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Out-of-hospital cardiac arrest is one of the leading causes of death in Mexico, but many survival and prognostic factors are unknown. The aim of this study was to assess out-of-hospital cardiac arrest in a Mexican city.
Methods:
This was a prospective, cohort study that evaluated the records of the major ambulance services in the city of Queretaro, Mexico. Means, standard deviation, and percentages for the categorical variables were obtained. Logistic regression was performed to determine the effects between interventions, times, and return of spontaneous circulation (ROSC).
Results:
For an 11-month period, 148 out-of-hospital cardiac arrest cases were recorded. The mean age of the victims was 54 ±22.6 years and 90 (65.3%) were males. Forty-nine cases were related to cardiac disease, 46 to other disease, 27 to trauma, 18 to terminal illnesses, and three to drowning. Twelve (8.6%) patients had a pulse upon hospital arrival, but none survived to discharge. No victims were defibrillated prior to ambulance arrival. The collapse-assessment interval was 22.5 ±19:1 minutes, the mean value for the ambulance response times was 13:6 ±10:4 minutes. Basic emergency medical technicians applied chest compressions to 40 victims (27.2%), controlled the airway in 32 (21.8%), and defibrillated seven (4.8%). Chest compressions and airway control showed an OR of 8 and 12 respectively for ROSC.
Conclusions:
The poor survival rate in this study emphasizes the need to improve efforts in provider training and public education. Authorities must promote actions to enhance prehospital emergency services capabilities, shorten response times, and provide community education to increase the chances of survival for out-of-hospital cardiac arrest victims in Mexico.
Iran is a country wim an area of 1,648,195 km2 with a population of >8,000,000 people. The devastating earthquake in the Bam District of Kerman Province struck on 26 December 2003 when the population was sleeping, and left a total of 29,878 dead and 22,628 injured. It had a magnitude of 7.4 on tbe Richter scale. The aim of this study was to determine the frequency of physical injuries.
Methods:
The data of 206 patients were collected from the medical records.
Results:
The majority of patients were in the 20–29 year age group. The female/male ratio was 1.51. The overall mortality rate was 2%. Most frequent injuries were lower extremity, pelvic, and spinal fractures respectively. Of the extremity fractures, 4.9% had open fractures, 95.1% had closed, and 19 patients underwent fasiotomy due to compartment syndrome. Of the pelvic fractures, 7.9% were unstable. Of the cases, 32% with vertebral fractures had spinal cord injuries. Other injuries were less frequent and included pneumothorax, hemothorax, abdominal viscous injuries, rib fracture, and head injuries.
Conclusions:
The main problems in the victims were orthopedic. Hospitals must prepare to treat these injuries.
Emergency medical services planners and providers consider the needs of many special populations (infants, elderly, disabled, etc.) during a disaster. However, the critical distinctions in gender-specific care, which are based not only on a woman's physiological makeup, but also within her psychosocial framework should be not overlooked. This research identifies key factors in female-specific care, including: (1) 12 risk factors that affect vulnerability, impact, and exposure; (2) post-traumatic stress disorder and pain; (3) triage and advocacy; and (4) supplies and services.
Methods:
More than 110 surveys were conducted among post-disaster females in the US and South Africa to obtain critical gender-disaggregated data in health services, aid, resources, and evacuations.
Results:
The results support the contention that many gender-sensitive services and supplies were needed in post-disaster care settings, but were inadequate or non-existent.
Conclusions:
Research indicates a pattern of gender differentiation in all areas of the disaster process—preparedness, response, impact, risk perception and exposure, recovery, and reconstruction. The research also issues and emphasizes interventions that could significantly reduce pain, suffering, and costs. These research conclusions indicate a dearth of gender-disaggregated data and the need for EMS planners and providers to take a more cognizant and proactive approach to gender-specific care in preparedness, triage, psychosocial needs assessment, aid, and advocacy.
Physicians practicing internationally provide comprehensive health care and often prepare with global health courses. These can be limited by timing and do not provide primary care training to sub-specialists. It is hypothesized that Oregon physicians are interested in global health education and want an accessible course that reviews skills used in international medicine.
Methods:
A survey-based needs assessment was conducted of licensed Oregon physicians that determined the level of interest in global health training. A total of 6,099 surveys were mailed to physicians in June 2007. The surveys included questions regarding demographics (age, gender, years of clinical practice, and practice specialty), international background (volunteer work, disaster relief), global health education interest (obtaining training, specialties desired), and course specifics (length, format, and cost).
Results:
A total of 624 surveys were returned for a 10.6% response rate. Of that group, 88.1% expressed interest in global health and 75.8% in a training course. Data analysis of this group showed that it consisted largely of physicians practicing for 15–34 years (mean = 23.8) and 45–64 years of age (mean = 55.8). Answers to course-specific questions indicated physician concerns about course time and educational interests based on differing clinical background.
Conclusions:
Oregon physicians are interested in international healthcare education. To meet this need, a global health course has been developed at the Oregon Health and Science University (OHSU).