The position of the tracheal tube in tracheal intubation is confirmed by the primary and secondary confirmation methods. However, incorrect intubation (esophageal intubation) can not be detected perfectly by these methods. Prehospital tracheal intubation often results in incorrect intubation. Objectives: A fiberscope (FS) was developed for the confirmation of intubation, and its usefulness for confirming the position of the tracheal tube was evaluated. Methods: The position of the tracheal tube was confirmed using a FS in 30 patients who underwent tracheal intubation in the emergency room. Results: Since one of the 30 patients showed esophageal intubation, tracheal intubation was performed 31 times. The tube was confirmed to be in the trachea in 28 of the 31 cases, and in the esophagus in one case. The position of the tube could be confirmed in 29 (93.5%) of the 31 cases. In two cases, the tube position could not be confirmed because of an inadequate visual field due to airway secretion, but reintubation after tracheal aspiration allowed confirmation of the tube in the trachea. The mean time required for confirmation was 7.1 ±3.1 seconds. Discussion: At present, the apparatus used by emergency medical technicians for the determination of esophageal intubation has a sensitivity of about 70%, causing many false-negative cases. Though the protocol indicates confirmation after pharyngeal re-exposure when emergency medical technicians are not confident after primary and secondary confirmation methods, this procedure is difficult. In such a situation, the FS, associated with a high accurate confirmation rate, is useful.
Study/Objective: To determine community level awareness of risk factors for stroke and cardiovascular disease, in a remote and medically underserved region of Ghana. Background: Hypertension and other non-communicable diseases are growing risk factors for cardiovascular disease and stroke in developing countries. A multi-region survey from a central clinic investigating participants' level of awareness and education surrounding hypertension and stroke, provides important information to guide primary prevention and public health response. Methods: A central clinic in Nkonya-Wurupong, Ghana, evaluated 1,671 patients in July 2016, and a group of 302 adults over the age of 18 provided a convenience sampling. The survey examined three main areas; demographics, medical history and knowledge deficit with respect to stroke and cardiovascular risk factors. Results: Fifty-six participants demonstrated hypertension (BP >139/89), of which 17 were male and 37 female. One-hundred and six believed hypertension was a risk factor for stroke. Twenty-six were medicated for hypertension. The majority of the participants believed that modifiable factors put them at risk for stroke, and that stroke was preventable. Diet, heart disease, smoking, obesity, diabetes, sedentary lifestyle or alcohol were not identified as risk factors. One-sided weakness was consistently associated with stroke. Other symptoms included in the survey were headache, slurred speech, visual changes, dizziness, and facial droop. It was difficult to discern the sources of participants' information. A few respondents did indicate school, internet, radio, TV, medical books, or health professionals. Conclusion: Knowledge of the link between hypertension, car-diovascular disease and stroke varies significantly, along with stroke-symptom identification and sources of medical information. Many participants indicated the belief that stroke can be prevented, however it is unclear what respondents believe modifiable risk factors consist of. This data suggests there are major areas where healthcare education is needed. Discerning baseline health and medical knowledge in remote and developing regions, is essential for disaster preparedness and primary prevention. "Zaschita", Moscow/Russian Federation Study/Objective: Analyze telemedicine consultations made in the All-Russian Center for Disaster Medicine (ARCDM). Background: The territory of the country is more than 11 billion square miles, and there is no sufficient, medically qualified staff centers. Methods: The structure of the provision of telemedicine consultations (TMC) of Russian disaster medicine service includes center of control crisis situations, having a connection with 21 federal hospitals and regional centers of disaster medicine, and having contact with the republican (regional) hospitals. ARCDM have mobile telemedicine complexes, based mobile satellite communication VSAT-stations, for use in emergency situations, which provides a system to quickly deploy remote support operations for rescuers and medical sta...
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