Imaging phase-separated domains in conducting polymer blend films with near-field scanning optical microscopy.

We present high-resolution images with near-field scanning optical microscopy to study phase separation in polymer films of poly(styrene) and poly(3-octyl-thiophene). Transmission and transmitted fluorescence near-field scanning optical microscope images were taken for direct visualization of the intermediate steps of phase separation in a regime where small domain sizes prevent investigation by conventional microscopy. The interpretation of near-field data on samples with large or varying film thickness or topography are also discussed, and a method for recognizing topographically induced artifacts in a quantitative way is suggested.

Recurrent themes in ambulance critique review sessions over eight years.

For 8 years biweekly ambulance critique review sessions have evaluated performance and discussed management of cases brought to our hospital by ambulance. Over 500 cases reviewed have centered primarily on evaluation and care at the scene and its possible relation to outcome. Problems which have recurred on the scene include whether the patient would have benefited from less time in stabilization and immobilization; manipulation of deformed fractures for splinting; use of tourniquets; techniques of airway maintenance; and management of infrequently seen problems such as hypothermia and drowning. Interaction problems with physicians on the scene and in the Emergency Room (ER) come from questioning physician authority even without specific knowledge of the appropriate techniques of emergency care. A related problem is lack of ER staff familiarity with Emergency Medical Technician (EMT) procedures and ambulance equipment. The value of critique review sessions has been seen in improved rapport and interaction among ER staff and ambulance personnel. Improved outcome needs to be assessed in a carefully controlled study. The enthusiasm and attendance of ER staff and ambulance personnel has grown and endured over 8 years. The review sessions have spread to other area hospitals with some success.

Emergency medical transportation. A survey of California ambulance operations.

The most urgent recommendation expressed by physicians, Red Cross officials, ambulance operators and others polled in this ambulance survey was to make much more emergency medical care training available to ambulance personnel. Very few sick and injured receive first aid before an ambulance arrives. Therefore there is also an urgent need to train and motivate the public to provide first aid at the scene of the emergency. Urban ambulances usually respond within 10 minutes, but often rural ambulances take more than 30 minutes to reach an emergency. It is during this interim that lives which could be saved by prompt first aid are lost. Little use has been made of aircraft as emergency ambulances; in 1968, only one emergency trip in 1500 was made by helicopter. Also, California has fewer ambulances which make fewer emergency trips on a population basis than the country at large. Communications at all levels need attention. Seventy-eight percent of the ambulance operations serving the public are not listed among the emergency numbers on the inside front page of telephone directories. Less than ten percent of ambulances have direct radio communication with hospitals. In California most ambulance services are commercially operated and there are formidable financial problems which must be solved before these services can be brought into place as a part of the emergency medical care system.