Mobile Intensive Care Units: Advanced Emergency Care Delivery Systems

Emergency care is improving throughout the world and thousands of lives are being saved each year. However, there are still too many patients who die before help reaches them in the form of advanced rescue and definitive emergency care techniques. In an effort to improve emergency care throughout the world, the International Committee of Emergency and Disaster Medicine meets bi­ annually. This meeting takes place in Mainz, Germany in September in order to discuss issues, exchange information, and establish re­ commendations designed to improve emergency care. The group is in~ dependent of political, national, racial, religious, or commercial influences and, in this sense, similar to the Club of Rome which attempts advances in sociology, biology and natural sciences. There­ fore, the organization could be called the "Club of Mainz" for the field of emergency and disaster medicine. The following book contains the proceedings of the International Symposiom on "Mobile Intensive Care Units and Advanced Emergency Care Units" at Mainz from September 24-27, 1973, and the discussions evoked by the first activities of the "Club of Mainz" and the inter­ nationally acknowledged "Recommendations". At this time we also announce the next meeting and International Symposium on Disaster Medicine, open to the public, organized by the "Club of Mainz" (October 1 - 2, 1977).

Table of Contents:
I. Flanning and Organization of the Emergency Medical Services System.- I. 1. The Concept of an Emergency Health Care Planning Team.- I. 2. On the Organization in the Piemonte and Torino Areas.- I. 3. The American Approach to Improvement of Emergency Medical Services: Community Councils of EMS.- I. 4. Political Roadblocks to Organizing Emergency Medical Services (EMS) in Allegheny County, USA.- I. 5. Allegheny County, Pennsylvania1s Emergency Care Non-System.- I. 6. Centralization of all Personnel and Equipment in Rescue Services.- I. 7. Intervention of Helicopters in Disaster Relief and Rescue Service in the Federal Republic.- II. Communications.- II. 1. Telemetry Command in an Integrated Emergency Care System.- II. 2. Interdisciplinary Nature of Mobile Intensive Care Units.- II. 3. Possibilities and Limits in the Use of Bio-Telemetric Appliances in Rescue-Services.- II. 4. A Communication Set up for Air, Sea and Ground EMS.- III. Treatment at the Scene and Düring TransportationIncluding Physician Command.- III. 1. The MAST-1 Garment in Hypovolemic Shock.- III. 2. Behandlung am Notfallort und während des Transportes im Hochgebirge.- III. 3. Cardiovascular and Other Effects of Transporting III Patients.- III. 4. A Simple Method for Continuous ECG Registration by Compact Casette Tape Recorder Düring Helicopter Transport.- III. 5. Features of a New Intensive Care. Ambulance.- III. 6. The S-61 Helicopter as Mobile Intensive Care Unit.- III. 7. Mobile Neonatal Intensive Care.- III. 8. Care for and transport of Newborn Babies in the Ambulance practice.- III. 9. Secondary Transportation in Southern Finland.- 111.10. The Mobile Intensive Care Unit in Helsinki.- 111.11. Experiences in a Mobile Intensive Care Unit in Lagos.- 111.12. Der Service d1 Aide Medicale d’Urgence.-111.13 Experiences with an Ambulance-Service in Oslo Manned by a Doctor.- 111.14. Mobile Intensive Care Units.- 111.15. Transport of the Severely Injured Düring Long-Distance Flight.- 111.16. Function of a Coordinated Helicopter-Emergency Service.- 111.17. Importance and Complications in Application of Cava- Catheters under Transport Conditions.- 111.18. Possibilities of Pain Alleviation at the Site of an Accident or Disaster.- 111.19. Ambulance Design and Equipment for Mobile Intensive Care.- IV. Continuing Life Support in the Hospital.- IV. 1. Critical Care Medicine: Organizing and Staffing ICUs.- IV. 2. Patient Care during Inter-Hospital Transfer.- V. Data Aoquisition and Evaluation of System.- V. 1. Evaluation Research.- V. 2. Evaluation of an EMS System by Analysis of Compiled Data from Run Reports and the Emergency Department Log.- V. 3. The Computer Interrogative Textbook Project: Ä Preliminary Report.- V. 4. Ein Vorschlag zur Verbesserung neurochirurgischer Verlaufskontrollen.- VI. Training of Non-Phy sicians and Physicians.- VI. 1. Erkennung und Erste Hilfe durch Laien (Ausbildung der Bevölkerung).- VI. 2. Operation of Cardiac Emergency Care Delivery System by Paramedical Personnel.- VI. 3. The Training of Emergency Medical Technicians-Cardiovascular.- VI. 4. Recognition and First Aid by Bystanders.- VI. 5. Suggestion for the Organization of Mobile Intensive Care Units.- VI. 6. Present Situation in the Training of Rescue Personnel.- VI. 7. Evolution of Emergency Medical Technicians and Paramedics in the U.S.A.- VI. 8. Inadequacy of Prehospital Emergency Care.- VI. 9. First Aid and Emergency Care Training; Its Effect on Prehospital Emergency Care.- VI.10. Advanced Life Support by Volunteer Fire Department Ambulance Personnel.- VI.11. Teachability ofUnemployed and Undereducated Individuais as Emergency Medical Technicians (EMT’s).- VII. The Emergency Cardiac Care System.- VII. 1. The Influence of Prehospital Emergency Cardiac Care upon Community Mortality from Coronary Artery Disease.- VII. 2. Einsatzerfahrungen mit dem Züricher “Kardiomobil”.- VII. 3. Blind Defibrillation.- VII. 4. The Efficacy of Pre-Hospital Therapy in Cardiac Disease.- VII. 5. Cardiopulmonary Resuscitation, Basic Life Support Self- Training System for All Personnel.- VIII. Disaster Preparedness and Care.- VIII. 1. Emergency Care in Major Accidents (Railway, Air, Road, Industrial).- VIII. 2. Intensive Care under Primitive Conditions.- VIII. 3.The Catastrophe Plans for Lausanne and the Canton of Vaud.- VIII. 4. International Preparedness Operation and Coordination in Cases of Disaster.- VIII. 5. Die ärztliche Versorgung bei Großkatastrophen.- VIII. 6. The Involvement of the Police Service in Great Britain with the Medical Services at Times of Disaster.- VIII. 7. A Network of Base Hospitals for Large Scale Catastrophes.- VIII. 8. Emergency Care Medicine under Primitive Conditions.- IX. Research and Innovations.- IX. 1. Research in Emergency and Critical Care Medicine (ECCM).- IX. 2. Reducing of Vibration Stress Inside Emergency-Ambulance.- IX. 3. Tragen, Ausführungen und Abmessungen. Anordnung der Lagerung in den Transportsystemen.- IX. 4. International Cooperation in the Field of Rescue-Technical Investigation.- IX. 5. Considerations on International Teamwork in the Field of Aid in Catastrophes and Emergency Medicine.- IX. 6. Verbesserungen des Rettungswesens in Rheinland-Pfalz.- X. Recommendations.- XI. Empfehlungen.