Emergency medical planning for the 2000 Republican National Convention.

Planning for emergency medical services (EMS) coverage for the 2000 Republican National Convention in Philadelphia was a complex process that involved the cooperation of municipal, state, and federal agencies as well as local hospitals. The medical needs of the delegates, members of the media, and support personnel at the convention venue had to be met. Contingency plans for the possibility of large, organized political protests and associated injuries had to be developed. Steps had to be taken to ensure the safety of emergency personnel who may have to respond to such incidents. Because of the heightened threat of terrorist attacks on civilian populations in recent years, specialized training and material to respond to such incidents were required. The important role that local hospitals may play in providing care to victims of a large, multicasualty incident, especially one involving weapons of mass destruction, was recognized. Therefore, steps were taken to increase the awareness of hospital staff to patient decontamination and isolation techniques as well as specific therapies for the chemical, biological, and radioactive agents that terrorists might use. Finally, despite the focus placed on the convention, the day-to-day emergency medical needs of the citizens of Philadelphia had to be met. Through careful planning, flexibility, and cooperation, it was possible to successfully address all of these issues.

Assessment of breath sounds during ambulance transport.

STUDY OBJECTIVE: To determine whether the environment of a moving ambulance affects the ability of our-of-hospital care providers to auscultate breath sounds. METHODS: Out-of-hospital care providers assessed breath sounds with a previously described breath-sounds model in a quiet environment (control) and in a moving ambulance. The setting was a nonurban emergency medical services system and an interhospital transport agency based at a 600-plus-bed tertiary care center. The participants were physicians, transport nurses, and advanced life support EMS providers routinely involved in the emergency out-of-hospital treatment and transportation of the ill and injured. The accuracy with which participants identified the presence or absence of breath sounds in the two environments was compared with the use of the chi 2 test, with the alpha-value set at .05. RESULTS: The accuracy of breath-sounds assessment in the control environment was 96% (251 of 260); the sensitivity was 96% and the specificity 97%. The accuracy of breath-sounds assessment in the experimental environment was 54% (140 of 260); the sensitivity was .09% and the specificity 98%. Participants were significantly less likely to hear breath sounds in the moving ambulance than in the quiet room (P < .001). CONCLUSION: Assessment of breath sounds is hampered by the environment of a moving ambulance.

Computerized digital photography in auditory research: a comparison of publication-quality digital printers with traditional darkroom methods.

Digital photography is the rapidly developing field of computer processing of images generated either directly from a digital camera or from scanned conventional film. Subsequent photographs output from digital color printers are publication-quality and superior to conventional darkroom prints because of greater image control (exposure, contrast, color correction). Because final print quality is the most critical factor in the research application of digital photography, we evaluated the photographic output of several continuous-tone digital printers. Digital images from selected microscopic sections of the middle and inner ear were generated by scanning black and white film and Ektachrome color transparencies and sent to commercial representatives for printing. Photographs from some printers were as good or better than traditional darkroom prints of the same film when evaluated for resolution, image quality, and costs. It is our hope that the hearing research field will benefit enormously by adoption of chemical-free digital photography because of its quality, convenience, speed, and low cost.