Emergenciologos Registrados en Republica Dominicana

LISTADO EMERGENCIOLOGOS EN REPÚBLICA DOMINICANA

Más información http://www.sodoem.org/

Consenso sobre la vacunación frente a la gripe en el personal sanitario. España 2012

Enlace para bajar documento en pdf
Consenso sobre la vacunación frente a la  gripe en el personal sanitario
España 2012

Emergency AmbiCycle

Emergency AmbiCycle 

Emergency AmbiCycle Designed to Save Lives in Tight Spots

The AmbiCycle is an alternative compact transportation device specifically designed to transport patients from the scene to the hospital

COLLEGE STATION, TX — From small villages with long dirt roads to crowded cities with traffic at a standstill, maneuvering today’s ambulance during an emergency simply may not be an option. But promptly reaching patients to treat them effectively is nonnegotiable.

That’s where the AmbiCycle comes in. An alternative compact transportation device specifically designed to transport patients from the scene to the hospital, it’s about the width of a Harley-Davidson motorcycle, nine feet long and has three wheels.

Mark Benden, PhD, CPE, assistant professor at the Texas A&M Health Science Center (TAMHSC) School of Rural Public Health, and Eric Wilke, M.D., medical director of College Station (TX) EMS, began design efforts on the AmbiCycle in summer 2008.

During a volunteer medical trip to Uganda a few months earlier, Dr. Wilke saw a need for an emergency transportation vehicle that could navigate crowded and narrow streets in rural areas.

Ambulances in the United States are typically around 13 feet long, eight feet high and struggle to maneuver through congested traffic. These bulky vehicles also face difficulties getting to patients in rural areas fast enough, sometimes taking more than 30 minutes to arrive.

Alternatives to ambulances had been attempted in rural and metropolitan areas but produced major setbacks. Trailers attached to bikes were not safe on modern roads with motorized traffic. Motorcycle sidecars had a width almost equal to a car and were difficult to maneuver.

After scratching ideas for trailers pulled by a moped or bike, Dr. Wilke and Dr. Benden focused on a vehicle that could offer improved performance compared to trailers and sidecars.

“The AmbiCycle becomes more stable to drive when a patient is loaded,” Dr. Benden said. “All the others have the opposite effect.”

The AmbiCycle is more stable since its compact body allows the driver and patient to be on the same plane and maintain visual contact. This small device is designed to evacuate patients from areas at risk, damaged by storms and under heavy traffic with inadequate emergency medical services.

“The AmbiCycle is the only patient transport that might make it through gridlocked traffic to get a patient to care during the ‘golden hour,’ ” Dr. Benden said.

This type of patient transport is an affordable alternative to a full ambulance. While a standard size ambulance costs $75,000, the AmbiCycle target cost is around $5,000. This vehicle gives users the option of either electric or gas power and gets 83 miles per gallon.

Medical accessories were specifically designed for the AmbiCycle, including helmets, unique litters, backboards and restraints. Patient covers and filtered air options are included in the designs, while high-tech medical monitoring and treatment devices are additional options.

The AmbiCycle isn’t just designed for everyday use, either; 36 can fit onto a single 53-foot trailer, making it ideal for disaster relief. It’s also an option for military wounded soldier transport.

Currently, a commercial prototype of the AmbiCycle has been developed using a platform from Automoto, a California company. This street legal vehicle has three wheels, two of which are in the front. The Automoto vehicle is used as a platform and modified into a prototype of the AmbiCycle.

This vehicle is U.S. patent pending, and a fourth-generation prototype is currently being evaluated by medics, emergency room doctors and nurses, and multiple international health care organizations, including several in the Middle East, South America and Africa.

“The idea at this point is to produce a scalable, deployable vehicle that can be affordable at purchase and during maintenance. We hope this evacuation solution will save lives all over the developing world,” Dr. Benden said.

About Texas A&M Health Science Center
The Texas A&M Health Science Center provides the state with health education, outreach and research through campuses in Bryan-College Station, Dallas, Temple, Houston, Round Rock, Kingsville, Corpus Christi and McAllen. Its six colleges are the Baylor College of Dentistry, College of Medicine, College of Nursing, School of Graduate Studies, Irma Lerma Rangel College of Pharmacy and School of Rural Public Health. Other units include the Institute of Biosciences and Technology and Coastal Bend Health Education Center.

Link this info was taken emsworld.com

No más saleros en Restaurantes de Buenos Aires Argentina

El gobierno de la provincia de Buenos Aires, en Argentina, inició este lunes un programa que eliminará a los saleros de las mesas de los restaurantes.
El objetivo de la medida –que se enmarca dentro del Programa Provincial de Hipertensión Arterial- es lograr una reducción en el consumo de sal y con ello reducir los riesgos cardíacos de la población.
Enlace para ampliar información desde BBCmundo.com

MANEJO DEL PACIENTE EN EL PARO CARDIORESPIRATORIO / RCP AVANZADA. Dr. Ovaldo Rois. Fundación EMME

RCP AVANZADA ACLS

RCP AVANZADA ACLS

RCP AVANZADA

FUNDACION EMME

By Dr. Osvaldo Rois

Fundación EMME Argentina

Enlace para bajar documento completo 

MANEJO DEL PACIENTE EN EL PARO CARDIORESPIRATORIO pdf

Enlace para bajar Guia RCP 2010

Propiedades anticancerígenas del orégano y el maíz. Estudio

Descubren propiedades anticancerígenas del orégano y el maíz

El doctor Silverio García Lara y los alumnos Fernando Castro Álvarez y Enrique García Pérez del Campus Monterrey realizan cultivos in vitro del orégano y el maíz, para evaluar sus propiedades anticancerígenas y otros beneficios para la salud

JST-Tec de Monterrey/DICYT Aunque el orégano y el maíz son alimentos milenarios que se han consumido durante siglos, en pleno Siglo XXI sus propiedades nutracéuticas siguen sorprendiendo a los investigadores, como dos alumnos de posgrado del Tecnológico de Monterrey, Campus Monterrey quienes recientemente, comprobaron que ambas plantas poseen fuertes propiedades anticancerígenas.

Fernando Castro Álvarez y Enrique García Pérez, alumnos de la Maestría en Ciencias con Especialidad en Biotecnología (MBI) del Campus Monterrey, desarrollaron una investigación que estuvo enfocada a determinar el perfil fitoquímico y nutracéutico del orégano y el maíz, dos alimentos que han sido básicos en la alimentación mexicana.

"Nuestra idea es redescubrir el potencial de las plantas mexicanas, pues siempre hemos conocido sus capacidades nutracéuticas, pero ahora lo estamos comprobando científicamente: son plantas consumibles que tienen capacidades anticancerígenas y que pueden prevenir enfermedades", dijo el doctor Silverio García Lara, profesor investigador de la Escuela de Biotecnología y Alimentos, y asesor de ambos alumnos.

Analizan plantas mexicanas

El alumno Enrique García evaluó los compuestos químicos del orégano mexicano, en particular de una especie silvestre que es muy común en la región de Nuevo León y Coahuila.

Mediante pruebas, pudo cuantificar el triptófano, los carotenoides y los compuestos fenólicos, los cuales previenen la oxidación de las células y se constató que podían ostentar propiedades anticancerígenas mediante tratamiento.

"Analicé la actividad antioxidante y anticancerígena de los compuestos químicos, y cómo estos se pueden incrementar tratando la planta de diferentes maneras. Lo que hicimos fue incrementar su potencial nutracéutico para prevenir enfermedades", explicó.

García dijo que tras asegurar la conservación de la especie, se realizó un cultivo de tejidos in vitro, y se observó que de esta forma la planta presentaba mejores características y beneficios para la salud que en su hábitat natural.

Por su parte, Fernando Castro analizó el perfil nutracéutico de un tipo de maíz elite con alta concentración de compuestos fitoquímicos, y descubrió que existe una relación entre el estrés biótico y el potencial nutracéutico, es decir, que los maíces que son resistentes a plagas presentan mayores propiedades.

El doctor Silverio García asegura que el maíz tiene más propiedades de las que se conocen, y que seguirá sorprendiendo a los científicos durante los próximos años. Asimismo, lamenta que su consumo vaya a la baja debido al estigma que tiene dicho alimento.

"El maíz ha sido la base de nuestra alimentación por siglos, por eso su estudio siempre nos ha interesado. Podemos decir que estamos apenas en la base de descubrir todos los compuestos nutracéuticos que contiene", señaló.

"Los mexicanos hemos consumido maíz durante siglos, pero eso es algo que nos ha estigmatizado mucho en México, ya que muchos piensan que la alimentación basada en maíz no es la mejor. Sin embargo, estamos comprobando científicamente que hemos adquirido muchas defensas desde el punto de vista de la salud. Desde que los mexicanos hemos dejado de consumir maíz se ha disparado el número de enfermedades crónico-degenerativas. Hay que regresar al maíz", comentó.

Ganan beca al Plant Biology 2012

Por sus descubrimientos y aportaciones, Fernando Castro y Enrique García fueron galardonados con una beca para asistir a la reunión anual de unas de las comunidades científicas más reconocidas en Estados Unidos, la American Society of Plant Biologist, la cual fue establecida en 1923.

Ambos estudiantes viajaron a Austin, Texas, del 19 al 24 de julio, en donde dieron a conocer los avances obtenidos de sus investigaciones y compartieron con otros investigadores extranjeros su experiencia de realizar la Maestría en Biotecnología.

"Aplicamos con nuestros proyectos científicos y la recompensa fue un viaje con todo pagado a la edición 2012 de dicho congreso. Fue una experiencia enriquecedora y a la vez una gran oportunidad para evaluar la investigación que realizamos en el Campus Monterrey con el resto del mundo", mencionó Enrique García.

Enlace para fuente de la información

Manual Operativo del COE Centro de Operaciones de Emergencias de la República Dominicana

El Centro de Operaciones de Emergencia (COE), en base a las experiencias hechas en el sector de la gestión de las emergencias, ha considerado necesario realizar un manual sintético, con el fin de estandarizar y unificar los procedimientos, las estructuras, el lenguaje y todos los otros aspectos que entran en juego durante una emergencia que requiere su activación.
Muchas veces, por supuesto, se encuentran actitudes de improvisación justo en los momentos que sería necesario seguir comportamientos consolidados y automáticos.
El objetivo fundamental es producir un documento de fácil consulta y de uso inmediato por parte del COE para que se definan de forma unificada roles, funciones y procedimientos.
La esperanza es que este documento sea un recurso vivo, conocido por cuantas más personas estén involucradas en la gestión de la emergencia y que tenga su asiento en cada una de la sala del COE para ser fácilmente consultado por parte de los operadores.

Enlace para bajar documento en formato pdf dedes la web www.coe.gov.do

Fecha publicación:	23.04.2010
Tamaño:	1.62 MB

Nuevo auto-Inyector de Epinefrina con guía verbal

Inyector de epinefrina Auvi-Q guíado verbalmente aprobado en EE.UU. (video)

Fuente MedGadget Español

by TILO FEBRES-CORDERO on ago 13, 2012 •

Sanofi acaba de anunciar la aprobación de la FDA para su inyector de epinefrina Auvi-Q, que guía al usuario verbalmente y paso por paso sobre cómo utilizarlo en caso de una reacción alérgica severa. Al extraer el dispositivo de su caja, una voz le indica cual es el primer paso.

Pequeños sensores detectan el cumplimiento de cada paso y al instante se sucede la próxima indicación verbal.

Le presentamos un video corto de cómo funciona el sistema:

MORITA Forest firefighting. VIDEO

Forest firefighting concept vehicle wins 2011 IDEA Gold Award

JUL. 15, 2011 - 05:27AM JST

From Japan today

OSAKA —

Morita Holdings Corp has been awarded a 2011 IDEA Gold Award - the highest possible award - in the Commercial and Industrial Products category for its forest firefighting concept vehicle. The International Design Excellence Awards (IDEA) are the preeminent design awards in the United States.

The award-winning forest firefighting concept vehicle is a future prototype fire truck developed through the joint efforts of Morita’s technical, development, and design teams. The goal of the concept vehicle’s design is to solve many of the problems encountered when fighting large-scale forest fires, which occur frequently around the world.

Communication is critical when fighting forest fires because the fires tend to change direction moment by moment due to weather and forest conditions. The concept vehicle is outfitted with all the advanced data and telecommunication functions to serve as a local communications base as well as with the ability to navigate through rough roads and fight fires while on the move. And because it is difficult to locate water sources in the midst of a forest fire, it is equipped with a compressed air foam system (CAFS) developed by Morita. Using only a small amount of water, CAFS gives the vehicle superb fire extinguishing capability.

In awarding the IDEA Gold Award, the judges praised the design of the forest firefighting concept truck: “The wildfire truck illustrates the power of a bold, refined prototype to test innovative thinking by richly probing a market space with a visceral, hands-on experience of the features and brand,” they said in a statement. 

JCN Newswire

Toronto EMS Special Operations Support Unit

Toronto EMS by gopherit2, on Flickr

Toronto EMS by gopherit2, on Flickr

Toronto EMS by gopherit2, on Flickr

Toronto EMS by gopherit2, on Flickr

Stretchers: Changing the Way We Move our Patients

Stretchers: Changing the Way We Move our Patients

Kathryn L. Hall-Boyer, MD, FACEP
Chair

In field medical exercises with the Army Reserve, we use two-wheeled stretchers to transport patients.  These stretchers are amazing. Due to fascination on my part, I decided to do a bit a research about these stretchers.

The wheel was developed around the 5th Century BC in Mesopotamia¹. There were no major changes in the wheel until the 19th century when pneumatic tires were invented. Two-wheeled stretchers were used back into at least the 19th century. Baron Mundy’s and Neuss’s two-wheeled stretchers² are shown in the references below. I found in Google Book Search the description of two-wheeled carts to transport patients in the Army Surgeon’s Manual printed in 1864³. We used these stretchers to move bags across the base in Bosnia when we moved into our quarters. They transport patients over all sorts of terrain and we continue to care for patients on these stretchers in the emergency treatment areas. The base has two wheels and stabilization bars at each end. These are raised when the cart is wheeled. The canvas stretcher on top is separate and also can be hand carried.

This is one amazing stretcher that with minimal modifications has been used over 140 years on the battle field. Modifications may further improve its durability, maneuverability, transportability, and other features, but it is still quite an invention.

References:

1. Longmore and Morris. A Manual of Ambulance Stretchers. 1893. p. 192-193. See also the discussion of the Geneva Convention and Red Cross starting on page 56. http://books.google.com/books?id=-qk9f_8VmhoC&pg=PA193&lpg=PA193&dq=Neuss's+two+wheeled&source=bl&ots=bHhtcnEH-G&sig=1-MO63RBXVaSU7WVC1ts6W2O3t8&hl=en&sa=X&oi=book_result&resnum=1&ct=result#PPA193,M1.
2. http://books.google.com/books?id=WptXLoeE3QcC&pg=PA22&lpg=PA22&dq=two+wheeled+army+stretcher&source=bl&ots=hVLWGkfISI&sig=fT1lwBwLRMo09COJlkuyHmBiRrs&hl=en&sa=X&oi=book_result&resnum=1&ct=result#PPA7,M1.

Curso de Reducción del Riesgo de Desastres (RRD). USAID

Curso de Reducción del Riesgo de Desastres (RRD) pdf

CURSO SEGURIDAD ESCOLAR (CUSE) Material de Referencia USAID

CURSO SEGURIDAD ESCOLAR (CUSE) pdf
Material de Referencia USAID

Wilderness Medicine Institute. VIDEOS

For two decades and with over 114,000 graduates, the NOLS Wilderness Medicine Institute's (WMI) mission is to provide the highest quality education and information for the recognition, treatment, and prevention of wilderness emergencies.

Mission

The Wilderness Medicine Institute is the leader in wilderness medicine education. Our goal is to provide the highest quality education and information for the recognition, treatment, and prevention of wilderness emergencies.

Link to National Outdoor Leadership School

"PREPARATE" CRUZ ROJA AMERICANA

Enlace para bajar lista en formato pdf

Opioid Overdose

Posted by Sara Fazio • July 13th, 2012

The rate of opioid analgesic overdose is proportional to the number of opioid prescriptions and the dose prescribed. A new review in our Drug Therapy series considers the epidemiology, mechanisms, and management of opioid analgesic overdose.

Opioid analgesic overdose is a preventable and potentially lethal condition that results from prescribing practices, inadequate understanding on the patient’s part of the risks of medication misuse, errors in drug administration, and pharmaceutical abuse. Between 1997 and 2007, prescriptions for opioid analgesics in the United States increased by 700%; the number of grams of methadone prescribed over the same period increased by more than 1200%.

Clinical Pearls

• What are the clinical manifestations of opioid analgesic overdose?

Opioid analgesic overdose encompasses a range of clinical findings. Although the classic toxidrome of apnea, stupor, and miosis suggests the diagnosis of opioid toxicity, none of these findings are consistently present. The sine qua non of opioid intoxication is respiratory depression. Failure of oxygenation, defined as an oxygen saturation of less than 90% while the patient is breathing ambient air and with ventilation adequate to achieve normal ventilation, is often caused by pulmonary edema that becomes apparent later in the clinical course. Hypothermia may arise from a persistently unresponsive state in a cool environment or from misguided attempts by bystanders to reverse opioid intoxication by immersing a patient in cold water. In addition, persons who have been lying immobile in an opioid-induced stupor may be subject to rhabdomyolysis, myoglobinuric renal failure, and the C.

• How does development of tolerance of respiratory depression compare to tolerance of analgesia?

Tolerance of respiratory depression appears to develop at a slower rate than analgesic tolerance; over time, this delayed tolerance narrows the therapeutic window, paradoxically placing patients with a long history of opioid use at increased risk for respiratory depression.

Morning Report Questions

Q: What laboratory tests should be ordered in cases of suspected opioid overdose?

A: The acetaminophen concentration should be measured in all patients because of the prevalence of diversion and misuse of acetaminophen-containing opioids. Clinicians often overlook acetaminophen hepatotoxicity. Quantitative measures of drug concentrations are useless in cases of overdose because patients who have been prescribed elevated doses of opioid analgesics may have therapeutic serum concentrations that greatly exceed laboratory reference ranges. Qualitative analyses of urine for drugs of abuse (toxic screens) rarely affect decisions about patient care and have little role in the emergency evaluation and management of opioid intoxication.

Q: How should opioid overdose be treated?

A: Naloxone, the antidote for opioid overdose, is a competitive mu opioid-receptor antagonist that reverses all signs of opioid intoxication. The onset of action is less than 2 minutes when naloxone is administered intravenously, and its apparent duration of  action is 20 to 90 minutes, a much shorter period than that of many opioids. Dosing of naloxone is empirical. The effective dose depends on the amount of opioid analgesic the patient has taken or received, the relative affinity of naloxone for the mu opioid receptor and the opioid to be displaced, the patient’s weight, and the degree of   penetrance of the opioid analgesic into the central nervous system. The initial dose of naloxone is 0.04 mg; if there is no response, the dose should be increased every 2 minutes to a maximum of 15 mg. If there is no abatement in respiratory depression after the administration of 15 mg of naloxone, it is unlikely that the cause of the depression is opioid verdose. Reversal of opioid analgesic toxicity after the administration of single doses of naloxone is often transient; recurrent respiratory depression is an indication for a continuous infusion or for orotracheal intubation.

Link information

"SAFE LIFES" Philips / AED

Link  to Philips Save Lifes

Demo how to use and AED 

Leonid Rogozov - The Surgeon Who Operated on Himself

In April, 29^th, 1961 a doctor of the 6^th Soviet Antarctic expedition Leonid Rogozov aged 27 felt pain in a right lower belly and fever. The next day brought only exasperation. Having no chance to call a plane and being the only doctor at the station “Novolazarevskaya”, at night, in April, 30^th the surgeon made an appendix removal operation on himself using local anesthesia. He was assisted by an engineer and the station’s meteorologist.




In 1959 Leonid Rogozov graduated from the Institute and was immediately accepted to the surgery clinical residency. However, his studies at the residency were broken off for some time due to Leonid’s trip to Antarctica in September, 1960 as a doctor of the 6^th Soviet Antarctic expedition to Novolazarevskaya station.

During this expedition there happened an event that made a 27-year old surgeon world-famous.




In the 4^th month of the wintering, in April, 29^th, 1961, Leonid showed disturbing symptoms: weakness, nausea, fever and pain in a right iliac region. The following day his temperature got even higher. Being the only doctor in the expedition consisting of 13 people, Leonid diagnosed himself: acute appendicitis. There were no planes at any of the nearest stations, besides, adverse weather conditions would not allow to fly to Novolazarevskaya anyway. In order to save the sick member of a polar expedition there was needed an urgent operation on site. And the only way out was to operate on himself.




At night, on the 30^th of April, 1961, the surgeon was being helped by a mechanical engineer and a meteorologist who were giving him the medical instruments and holding a small mirror at his belly. Lying half bent on the left side, the doctor made a local anesthesia with novocaine solution and made a 12cm incision in the right iliac region with a scalpel. Either watching in the mirror or by touch he removed an inflamed appendix and injected antibiotic in the abdominal cavity. In 30 or 40 minutes from the beginning of the operation there developed a faint and giddiness and the surgeon had to make pauses for some rest. Nevertheless, by midnight the operation lasting 1 hour and 45 minutes was over. In five days the temperature normalized, in two days more – the stitches were taken out.




In the St. Petersburg Museum of the Arctic and the Antarctic there is an exposure of surgical instruments that Leonid Rogozov applied for this uneasy operation. 




An astronaut-pilot of the USSR, a Hero of the Soviet Union, German Titov wrote in his book “My blue planet”:

“In our country an exploit is life itself.

… We admire the Soviet doctor Boris Pastukhov, who injected himself with plague vaccine before applying it on the sick people: we envy the courage of the Soviet doctor Leonid Rogozov who made an appendix removal operation on himself in the hard conditions of the Antarctic expedition.

Sometimes I reflect upon this in solitude and ask myself if I could do the same and only one answer comes to my mind: “I would do my best…” 

Areas mayor vulnerabilidad en Republica Dominicana

Noticias|29 jun|   Argénida Romero

 Trece provincias en alto grado de vulnerabilidad

Santo Domingo. Trece provincias del país, cerca de un 40% del territorio nacional, se encuentran en un estado de alta vulnerabilidad ante los fenómenos naturales y el cambio climático.

Así lo revelaron los resultados del estudio "Puntos críticos para la Variabilidad y Vulnerabilidad al Cambio Climático y su Adaptación al mismo", presentado ayer con los auspicios de la Agencia de los Estados Unidos para el Desarrollo (USAID, por sus siglas en inglés) y The Nature Conservancy.

Los resultados, expuestos por la consultora Michela Izzo, establecen que de estas provincias, las más vulnerables son Pedernales, Bahoruco, Barahona, Elías Piña, El Seibo y Santo Domingo (provincia Santo Domingo y Distrito Nacional). A éstas les siguen La Altagracia, San Pedro de Macorís, Monte Plata, Peravia, Montecristi y Valverde.

Entre los puntos críticos de estas demarcaciones están: en Santo Domingo la gran concentración poblacional, urbana e industrial; en las provincias de la región Suroeste las inundaciones, sequía y ciclones tropicales; y en la provincias del Este por los elementos insostenibilidad del modelo turístico (salinización de las aguas subterráneas, ecosistemas degradados, etc.).

En sus recomendaciones, el estudio indica la necesidad de educación de la población sobre los eventos de peligrosidad ambiental, buscar soluciones locales con la participación de las comunidades, fomentar modelos alternativos de desarrollo, entre otras.

Fuente de la Informacion Diariolibre.com 

Mas Informacion Listindiario.com

Curso PHTLS Avanzado en Rep. Dominicana

27-28-29 SEPTIEMBRE 2012

Contacto: Alexander Pacheco 

emssolutionsint@gmail.com 

Tel +1 809 849 9295 

Mas informacion en el Enlace Curso PHTLS

MANEJO TORMENTAS SEVERAS Centro Nacional de Prevención de Desastres Mexico

MANEJO DE TORMENTAS
Manual en formato pdf
Centro Nacional de Prevención de Desastres Mexico

GUIA DE ACTUACION EN URGENCIAS 4ta Edicion Mayo 2012

GUIA DE ACTUACION EN URGENCIAS 

4ta Edicion Mayo 2012

MANUEL JOSE VAZQUEZ LIMA / JOSE RAMON CASAL CODECIDO

Enlace para bajar Guia en formato pdf

DESASTRES AEREOS Dr. Javier Vásquez Salas, Peru

Enlace para visualizar presentación en pdf desde reeme.arizona.edu