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Biomedical subjects

G A Koehler

Publications and source records attributed to G A Koehler.

4 recordsLinked to original sources
PubMed1992

Medical response to catastrophic events: California's planning and the Loma Prieta earthquake.

The threat of a great earthquake has compelled California to develop a disaster plan for catastrophic medical events that calls for local response with state-coordinated mutual aid and casualty evacuation, if necessary. During the 1989 Loma Prieta earthquake that killed 63 people and injured 3,700, local emergency medical services systems were busy but not stressed excessively. The medical mutual aid system delivered medical personnel, supplies, and blood. One hospital suffered severe nonstructural damage, but it was able to treat large numbers of casualties. Our system performed admirably in this limited response, but was hampered by difficulties with disaster intelligence, communications, emergency medical services dispatch, patient care records, hospital damage, and inadequate disaster training. We describe our state's mutual aid system, the Loma Prieta response, and lessons and recommendations for the future.

California↗
PubMed1990

Cellular communication.

Generally, cellular-telephone communications seem to be a valuable means for the public to communicate that an accident has occurred on highways in metropolitan areas. Response time is reduced and congestion quickly relieved. This system could be improved by making a provision in emergency call boxes for the separation of vehicle problems from true emergency calls to ensure the proper response priority. Cellular-telephone communications are a valuable adjunct to EMS radio communications for biotelemetry, when channels are overcrowded or communications are needed in a "dead" area. A system of dedicated hospital-emergency-department lines and telephone numbers is needed. Cellular telephones shouldn't be used as a primary means of providing medical control. Advance planning should be undertaken to ensure immediate access to hospital emergency departments if cellular is used for secondary purposes. The amount of communication traffic at and surrounding a multi-casualty incident or disaster may overwhelm a local cell. Priority numbers providing immediate access and bumping of non-emergency calls for emergency responders are needed. All means of communication should be coordinated by an EMS communications MCI or disaster plan.

California↗
PubMedDate not supplied

The emergency medical response to the Cantara hazardous materials incident.

On 14 July 1991, at 2150 h, a train derailment occurred near the Cantara rail curve about six miles above Dunsmuir in Northern California. The derailment spilled approximately 19,000 gallons of metam-sodium into the Sacramento River. When mixed with water, metam-sodium degrades to methylisothiocyanate (MITC) and other gases. The contaminated river water passed the town of Dunsmuir and other occupied areas exposing residents to MITC gas. From 15 July to 20 July (five days), a total of 360 people underwent triage. The majority of patients displayed minor exposure symptoms that did not require hospital care. Mercy Mt. Shasta Hospital, a small rural hospital close to Dunsmuir, received the majority of patients. As of 29 July, 15 days after the incident, Mercy Mt. Shasta Hospital had seen 244 exposed patients in its emergency department, and had admitted five. Three had symptoms that could have been spill-related. Three Regional Poison Control Centers provided medical toxicology advice. Medical management of the emergency medical services (EMS) response to the event was piecemeal and weak. There did not appear to be a medical operations component at local Emergency Operations Centers (EOC). Most health care personnel interviewed complained about inadequate information about the substance and the situation. Local fire service mutual-aid agreements to obtain additional fire service and ambulance personnel worked well. It is important to emphasize that everyone who believed they had been exposed to the chemical underwent triage and received appropriate acute medical care.

California↗