PubMed · 10144796
What's red and white and huge all over? Monster ambulances built by Braun Northwest of Chehalis, Wash., for a Russian mining company.
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M A Garza. 1995. Hyper rigs.. https://pubmed.ncbi.nlm.nih.gov/10144796/
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OBJECTIVE: To study the availability of antidotes in French emergency medical aid units (SAMU). METHODS: The physicians or nurses responsible for antidotes in French emergency medical aid units (SAMU) were interviewed by phone. The study involved 102 SAMU in metropolitan France. Four answers on availability of 37 antidotes were possible: the antidote was available in the emergency vehicle used for interventions; the antidote was available in the hospital-located SAMU; the antidote was available in the referral hospital (emergency unit, intensive care unit, operating room, pharmacy); the antidote was not available or not known to be available. RESULTS: Adrenaline and atropine were available in all the intervention vehicles. Nine other antidotes were available in more than two-thirds of the vehicles: 30% glucose (101/102), isoprenaline (100/102), dobutamine (98/112), sodium bicarbonate (97/102), naloxone (95/102), calcium chloride or bicarbonate (89/102), flumazénil (83/102), sodium lactate (77/102), and magnesium sulfate (66/102). Among the other antidotes, hydroxocobalamine and propranolol were available in 24/102 intervention vehicles and activated charcoal in 22/102. Antidigitalic antibodies and 4-methylpyrazole were not available in any vehicle, and were available in less than 25% of the hospitals. CONCLUSION: There is a great disparity of antidote availability. Certain essential antidotes, for which there is no alternative, are not available in emergency intervention vehicles and even in the hospital. The SAMU should develop an economically acceptable departmental management scheme for exceptional-use antidotes.
A 4-year-long experience is reported on mobile neonatal emergency transport service for pathological newborn babies from referral hospitals to the NICU level III. The area covered by the NICU consists of three counties with a total population of 1 million. Distance of the hospitals from the NICU ranges 0.5-115 km, transport time varies from 0.5-5.0 hours. In the transport staff are dedicated neonatal team from the NICU III, the driver and the emergency medical technician are the employee of the National Ambulance Service. During the study period 385 patients were transported. Clinical condition and characteristic laboratory parameters of the babies at departure and arrival are analysed and compared to evaluate the efficacy and quality of the system. Furthermore, some questions regarding organisation, transit time and response time and legal aspects are discussed.
PURPOSE: Focus on hygienic management in ambulances is presented based on findings from hygienic microbiological sampling. METHODS: In 44 ambulances, the handwashing area, equipment for artificial respiration, insufflation, intubation, aspiration, intravasal catheterisation, blood-pressure measurement, and sterile materials storage were examined hygienically and microbiologically using the following methods: water sampling, imprint technique, and swab technique with subsequent cultivation on blood-, endo-, and Sabouraud agar. RESULTS: The highest contamination was found in the hand-washing area and on insufflation equipment (up to > or = 100,000 cfu/ml), where proof of the potential pathogens Pseudomonas, Acinetobacter, and Alcaligenes spp. was found. The second highest contamination level was found on the sphygmomanometer cuffs, stethoscopes, and respirator masks (e.g., Enterococci and S. aureus were identified). Apparently, the germs chiefly originate from the drinking water at the handwashing station, from the environment and mucous membranes from the skin, and intestines of the ambulance personnel. The predominant hygienic deficiensies were found in the equipment of the handwashing areas, and in the storage of resuscitation equipment and sterile materials. CONCLUSIONS: Based on the results of hygienic microbiological analysis, the main focus of hygienic measures--besides hand disinfection--should be on spray disinfection of the sphygmomanometer cuffs and stethoscopes as well as disinfection of ambulance equipment and storage areas for sterile devices, supplemented by dust protection of ready-to-use materials and devices. Stationary dispensers for hand disinfection possessing at least midlength levers must become the standard in ambulances, and conventional handwashing basins with plastic drinking-water containers and pump must be eliminated entirely.