (the outdoor service and crew of dredger) has negative correlation with age.
