Accidental Death and Disability The Neglected Disease of Modern Society (1966) / Chapter Skim
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Emergency First Aid and Medical Care
Emergency First Aid and Medical Care
Pages 12-22
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From page 12... ...
First Aid Beyond the fifth grade of elementary school, every American citizen should be trained in basic first aid. Since initiation of the American National Red Cross first aid training program in 1909, over 28,000,000 students have been certified by qualified instructors (who currently number over 73,0001.8 This course should be, but is not, universally required as a prerequisite to the more advanced training of lifeguards, rescue squad personnel, ambulance attendants, policemen, firemen, personnel in public health and industrial clinics, and attendants at sports events.
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From page 13... ...
Only in the American National Red Cross training program and in the Medical Self-Help Program are nationally acceptable textbooks and standardized courses of instruction provided. There is need for equally acceptable textbooks and courses of instruction to meet the special requirements of rescue squad personnel and of ambulance attendants.
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From page 14... ...
There are no generally accepted standards for the competence or training of ambulance attendants. Attendants range from unschooled apprentices lacking training even in elementary first aid to poorly paid employees, public-spirited volunteers, and specially trained full-time personnel of fire, police, or commercial ambulance companies.
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From page 15... ...
3. Adoption at district, county, and municipal levels of ways and means of providing ambulance services applicable to the conditions of the locality, control and surveillance of ambulance services, and coordination of ambulance services with health departments, hospitals, traffic authorities, and communication services.
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From page 16... ...
Communication Although it is possible to converse with the astronauts in outer space, communication is seldom possible between an ambulance and the emergency department that it is approaching. It is important to recognize that major accidents, including disasters, provoke community response not only of first aid workers, ambulances, and hospital emergency departments but also authorities concerned with traffic, fire, security, utilities, civil defense, and others, and that communication facilities involve functions pertinent to each responding agency.
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From page 17... ...
Usually a hospital is notified of a disaster through local radio or television or by telephone communication from police, or by the walking wounded. Certainly, the seriously ill and the injured deserve centralized screening and dispatching communication facilities as efficient as those used by taxicabs and in the coordination of personnel and equipment in fire fighting, forestry service, or highway maintenance.
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From page 18... ...
Emergency Departments For decades the `'emergency" facilities of most hospitals have consisted only of "accident rooms," poorly equipped, inadequately manned, and ordinarily used for limited numbers of seriously ill persons or for charity victims of disease or injury. Very few hospitals have met the needs imposed since World War II for the vast expansion of facilities, equipment, and personnel demanded by society, poor and rich, for routine off-hour treatment of nonemergency conditions and of the steadily increasing numbers of accidental injuries.
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From page 19... ...
These include contractual relationships between the hospital and a group of physicians, usually general practitioners, who undertake all emergency care and staffing requirements for the emergency department. Some hospitals require that all medical personnel, regardless of specialty, share emergency department responsibility, including night coverage.
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From page 20... ...
Once the required numbers and the types of treatment facilities have been determined, it may be necessary to lessen the requirements in some institutions, increase them in others, and even redistribute resources to support space, equipment, and personnel in the major emergency facilities. Until patient, ambulance driver, and hospital staff are in accord as to what the patient might reasonably expect and what the staff of an emergency facility can logically be expected to administer, and until effective transportation and adequate communication are provided to deliver casualties to proper facilities, our present levels of knowledge cannot be applied to optimal care and little reduction in mortality or lasting disability can be expected.
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From page 21... ...
Type 2. The Limited Emergency Facility This type is found in many hospitals whose emergency departments function 24 hours daily, chiefly as outpatient clinics or first aid facilities, but are nevertheless often confronted with the need to render major emergency care beyond their capabilities.
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From page 22... ...
Specialized consultants must be available at all times. The need for ready availability of highly qualified specialists in all branches of medicine and surgery and of laboratories devoted to clinical support and research strongly supports the view that the major emergency facility should be an integral element of large hospitals and university medical centers, rather than an isolated facility devoted solely to emergency care.
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