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TACTICAL MEDICINE TACMED España
by EMS SOLUTIONS INTERNATIONAL

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viernes, 23 de noviembre de 2012

Mbeat PRO tecnología española para una temprana monitorización del infarto agudo de miocardio en el ámbito extrahospitalario

Mbeat PRO


Mbeat PRO

TECNICOS DE EMERGENCIAS SANITARIAS: Mbeat PRO tecnología española para una temprana mo...: Javier Álvarez Osunambeat es un sistema basado en la tecnología m-INSYDIA (mobile INteractive SYStem Diagnostic Aided) que permite una comunicación y transferencia de datos biomédicos incluso en zonas con baja cobertura.

martes, 20 de noviembre de 2012

Investigators: Risky rescues

Posted: Nov 19, 2012 7:55 PM Updated: Nov 19, 2012 10:33 PM

Investigators: Risky rescues: There have been more than 140 crashes involving accidents in the past three years, creating a risky road to rescue.


When an ambulance rushes through traffic with lights flashing and sirens blaring, it can create a wave of confusion among drivers, and some experts argue it can be an unnecessary risk to public safety.
FOX 9 Investigator Jeff Baillon got a rare firsthand look at the danger and what can be done to reduce the threat of accidents


Read more: Investigators: Risky road to rescue - KMSP-TV http://www.myfoxtwincities.com/story/20142219/investigators-medical-mayhem#ixzz2ClrmDWJJ

sábado, 17 de noviembre de 2012

Programa de formación online (gratuito):Gestión y asistencia a múltiples víctimas en situación NBQ. MERK, S.L.

Programa de formación online (gratuito): Gestión y asistencia a múltiples víctimas en situación NBQ. MERK, S.L.

Este programa ha sido acreditado por la Comisión de Formación Continuada de las
Profesiones Sanitarias de la Comunidad de Madrid-Sistema Nacional de Salud
con 7,1 créditos de formación continuada exclusivamente para las siguientes
Profesiones Sanitarias:
Médico
Enfermería
Psicología Clínica
Técnicos en Emergencias Sanitarias en posesión del título de F.P Grado medio
Técnicos en cuidados Auxiliares de Enfermeria.

El certificado expedido no tiene validez si no se acompaña del título acreditativo
correspondiente 

SI UD. PERTENECE A OTROS COLECTIVOS PROFESIONALES
OBTENDRÁ UN CERTIFICADO DE HABER REALIZADO EL PROGRAMA
CON EL NÚMERO DE HORAS DE PARTICIPACIÓN A DISTANCIA,
SIN QUE CONSTE EL Nº DE CRÉDITOS NI EL LOGOTIPO DE ACREDITACIÓN 
DE FORMACIÓN CONTINUADA.

Enlace para realizar el curso online ASINTES-USF

lunes, 12 de noviembre de 2012

SAM Pelvic Sling™ II



SAM PELVIC SLING II
FOR STABILIZATION OF PELVIC FRACTURES WITH THE CORRECT FORCE
The SAM Pelvic Sling™ II is the first and only force-controlled circumferential pelvic belt scientifically proven in peer-reviewed studies to safely and effectively reduce and stabilize open-book pelvic ring fractures. The SAM Pelvic Sling II was designed not to over-tighten or under-tighten, unlike other commercial binders which allow unlimited force to be applied to the patient. Researchers at Legacy Health System utilized cadaver studies and clinical trials to determine the optimum range of force required to safely and effectively close an unstable pelvic fracture.
The SAM Pelvic Sling II's patented Autostop buckle is programmed to stop your pull once the correct compression force has been obtained. This is vital in high stress environments where over-tightening by emergency medical personnel under duress could potentially be extreme and harmful.
Trauma surgeons around the world recognize the importance of stabilizing pelvic fractures during the critical first "golden hour" following severe trauma. Because of the potentially devastating hemorrhage associated with such fractures, standard first aid protocol includes applying some type of circumferential binder around the victim's hips.
ONE-PIECE DESIGN
The SAM Pelvic Sling II offers a simpler one-piece design with no detachable hardware. It is compact, easy to use (only three steps), and quick to apply (usually in less than one minute). The standard size fits (without cutting or trimming) 98% of the adult population. It does not require a fine touch to operate and gives clear feedback by sound and feel to confirm correct application.
The sling is durable and unaffected by extremes of moisture and temperature or by exposure to hard or sharp objects. It is also radiolucent, MRI safe, and can be cleaned for re-use with common detergents or anti-microbial solutions.
APPLIES IN 3 EASY STEPS
 
IMPORTANT WARNING
Based on in vitro testing, the SAM Pelvic Sling™ II will not present a hazard or risk to a patient undergoing an MRI procedure using an MR system operating at 3-Tesla or less. The SAM Pelvic Sling™ II contains ferromagnetic springs in the buckle. Therefore, it is important to ensure that the SAM Pelvic Sling™ II is firmly applied to the patient prior to entry into the MRI environment (as stated in the labeling for this device). Accordingly, there will be no hazard or risk to a patient undergoing an MRI procedure. The SAM Pelvic Sling™ II should not be removed from the patient while in the MRI system room.
WHY DOES CONTROLLING CIRCUMFERENTIAL FORCE MATTER IN THE TREATMENT OF PELVIC FRACTURES?
At the time of initial evaluation, the exact type of fracture is usually unknown. In some cases, too little force will not close or stabilize the fracture; in others, too much force can collapse the pelvic ring. The SAM Pelvic Sling II stands alone as the only pelvic binder pre-programmed to apply the safe and correct force for all pelvic fractures.
BENEFITS AND FEATURES
• Scientifically and clinically proven to provide safe and effective force to stabilize pelvic fractures
• Buckle maintains correct force; cannot be over-tightened
• Standard size fits 98% of population
• "Click" provides clear feedback to confirm correct application
• Pulling gradually and symmetrically increases sling tension and reduces the pelvis
• Low friction posterior slider facilitates transfers
• Front of Sling is narrow and tapered to facilitate urinary catheterization, interventional radiology, external fixation and abdominal surgery
• Fabric does not stretch and cleans for reuse with standard detergents or antimicrobial solutions
• Radiolucent (allowing for X-rays without removal)
• Ease of application: just insert belt through buckle, pull strap, and secure
• Velcro on strap and sling for quick and easy fastening
• Reusable, not a onetime use device
• Latex free


TECHNICAL DATA
Extra Small: Hip Circumference: 27"-47" (69cm x 119cm); 9oz
Standard: Hip Circumference: 32"-50" (81cm x 127cm); 9oz
Extra Large: Hip Circumference: 36"-60" (91cm x 152cm); 9oz
Military: Hip Circumference: 32"-50" (81cm x 127cm); 9oz
Made in USA
CE Approved
ISO 13485:2003
NSN# 6515-01-509-6866
Meets ASTM Standard F2428-04
Patents:
#8,192,383
#6,554,784



viernes, 9 de noviembre de 2012

Prehospital topical hemostatic agents - A review of the current literature


Prehospital topical hemostatic agents - A review of the current literature

Prehospital topical hemostatic agents – A review of the current literature
PHTLS Executive Committee
Lance E. Stuke, M.D. MPH

Background: The 7th edition PHTLS textbook discusses the use of topical hemostatic agents which were are available for prehospital use. Products come and go from the market so it is difficult to remain current on all available products. Additionally, older products may still be in use due to surplus, although they may not be commercially available.  Data on many of these products is based primarily on military reports and very little data is available on their use in the civilian prehospital setting. The vast majority of these products have been researched and developed for use in the military setting in Iraq and Afghanistan although some limited civilian data is also available. At the time of printing of the 7th edition of PHTLS, only Combat Gauze has been recommended by the Tactical Combat Casualty Care Committee (COTCCC) for military use.
            The perfect hemostatic dressing does not exist. Ideally, the dressing should be lightweight, easy to store, and able to be rapidly applied to a hemorrhaging wound. It should be conformable to the wound, allowing the hemostatic agent to reach areas of injury which are difficult to access with direct pressure (i.e. deep groin wounds). The dressing should cause minimal local tissue destruction, be easily removable from the wound, and not contain particles which can spread systemically. Finally, the dressing must not be washed away by rapid bleeding from high-flow blood vessels.
 Manufacturers have tried various methods to deliver hemostatic agents into bleeding wounds. Some products are packaged into a granular form which can be poured directly into the wound. Others are incorporated into a dressing or mesh which allows the provider to apply direct pressure to the site of injury. This dressing can be formed either as a rigid bandage, a small bag, or a gauze which must be unrolled prior to application. Each method of preparation has distinct advantages and disadvantages depending on the location and type of injury being treated.
Literature and Product Review:
HemCon: HemCon dressing (Hemorrhage Control Technologies, Portland, OR), is composed of chitosan, a substance derived from arthropod skeletons. Chitosan dressings are thought to function by mechanically sealing the wound and adhering to surrounding tissue. HemCon is a dual-sided 4 x 4 inch rectangular bandage: a chitosan-containing active side which must be placed directly on the wound and a nonstick side which the provider uses to apply pressure. The efficacy of HemCon depends entirely on the bandage adhering well to the wound, which is difficult in wounds which aren’t flat and easily accessible. The bandage isn’t flexible and can break when forced into a wound. It is best applied to flat, superficial wounds which are easily accessible. HemCon has been studied in both the military and civilian settings. The military demonstrated a 97% success rate in controlling bleeding with HemCon.1,2  The civilian experience has been less optimistic, controlling bleeding in 27 of 34 cases studied (79%). Of the seven failures, six were felt to be due to user error, possibly due to less training by civilian EMS providers in the proper use of the product.3   An additional study using a complex groin injury model in swine noted an increase in the rate of rebleeding and mortality between those treated with HemCon versus QuikClot.  The authors noted that application of HemCon was more difficult than other agents and all failures of HemCon were due to the bandage not adhering to the injured tissue to which it was applied.4
            As previously noted, a disadvantage of the HemCon dressing is that it is relatively non-conformable and difficult to pack into deeper wounds. ChitoFlex is the latest development from HemCon Medical Technologies. It utilizes the same chitosan-based hemostatic agent but packages it into a gauze form. This allows the dressing to be packed into deep bleeding wounds for improved access to the site of hemorrhage. ChitoFlex is available in several sizes, including 1”x3”, 3”x9”, and as a 3”x28” roll. In one study, ChitoFlex was found to be equivalent, but not superior to QuikClot and Celox (a chitosan granule).5
WoundStat: WoundStat was an FDA-approved mineral-based agent consisting of granular smectite, a nonmetallic clay. When the granules were exposed to blood they absorbed water, swelled, and formed a clay paste with strong adhesiveness to the surrounding tissue. Initial studies were promising6,7,8  and it was used by the U.S. Army for a short time. However, later data demonstrated that the granules could cause injury to the blood vessels and make repair difficult. The granules were also shown to enter the circulatory system and cause thrombosis in distal organs.9 Because of these potentially serious side effects, the U.S. Army announced in April 2009 that WoundStat would no longer be used by their medical personnel.
QuikClot:  QuikClot (Z-Medica, Wallingford, CT) is a granular product consisting of kaolin, which is a combination of inert minerals such as silicon, aluminum, magnesium, and sodium found in volcanic rock. When placed in a bleeding wound, it absorbs water thereby increasing the local concentration of clotting factors, platelets, and red blood cells to stimulate clot formation. A byproduct of its mechanism is a severe exothermic reaction, with heat generation of up to 70̊ C (158o F). This heat generation causes local tissue destruction and even burns. QuikClot has been studied in both the military and civilian sector, with up to 92% effectiveness in stopping hemorrhage.10 QuikClot was issued to U.S. soldiers in the Iraq and Afghanistan conflicts. Civilian use has been by a wide range of providers, including EMT/firefighters, paramedics, and police. Examples of civilian use include treatment of severe lacerations, gunshot wounds to the neck and even hemodialysis catheter dislodgement. Trauma surgeons have also used QuikClot for successful treatment of bleeding during surgery in the chest, abdomen, and pelvis. QuikClot was noted to have two significant weaknesses. Since it is a granular powder poured into a wound, it had limited usefulness in high-pressure bleeding (i.e. femoral artery bleed) as the granules were washed away by the bleeding before they were able to form a clot. Furthermore, the heat generated from its use was associated with several burns.
QuikClot production was stopped after development of several newer generation products. These newer generation products have minimal heat production and are packaged both as gauzes and in a bagged form. Currently Z-Medica sells QuikClot packaged in 2”x2” and 4”x4” gauze pads for use on superficial lacerations which don’t have severe bleeding. QuikClot has also developed a small zeolite-impregnated pad (QuikClot ACS+) and as a laparotomy pad (QuikClot Trauma Pad) for use by trauma surgeons in the operating room for cases of severe bleeding during surgery. This later product remains in the research phase and is not yet approved for widespread use.
Combat GauzeTM  is a 3”x4 yard long roll of nonwoven gauze impregnated with kaolin. Combat Gauze has all the advantages of normal gauze (easy application, flexible, large coverage area, and easily removable) with the additional advantage of hemostatic function from the kaolin. It is designed for packing into deep wounds which are actively bleeding (i.e. arterial injury in the groin). Prehospital personnel can also use combat gauze as they would any standard Kerlix gauze. Combat Gauze was recently compared to several newer generation products, including the HemCon RTS, and found to be superior and had no apparent side effects.11 A study from the Israel Defense Force reviewed fourteen uses of Combat Gauze and noted a 79% success rate.12 The authors noted that in the three instances where Combat Gauze was unsuccessful, the soldiers had such severe injuries that only surgical control was successful. One of the three soldiers died from the severity of his wounds. Currently, Combat Gauze is the only product endorsed by the Tactical Combat Casualty Care Committee and they recommend it as first line treatment for life-threatening hemorrhage on external wounds not amendable to direct pressure and tourniquet placement.
A disadvantage of most topical hemostatic agents is they require 2-5 minutes of direct pressure to be effective. This amount of time is often not available during care under fire situations seen in combat or during a mass casualty situation. A study published in the Journal of Trauma compared Combat Gauze (used by the U.S. military), Celox Gauze (used by the United Kingdom), and standard Kerlix gauze.13 A 6mm side-wall injury was created in swine, 30 seconds of free hemorrhage was allowed, and wounds were packed with one of the three gauzes. The animals were resuscitated with Lactated Ringers to maintain baseline mean arterial pressure. The authors noted no difference in success of either dressing. The Kerlix gauze was packed faster than Combat and Celox Gauze. There was no difference in survival, dressing success, or blood loss between the three dressings. The authors note they were somewhat surprised by this finding and note that in care under fire situations where tourniquet use is not an option, standard gauze packed in a wound performed equally well to Combat Gauze and Celox Gauze.
A study from the Naval Medical Center in Portsmouth, VA compared several commercially available topical hemostatic agents to the application of direct pressure with standard gauze.14 The authors used a swine model with a severed femoral artery and vein to simulate a high-velocity projectile injury with jagged surrounding muscle. Combat Gauze, WoundStat, Celox-A, and ChitoFlex were applied to the created injuries per the manufacturer recommendations. They were then compared to each other and to standard gauze applied using direct pressure. Manual pressure was held for 5 minutes and any bleeding occurring after this was considered a failure of hemostasis. Primary outcome measures were failure of initial hemostasis and the incidence of rebleeding. Secondary measures included total blood loss, amount of rebleeding, and survival. WoundStat performed more poorly than Celox-A in achieving initial hemostasis and in the incidence of rebleeding. Surprising to the authors, standard gauze and direct pressure performed equally as well as the 4 commercially available topical hemostatic agents. There were no significant differences in failure of initial hemostasis, rebleeding, or death between standard gauze and the other agents.

Summary:
- Numerous topical hemostatic products have been developed and released onto the       market.
- Some of these products have since been discontinued, while others are widely used. 
-Economic and medical considerations continue to make this a rapidly evolving and       growing area of prehospital care. It is important for the EMS provider to remain     cognizant of these products and their advantages, disadvantages, and complications as             they continue to evolve.
- Recent data suggests direct pressure with standard gauze may be equally effective as   commercially available hemostatic agents. Providers should consider this when attempting to control hemorrhage. Principles of adequate direct pressure and wound             packing continue to be the cornerstone of controlling severe traumatic bleeding from             penetrating extremity wounds.
PHTLS Recommendation:  Topical hemostatic agents may be used to control hemorrhage occurring in sites not amenable to tourniquet placement and which cannot be controlled by direct pressure alone.


           
            Bibliography
1.      Achneck HE, Sileshi B, Jamiolkowski RM, et al. A comprehensive review of topical hemostatic agents: Efficacy and recommendations for use. Annals of Surgery 2010; 251: 217-228.
2.      Mabry R and McManus JG. Prehospital advances in the management of severe penetrating trauma. Crit Care Med. 2008:36(7);S258-266.
3.      Brown MA, Daya MR, Worley JA. Experience with chitosan dressings in a civilian EMS system. J Emerg Med. 2009;62:239-243.
4.      Kozen BG, Kircher SJ, Henao J, et al. An alternative hemostatic dressing: comparison of CELOX, HemCon, and QuikClot.Acad Emerg Med. 2008; 15:74-81.
5.      Devlin JJ, Kircher S, Kozen BG, et al. Comparison of ChitoFlex, CELOX, and QuikClot in control of hemorrhage. J Emerg Med. 2009 Apr 1 (Epub ahead of print).
6.      Ward KR, Tiba MH, Holbert WH, et al. Comparison of a new hemostatic agent to current combat hemostatic agents in a swine model of lethal arterial hemorrhage. J Trauma. 2007;63:276-284.
7.      Kheirabadi BS, Edens JW, Terrazas IB, et al. Comparison of new hemostatic granules/powders with currently deployed hemostatic products in a lethal model of extremioty arterial hemorrhage in swine. J Trauma. 2009;66:316-328.
8.      Arnaud F, Parreno-Sadalan D, Tomori T, et al. Comparison of 10 hemostatic dressings in a groin transaction model in swine. J Trauma. 2009;67:848-855.
9.      Bheirabadi BS, Mace JE, Terrazas IB, et al. Safety evaluation of new hemostatic agents, smectite granules, and kaolin-coated gauze in a vascular injury wound model in swine. J Trauma. 2010;68:269-278.
10.  Rhee P, Brown C, Martin M, et al. QuikClot use in trauma for hemorrhage control: case series of 103 documented uses. J Trauma. 2008;64:1093-1099.
11.  Kheirabadi BS, Scherer MR, Estep JS, et al. Determination of efficacy of new hemostatic dressings in a model of extremity arterial hemorrhage in swine. J Trauma. 2009;67:450-460.
12.  Ran Y, Hadad E, Daher S, et al. QuikClot Combat Gauze Use for Hemorrhage Control in Military Trauma: January 2009 Israel Defense Force Experience in the Gaza Strip – A Preliminary Report of 14 Cases. Prehop Disaster Med 2010;25(6):584-588.
13.  Watters JM, Van PY, Hamilton GJ, et al. Advanced Hemostatic Dressings Are Not Superior to Gauze for Care Under Fire Scenarios. J Trauma. 2011;70:1413-1419.
14.  Littlejohn LF, Devlin JJ, Kircher SS, et al. Comparison of Celox-A, ChitoFlex, WoundStat, and Combat Gauze Hemostatic Agents Versus Standard Gauze Dressing in Control of Hemorrhage in a Swine Model of Penetrating Trauma. Acad Emerg Med. 2011:18(4);340-350.



FERNO XT FOR RAPID EXTRICATION

Ferno XT

Ferno XT



Product Category: Extrication
Ferno Product Code: FWE-XT1/2
Description:
The Ferno XT is a revolutionary utility board designed for rapid extrication and spinal
immobilisation in confined space areas and critical situations. It can accommodate a wide range of patients and clinical protocols including paediatric, special needs, bariatric, and pregnant women.
Key Features

• Fast extrication: less than 20 seconds with simplified application procedure.
• Easy application with four hi-visibility colour coded restraints and buckles
• Lightweight composite fibre board
• 100% x-ray translucent
• Easy to decontaminate
• Comes with QHI Quick Head Immobiliser with head/chin strap with storage pouch
• Dimensions: L 83 cm x W 30 cm
• Weight 2 kg


link to FERNO 

Enlace estudio relaciona en formato pdf (Ingles)

Pre-Hospital Care Management of a Potential Spinal Cord Injured Patient: A Systematic Review
of the Literature and Evidence-Based Guidelines

jueves, 8 de noviembre de 2012

República Dominicana avanza en materia de Rescate y Manejo de Desastres


República Dominicana avanza en materia de Rescate y Manejo de Desastres


DEFENSA CIVIL

El país cuenta con equipos modernos para realizar rescates

El país cuenta con equipos modernos para realizar rescates


 - 
Entre ellos están las “quijadas de vida” que se utilizan para salvar gente atrapada en vehículos accidentados

Republica Dominicana avanza en materia de Rescate y Manejo de Desastres
La Defensa Civil Dominicana cuenta con equipos de última generación para sus labores de salvamento en las circunstancias que se requieran, los cuales  han sido adquiridos por la entidad y donados por instituciones nacionales y extranjeras, así como por gobiernos y personalidades. A diferencia de como era antes, ahora la entidad está  más preparada para asistir a los ciudadanos en cualquier emergencias, lo que para algunos, constituye un avance en la prevención y el socorro.

Manuel Raimer, encargado de la Unidad Nacional de Respuestas Inmediatas, cuenta que los equipos a su disposición   están divididos por áreas, como por ejemplo los que utiliza la Unidad de Búsqueda y Rescate en Estructuras Colapsadas, dependencia creada hace tres años. Algunos de los equipos con que cuentan son los martillos de impacto, gatos hidráulicos, cinceles, motosierras y otros.

En el área de rescate vehicular tienen equipos de última generación. Para el rescate de víctimas en accidentes de vehículos pesados tienen extractores, los cuales se pueden utilizar como ventiladores, y gatos hidráulicos con capacidad de hasta veinte toneladas.

La entidad también cuenta con “quijadas de vida” que pueden cortar la carrocería de un vehículo para liberar a un accidentado. También tienen expansores, cortadoras y colchones neumáticos, entre otros equipos, mientras que para rescate en torrentes de agua, cuentan con chalecos con flotabilidad positiva, que ayuda a socorrer a una persona que se haya caído en un río.

También tienen cilindros de buceo, chapaletas, capas, botas y otros instrumentos indispensables para sus labores de asistencia a las víctimas en las distintas formas de accidentes e incidentes.

Lo que le hace falta

El cuerpo de socorro necesita unidades de traslado aéreo, pero mientras tanto, cuando es necesario utilizan helicópteros de la Fuerza Aérea Dominicana que inmediatamente se ponen a disposición, como manda la ley 147-02  sobre gestión de riesgo.

“Hemos ido de la mano con las necesidades y se han ido equipando todas las áreas. Tenemos la particularidad de que los miembros de la Unidad de Respuesta Inmediata son multidisciplinarios, capacitados en diferentes áreas y preparados para agotar distintos protocolos de trabajo, por ejemplo en caso de un derrame de combustibles, por el protocolo nosotros nos ponemos a disposición del Cuerpo de Bomberos, específicamente en la evacuación de las personas del lugar del accidente”, dice Raimer.

Aportes

Entre las instituciones que han hecho aportes tanto en equipos como en entrenamientos están el Programa de las Naciones Unidas para el Desarrollo; La Comunidad Europea y la Agencia de Cooperación Internacional de Corea (Koica).

Esta última donó equipos de comunicación como una antena omnidireccional tipo bahía, cargadores inteligentes y conectores para cables. En el Bajo Yuna existen equipos especializados para el rescate acuático como lanchas, equipos de buceo, boyas, cuerdas, mascarillas, aros salvavidas, cascos de rescate acuáticos, tablas flotantes y otros, para las inundaciones que con frecuencia se originan en esa zona.

En la actualidad, la Defensa Civil cuenta con 29 ambulancias distribuidas en puntos estratégicos en el país, que entran en acción cuando así lo requieren las circunstancias, pero durante los operativos de Semana Santa, Navidad y en las temporadas de emergencia, se suman otras unidades de la Cruz Roja, Salud Pública, de legisladores y del sector privado.

La Fuerza Aérea y la Caballería del Ejército ponen sus helicópteros a disposición de los operativos de rescate durante inundaciones y en otras ocasiones. Y aunque la entidad carece de helicópteros equipados para emergencias, por lo menos tiene su helipuerto cerca de la sede  donde funcionan las oficinas principales en la Plaza de la Salud.
Las tragedias lo hacen más fuerte
Mi momento más difícil fue un incendio que hubo en la cárcel de Higüey, donde fallecieron 117 reclusos. Nunca había visto morir a tanta gente calcinada en una misma cárcel. Me conmovió eso y el terremoto de Haití, donde dirigimos las operaciones hechas por la Defensa Civil”.

Sobre esta experiencia dijo que fue un impacto fuerte para él ver tantas personas muertas, a tal punto que debieron buscar ayuda de psicólogos guatemaltecos que estaban allá para superar las impresiones. Narra que los tres primeros días después del terremoto fueron difíciles.

“Vamos  para tres años de eso y todavía lo siento como si fuera hoy...Nosotros coordinábamos con las instituciones las extracciones de cadáveres, enfundarlos y esa forma nos llenaba de terror, esos tres primeros días en Haití no fueron fáciles”, dice.

Dice que entró a las instituciones de socorro por los huracanes David y Georges, pues vio que en su barrio no había personal de la Defensa Civil y convenció a otros jóvenes para juntos  crear el Comité de Los Mameyes.

6 minutos Tiempo de Respuesta de Bomberos del D.N. Rep. Dominicana

6 minutos Tiempo de Respuesta de Bomberos del D.N. Rep. Dominicana


Bomberos del DN garantizan respuesta en seis minutos

Especialista destaca desarrollo técnico de los bomberos del país
SANTO DOMINGO. El teléfono de los bomberos del Distrito Nacional es el 809-682-2000. A partir del llamado, los bomberos garantizan asistir la emergencia en un período entre cuatro y seis minutos.
En los últimos años, el Ayuntamiento del Distrito Nacional (ADN) y el Cuerpo de Bomberos se han establecido en doce estaciones y un Cuartel General dentro de los 92 kilómetros cuadrado capitaleños. La descentralización, asegura el jefe de los bomberos del Distrito Nacional, general Guillermo García, "permite tener una primera atención en tiempo por debajo de los parámetros internacionales, tenemos una estación por cada 6.5 kilómetros cuadrado. Inclusive en horas de mucho tráfico, entre cuatro y seis minutos".
En las circunstancias actuales resta como zona vulnerable la carretera Sánchez o avenida Independencia. Actualmente, el ADN construye la estación número trece, próximo al Kilometro 10 1/2, en el lugar también se adecua una funeraria municipal. Los puntos más cercanos a la zona denominada "Los Kilómetros" son las estaciones del Centro de los Héroes y la del Parque Mirador Sur. "Ahora mismo estamos débiles en los Kilómetros", admite.
Según García, los bomberos han podido establecer un sistema de atención a emergencias que a su entender ha demostrado funcionar con eficacia. "Tenemos la ciudad cuadriculada, ante un llamado, inclusive durante el peor momento del tránsito, podemos identificar de cuál estación podrá llegar primero un camión de bomberos. Porque si no podemos llegar con el más cercano desde una estación lo podemos hacer con otra", dice.
El técnico en situaciones de emergencia y Jefe de Operaciones del Centro de Operaciones de Emergencia (COE), Edwin Olivares, destaca que, además del despliegue que han logrado los bomberos en la capital, también se han desarrollado técnicamente. "Los bomberos del Distrito Nacional, los de San Francisco de Macorís, Santiago, Santo Domingo Este y Oeste se han ido profesionalizando y no son solo apagafuegos", dice Olivares.
Señala, no obstante, que por la naturaleza municipal de los bomberos, no hay suficiente equipamiento para las emergencias que se puedan presentar.
En el caso de los bomberos del Distrito Nacional, Olivares dice que ha podido adaptarse a las características locales. "El Distrito Nacional tiene condiciones muy especiales, tiene edificios muy altos y barrios muy pobres, tiene río, tiene mar, tiene calles muy estrechas y continúan trabajando para dar respuesta a las situaciones que se puedan presentar".
Personal de los bomberos
El cuerpo de bomberos está compuesto por 722 bomberos, de los cuales 322 son voluntarios y 400 son asalariados. Ambos grupos se someten a jornadas de trabajo de doce horas, en turnos de seis a seis, en supervisión nocturna y diaria.
En cada estación de bomberos hay un personal asignado compuesto por el comandante, el chofer, y tres miembros que ante una emergencia se convierte en la unidad de combate. Dependiendo de la emergencia, existen unidades de apoyo, compuestos por tres miembros, el chofer y otros dos bomberos.
"Pese a la capacidad de respuesta que podamos tener, los primeros minutos son los que determinan la función de los bomberos. Si no se hace la llamada rápidamente, lo que es un conato de incendio se puede convertir en un fuego en el que se pierda todo", dice García. Llama la atención que con frecuencia los que hacen la llamada telefónica son las personas que no tienen relación directa con el incendio. "La mayoría de las llamadas que recibimos son de las personas que no ven el fuego, hasta que sale de la casa. En esos casos lo que se busca es tratar de evitar la pérdida total", concluye el general.
CaracterísticasEquipamiento, tema de estado
18 camiones contra incendios tiene el Distrito Nacional.
7 Camiones pequeños combaten incendios en calles estrechas dentro de barrios y distribuyen agua.
Tres equipos en el Cuartel General, la avenida John F. Kennedy y La Feria asisten accidentes de tránsito.
En la estación de la Kennedy la unidad tiene capacidad para rescate de altura con un carro escala.
La estación en el barrio de La Ciénaga está equipada con un bote de rescate con capacidad para combatir incendios desde el río Ozama.
En 2011 fue creado el equipo de búsqueda y rescate Hurón compuesto por ocho hombres.
EQUIPAMIENTO, tema de estado 
El Jefe de Operaciones del COE, Edwin Olivares, explica que el equipamiento de los bomberos de todo el país debe manejarse como un asunto de Estado. "Los bomberos están preparados para el rescate de altura, espacios confinados, accidentes de tránsito, y accidentes industriales; pero por el Distrito Nacional, por ejemplo, transportan químicos que escapan de la ciudad, sustancias que no se apagan con agua ", dice Olivares, al señalar que el Gobierno central debe ayudar a las instituciones de emergencia por el alto costo que representa tener abastecimiento para tratar ese tipo de situaciones.

martes, 6 de noviembre de 2012

Sistema óptico no invasivo C8 para monitorizar la glucosa

Sistema óptico no invasivo C8 para monitorizar la glucosa

Sistema óptico no invasivo C8 para monitorizar la glucosa aprobado para su comercialización en Europa (VIDEO)

by  on  • 2:09 pm


C8 MediSensors, una compañía de San Jose, California, puede estar haciendo un poco historia al recibir la marca CE europea para su sistema óptico de monitarización de la glucosa. El sensor de la empresa utiliza la espectroscopia Raman para detectar la glucosa en sangre de manera no invasiva, utilizando el resplandor de la luz a través de la piel y detectando los cambios en el espectro que regresa.

Una vez que el sensor se pega a la piel, envía a un teléfono inteligente lecturas regulares de manera inalámbrica y utilizando Bluetooth, resultando en un control estricto de la glicemia y alertas casi instantáneas cuando los niveles de glucosa se salen de los parámetros preestablecidos. Actualmente el sistema es compatible con los teléfonos Android y se espera que esté disponible el año que viene una aplicación iOS.

Desde la página del producto:
El monitor C8 MediSensors no requiere recalibración constante para mantener la precisión del sensor. Excepto para mediciones periódicas de referencia de la línea de base, no hay que pinchar los dedos constantemente para recalibrar este monitor. Cuando se remueve y se vuelve a colocar, el monitor vuelve a medir la glucosa – sin necesidad de recalibrar o de reemplazar el sensor.

Nuestra técnica implica dirigir una fuente de luz monocromática sobre la piel y detectar la luz dispersada. Los colores generados por la dispersión Raman son muy específicos de la estructura química exacta de las moléculas en la muestra. Las diferentes formas, tamaños, átomos y tipos de enlaces químicos de las moléculas generarán espectros de Raman únicos, una ‘huella’ Raman singular que puede utilizarse para leer y medir la glucosa de manera no invasiva.
Pagina oficial del producto 


C8 Non-Invasive Optical Glucose Monitor

C8 Non-Invasive Optical Glucose Monitor

C8 Non-Invasive Optical Glucose Monitor System Cleared for Sale in Europe (VIDEO)

by  on  • 2:09 pm


C8 MediSensors, a San Jose, California company, maybe making a bit of history by  receiving the European CE Mark for their Optical Glucose Monitor System. The firm’s  sensor uses Raman spectroscopy to non-invasively detect glucose in blood by shining light through the skin and detecting changes in the returning spectrum.
Once the sensor is attached to the skin it sends out regular readings wirelessly over Bluetooth to a smartphone, allowing for tight glycemic control and near instant alerts when glucose levels go outside preset parameters. It’s currently compatible with Android phones and an iOS app is expected to be available next year.
From the product page:
The C8 MediSensors monitor does not require constant recalibration to maintain sensor accuracy. Except for periodic baseline reference measurements, there is no need for ongoing finger sticks to constantly recalibrate the C8 MediSensors monitor. After being removed and put back on, the monitor will resume measuring glucose – no recalibration or sensor replacement required.
Our technique involves shining a monochromatic light source into the skin and detecting the scattered light. The colors generated by Raman scattering are very specific to the exact chemical structure of the molecules in the sample. The molecules’ various shapes, sizes, atoms, and types of chemical bonds will generate unique Raman spectra, a unique Raman “fingerprint” that can be used to non-invasively read and measure glucose.
Official Web



lunes, 5 de noviembre de 2012

Abominal Aortic Tourniquet AAT™

Abominal Aortic Tourniquet AAT™

The Abdominal Aortic Tourniquet - AAT™Hemorrhage Stops Here™

The Abdominal Aortic Tourniquet is the first device to provide stable and complete occlusion of flow of blood to the lower extremities. It has 510(k) approval from the FDA for difficult to control inguinal hemorrhage. It is applied to the mid-abdomen, tightened and inflated and may remain on for up to an hour safely.

Available Mid-April 2012


Abdominal Aortic Tourniquet – AAT™

The project is focused at the number one priority identified by the Institute of Surgical Research for care on the battlefield: how to address uncompressible hemorrhage that is not treatable by a tourniquet in the leg, groin and inguinal region. This encompasses a significant capability gap related to preventable deaths. The solution to this problem must be stable, easy to apply and completely stop the loss of blood. The AAT™ is capable of this, and animal and human studies have demonstrated its safety and efficacy.

The AAT™ provides a rapid application of pneumatic compression to the aorta at the abdominal-pelvic junction to occlude blood flow in the inguinal arteries. The specific claim of the device is to occlude arterial flow through the inguinal region. The target of the compression is the aortic bifurcation, which has historically been identified in relation to the umbilicus or the superior margin of the iliac crests. Difficult bleeds in the inguinal region continue to be a significant source of morbidity and mortality on the battlefield. Providing solutions for treating these wounds have direct life saving results. Wounds to the pelvis and inguinal region are now preventable causes of death.

The AAT™ is a circumferential device that greatly increases the stability of the compression. The pneumatic wedge shaped bladder provides focused pressure to squeeze the blood vessels passing through the lower abdomen and preventing flow. The research referenced below demonstrates the safety of up to one hour of application and its effectiveness in non-invasively cross-clamping the aorta or fully stopping all blood flow to the pelvis and lower extremities. In essence the AAT™ acts as a valve to figuratively ‘turn the faucet off’ and prevent the further flow of blood out of wounds below its application site.

Blood is the vital component to surviving blunt or penetrating trauma in the golden hour. It allows oxygen to be carried to the heart, brain and kidneys. Every drop of blood lost impacts survival. Why let any of it spill to the ground when we can prevent its loss?

Research

Georgia Health Sciences University (formerly the Medical College of Georgia) has conducted research on the device using a swine model in 2009. Flow was undetectable in the femoral catheter during the tourniquet application. For hemodynamic variables, there were no significant differences in MAP or CVP measurements among animals. However, using one way repeated measures analysis of variance, there was a significant difference in MAP (P = 0.008) between 0 and 55 minutes for each subject. Serum potassium did not reach clinically significant numbers. However, serum lactate was significantly different between times 55 minutes (3.6 mmol/L +/- .95) and after tourniquet release 65 minutes 5.9 mmol/L +/- .87) (p <0.001). Gross and histological examination revealed no signs of significant ischemia or necrosis of the small and large intestine. These data were presented at the Advanced Technology Applications for Combat Casualty Care conference in August 2009 and the American College of Emergency Physicians Scientific Assembly in 2009.

Application of the device was studied on humans in 2011 again at the Georgia Health Sciences University and found to be safe and effective during the protocol. The Common Femoral Artery (CFA) was reduced to a no flow state by applying an average of 191 mm Hg. The device was associated with moderate discomfort that resolved completely with device removal. These data were presented at the Advanced Technology Applications for Combat Casualty Care conference in August 2011.

FDA Approval

Compression Works received FDA approval for the AAT™ on October 22, 2011.
AUGUSTA, Ga. – Two emergency medicine physicians with wartime experience have developed a weapon against one rapidly lethal war injury. Insurgents commonly aim just below a soldier’s body armor, where the trunk and legs join, to injure the body’s largest blood vessels, causing soldiers to bleed to death within minutes.
Dr. Richard Schwartz“There is no way to put a tourniquet around it, so soldiers are getting shot in this area and dying within several minutes,” said Dr. Richard Schwartz, Chairman of the Department of Emergency Medicine in the Medical College of Georgia at Georgia Health Sciences University. Police officers wearing chest protection as well as automobile accident victims can sustain similar injuries.
Efforts to externally compress the injury have been largely ineffective; the inch-round aorta runs parallel to the spine, so it can’t be approached from the back, and is several inches inside the abdomen even in a fit soldier.
Schwartz and Dr. John Croushorn, Chairman of the Department of Emergency Medicine at Trinity Medical Center in Birmingham, Ala., hope their inflatable wedge-shaped bladder will make a lifesaving difference.
Abdominal Aortic Tourniquet
Abominal Aortic Tourniquet AAT™
It’s called an abdominal aortic tourniquet and it’s placed around the body at the navel level, tightened then, much like a blood pressure cuff, inflated into the abdomen until it occludes the aorta and stops the bleeding. The goal is to restore the golden hour so soldiers survive long enough to get definitive care for their injury.
“By effectively cross-clamping the aorta with the abdominal aortic tourniquet, you are essentially turning the faucet off,” Croushorn said.  “You are stopping the loss of blood from the broken and damaged blood vessels. You are buying the patient an additional hour of survival time based on blood loss.”
It was known that the knee pressed into the mid-abdomen could slow bleeding and block blood flow to the legs. The idea for the device came from studies conducted at GHSU in 2006 that quantified pressure needed to occlude the abdominal aorta. Schwartz and Croushorn started talking about turning that concept into a lifesaving device at an American College of Emergency Physicians meeting.
They first put the device on pigs, inflated it to the point there was no blood flow from the aorta to the femoral arteries and left it that way for an hour. There saw no potentially deadly increase in potassium levels in the blood and the pigs’ leg and gut tissue remained healthy. Next they used it on healthy humans for a shorter duration to ensure that the aorta could be completed occluded.
Croushorn and Schwartz have premarket clearance for the abdominal aortic tourniquet from the Food and Drug Administration and have identified a manufacturer. They already have orders for the device from the U.S. military and will teach courses on how to use it to the military and law enforcement. Device development was funded by the U.S. Department of Defense.
The physicians still want to explore their device’s potential for also helping CPR recipients. The chest compression that is the hallmark of CPR actually pushes blood all the way out to the extremities when the focus is keeping vital organs alive.
“With this device, you could, in theory, double the blood flow to the kidneys, heart and brain,” Schwartz said. They also believe it will help concentrate drugs given during CPR where they are needed. “Now when a medic pushes a cardiac drug during cardiac arrest, the drug is circulated through the toes before it reaches steady state concentrations in the heart,” Croushorn said.
Schwartz was a member of the 5th Special Forces Group (Airborne) during Operation Desert Shield and Desert Storm. He works with the Federal and Georgia Bureaus of Investigation and helped develop courses that bridge the gap between military and civilian groups that may work together during major disasters.  Croushorn served as Command Surgeon, Task Force 185 Aviation in the U.S. Army in Iraq in 2004. He also works with the FBI.

Emergency medicine physicians develop device to stop lethal bleeding in soldiers