Medical relief for the 2011 Japan earthquake: a nursing account.

In 2011 the east coast of Japan experienced a massive earthquake which triggered a devastating tsunami destroying many towns and killing over 15 000 people. The work presented in this paper is a personal account that outlines the relief efforts of the Humanitarian Medical Assistance team and describes the efforts to provide medical assistance to evacuees. The towns most affected had a large proportion of older people who were more likely to have chronic conditions and required medication to sustain their health. Since personal property was destroyed in the tsunami many older people were left without medication and also did not remember which type of medication they were taking. Some evacuees had brought a list of their medication with them, this assisted relief teams in obtaining the required medication for these people. The more successful evacuation centers had small numbers of evacuees who were given tasks to administer the center that kept them occupied and active.

Medical treatment at Louis Armstrong New Orleans International Airport after hurricane Katrina: the experience of disaster medical assistance teams WA-1 and OR-2.

In the week following Hurricane Katrina, over 3000 patients were evacuated by air from a triage and medical treatment station at the Louis Armstrong New Orleans International Airport. This represents the largest air evacuation in history. Over 24,000 additional evacuees were transported from the airport to shelters. Disaster Medical Assistance Teams (DMATs) from several US states were deployed to the Louis Armstrong New Orleans International Airport to provide medical care to those evacuated from New Orleans. Despite warning from the US National Weather Service of catastrophic damage to New Orleans, adequate medical staffing was not attained at the airport triage station until 6 days after the hurricane struck. Organizational lapses, including inadequate medical and operational planning, understaffing of medical personnel, and failure to utilize Incident Command System, diminished the effectiveness of the Hurricane Katrina New Orleans Medical Operation.

Using a novel technology for disaster staff notification.

Notification of backup staff and determining their ability to augment frontline staff is a major component of any disaster plan. However, the communication and organization of this effort has many challenges. These include communication system overload, the disaster setting, disrupted transportation, and staffing impacts on normal operations. An optimal disaster notification system must have the ability to be modified to include all hazards and the unique environment in which the plan is being made. This article highlights a unique disaster staff notification system using a novel technology, an outside administrator, and a multilayer system of redundant communication.

Communication with emergency medical services providers.

Communication between the emergency medical services provider and the emergency physician can be either a rewarding or a frustrating experience. As many emergency physicians have found to their chagrin, the EMS provider has a memory for mistakes or bad tidings. This article discusses the relationship between EMS providers and emergency physicians.

EMS communications: an inside look at New York City.

The opportunity to provide effective EMS begins at the point of citizen access, with successive links to emergency response and medical control. This responsibility places much pressure on the communications division of any EMS system. Communications specialists must be acutely aware that each flashing number on the computer screen represents someone in trouble--a person's life. This unique situation is highlighted when, through emergency medical instructions given over the phone to the caller, a life is saved. This type of event has become more common throughout the United States, with most EMS systems implementing proactive protocols for pre-arrival instructions. The strength of an EMS system directly correlates with the effectiveness of its communications center and the professionalism of communications personnel. Unlike other individuals in the EMS system, communications specialists rarely see their patients "in the flesh" and must experience the rewards of accomplishment vicariously through the actions of the crews dispatched. In the same vein, they also share the tragedies and disappointments that are all too often part of an EMS career.

Emergency medical services in Connecticut.

This article describes emergency medical services (EMS) systems in Connecticut, beginning with a historical perspective. The discussion of statewide oversight of the EMS system includes legislative and regulatory mandates as well as recent external reviews of the system. Medical oversight of EMS care and services is provided by sponsor hospitals rather than individual medical directors. Most of the 169 cities and towns in the State maintain or contract for local EMS, and have traditionally resisted regionalization. This snapshot of the EMS system in Connecticut can serve as a reference for comparison of EMS systems in other jurisdictions.

Effect of a comprehensive quality management process on compliance with protocol in an emergency medical dispatch center.

STUDY OBJECTIVE: Modern emergency medical dispatch provides appropriate resource responses with the use of an emergency medical dispatch priority reference system (EMDPRS). The EMDPRS is a systematic protocol for all aspects of the dispatch process, including interrogating the caller, matching responses with severity, and providing pre-arrival care. We tested the hypothesis that appropriate performance feedback would increase dispatcher compliance with the protocol. METHODS: We examined how emergency medical dispatchers complied with the protocols contained in the Advanced Medical Priority Dispatch System, a commercially available EMDPRS. Six key areas and overall compliance were studied. Dispatchers performed for 2 months without feedback and for a further 2 months with performance feedback. We used statistical methods to compare the dispatchers' compliance with the protocols each month. RESULTS: The mean overall compliance score improved from 76.4%+/-10.2% (mean+/-SD) in the absence of performance feedback to 96.2%+/-4.0% (n=217; P <.001) when performance feedback was provided. Five of 6 key areas showed similar improvements. CONCLUSION: Providing emergency medical dispatchers with regular and objective feedback regarding their performance dramatically improves how rigorously they follow a systematized dispatch protocol.