State of play: clearing the thoracolumbar spine in blunt trauma victims.

INTRODUCTION: The present article reviews the clinical and imaging clearance of the thoracic and lumbar spines of blunt trauma victims and the evolution of these strategies with the use of new imaging technologies. METHODS: A comprehensive literature search was performed, and articles identified were critically appraised RESULTS: Twenty papers were identified, 12 directly comparing computed tomography screening with plain X-rays. Evidence-based protocols are presented. The evolution of imaging strategies in response to new technology is described. CONCLUSIONS: Thoracolumbar spine screening is best done using reformatted images acquired when scanning the chest and abdomen of high-risk multi-trauma patients. If computed tomography is not clinically indicated for investigation of other injuries then plain films are the first line investigation.

Burns assessment team as part of burn disaster response.

With a huge, climactically hostile catchment area, limited retrieval options and finite resources at the only adult burns unit in South Australia, this paper discusses the case for the establishment and maintenance of a Burns Assessment Team in South Australia. The composition and role of the team and its relationship with other retrieval services, the primary care unit, and the proposed National Burn Coordinator also are discussed.

Team Echo: observations and lessons learned in the recovery phase of the 2004 Asian tsunami.

The 26 December 2004 Tsunami resulted in a death toll of >270,000 persons, making it the most lethal tsunami in recorded history. This article presents performance data observations and the lessons learned by a civilian team dispatched by the Australian government to "provide clinical and surgical functions and to make public health assessments". The team, prepared and equipped for deployment four days after the event, arrived at its destination 13 days after the Tsunami. Aspiration pneumonia, tetanus, and extensive soft tissue wounds of the lower extremities were the prominent injuries encountered. Surgical techniques had to be adapted to work in the austere environment. The lessons learned included: (1) the importance of team member selection; (2) strategies for self-sufficiency; (3) personnel readiness and health considerations; (4) face-to-face handover; (5) coordination and liaison; (6) the characteristics of injuries; (7) the importance of protocols for patient discharge and hospital staffing; and (8) requirements for interpreter services. Whereas disaster medical relief teams will be required in the future, the composition and equipment needs will differ according to the nature of the disaster. National teams should be on standby for international response.

Team Echo: Observations and Lessons Learned in the Recovery Phase of the 2004 Asian Tsunami.

The 26 December 2004 Tsunami resulted in a death toll of >270,000 persons, making it the most lethal tsunami in recorded history. This article presents performance data observations and the lessons learned by a civilian team dispatched by the Australian government to "provide clinical and surgical functions and to make public health assessments". The team, prepared and equipped for deployment four days after the event, arrived at its destination 13 days after the Tsunami. Aspiration pneumonia, tetanus, and extensive soft tissue wounds of the lower extremities were the prominent injuries encountered. Surgical techniques had to be adapted to work in the austere environment. The lessons learned included: (1) the importance of team member selection; (2) strategies for self-sufficiency; (3) personnel readiness and health considerations; (4) race-to-face handover; (5) coordination and liaison; (6) the characteristics of injuries; (7) the importance of protocols for patient discharge and hospital staffing; and (8) requirements for interpreter services. Whereas disaster medical relief teams will be required in the future, the composition and equipment needs will differ according to the nature of the disaster. National teams should be on standby for international response.