Light horse field ambulance
A light horse field ambulance was an Australian World War I military unit whose purpose was to provide medical transport and aid to the wounded and sick soldiers of an Australian Light Horse brigade. A Lieutenant Colonel commanded each ambulance. All officers of the ambulance were medical surgeons. Dental units were attached to the ambulance as well. An ambulance consisted of the Mobile and the Immobile; the Mobile Section travel with its brigade into combat. It use carts to retrieve the wounded and transport them to the Dressing Station; the Immobile Section established and operated a Receiving Station, which received the wounded the Dressing Station sent on. The ambulance's surgeons would operate on the wounded at the Receiving Station. From the Receiving Station, the sick and wounded would go first to the Casualty Clearing Station and to a Base Hospital; the light horse field ambulances operated in the Middle East theatre: Egypt, the Sinai peninsula and Syria. The methods used to transport the wounded had to operate in the sandy, dusty environment.
Stretcher As in infantry field ambulances, stretchers were used for transport over short distances, rough terrain or when enemy fire prevented the safe employment of bearer animals. Cycle stretcher These were ineffective. Sand cart, it was designed be able to carry three stretchers over soft sand. Six horses or mules provided the motive power; the sand cart was poorly suited to operating on the hard, rough ground of Palestine and Syria, breakdowns were frequent. Sand sledge Used to transport one stretcher case over sand. Light ambulance wagon Drawn by a four horse team, the light ambulance wagon was designed by Surgeon Colonel W. D. C. Williams. Wagons of this type were taken to Egypt by some of the field ambulance units during the early days of World War I. Camel cacolet The camel cacolet was used to carry wounded over long distances on rough terrain impassable to wheeled transport. There were two types of cacolet: the lying down type. One camel would carry one on either side of the camel's hump. Military unit Field hospital Australian Army Medical Units, World War I
Motorcycle ambulance
Motorcycle ambulances are a type of emergency vehicle which either carries a solo paramedic or first responder to a patient. Because of its size and performance, a motorcycle ambulance is able to respond to a medical emergency much faster than a car, van, or fire truck in heavy traffic, which can increase survival rates for patients suffering cardiac arrest. Motorcycle ambulances were used during World War I by the British and Americans. At the time the advantages of light weight and mobility over larger vehicles was cited as the motive for the use of sidecar rigs in this role; the US version had two stretchers arranged one on top of the other. The French ambulance used a sidecar that held a single patient, who could either sit up; the British Red Cross Society used an 8 bhp NUT motorcycle with a double decker sidecar like the US version. During testing it needed only a 9 ft turning area, versus 35 ft for a motor car ambulance, had a lower fuel consumption of 55–65 mpg‑US, compared with 12–17 mpg‑US for car ambulances.
Due to lighter weight they were said to be less to get stuck and could be pushed out more than a large vehicle. Sidecar ambulances were used in Redondo Beach, California in 1915, stationed at a bath house at a beach resort to reach drowning victims quickly. Prior to using the motorcycle, life guards had to run or row up to several miles along the beach to respond to calls; the Knightsbridge Animal Hospital and Institute, was using a sidecar ambulance to transport dogs in 1912, this mode was still in use in 1937 by the Maryland Humane Society. In 1993 the Ambulance Service of New South Wales was the first ambulance service in Australia to introduce "Motorcycle Rapid Response Team" crewed with an Intensive care or Mobile intensive care ambulance paramedic. Two BMW K100RT motorcycles were borrowed from the New South Wales Police Force Highway Patrol with riders undertaking the police motorcycle course. At present there are two motorcycle rapid response crews covering the Sydney CBD at any one time utilising Yamaha FJR1300 motorcycles.
With Sydney's narrow streets, the Sydney Harbour Bridge, numerous parklands, areas difficult to access in a conventional ambulance the "rapid responder" motorcycles are able to arrive on scene and begin critical treatment of patients several minutes before the arrival of a conventional ambulance whilst still carrying all the essential equipment of an ambulance. It takes an average six minutes for a motorcycle rapid response paramedic to reach an emergency situation in the CBD, compared to 12 minutes for ambulances proving an invaluable resource. At present there are two motorcycle rapid response crews covering the Sydney CBD at any one time. In 2012 Ambulance Victoria introduced the'Motorcycle Paramedic Unit' equipped with six motorcycle paramedics for rapid response to emergencies. Different types of motorcycles have been trialed including the initial roll out of Piaggio 500cc which has now been replaced with the BMW F700GS; the unit operates during peak traffic and during major events and festivals, within Melbourne's inner metro area.
In South Australia, there are paramedics who ride on a motorcycle. Since 2000, the São Paulo Fire Department has operated Honda motorcycle ambulances in a first responder role, to offset the influence of traffic on the response times of traditional ambulances; the motorcycles carry a variety of emergency care equipment and are always deployed in two-man teams, with the lead vehicle carrying a first aid kit and intravenous fluids and the rear vehicle carrying more advanced equipment, including an automated external defibrillator, suction devices, emergency delivery kits. Fire departments in other states, such as Minas Gerais, Mato Grosso do Sul and Pernambuco, have adopted motorcycle ambulances since 2008. In August 2008, SAMU, the federal emergency medical services, purchased 400 motorcycle ambulances to be deployed nationwide between December 2008 and 2009; the Bavarian Red Cross has operated motorcycle ambulances since 1983. As of 2011 they report a fleet of 100 volunteer paramedics. According to the book Rescue Mission, written by an Emergency Medical Assistant of Hong Kong Fire Services Department, the H.
K. F. S. D. Established the first motorcycle programme in 1982. At first, there are only two motorcycles stationed in Morrison Hill Ambulance Depot. In 1986, the H. K. F. S. D. Found that motorcycles are useful for responding to medical calls, so they bought seven more motorcycles in 1987. In 1989, the motorcycle team stationed in several ambulance depots. Today, the H. K. F. S. D. has 35 motorcycles. Auxiliary Medical Service, another government-owned service has motorcycles. Motorbike ambulance launched in Bengaluru India on April 16, 2015. Volunteer ambulance operator Karimul Haque received the Padma Shri award in 2017. Ambulances on a motorcycle platform have been launched in multiple other states of India such as Chhattisgarh and Haryana; these ambulances have provided emergency health services from ferrying pregnant women to a Primary Health Center to attending to First Aid in case of accidents. Israel makes extensive use of ambucycles through both Magen David Adom and particularity United Hatzalah. In some areas of Japan, Japanese fire departments use off-road motorcycles as emergency vehicles.
They are useful for negotiating the small streets and heavy traffic in the large urban areas o
Aviation medicine
Aviation medicine called flight medicine or aerospace medicine, is a preventive or occupational medicine in which the patients/subjects are pilots, aircrews, or astronauts. The specialty strives to treat or prevent conditions to which aircrews are susceptible, applies medical knowledge to the human factors in aviation and is thus a critical component of aviation safety. A military practitioner of aviation medicine may be called a flight surgeon and a civilian practitioner is an aviation medical examiner. One of the biggest differences between the military and civilian flight doctors is the military flight surgeon's requirement to log flight hours. Broadly defined, this subdiscipline endeavors to discover and prevent various adverse physiological responses to hostile biologic and physical stresses encountered in the aerospace environment. Problems range from life support measures for astronauts to recognizing an ear block in an infant traveling on an airliner with elevated cabin pressure altitude.
Aeromedical certification of pilots and patients is part of Aviation Medicine. A final subdivision is the AeroMedical Transportation Specialty; these military and civilian specialists are concerned with protecting aircrew and patients who are transported by AirEvac aircraft. Atmospheric physics affect all air travelers regardless of the aircraft; as humans ascend through the first 9100–12,300 m, temperature decreases linearly at an average rate of 2 °C per 305 m. If sea-level temperature is 16 °C, the outside air temperature is −57 °C at 10,700 m. Pressure and humidity decline, aircrew are exposed to radiation and acceleration forces. Aircraft life support systems such as oxygen and pressurization are the first line of defense against most of the hostile aerospace environment. Higher performance aircraft provide more sophisticated life support equipment, such as "G-suits" to help the body resist the adverse effects of acceleration, along with pressure breathing apparatus, or ejection seats or other escape equipment.
Every factor contributing to a safe flight has a failure rate. The crew of an aircraft is no different. Aviation medicine aims to keep this rate in the humans involved equal to or below a specified risk level; this standard of risk is applied to airframe and systems associated with flights. AeroMedical examinations aim at screening for elevation in risk of sudden incapacitation, such as a tendency towards myocardial infarction, epilepsy or the presence of metabolic conditions diabetes, etc. which may lead to hazardous condition at altitude. The goal of the AeroMedical Examination is to protect the life and health of pilots and passengers by making reasonable medical assurance that an individual is fit to fly. Other screened conditions such as colour blindness can prevent a person from flying because of an inability to perform a function, necessary. In this case to tell green from red; these specialized medical exams consist of physical examinations performed by an Aviation Medical Examiner or a military Flight Surgeon, doctors trained to screen potential aircrew for identifiable medical conditions that could lead to problems while performing airborne duties.
In addition, this unique population of aircrews is a high-risk group for several diseases and harmful conditions due to irregular work shifts with irregular sleeping and irregular meals and work-related stress. Zadik, Y. Retrieved 2008-07-15. Zadik, Y. "Barodontalgia Due to Odontogenic Inflammation in the Jawbone". Retrieved 2008-07-15. Zadik, Y. "Dental Fractures on Acute Exposure to High Altitude". Retrieved 2008-07-15. Aeromedics - medical retrieval specialists Aerospace Medical Association Civil Aerospace Medical Institute Directory of US AMEs designated to perform FAA Aeromedical Examinations for pilots and aircrew Aviation Medicine from the Aviation Medicine Unit at the Department of Medicine, Wellington School of Medicine and Health Sciences, University of Otago, New Zealand. Aerospace Medicine Article from Emedicine Aviation Medicine International Inc. Canadian Civil Aviation Medicine Medicina Aeroespacial Colombia Royal New Zealand Air Force Aviation Medicine Unit
Certified first responder
For the more current term, see Emergency medical responder A certified first responder is a person who has completed a course and received certification in providing pre-hospital care for medical emergencies. Certified individuals should have received much more instruction than someone, trained in basic first aid and cardiopulmonary resuscitation but they are not a substitute for more advanced emergency medical care rendered by emergency medical technicians and paramedics. First responders provide advanced first aid level care, CPR, automated external defibrillator usage; the term "certified first responder" is not to be confused with "first responder", a generic term referring to the first medically trained responder to arrive on scene and medically trained telecommunication operators who provide pre-arrival medical instructions as trained Emergency Medical Dispatchers. Many police officers and firefighters are required to receive training as certified first responders. Advanced medical care is provided by EMS, although some police officers and firefighters train to become emergency medical technicians or paramedics.
See "Emergency Medical Responder" Many options are available in order to become a certified First Responder in Canada. Courses are offered by many sources including the Canadian Red Cross, St. John Ambulance, the Department of National Defence. Certified First Responder courses in Canada are separated into either "First Responder" or "Emergency Medical Responder" level courses. "First Responder" level courses are between 40 and 60 hours in length and is considered the minimum level of training for crews providing medical standby at events, as well as for employment with some private stable transport companies that provide inter-hospital transfer for patients in need of a bed, but are stable and do not require advanced medical care. "Emergency Medical Responder" level courses meet the Paramedic Association of Canada's National Occupational Competency Profile, those who receive certification at this level can work for Emergency Medical Services in some provinces. The Canadian Ski Patrol, St. John Ambulance Patient Care Divisions, Fire Departments, Campus Emergency Response Teams, few private medical services, the Canadian Coast Guard all provide First Responder level emergency medical care, in some cases as a support to existing services, in others as the primary emergency response organization.
While all Certified First Responders in Canada are covered under Good Samaritan laws in jurisdictions where they are enacted, in some cases they have a Duty To Act for example, Ontario. Certified First Responders who are providing medical coverage to events, as well as those who are employed by Volunteer Fire Departments, Campus Response Teams, others who are required to perform Emergency Medical Response as part of their duties all have a Duty to Act. While Certified First Responders in general are not required to render aid to injured/ill persons, those who work in the aforementioned areas can be accused of and prosecuted for negligence if they fail to respond when notified of a medical emergency, if their care does not meet the standard to which they were trained, or their care exceeds their scope of practice and causes harm to the patient; as with all medically trained and certified persons, Certified First Responders are immune to successful prosecution if assistance was given in good faith up to, not beyond, the limits of certification and training.
In France, pre-hospital care is performed either by first responders from the fire department or from a private ambulance company, or by a medical team that includes a physician, a nurse and an ambulance technician. The intermediate scale, the firefighter nurse, is only a recent evolution and is performed by nurses who have been specially trained acting with emergency protocols; the arrival of first responders is thus the most common result of an emergency call. In addition, in France there exists a network of first responder associations, as French Red Cross, French Civil Protection, FFSS or others; these CFR volunteers are allowed to supervise massive outside meetings, student gatherings, et cetera. These volunteers have followed the same special rescuer training as firefighters, trainees always know what they are going into, they would be given basic medical training transferred to the Fire Department, they shall always show humanistic interaction, shall assist and help people with their concerns.s In the Kingdom of Thailand First Responder is a certification most achieved by local volunteers.
This certification is referred to as Emergency Medical Responder or EMR. EMRs can provide emergency care for vehicle collisions, trauma, CPR, other emergencies. EMRs must maintain their certification through a foundation, association, or government agency; the next level of certification in emergency response is Emergency Medical Technician Basic. Training for EMR level must be done through an approved training. Most provincial hospitals are directly connected with teaching the training. EMR is a 50 hour course; the National Institute for Emergency Medicine of
Emergency management
Emergency management is the organization and management of the resources and responsibilities for dealing with all humanitarian aspects of emergencies. The aim is to reduce the harmful effects including disasters; the World Health Organization defines an emergency as the state in which normal procedures are interrupted, immediate measures need to be taken to prevent that state turning into a disaster. Thus, emergency management is crucial to avoid the disruption transforming into a disaster, harder to recover from. Emergency management should not be equated to disaster management. Emergency planning, a discipline of urban planning and design, first aims to prevent emergencies from occurring, failing that, should develop a good action plan to mitigate the results and effects of any emergencies; as time goes on, more data become available through the study of emergencies as they occur, a plan should evolve. The development of emergency plans is a cyclical process, common to many risk management disciplines, such as business continuity and security risk management, as set out below: Recognition or identification of risks Ranking or evaluation of risks Responding to significant risks Tolerating Treating Transferring Terminating Resourcing controls and planning Reaction planning Reporting and monitoring risk performance Reviewing the risk management frameworkThere are a number of guidelines and publications regarding emergency planning, published by professional organizations such as ASIS, National Fire Protection Association, the International Association of Emergency Managers.
There are few emergency management specific standards, emergency management as a discipline tends to fall under business resilience standards. In order to avoid or reduce significant losses to a business, emergency managers should work to identify and anticipate potential risks. In the event that an emergency does occur, managers should have a plan prepared to mitigate the effects of that emergency, as well as to ensure business continuity of critical operations after the incident, it is essential for an organization to include procedures for determining whether an emergency situation has occurred and at what point an emergency management plan should be activated. An emergency plan must be maintained, in a structured and methodical manner, to ensure it is up-to-date in the event of an emergency. Emergency managers follow a common process to anticipate, prevent, prepare and recover from an incident. Cleanup during disaster recovery involves many occupational hazards; these hazards are exacerbated by the conditions of the local environment as a result of the natural disaster.
While individual workers should be aware of these potential hazards, employers are responsible for minimizing exposure to these hazards and protecting workers, when possible. This includes identification and thorough assessment of potential hazards, application of appropriate personal protective equipment, the distribution of other relevant information in order to enable safe performance of the work. Maintaining a safe and healthy environment for these workers ensures that the effectiveness of the disaster recovery is unaffected. Flood-associated injuries: Flooding disasters expose workers to trauma from sharp and blunt objects hidden under murky waters causing lacerations, as well as open and closed fractures; these injuries are further exacerbated with exposure to the contaminated waters, leading to increased risk for infection. When working around water, there is always the risk of drowning. In addition, the risk of hypothermia increases with prolonged exposure to water temperatures less than 75 degrees Fahrenheit.
Non-infectious skin conditions may occur including miliaria, immersion foot syndrome, contact dermatitis. Earthquake-associated injuries: The predominant injuries are related to building structural components, including falling debris with possible crush injury, trapped under rubble and electric shock. Chemicals can pose a risk to human health. After a natural disaster, certain chemicals can be more prominent in the environment; these hazardous materials can be released indirectly. Chemical hazards directly released after a natural disaster occur concurrent with the event so little to no mitigation actions can take place for mitigation. For example, airborne magnesium, chloride and ammonia can be generated by droughts. Dioxins can be produced by forest fires, silica can be emitted by forest fires. Indirect release of hazardous chemicals can be unintentionally released. An example of intentional release is insecticides used after a flood or chlorine treatment of water after a flood. Unintentional release is.
The chemical released is toxic and serves beneficial purpose when released to the environment. These chemicals can be controlled through engineering to minimize their release when a natural disaster strikes. An example of this is agrochemicals from inundated storehouses or manufacturing facilities poisoning the floodwaters or asbestos fibers released from a building collapse during a hurricane; the flowchart to the right has been adopted from research performed by Stacy Young, et al. and can be found here. Exposure limits Below are TLV-TWA, PEL, IDLH values for common chemicals workers are exposed to after a natural disaster. Direct release Magnesium Phosphorus Ammonia SilicaIntentional release Insecticides Chlorine dioxideUnintentional release Crude oil components Benzene, N-hexane, hydrogen sulfi
Air medical services
Air medical services is a comprehensive term covering the use of air transportation, airplane or helicopter, to move patients to and from healthcare facilities and accident scenes. Personnel provide comprehensive prehospital and emergency and critical care to all types of patients during aeromedical evacuation or rescue operations aboard helicopter and propeller aircraft or jet aircraft; the use of air transport to provide medical evacuation on the battlefield dates to World War I, but its role was expanded during the Korean and Vietnam wars. On, aircraft began to be used for the civilian emergency medical services. Helicopters can bring specialist care to the scene and transport patients to specialist hospitals for major trauma cases. Fixed-wing aircraft are used for long-distance transport. In some remote areas, air medical services deliver non-emergency healthcare such as general practitioner appointments. An example of this is the Royal Flying Doctor Service of Australia, who provide emergency care.
Air medical services can operate in a wider coverage area than a land ambulance. This makes them useful in sparsely-populated rural areas. Air medical services have a particular advantage for major trauma injuries; the well-established theory of the golden hour suggests that major trauma patients should be transported as as possible to a specialist trauma center. Therefore, medical responders in a helicopter can provide both a higher level of care at the scene of a trauma and faster transport to a trauma center, they can provide critical care when transporting patients from community hospitals to trauma centers. Effective use of helicopter services for trauma depends on the ground responder's ability to determine whether the patient's condition warrants air medical transport. Protocols and training must be developed to ensure. Excessively stringent criteria can prevent rapid transport of trauma victims. Crew and patient safety is the single most important factor to be considered when deciding whether to transport a patient by helicopter.
Weather, air traffic patterns, distances must be considered. Another reason for cancelling a flight is based on the comfort of the flight crew with the flight; the general rule of safety is upon the crew, when there is one pilot and two medical crew is: "3 to go, 1 to say'NO'". If one flight member is not comfortable with the flight for whatever reason, the flight is cancelled; some have questioned the safety of air medical services. While the number of crashes may be increasing, the number of programs and use of services has increased. Factors associated with fatal crashes of medical transport helicopters include flying at night and during bad weather, postcrash fires. An air ambulance is a specially outfitted helicopter or fixed-wing aircraft that transports injured or sick people in a medical emergency or over distances or terrain impractical for a conventional ground ambulance. Fixed-wing aircraft are more used to move patients over long distances and for repatriation from foreign countries.
These and related operations are called aeromedical. In some circumstances, the same aircraft may be used to search for wanted people. Like ground ambulances, air ambulances are equipped with medical equipment vital to monitoring and treating injured or ill patients. Common equipment for air ambulances includes medications, ventilators, ECGs and monitoring units, CPR equipment, stretchers. A medically staffed and equipped air ambulance provides medical care in flight—while a non-medically equipped and staffed aircraft transports patients without care in flight. Military organizations and NATO refer to the former as medical evacuation and to the latter as casualty evacuation. Air Traffic Control grants special treatment to air ambulance operations, much like a ground ambulance using lights and a siren, only when they are operating with a patient; when this happens, air ambulance aircraft take the call sign MEDEVAC and receive priority handling in the air and on the ground. As with many Emergency Medical Service innovations, treating patients in flight originated in the military.
The concept of using aircraft as ambulances is as old as powered flight itself. Although balloons were not used to evacuate wounded soldiers at the Siege of Paris in 1870, air evacuation was experimented with during the First World War; the first recorded British ambulance flight took place in 1917 in Turkey when a soldier in the Camel Corps, shot in the ankle was flown to hospital in a de Havilland DH9 in 45 minutes. The same journey by land would have taken some 3 days to complete. In the 1920s several services, both official and unofficial, started up in various parts of the world. Aircraft were still primitive at the time, with limited capabilities, the effort received mixed reviews. Exploration of the idea continued and France and the United Kingdom used organized air ambulance services during the African and Middle Eastern Colonial Wars of the 1920s. In 1920, the British, while suppressing the "Mad Mullah" in Somalialand, used an Airco DH.9A fitted out as an air ambulance. It carried a single stretcher under a fairing behind the pilot.
The French evacuated over 7,000 casualties during that period. By 1936, an organized military air ambulance service evacuated wounded from the Spanish
Casualty lifting
Casualty lifting is the first step of casualty movement, an early aspect of emergency medical care. It is the procedure used to put the casualty on a stretcher. Developed emergency services use lifting devices, such as scoop stretchers, that allow secured lifting with minimal personnel. Other methods can be used. Since only stabilised casualties are moved, the lifting is never performed in emergency; this depends on the specific circumstances. Maximum care must be taken to avoid to worsen an unstable trauma; the head-neck-chest axis must be kept straight to protect the spine, the first responders must keep the patient's body stable during the lift. The first responders have to carry a heavy load in an uncomfortable position. There is thus a risk of injury to the carrier of the lumbar back. To avoid an injury, they must push with their legs; the stretcher must be unfolded, the hinges secured and tested: a first responder presses the cloth with his knee at several points. When a vacuum mattress is used, it must be put on the stretcher, the balls must be evenly distributed.
A blanket is used since hypothermia is a major risk for a casualty. The blanket must be wrapped around the casualty to avoid the heat leak from below. For this purpose, the blanket is put before the lifting, folded in a specific way: the blanket is laid so the diagonal is along the axis of the stretcher; the use of a scoop stretcher allows a secure lifting with only two team members in case of a spinal trauma. The use of this device is thus recommended for most operations. However, in many situations, there is a lack not of people but of devices. Additionally, the scoop stretcher does not allow to maintain the legs up or a half-seated position for the casualty. For these reasons, the other methods are still taught; the most secured way to put a casualty on a stretcher is to use a vertical lift with five first responders including the chief. The casualty is lifted by four first responders: the chief has one knee down, one knee up, holds the head; the feet of the team members must be enough spaced.
If the chief uses the occipital-chin grip, the knee, up is the knee on the side of the hand under the neck: as this arm supports the heaviest weight, it can supports itself on the knee. Another method consists in placing the team members at both sides of the casualty and holding the cloths; the cloths must be strong enough. On the order of the chief, the casualty is lifted, the stretcher is pushed, the casualty is put down on the stretcher. During this procedure, the chief remains kneeling; the first and second team members pull back, supporting themselves on the shoulder of a still standing member. With this method, the movement of the casualty is minimal, just vertical; when there is no room at the feet of the casualty for the stretcher, it must be placed on the side of the head. The chief must kneel aside. If he uses the occipital-chin grip, the hand under the neck must be the closest to the casualty's feet. With only four first responders, it is necessary to use a "simple" lift: the chief plays the role of the first team member: he steps over the casualty and places one hand under the neck, the other hand under the back, between the shoulder blades.
The stretcher can come from the head. This method is not adapted in case of suspicion of a spine trauma; when the casualty has no specific trauma, it is possible to slide a long spine board little by little. A team member lifts a part of the body, the other one slide the board. A handling strap can help the lifting; the strap for this use should be 6 m long, at least 3 cm wide to share out the weight and avoid the pain, resist at least to a weight of 150 kg. The strap is slid under the casualty: the flat profile can slide under the back and the pelvis without lifting the casualty; this strap will form two handles, the team member at the pelvis will have a better grip and a vertical back. The verti
One or more of the preceding sentences incorporates text from a work in the public domain: "Paramedics/EMTs in the Emergency Department (ED)". U.S. Texas Board of Nursing. Retrieved 22 January 2015.
