Patient transport equipment

The management of information by the use of technology invites the question, could the DM provider be led by an IT company Sites, or locations for care, or patient transport, might be required, which means that a facilities management company will be involved. In some disease areas a medical equipment supplier might be pre-eminent, e.g. in the case of dialysis and where the evaluation of samples is a prominent requirement, a pathology laboratory. 

Where the application of new CWA detection technologies could be of greatest potential benefit to the medical community is in fixed medical facilities and patient transport vehicles for monitoring air samples for low levels of CWA that may cause occupational hazards. Additionally, standoff detection equipment can also assist medical planners in obtaining pre-incident intelligence so critical to providing the appropriate emergency response. 

The hospital staff will provide the diagnostic equipment and services (e.g., magnetic resonance imaging [MRI]), CAT scan, computer modelling, patient selection) and all other medical services (e.g., patient transportation). 

Obtain initial status and information from the Planning Section Chief to provide as appropriate to the inter-hospital emergency communication network and local and/or county EOC, upon request Patient Care Capacity - The number of immediate (red), delayed (yellow), and minor (green) patients that can be received and treated immediately, and current census. Hospital s Overall Status - Current condition of hospital structure, security, and utilities. Any current or anticipated shortage critical resources including personnel, equipment, supplies, medications, etc. Number of patients and mode of transportation for patients requiring transfer to other hospitals, if applicable. Any resources that are requested by other facilities (e.g., personnel, equipment, supplies, medications, etc.). Media relations efforts being initiated, in conjunction with the PIO. ... 

Figure 6. Interaction of the red and white plans for the evacuation of casualties following a disaster. The fire service are responsible for rescue and primary evacuation of casualties as far as the advanced medical post. Here, casualties are triaged and receive primary treatment. The hospital white plan for the management of mass casualties is extended to this point using medically manned mobile intensive care units which can carry out extensive early care before transporting the patient to the most appropriate hospital facility. In the case of a toxic release, this will be to a special reference hospital, manned and equipped to deal with casualties from a chemical-biological release...

Intensive care aims at the replacement or support of deficient central functions. Important functions are respiration and a sufficient cardiac and circulation function. Monitoring the gas exchange in intensive care especially of ventilated patients requires, in addition to gas analysis at several measuring sites in the body, information on the heart function, eg, heart rate, on the pressure of the circulation system, eg, arterial pressure, and on the actual utilization of the available amount of oxygen. With regard to the methods required to achieve information that is as complete as possible, the clinical task consists in the determination of gas concentrations or partial pressures in the gas phase of the lung, airways, and equipment hoses, in the transportation system of the blood, and in the tissue. In recent years there has been an increasing importance of non-invasive methods, as invasive procedures are combined with risk and additional stress for the patient. 

The removal of solid or liquid chemical agent from exposed individuals is the first step in preventing severe injury or death. Civilian Hazmat teams generally have basic decontamination plans in place, though proficiency may vary widely. Very few teams are staffed, equipped, or trained for mass decontamination. Hospitals need to be prepared to decontaminate patients, despite plans that call for field decontamination of all patients before transport to hospitals. However, few hospitals have formal decontamination facilities even fewer have dedicated outdoor facilities or an easy way of expanding their decontamination operations in an event involving mass casualties. 

Many patients who have field decontamination (especially those with only dry decontamination) will require further decontamination at the hospital. If the scene is close to the hospital, many victims may transport themselves directly to the hospital and amve having had no decontamination at all (as in the Tokyo sarin attacks). Hospitals usually have little in the way of decontamination equipment other than wading pools, water hoses, and soap. Most emergency departments have no PPE available and no training in the use of PPE. Thus, if contaminated victims arrived at the emergency department, the staff would become cross-contaminated while trying to perform decontamination of the patients. Most hospitals depend on the fire service, EMS, or EMA to provide a decon trailer in an emergency situation. The problem with this is the decon trailer may be in use at the scene of the incident and not be available. 

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