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Bleeding Control Protections Within US Good Samaritan Laws
- Matthew J. Levy, Christopher M. Wend, William P. Flemming, Antoin Lazieh, Andrew J. Rosenblum, Candace M. Pineda, Douglas M. Wolfberg, Jennifer Lee Jenkins, Craig A. Goolsby, Asa M. Margolis
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- Journal:
- Prehospital and Disaster Medicine / Volume 39 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 04 April 2024, pp. 156-162
- Print publication:
- April 2024
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Introduction:
In the United States, all 50 states and the District of Columbia have Good Samaritan Laws (GSLs). Designed to encourage bystanders to aid at the scene of an emergency, GSLs generally limit the risk of civil tort liability if the care is rendered in good faith. Nation-wide, a leading cause of preventable death is uncontrolled external hemorrhage. Public bleeding control initiatives aim to train the public to recognize life-threatening external bleeding, perform life-sustaining interventions (including direct pressure, tourniquet application, and wound packing), and to promote access to bleeding control equipment to ensure a rapid response from bystanders.
Methods:This study sought to identify the GSLs in each state and the District of Columbia to identify what type of responder is covered by the law (eg, all laypersons, only trained individuals, or only licensed health care providers) and if bleeding control is explicitly included or excluded in their Good Samaritan coverage.
Results:Good Samaritan Laws providing civil liability qualified immunity were identified in all 50 states and the District of Columbia. One state, Oklahoma, specifically includes bleeding control in its GSLs. Six states – Connecticut, Illinois, Kansas, Kentucky, Michigan, and Missouri – have laws that define those covered under Good Samaritan immunity, generally limiting protection to individuals trained in a standard first aid or resuscitation course or health care clinicians. No state explicitly excludes bleeding control from their GSLs, and one state expressly includes it.
Conclusion:Nation-wide across the United States, most states have broad bystander coverage within GSLs for emergency medical conditions of all types, including bleeding emergencies, and no state explicitly excludes bleeding control interventions. Some states restrict coverage to those health care personnel or bystanders who have completed a specific training program. Opportunity exists for additional research into those states whose GSLs may not be inclusive of bleeding control interventions.
911 EMS Activations by Pregnant Patients in Maryland (USA) during the COVID-19 Pandemic
- Megan E. Hadley, Arthur J. Vaught, Asa M. Margolis, Timothy P. Chizmar, Teferra Alemayehu, Torre Halscott, J. Lee Jenkins, Matthew J. Levy
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- Journal:
- Prehospital and Disaster Medicine / Volume 36 / Issue 5 / October 2021
- Published online by Cambridge University Press:
- 14 July 2021, pp. 570-575
- Print publication:
- October 2021
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Introduction:
In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, United States Emergency Medical Services (EMS) experienced a decrease in calls, and at the same time, an increase in out-of-hospital deaths. This finding led to a concern for the implications of potential delays in care for the obstetric population.
Hypothesis/Problem:This study examines the impact of the pandemic on prehospital care amongst pregnant women.
Methods:A retrospective observational study was conducted comparing obstetric-related EMS activations in Maryland (USA) during the pandemic (March 10-July 20, 2020) to a pre-pandemic period (March 10-July 20, 2019). Comparative analysis was used to analyze the difference in frequency and acuity of calls between the two periods.
Results:There were fewer obstetric-related EMS encounters during the pandemic compared to the year prior (daily average during the pandemic 12.5 [SD = 3.8] versus 14.6 [SD = 4.1] pre-pandemic; P <.001), although the percent of total female encounters remained unchanged (1.6% in 2020 versus 1.5% in 2019; P = .091). Key indicators of maternal status were not significantly different between the two periods. African-American women represented a disproportionately high percentage of obstetric-related activations (36.2% in 2019 and 34.8% in 2020).
Conclusions:In this state-wide analysis of EMS calls in Maryland early in the pandemic, no significant differences existed in the utilization of EMS by pregnant women. Prehospital EMS activations amongst pregnant women in Maryland only decreased slightly without an increase in acuity. Of note, over-representation by African-American women compared to population statistics raises concern for broader systemic differences in access to obstetric care.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Assessing Pediatric and Young Adult Substance Use Through Analysis of Prehospital Data
- Elizabeth L. Seaman, Mathew J. Levy, J. Lee Jenkins, Cassandra Chiras Godar, Kevin G. Seaman
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- Journal:
- Prehospital and Disaster Medicine / Volume 29 / Issue 5 / October 2014
- Published online by Cambridge University Press:
- 04 August 2014, pp. 468-472
- Print publication:
- October 2014
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Introduction
Substance use in young adults is a significant and growing problem. Emergency Medical Services (EMS) personnel often encounter this problem, yet the use of prehospital data to evaluate the prevalence and magnitude of substance abuse has been limited.
Hypothesis/ProblemThis study evaluated drug and alcohol use through the use of prehospital and EMS data in one suburban county in Maryland (USA). The primary hypothesis was that the type of drug being abused is associated with age. The secondary hypothesis was substance abuse incidence is associated with location. The tertiary hypothesis was that substance abuse is associated with a history of mental illness.
MethodsDeidentified patient care reports (PCRs) were obtained during a 24-month period from October 2010 through September 2012 for patients 0 through 25 years of age. Inclusion criteria included chief complaint of alcohol overdose, drug overdose, or the use of naloxone.
ResultsThe primary hypothesis was supported that age was associated with drug category (P < .001). Younger adolescents were more likely to use household items, prescription drugs, or over-the-counter drugs, whereas older adolescents were more likely to use illicit drugs. The secondary hypothesis was supported that both alcohol (P < .001) and drugs (P < .001) were associated with location of call. Calls involving alcohol were more likely to be at a home or business, whereas calls involving drugs were more likely to be at home or at a public venue. The tertiary hypothesis was supported that both alcohol (P = .001) and drug use (P < .001) were associated with history of mental illness. Older adolescents were more likely to report a history of mental illness. Chi-squared tests indicated there were significant differences between genders and drug category (P = .002) and gender and current suicide attempt (P = .004). Females were more likely to use prescription drugs, whereas males were more likely to use illicit drugs. Calls involving younger adolescents under 18 were more likely to be at school or the mall, whereas calls involving older adolescents were likely to be at a prison, public venue, or a business.
ConclusionAll three hypotheses were supported: the type of substance being abused was associated with both age and location, and substance abuse was associated with a history of mental illness. This research has important implications for understanding how EMS resources are utilized for substance use. This information is valuable in not only the education and training of prehospital care providers, but also for the targeting of future public health interventions.
. ,Seaman EL ,Levy MJ ,Jenkins JL ,Godar CC .Seaman KG Assessing Pediatric and Young Adult Substance Use Through Analysis of Prehospital Data . Prehosp Disaster Med.2014 ;29 (4 ):1 -6
A Poor Association Between Out-of-Hospital Cardiac Arrest Location and Public Automated External Defibrillator Placement
- Matthew J. Levy, Kevin G. Seaman, Michael G. Millin, Richard A. Bissell, J. Lee Jenkins
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- Journal:
- Prehospital and Disaster Medicine / Volume 28 / Issue 4 / August 2013
- Published online by Cambridge University Press:
- 23 May 2013, pp. 342-347
- Print publication:
- August 2013
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Introduction
Much attention has been given to the strategic placement of automated external defibrillators (AEDs). The purpose of this study was to examine the correlation of strategically placed AEDs and the actual location of cardiac arrests.
MethodsA retrospective review of data maintained by the Maryland Institute for Emergency Medical Services Systems (MIEMSS), specifically, the Maryland Cardiac Arrest Database and the Maryland AED Registry, was conducted. Location types for AEDs were compared with the locations of out-of-hospital cardiac arrests in Howard County, Maryland. The respective locations were compared using scatter diagrams and r2 statistics.
ResultsThe r2 statistics for AED location compared with witnessed cardiac arrest and total cardiac arrests were 0.054 and 0.051 respectively, indicating a weak relationship between the two variables in each case. No AEDs were registered in the three most frequently occurring locations for cardiac arrests (private homes, skilled nursing facilities, assisted living facilities) and no cardiac arrests occurred at the locations where AEDs were most commonly placed (community pools, nongovernment public buildings, schools/educational facilities).
ConclusionA poor association exists between the location of cardiac arrests and the location of AEDs.
. ,Levy MJ ,Seaman KG ,Millin MG ,Bissell RA .Jenkins JL A Poor Association Between Out-of-Hospital Cardiac Arrest Location and Public Automated External Defibrillator Placement . Prehosp Disaster Med.2013 ;28 (4 ):1 -6
List of contributors
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- By Nazia M. Alam, Enrico Alleva, Hiroyuki Arakawa, Robert H. Benno, Fred G. Biddle, D. Caroline Blanchard, Robert J. Blanchard, Richard J. Bodnar, John D. Boughter, Igor Branchi, Richard E. Brown, Abel Bult-Ito, Jonathan M. Cachat, Peter R. Canavello, Francesca Cirulli, Giovanni Colacicco, John C. Crabbe, Jacqueline N. Crawley, Wim E. Crusio, Sietse F. de Boer, Ekrem Dere, Brenda A. Eales, Robert T. Gerlai, Howard K. Gershenfeld, Thomas J. Gould, Martin E. Hahn, Peter C. Hart, Andrew Holmes, Joseph P. Huston, Allan V. Kalueff, Benjamin Kest, Robert Lalonde, Sarah R. Lewis-Levy, Hans-Peter Lipp, Sheree F. Logue, Stephen C. Maxson, Jeffrey S. Mogil, Douglas A. Monks, Dennis L. Murphy, Lee Niel, Timothy P. O’Leary, Susanna Pietropaolo, Peter K.D. Pilz, Claudia F. Plappert, Bernard Possidente, Glen T. Prusky, Laura Ricceri, Heather Schellinck, Herbert Schwegler, Burton Slotnick, Frans Sluyter, Shad B. Smith, Catherine Strazielle, Douglas Wahlsten, Hans Welzl, James F. Willott, David P. Wolfer, Armin Zlomuzica
- Edited by Wim E. Crusio, Université de Bordeaux, Frans Sluyter, Robert T. Gerlai, University of Toronto, Susanna Pietropaolo, Université de Bordeaux
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- Book:
- Behavioral Genetics of the Mouse
- Published online:
- 05 May 2013
- Print publication:
- 25 April 2013, pp ix-xii
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Disaster Curricula in Medical Education: Pilot Survey
- Jared Smith, Matthew J. Levy, Edbert B. Hsu, J. Lee Levy
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- Journal:
- Prehospital and Disaster Medicine / Volume 27 / Issue 5 / October 2012
- Published online by Cambridge University Press:
- 21 August 2012, pp. 492-494
- Print publication:
- October 2012
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Introduction
An understanding of disaster medicine and the health care system during mass-casualty events is vital to a successful disaster response, and has been recommended as an integral part of the medical curriculum by the Association of American Medical Colleges (AAMC). It has been documented that medical students do not believe that they have received adequate training for responding to disasters. The purpose of this pilot study was to determine the inclusion of disaster medicine in the required course work of medical students at AAMC schools in the United States, and to identify the content areas addressed.
MethodsAn electronic on-line survey was developed based upon published core competencies for health care workers, and distributed via e-mail to the education liaison for each medical school in the United States that was accredited by the AAMC. The survey included questions regarding the inclusion of disaster medicine in the medical school curricula, the type of instruction, and the content of instruction.
ResultsOf the 29 (25.2%) medical schools that completed the survey, 31% incorporated disaster medicine into their medical school curricula. Of those schools that included disaster medicine in their curricula, 20.7% offered disaster material as required course work, and 17.2% offered it as elective course work. Disaster medicine topics provided at the highest frequency included pandemic influenza/severe acute respiratory syndrome (SARS, 27.5%), and principles of triage (10.3%). The disaster health competency included most frequently was the ability to recognize a potential critical event and implement actions at eight (27.5%) of the responding schools.
ConclusionsOnly a small percentage of US medical schools currently include disaster medicine in their core curriculum, and even fewer medical schools have incorporated or adopted competency-based training within their disaster medicine lecture topics and curricula.
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,Smith J ,Levy MJ ,Hsu EB .Levy JL Disaster Curricula in Medical Education: Pilot Survey . Prehosp Disaster Med.2012 ;27 (5 ):1 -3 .
A Human Factors Analysis of an EMS Crew's Exposure to Carbon Monoxide
- Matthew J. Levy, Kevin G. Seaman, J. Lee Levy
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- Journal:
- Prehospital and Disaster Medicine / Volume 27 / Issue 3 / June 2012
- Published online by Cambridge University Press:
- 15 June 2012, pp. 297-298
- Print publication:
- June 2012
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The safety of personnel and resources is considered to be a cornerstone of prehospital Emergency Medical Services (EMS) operations and practice. However, barriers exist that limit the comprehensive reporting of EMS safety data. To overcome these barriers, many high risk industries utilize a technique called Human Factors Analysis (HFA) as a means of error reduction. The goal of this approach is to analyze processes for the purposes of making an environment safer for patients and providers. This report describes an application of this approach to safety incident analysis following a situation during which a paramedic ambulance crew was exposed to high levels of carbon monoxide.
Levy MJ, Seaman KG, Levy JL. A human factors analysis of an EMS crew's exposure to carbon monoxide. Prehosp Disaster Med. 2012;27(3):1-2.
Contributors
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- By Giustino Albanese, Andrew Amaranto, Brandon H. Backlund, Alexander Baxter, Abraham Berger, Mark Bernstein, Marian E. Betz, Omar Bholat, Suzanne Bigelow, Carl Bonnett, Elizabeth Borock, Christopher B. Colwell, Alasdair Conn, Moira Davenport, David Dreitlein, Aaron Eberhardt, Ugo A. Ezenkwele, Diana Felton, Spiros G. Frangos, John E. Frank, Jonathan S. Gates, Lewis Goldfrank, Pinchas Halpern, Jean Hammel, Kristin E. Harkin, Jason S. Haukoos, E. Parker Hays, Aaron Hexdall, James F. Holmes, Debra Houry, Jennifer Isenhour, Andy Jagoda, John L. Kendall, Erica Kreisman, Nancy Kwon, Eric Legome, Matthew R. Levine, Phillip D. Levy, Charles Little, Marion Machado, Heather Mahoney, Vincent J. Markovchick, Nancy Martin, John Marx, Julie Mayglothling, Ron Medzon, Maurizio A. Miglietta, Elizabeth L. Mitchell, Ernest Moore, Maria E. Moreira, Sassan Naderi, Salvatore Pardo, Sajan Patel, David Peak, Christine Preblick, Niels K. Rathlev, Charles Ray, Phillip L. Rice, Carlo L. Rosen, Peter Rosen, Livia Santiago-Rosado, Tamara A. Scerpella, David Schwartz, Fred Severyn, Kaushal Shah, Lee W. Shockley, Mari Siegel, Matthew Simons, Michael Stern, D. Matthew Sullivan, Carrie D. Tibbles, Knox H. Todd, Shawn Ulrich, Neil Waldman, Kurt Whitaker, Stephen J. Wolf, Daniel Zlogar
- Edited by Eric Legome, Lee W. Shockley
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- Book:
- Trauma
- Published online:
- 07 September 2011
- Print publication:
- 16 June 2011, pp ix-xiv
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Challenges in Disaster Data Collection during Recent Disasters
- Melinda Morton, J. Lee Levy
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- Journal:
- Prehospital and Disaster Medicine / Volume 26 / Issue 3 / June 2011
- Published online by Cambridge University Press:
- 03 August 2011, pp. 196-201
- Print publication:
- June 2011
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Gathering essential health data to provide rapid and effective medical relief to populations devastated by the effects of a disaster-producing event involves challenges. These challenges include response to environmental hazards, security of personnel and resources, political and economic issues, cultural barriers, and difficulties in communication, particularly between aid agencies. These barriers often impede the timely collection of key health data such as morbidity and mortality, rapid health and sheltering needs assessments, key infrastructure assessments, and nutritional needs assessments. Examples of these challenges following three recent events: (1) the Indian Ocean tsunami; (2) Hurricane Katrina; and (3) the 2010 earthquake in Haiti are reviewed. Some of the innovative and cutting-edge approaches for surmounting many of these challenges include: (1) the establishment of geographical information systems (GIS) mapping disaster databases; (2) establishing internet surveillance networks and data repositories; (3) utilization of personal digital assistant-based platforms for data collection; (4) involving key community stakeholders in the data collection process; (5) use of pre-established, local, collaborative networks to coordinate disaster efforts; and (6) exploring potential civil-military collaborative efforts. The application of these and other innovative techniques shows promise for surmounting formidable challenges to disaster data collection.
Contributors
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- By Waiel Almoustadi, Brian J. Anderson, David B. Auyong, Michael Avidan, Michael J. Avram, Roland J. Bainton, Jeffrey R. Balser, Juliana Barr, W. Scott Beattie, Manfred Blobner, T. Andrew Bowdle, Walter A. Boyle, Eugene B. Campbell, Laura F. Cavallone, Mario Cibelli, C. Michael Crowder, Ola Dale, M. Frances Davies, Mark Dershwitz, George Despotis, Clifford S. Deutschman, Brian S. Donahue, Marcel E. Durieux, Thomas J. Ebert, Talmage D. Egan, Helge Eilers, E. Wesley Ely, Charles W. Emala, Alex S. Evers, Heidrun Fink, Pierre Foëx, Stuart A. Forman, Helen F. Galley, Josephine M. Garcia-Ferrer, Robert W. Gereau, Tony Gin, David Glick, B. Joseph Guglielmo, Dhanesh K. Gupta, Howard B. Gutstein, Robert G. Hahn, Greg B. Hammer, Brian P. Head, Helen Higham, Laureen Hill, Kirk Hogan, Charles W. Hogue, Christopher G. Hughes, Eric Jacobsohn, Roger A. Johns, Dean R. Jones, Max Kelz, Evan D. Kharasch, Ellen W. King, W. Andrew Kofke, Tom C. Krejcie, Richard M. Langford, H. T. Lee, Isobel Lever, Jerrold H. Levy, J. Lance Lichtor, Larry Lindenbaum, Hung Pin Liu, Geoff Lockwood, Alex Macario, Conan MacDougall, M. B. MacIver, Aman Mahajan, Nándor Marczin, J. A. Jeevendra Martyn, George A. Mashour, Mervyn Maze, Thomas McDowell, Stuart McGrane, Berend Mets, Patrick Meybohm, Charles F. Minto, Jonathan Moss, Mohamed Naguib, Istvan Nagy, Nick Oliver, Paul S. Pagel, Pratik P. Pandharipande, Piyush Patel, Andrew J. Patterson, Robert A. Pearce, Ronald G. Pearl, Misha Perouansky, Kristof Racz, Chinniampalayam Rajamohan, Nilesh Randive, Imre Redai, Stephen Robinson, Richard W. Rosenquist, Carl E. Rosow, Uwe Rudolph, Francis V. Salinas, Robert D. Sanders, Sunita Sastry, Michael Schäfer, Jens Scholz, Thomas W. Schnider, Mark A. Schumacher, John W. Sear, Frédérique S. Servin, Jeffrey H. Silverstein, Tom De Smet, Martin Smith, Joe Henry Steinbach, Markus Steinfath, David F. Stowe, Gary R. Strichartz, Michel M. R. F. Struys, Isao Tsuneyoshi, Robert A. Veselis, Arthur Wallace, Robert P. Walt, David C. Warltier, Nigel R. Webster, Jeanine Wiener-Kronish, Troy Wildes, Paul Wischmeyer, Ling-Gang Wu, Stephen Yang
- Edited by Alex S. Evers, Washington University School of Medicine, St Louis, Mervyn Maze, University of California, San Francisco, Evan D. Kharasch, Washington University School of Medicine, St Louis
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- Book:
- Anesthetic Pharmacology
- Published online:
- 11 April 2011
- Print publication:
- 10 March 2011, pp viii-xiv
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An outbreak of Cryptosporidium hominis infection at an Illinois recreational waterpark
- L. M. CAUSER, T. HANDZEL, P. WELCH, M. CARR, D. CULP, R. LUCHT, K. MUDAHAR, D. ROBINSON, E. NEAVEAR, S. FENTON, C. ROSE, L. CRAIG, M. ARROWOOD, S. WAHLQUIST, L. XIAO, Y.-M. LEE, L. MIREL, D. LEVY, M. J. BEACH, G. POQUETTE, M. S. DWORKIN
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- Journal:
- Epidemiology & Infection / Volume 134 / Issue 1 / February 2006
- Published online by Cambridge University Press:
- 03 June 2005, pp. 147-156
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Cryptosporidium has become increasingly recognized as a pathogen responsible for outbreaks of diarrhoeal illness in both immunocompetent and immunocompromised persons. In August 2001, an Illinois hospital reported a cryptosporidiosis cluster potentially linked to a local waterpark. There were 358 case-patients identified. We conducted community-based and waterpark-based case-control studies to examine potential sources of the outbreak. We collected stool specimens from ill persons and pool water samples for microscopy and molecular analysis. Laboratory-confirmed case-patients (n=77) were more likely to have attended the waterpark [odds ratio (OR) 16·0, 95% confidence interval (CI) 3·8–66·8], had pool water in the mouth (OR 6·0, 95% CI 1·3–26·8), and swallowed pool water (OR 4·5, 95% CI 1·5–13·3) than age-matched controls. Cryptosporidium was found in stool specimens and pool water samples. The chlorine resistance of oocysts, frequent swimming exposures, high bather densities, heavy usage by diaper-aged children, and increased recognition and reporting of outbreaks are likely to have contributed to the increasing trend in number of swimming pool-associated outbreaks of cryptosporidiosis. Recommendations for disease prevention include alteration of pool design to separate toddler pool filtration systems from other pools. Implementation of education programmes could reduce the risk of faecal contamination and disease transmission.
The Ventricular System in Chronic Schizophrenic Patients: A Controlled Computed Tomography Study
- Anand K. Pandurangi, Mantosh J. Dewan, Seungho Howard Lee, Tarakad Ramachandran, Benjamin F. Levy, Michael Boucher, Allan Yozawitz, Leslie Major, Anand K. Pandurangi
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- Journal:
- The British Journal of Psychiatry / Volume 144 / Issue 2 / February 1984
- Published online by Cambridge University Press:
- 29 January 2018, pp. 172-176
- Print publication:
- February 1984
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Twenty-three chronic schizophrenic patients and 23 controls, all males between 20 and 40 years of age, were evaluated by CT scan. The lateral, third and fourth ventricles, the Sylvian fissures, and the largest sulcus from each of the frontal, parietal, and occipital lobes, were measured in order to determine whether the previously reported ventriculomegaly in schizophrenics was perhaps due to a disturbance of CSF flow or to atrophy, two common causes of ventricular enlargement. We found that in the schizophrenic group the third and fourth ventricles and both Sylvian fissures were significantly enlarged, but not the lateral ventricles or cerebral sulci. Our data suggest that these ventricular changes are not due to a disturbance of CSF flow or to cerebral atrophy. Other possible explanations are discussed.