Optimizing Medical Care during a Nerve Agent Mass Casualty Incident Using Computer Simulation.

Introduction: Chemical mass casualty incidents (MCIs) pose a substantial threat to public health and safety, with the capacity to overwhelm healthcare infrastructure and create societal disorder. Computer simulation systems are becoming an established mechanism to validate these plans due to their versatility, cost-effectiveness and lower susceptibility to ethical problems.

Methods: We created a computer simulation model of an urban subway sarin attack analogous to the 1995 Tokyo sarin incident.

Commuting and sick leave: a retrospective longitudinal study among a Belgian military population.

Objectives: In a military context, people often have to deal with long commuting distance. The aim of the current study is to investigate to what extent commuting distances predict sickness absence among a military population.

Methods: The present study is based on a dynamic cohort of active-duty military personnel of the Belgian Defence.

Creating realistic nerve agent victim profiles for computer simulation of medical CBRN disaster response.

In the last decades, Chemical, Biological, Radiological and Nuclear (CBRN) threats have become serious risks prompting countries to prioritize preparedness for such incidents. As CBRN scenarios are very difficult and expensive to recreate in real life, computer simulation is particularly suited for assessing the effectiveness of contingency plans and identifying areas of improvement. These computer simulation exercises require realistic and dynamic victim profiles, which are unavailable in a civilian context.

SIMEDIS: a Discrete-Event Simulation Model for Testing Responses to Mass Casualty Incidents.

It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion.

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.

Carotid artery dissection: three cases and a review of the literature.

Carotid artery dissections are potentially disabling, probably underdiagnosed, and mainly affect young-aged and middle-aged people. We present three consecutive cases illustrating different clinical presentations and thereby emphasizing the diagnostic challenge of carotid artery dissections for the emergency physician. Neck and facial pain, headache, unilateral pulsatile tinnitus, partial Horner's syndrome (or oculosympathetic palsy), amaurosis fugax, retinal infarction, and anterior circulation brain ischemia may all occur in isolation or in various combinations.

Aetiology of unsuccessful prehospital witnessed cardiac arrest of unclear origin.

Objectives: To determine, by means of autopsy, the cause of death following unsuccessful cardiopulmonary resuscitation of patients with a witnessed prehospital cardiac arrest of unclear origin.

Method: Observational study of all prehospital-witnessed cardiac arrest of unclear origin over a period of 19 months in the emergency medical service region of a tertiary care hospital.

Results: During the study period, 211 prehospital cardiopulmonary resuscitation attempts were recorded.

The effect of anti-L-selectin (aselizumab) in multiple traumatized patients--results of a phase II clinical trial.

Objective: The objectives of this study were to evaluate safety (primary) and clinical efficacy (secondary) of the humanized monoclonal anti-L-selectin antibody aselizumab in severely injured patients.

Design: Prospective phase II, parallel group, double-blind, randomized, placebo-controlled clinical trial.

Setting: Fourteen medical intensive care units or trauma units in level I trauma centers in Belgium, Germany, and Poland.

What do we know about patients dying in the emergency department?

Objective: To determine our knowledge in terms of cause of death and quality of death certification about patients who die in the emergency department. To establish the role of autopsy in this matter.

Methods: Retrospective chart review of all patients dying in an academic emergency department (ED) of a tertiary hospital over a period of 1 year.