Last updated 10th July 2024: Online ordering is currently unavailable due to technical issues. We apologise for any delays responding to customers while we resolve this. For further updates please visit our website https://www.cambridge.org/news-and-insights/technical-incident
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
This journal utilises an Online Peer Review Service (OPRS) for submissions. By clicking "Continue" you will be taken to our partner site
https://mc.manuscriptcentral.com/pdm.
Please be aware that your Cambridge account is not valid for this OPRS and registration is required. We strongly advise you to read all "Author instructions" in the "Journal information" area prior to submitting.
To save this undefined to your undefined account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your undefined account.
Find out more about saving content to .
To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Scuba diving has become a popular sport resulting in an increased incidence of diving accidents. A survey done by the United States Navy from 1955 to 1960 revealed that decompression sickness (D.C.S.) is the most common serious complication experienced by scuba divers and the third most likely cause of death. The major cause is drowning and the second is arterial gas embolism from pulmonary barotrauma.
D.C.S. has been classified into two groups. Type I includes the less severe forms with bubbles in the skin (“itches”), joints and other tissues. Type II includes the serious conditions with neurological involvement “staggers.” A detailed knowledge of D.C.S., commonly known as “the bends,” is essential to both divers and emergency personnel in order to minimize the morbidity and mortality associated with this condition.
A case of Type II bends with spinal cord damage is presented and the condition discussed.
The traditional hospital disaster plan is complex and inefficient. Implementation during an actual or perceived crisis usually results in the mobilization of the entire hospital staff and multiple medical resources. This “all or none” phenomenon is costly in terms of manpower and supplies. Furthermore, there is protracted disruption of normal hospital services during disaster plan activation for training or real emergencies.
Disaster relief and the spirit of volunteerism have been inextricably interwoven with the design and development of Red Cross societies around the world. The American Red Cross is one of 131 members of an international federation of national Red Cross and Red Crescent societies, the League of Red Cross Societies. Societies are chartered by their own governments and conduct programs in the fields of health, welfare, and safety in accordance with each nation's needs.
In spite of the current interest in intraoperative reinfusion and the acknowledged benefits of the autologous versus homologous transfusions, this approach towards blood conservation and minimizing the risks inherent to blood transfusions (Table I) has not received the recognition which it properly deserves. Reluctance by surgeons to use this technique is undoubtedly due to the confusion which still exists in the literature regarding the possibility of complications in using this procedure. Widely divergent hematological abnormalities in the form of various coagulopathies and hypofibrinogenemia still appear in medical communications.
Activity in nociceptive nerve fibers does not only trigger the sensation of pain but it also starts a variety of nocifensive reflexes to protect the organism from the noxious agent. Some of these reflexes may, if active long enough, be harmful themselves, causing ischemia in visceral organs or other inadvertent reactions. Recently, several endogenous mechanisms have been discovered that can inhibit the transmission of nerve impulses from nociceptive afferents to other nerve cells, thus not only preventing the pain sensation but also modulating the nocifensive reflex responses. Several such mechanisms may involve the release of endorphins. These are small peptides, with opiate-like activity that were first discovered in 1975 by Hughes and Kosterlitz in Great Britain and by Terenius in Sweden. The distribution of such endorphins in the central nervous system was first investigated by Hökfelt and his coworkers. They found terminals and cell bodies containing endorphins in several areas of interest from the point of view of nociception. Thus the dorsal horn of the spinal cord, the corresponding area of the fifth cranial nerve and the periaqueductal gray matter contained such material.
The arrangements for dealing with Major Accidents in the United Kingdom are set out in the Health Circular (HC(77)1) which places the onus for planning on Health Districts—each district serving a population of no greater than 200,000. The Metropolitan Area of West Yorkshire, served by the West Yorkshire Metropolitan Ambulance Service, the West Yorkshire Metropolitan Police and the West Yorkshire Fire Service, takes in nine such districts and covers an area of 794,000 square miles and a population of just over two million. West Yorkshire is traversed by two motorways and a major trunk road.
The increasing popularity of scuba diving as a sport necessitates that emergency personnel become familiar with medical diving problems. It is important to understand that pulmonary barotrauma can be sustained with an uncontrolled ascent of little more than 1 meter. This can occur under any circumstance in which compressed air is breathed under water. The most common is scuba diving or submarine escape training, but it may also be encountered when a person escapes from a submerged car or a child surfaces after breathing from an inverted bucket in a swimming pool. Two cases of pulmonary barotrauma are reported and the spectrum of presentation of this condition is discussed.
Knowledge of this condition increases clinical awareness resulting in early diagnosis and effective treatment. It will be shown that it is better to over treat this condition, as the side effects of treatment are minimal and the results of failure to treat can be disastrous.
Triage is the process of classifying injured patients according to a predetermined hierarchy. Triage typically involves the urgency prioritization of trauma patients in mass casualty circumstances. The triage process is also used daily in Emergency Medical Systems that incorporate trauma care systems to identify how severely a patient is injured and to channel the patient into the appropriate treatment echelon, i.e., to determine a threshold level of severity that merits a specific level of care.
Important modifications in ambulance design were suggested and introduced by Safar in 1965 and in 1971. However, most of these modifications have not reached the developing countries. The present “ambulance” in these countries are low ceiling and carry no equipment or trained personnel. They could be better defined as “taxis for horizontal transportation.” Recently, we have been able to introduce onto the market of these countries, a new ambulance that is competitive in price and adapted to the availability of materials, equipment, and personnel.