When severe storms strike, would you know how to evacuate public places?

From the Des Moines Register:

Similar quick thinking in the heart of the emergency helped the staff and patients at Greater Regional Medical Center in Creston last Saturday.

The National Weather Service had warned of severe weather for a few days before the storm. Hospital staff took precautions. They pulled blinds in patient rooms. They reviewed evacuation and tornado safety procedures. When the storm came as promised, the hospital and nearby Southwestern Iowa Community College took big hits.

An EF2 tornado with winds topping out at 100 mph toppled mobile phone towers, ripped loose phone lines and knocked out power to much of the city of 7,800. The Union County emergency dispatch center experienced a brief glitch.

“The best-laid plans don’t always come to fruition,” said LouAnn Snodgrass, spokeswoman for Greater Regional Medical Center. “We had to respond to the change. It made us scramble, but everybody got the job done.”

It forced emergency responders in Creston to get creative in communications. Officials followed protocols established as part of the post-Sept. 11, 2001, terrorist attacks called the National Incident Management System. The system standardizes responses and communications for everything from a weather disaster to a terrorist attack so that agencies from the National Guard to volunteer firefighters can mitigate damage and casualties.

Post-Resuscitation Therapeutic Hypothermia Decreases Mortality

From Science Daily (Hat Tip: Steve Flugrad):

Forced body cooling known as therapeutic hypothermia has reduced in-hospital deaths among sudden cardiac arrest patients nearly 12 percent between 2001 and 2009, according to a Mayo Clinic study being presented at the upcoming American Academy of Neurology 2012 Annual Meeting in New Orleans.

The Emergency Department Action in Smoking Cessation (EDASC) Trial: Impact on Delivery of Smoking Cessation Counseling

From Academic Emergency Medicine:

Objectives:  The focus on acute care, time pressure, and lack of resources hamper the delivery of smoking cessation interventions in the emergency department (ED). The aim of this study was to 1) determine the effect of an emergency nurse-initiated intervention on delivery of smoking cessation counseling based on the 5As framework (ask-advise-assess-assist-arrange) and 2) assess ED nurses’ and physicians’ perceptions of smoking cessation counseling.

Methods:  The authors conducted a pre-post trial in 789 adult smokers (five or more cigarettes/day) who presented to two EDs. The intervention focused on improving delivery of the 5As by ED nurses and physicians and included face-to-face training and an online tutorial, use of a charting/reminder tool, fax referral of motivated smokers to the state tobacco quitline for proactive telephone counseling, and group feedback to ED staff. To assess ED performance of cessation counseling, a telephone interview of subjects was conducted shortly after the ED visit. Nurses’ and physicians’ self-efficacy, role satisfaction, and attitudes toward smoking cessation counseling were assessed by survey. Multivariable logistic regression was used to assess the effect of the intervention on performance of the 5As, while adjusting for key covariates.

Results:  Of 650 smokers who completed the post-ED interview, a greater proportion had been asked about smoking by an ED nurse (68% vs. 53%, adjusted odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.3 to 2.9), assessed for willingness to quit (31% vs. 9%, adjusted OR= 4.9, 95% CI = 2.9 to 7.9), and assisted in quitting (23% vs. 6%, adjusted OR = 5.1, 95% CI = 2.7 to 9.5) and had arrangements for follow-up cessation counseling (7% vs. 1%, adjusted OR = 7.1, 95% CI = 2.3 to 21) during the intervention compared to the baseline period. A similar increase was observed for emergency physicians (EPs). ED nurses’ self-efficacy and role satisfaction in cessation counseling significantly improved following the intervention; however, there was no change in “pros” and “cons” attitudes toward smoking cessation in either ED nurses or physicians.

Conclusions:  Emergency department nurses and physicians can effectively deliver smoking cessation counseling to smokers in a time-efficient manner. This trial also provides empirical support for expert recommendations that call for nursing staff to play a larger role in delivering public health interventions in the ED.