RESUMO
The organization of hospitals during an external or internal disaster frequently is defined in the required disaster plan. However, the organizational structure is not uniform. This article describes the incident management system (IMS) established for the organization of out-of-hospital disaster responses and suggests a similar system for use in disaster management within hospitals. Adoption of the Hospital Incident Management System (HIMS) not only would provide a powerful framework for all hospital emergency responses, but it also would provide a necessary link to outside agencies.
Assuntos
Planejamento em Desastres/organização & administração , Serviços Médicos de Emergência/organização & administração , Administração Hospitalar , Acreditação , Humanos , Joint Commission on Accreditation of Healthcare Organizations , Modelos Organizacionais , Estados UnidosRESUMO
The optimal extent of prehospital care, including intravenous (IV) therapy for critically ill patients, remains unclear. The authors evaluated the success rate for IV cannulation in a moving ambulance by trained emergency medical technicians and paramedics in 641 adult medical- and trauma-related cases. At least one IV line was started in 80% of medical patients and 92% of trauma patients, regardless of blood pressure. In hypotensive patients, the success rates for at least one IV in medical and trauma patients were 80% and 95%, respectively. These data suggest that IV lines can be secured with a high degree of success en route to the hospital by trained personnel, and that prompt transport of unstable patients should not be delayed solely to obtain IV access.
Assuntos
Pessoal Técnico de Saúde , Serviços Médicos de Emergência/normas , Auxiliares de Emergência , Adulto , Ambulâncias , Emergências , Estudos de Avaliação como Assunto , Humanos , Infusões Intravenosas , Pessoa de Meia-Idade , Transporte de Pacientes , Ferimentos e Lesões/terapiaRESUMO
The purpose of the study was to determine the effect of visual and auditory warning on visual reaction time with variations of subjects' alertness. An experimental group of 30 subjects was tested with an auditory or visual warning signal; foreperiods lasted 3, 2, and 4 sec. Reaction time was shorter as alertness improved and with an auditory warning signal. Comparable measures in a control group showed that visual reaction time was shorter when an auditory warning signal was used.
Assuntos
Anestesia Geral , Nível de Alerta/efeitos dos fármacos , Percepção Auditiva/efeitos dos fármacos , Enflurano , Isoflurano , Tempo de Reação/efeitos dos fármacos , Percepção Visual/efeitos dos fármacos , Adulto , Idoso , Atenção/efeitos dos fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigília/efeitos dos fármacosRESUMO
The reliability and validity of three psychomotor tests of recovery from anesthesia were evaluated. Rotary pursuit and pegboard tests were not reliable, but the Bender Gestalt Track Tracer was a reliable and valid measure of recovery from anesthesia. The interaction between the reliability and the validity of these tests is discussed along with their relationships to "street fitness" in a day-care surgery unit.
