Hospitals receiving

Although the burgeoning system of employer-sponsored coverage addressed the needs of employed persons and often their dependents as well, it left uncovered the elderly and the nonworking population. Services to uninsured persons were sometimes available through a patchwork of public health facilities and charity health organizations. Hospitals received... 

To predict the total number of casualties your hospital can expect, double the number of casualties the hospital receives in the first hour. 

These cases also provoked an investigation into FDA policies by the Institute of Medicine (IOM), a division of the National Academy of Sciences. Criticizing the absence of national reporting requirements, the IOM report suggested that hospitals receiving federal Medicare and Medicaid funds should be required to report to the FDA.54 IOM members also proposed a National Center for Patient Safety that would review drugs on the market and distribute information to physicians and the public. 

The Health Emergency Response System (HERS) at the Mt. Sinai Hospital receives the call, locates Jane based on the microbot signal through the Global Positioning System, and dispatches an air ambulance to pick her up. 

This chapter, and the two following, were written while the author was on leave at the Department of Chemistry, The University of Wisconsin, Madison, Wisconsin. The author expresses his sincere thanks to the University of Wisconsin for hospitality received. 

Availability is the major weakness of the mechanical approach. Performing PCI on acutely ill AMI patients requires a skilled and experienced operator and team. Many hospitals receiving AMI patients do not have catheterization laboratories or such teams. Those that do may have all of their procedure rooms busy during the day, and there may be unacceptable delays in the off hours to assemble the necessary staff. The benefits of PCI, like thrombolysis, are time dependent (41). Unlike thrombolysis, PCI requires a certain volume of patients to develop and maintain operator skills (56,57) therefore, concentrating this approach at specialized centers is attractive. 

Antibiotics are frequently administered to clients with viral infections to prevent secondary bacterial infections. This client is considered at risk or the client would not be in a hospital receiving care. There is no reason to question this medication. 

Supporting this view is a report from the Tokyo subway terrorist incident of 1995. One hospital received two casualties who were apneic with no heartbeat. With vigorous resuscitation, cardiac activity was established in both. One resumed spontaneous respiration and walked out of the hospital several days later, and the other did not start breathing spontaneously and died days later. These anecdotes suggest that when circumstances permit, resuscitation should be attempted. In a contaminated area where resources, including personnel, are limited, the use of ventilatory support and closed chest cardiac compression must be balanced against other factors (see above), but the immediate administration of diazepam and additional atropine requires little effort and can be very rewarding in the casualty who still has apparent cardiopulmonary function. Cyanide... 

Hospitals receive not only field-decontaminated patients but also "walk-ins" who may have bypassed field decontamination. Despite Joint Commission on Accreditation of Healthcare Organizations standards calling for hospitals to have hazardous materials (Hazmat) plans and conduct Hazmat training, two recent reviews have suggested that most hospitals in the United States are ill prepared to treat chemically contaminated patients. 

The Watt Committee s Working Group members were impressed with what they observed during their short visit. The Committee wishes to record its thanks for all the help and assistance given and for the hospitality received from the Principal and all his staff. 

Hospital incident command system—A generic crisis management plan expressly for comprehensive medical facilities that is modeled closely after the fire service incident command system. Hospital postdecontamination zone— The hospital postdecontamination zone is an area considered uncontaminated. At a hospital receiving contaminated victims, the hospital postdecontamination zone includes the emergency department (unless contaminated). This zone is sometimes called the cold zone or clean area. 

Security personnel and other identified staff members shonld nndergo appropriate education and training to ensure they possess and maintain the skills and knowledge necessary to safeguard the security of patients, visitors, and staff. All hospital onployees must receive instruction on security issues as part of their general orientation. This inclndes instruction on how to report security incidents involving patients, visitors, and employees, and how to summon security assistance. In addition, anployees in security-sensitive areas of the hospital receive additional education in their departments to identify specific mechanisms or procedures designed to minimize security risk. 

There are two medieal insurance systems in Japan Social Insurance System for those working at a company or an office and National Health Insurance System for those not covered by the Social Insurance System. The hospital receives individual payments from patients and the remaining medical service fees from the medical insurance system. The fees are established for the rental rate of the equipment such as a ventilator and a humidifier. TTie currency has been converted using a rale of 110 to the US. ... 

The ambulance circuits and loading points should be upwind of the incident site and outside the outer cordon. The evacuation plan should also be coordinated at a higher level to ensure casualties are sent to appropriate hospitals and distributed so that no single hospital is overwhelmed if possible. In the event of a hospital receiving a significant number of contaminated casualties the evacuation plan may be changed to redirect clean casualties to alternative hospitals. 

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