Utstein-style template for uniform data reporting of acute medical response in disasters.

Background: In 2003, the Task Force on Quality Control of Disaster Management (WADEM) published guidelines for evaluation and research on health disaster management and recommended the development of a uniform data reporting tool. Standardized and complete reporting of data related to disaster medical response activities will facilitate the interpretation of results, comparisons between medical response systems and quality improvement in the management of disaster victims.

Methods: Over a two-year period, a group of 16 experts in the fields of research, education, ethics and operational aspects of disaster medical management from 8 countries carried out a consensus process based on a modified Delphi method and Utstein-style technique.

Spontaneous intrahepatic gas gangrene and fatal septic shock.

Gas gangrene of the liver is a rare clinical syndrome associated with a high rate of mortality. It is mostly associated with malignancy and immunosuppression. We report on a male patient who presented at the department of emergency medicine with high fever but no localised complaints.

An unusual case of hyperglycemia, abdominal pain, and increased anion gap acidosis.

In this case report we try to illustrate the importance of correct diagnostic reasoning and the misleading features of point-of-care testing. This case illustrates that even though hyperglycemia, ketonuria, a raised anion gap metabolic acidosis, and acute abdominal pain almost inevitably warrant a diagnosis of diabetic ketoacidosis, other possibilities still exist and need to be excluded. In that light, we emphasize the clinical and therapeutic importance of determining serum lactate and urinary ketones in the differential diagnosis of a raised anion gap metabolic acidosis.

European survey on training objectives in disaster medicine.

Objectives: As part of the I SEE (Interactive Simulation Exercise for Emergencies) project, financially supported by the Leonardo da Vinci Programme 2000-2006 of the European Commission, a study was planned to assess the type of disaster and to establish the tasks to be included in an emergency exercise to be developed, according to the possible target groups, physicians, nurses, ambulance personnel, dispatchers and first responders. A secondary objective was a description of the actual computer-based training situation in the training centres. A study involving different actors or target groups has not yet been conducted.

Sudden drooling and supine gagging: an important emergency?

We describe a case of an eupnoeic patient complaining of a foreign body sensation in his mouth and throat, with sudden drooling and supine gagging. This condition was caused by an isolated uvular angioedema (Quincke's oedema). As this uvular hydrops did not decrease with initial standard therapy for angioedema, epinephrin was applied directly on the swollen uvula, causing it to shrink very rapidly.

A proposed universal medical and public health definition of terrorism.

The lack of a universally applicable definition of terrorism has confounded the understanding of terrorism since the term was first coined in 18th Century France. Although a myriad of definitions of terrorism have been advanced over the years, virtually all of these definitions have been crisis-centered, frequently reflecting the political perspectives of those who seek to define it. In this article, we deconstruct these previously used definitions of terrorism in order to reconstruct a definition of terrorism that is consequence-centered, medically relevant, and universally harmonized.

The problems faced by three government disaster response teams of Ankara city during the Marmara earthquake - 1999 response.

Objectives: The objectives of this study were to determine the organization/system and personal problems faced by the personnel of Ankara greater municipality Firebrigade Department (firemen), Ankara Emergency Aid and Rescue Services (ambulance personnel), Civil Defence General Directorate's Ankara Search and Rescue Unit (rescuers), who participated in the 1999 Marmara earthquake.

Materials And Methods: A total of 1132 individuals were in the universe of the study; the total rate of participation was 95.1% (1076 individuals).

Hollow visceral injury after blunt lower thoracic and abdominal trauma.

The early diagnosis of hollow viscous injury after blunt abdominal trauma remains a challenge for physicians in the Emergency Department, although the early diagnosis of hollow viscous injury decreases morbidity and mortality. After a description of two cases of hollow viscous injury after blunt abdominal trauma, a literature review is performed concerning the indications and limitations of diagnostic imaging modalities. Focused abdominal sonography for trauma, computed tomography scan and diagnostic peritoneal lavage are described.

Nursing issues in care for the elderly in the emergency department: an overview of the literature.

Emergency care is an important link in the chain of care for geriatric patients. Due to the specific physiological, psychological, and social needs of elderly people, the type and quantity of emergency care are different for this group of patients than for other age groups. Consequently, they have a significant impact on the health care system.

Fatal intentional poisoning cases admitted to the University Hospitals of Leuven, Belgium from 1993 to 1996.

Between January 1993 and July 1996, a total of 2827 intentional cases of poisoning were registered in the University Hospitals of Leuven, Belgium. Ten of these cases were fatal. This study was set up to evaluate the substances involved, the circumstances, the features and the characteristics of the patients who died due to intentional poisoning.

Chest pain in the emergency department: the broad spectrum of causes.

We performed a prospective study to describe the broad spectrum of causes of chest pain in patients presenting to the emergency department and to compare the diagnoses in referred patients, self-referred patients and patients rushed in by ambulance. The final diagnosis in a consecutive case series of 578 chest pain patients was established after discharge from the hospital. The underlying disorders were grouped into cardiac, respiratory, gastro-oesophageal disorders, musculoskeletal pathology, somatization disorders, other diseases and unknown.

Chest pain in general practice or in the hospital emergency department: is it the same?

Objective: The aim of the present study was to provide a description of the impact of setting on the diagnostic case mix that is identified in consecutive patients presenting with chest pain.

Methods: A cross-sectional study was carried out of patients presenting with chest pain according to setting: general practice, self-referred, referred or arriving by ambulance at the hospital emergency department (ED). GPs from 25 general practices situated in the Flemish part of Belgium were recruited, and the hospital involved was a major teaching hospital in the same area.

A nurse-led interdisciplinary intervention program for delirium in elderly hip-fracture patients.

Objectives: To develop and test the effect of a nurse-led interdisciplinary intervention program for delirium on the incidence and course (severity and duration) of delirium, cognitive functioning, functional rehabilitation, mortality, and length of stay in older hip-fracture patients.

Design: Longitudinal prospective before/after design (sequential design).

Setting: The emergency room and two traumatological units of an academic medical center located in an urban area in Belgium.

Telehealth and communication technologies in health: summary and action plan.

Introduction: Rapid innovations and improvements in communication technologies have opened many new channels for health education and delivery, as well as disaster management. Theme 2 examined the role and applicability of these technologies to Disaster Medicine and Management and the various issues involved in their use.

Methods: Details of the methods used are provided in the introductory paper.

Systematic triage in the emergency department using the Australian National Triage Scale: a pilot project.

The objective of this study was to evaluate the validity in Belgium of the National Triage Scale for judgement of the urgency of a patient's condition and making a case-mix description of the patient profiles in the different urgency categories. The study is of a descriptive retrospective and descriptive correlational design and was carried out in the emergency department at the University Hospital Gasthuisberg in Leuven, Belgium. The urgency of patients arriving at the emergency department was evaluated during one randomly selected shift a day over 12 weeks in 1997 by one of the four triage-educated nurses, using an instrument based on the National Triage Scale.