Today's society is exposed to an increasing number of disasters and large scale emergencies (e.g. earthquake in Haiti, global swine flu, or manmade disasters like the oil spill in the Gulf of Mexico). Information and communication technology (ICT) can help to prevent and mitigate the effects of threatening situations if applied appropriately. In industry ICT governance methods have become important tools to successfully align ICT with business goals. However, the domain of emergency management (EM) has to deal with unpredictable situations, multi organizational collaborations and ad-hoc teams, conditions which make conventional ICT governance frameworks and methods less useful. Based on a qualitative analysis of several European and Australian EM organizations and government agencies this paper discusses the issues and benefits of strategic ICT alignment in EM and identifies the current barriers and the special requirements of this domain. Finally, it presents a prototypical approach to fill this gap.

Strategic ICT Alignment in Uncertain Environments: An Empirical Study in Emergency Management Organizations

Purpose

To investigate the relationship between different types of adverse drug reaction (ADR) and late time to N-acetylcysteine (NAC) infusion in patients presenting to the hospital with acetaminophen overdose.



Methods

This is a retrospective study of patients admitted to the hospital for acute acetaminophen overdose over a period of 5 years (1 January 2004 to 31 December 2008). The primary outcome of interest was the relationship between ADR, if any, and late time to NAC infusion. Parametric and non-parametric tests were used to test differences between groups depending on the normality of the data. SPSS 15 was used for data analysis.



Results

Of 305 patients with acetaminophen overdose, 146 (47.9%) were treated with intravenous NAC and 139 (45.6%) were included in this study. Different types of ADR were observed in 94 (67.6%) patients. Late time to NAC infusion was significantly associated with cutaneous anaphylactoid reactions when compared to patients without this type of ADR (p < 0.001). However, there were no significant differences in time to NAC infusion between patients with and without the following ADR: gastrointestinal reactions (p = 0.11), respiratory reactions (p = 0.77), central nervous reactions (p = 0.64), and cardiovascular reactions (p = 0.63).



Conclusion

Late time to NAC infusion is a risk factor for developing cutaneous anaphylactoid reactions, suggesting, rather than proving, that early NAC infusion (≤8 hours) may be protective against this type of ADR. Copyright © 2010 John Wiley & Sons, Ltd.

Effects of delay in infusion of N-acetylcysteine on appearance of adverse drug reactions after acetaminophen overdose: a retrospective study.

Factors at the scene of injury associated with air versus ground transport to definitive care in a state with a large rural population.

Trust has long been identified as an essential component in different disciplines. However, trust in the context of emergency management is a less often researched phenomenon. This article intends ...

Trust and emergency management: Experiences from the Arctic Sea region

Introduction: Community paramedicine (CP) establishes an ongoing patient relationship beyond short emergency care episodes. How care planning and case management have been adapted from the isolated incidents of traditional practice is unclear.  The objective of this study is to contribute to paramedic practice by examining broad areas of care planning in CP, identifying gaps in the evidence, clarifying key concepts, and reporting on the types of evidence that address and inform practice.  A qualitative analysis of included literature outlines program capacities and identifies comprehensive models of care that can inform clinical practice in CP. Methods:  A scoping study was completed that included conducting a systematic search of the literature (in MEDLINE and CINAHL) and selecting relevant studies, followed by data extraction, summarizing, and reporting.  The authors of included studies were contacted to confirm the aspects of care planning that were extracted from their respective studies.  Aspects of care planning were compared between studies and used to generate a comprehensive list of existing practices. Results:   Ten of 1648 studies met inclusion criteria.  Qualitative analysis identified 22 aspects of care planning along four themes; enrollment (n=3), assessment and management (n=6), intervention and care (n=5), and collaboration (n=8).  No study included all 22 aspects of care planning.  One aspect of care planning was present in all 10 studies; collaboration with primary care providers. Conclusion:  The aspects of care planning identified through this study provide a framework that can guide service providers in the delivery of care and researchers in defined outcome measures to be assessed.  Future program development should be guided by the finding that all articles included in this study included collaboration with primary care providers.  By summarizing care planning within CP programs, ongoing program development can embrace collaboration with other care providers to help insure that patients receive the appropriate care.

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A scoping study and qualitative assessment of care planning and case management in community paramedicine

Do you ever know the book? Yeah, this is a very interesting book to read. As we told previously, reading is not kind of obligation activity to do when we have to obligate. Reading should be a habit, a good habit. By reading, you can open the new world and get the power from the world. Everything can be gained through the book. Well in brief, book is very powerful. As what we offer you right here, this principles of ems systems is as one of reading book for you.

Bruce Evans

Papers

Principles of EMS Systems

Toxic temptations: treating pediatric patients with hydrocarbon poisoning.