IOM: Emergency health system unprepared for disasters

first_imgJun 20, 2006 (CIDRAP News) – The US emergency medical care system is woefully inadequate and unprepared for a pandemic, bioterrorist attack, natural disaster, or other national crisis, three recent reports from the Institute of Medicine (IOM) conclude.The nation’s emergency care system, the reports say, is overburdened, underfunded, and too fragmented to communicate and cooperate effectively across levels and geographic areas. It has little surge capacity to deal with a disaster. In addition, emergency care staff members are often not adequately trained to respond to large-scale disasters or to work with pediatric patients.The IOM report preceded by 2 days a Department of Homeland Security report that describes major shortcomings in the nation’s general preparedness for catastrophic events such as category 5 hurricanes.Emergency system needs comprehensive help”Unfortunately, the [emergency care] system’s capacity is not keeping pace with the increasing demands being placed on it,” said Gail L. Warden, MHA, in a Jun 14 news release from the National Academies, the IOM’s parent organization.”We need a comprehensive effort to shore up America’s emergency medical care resources and fix problems that can threaten the health and lives of people in the midst of a crisis,” added Warden, chair of the committee that wrote the reports and president emeritus of Henry Ford Health System in Detroit.To remedy this situation, the committee that wrote the reports recommends that:Congress appropriate at least $325.5 million toward shoring up the emergency care system—plus funding for readying the system for potential disasters.The emergency care system be “regionalized” so that neighboring hospitals, emergency medical services, and other agencies work together to provide care for all the people in their region.The Veterans Health Administration (VHA) be integrated into civilian disaster planning and management.Guidelines on overcrowding and redirecting ambulances away from packed emergency departments (EDs) be enforced, and coordination and communication between facilities improved.Streamlining tools, such as queuing theory, dashboard systems, and 23-hour observation units, be used to optimize patient treatment and flow.The IOM’s 26-member Committee on the Future of Emergency Care in the US Health System convened in September 2003. Its conclusions on problem areas and recommended solutions have just been published as a series of three reports: Hospital-Based Emergency Care: At the Breaking Point, Emergency Medical Services at the Crossroads, and Emergency Care for Children: Growing Pains.Concerning funding, an IOM overall summary of the three documents states, “Perhaps the area in which greater funding is most important is disaster preparedness. To date, despite their importance in any response to disaster, the various parts of the emergency care system have received very little of the funds that Congress has dispensed for disaster preparedness.”In part this is because the money tends to be funneled through public safety agencies that consider medical care to be a low priority. Congress should therefore make significantly more disaster-preparation funds available to the emergency system through dedicated funding,” the summary says.Hospital-Based Emergency Care: At the Breaking Point specifies the following preparedness funding priorities:Strengthening and sustaining trauma care systemsEnhancing ED, trauma center, and inpatient surge capacityImproving EMS response to explosivesDesigning evidence-based training programsIncreasing the availability of decontamination showers, standby intensive care unit capacity, negative-pressure rooms, and appropriate personal protective equipmentConducting international collaborative research on the civilian consequences of conventional-weapons terrorismIn addition to asking for more preparedness funding, the IOM committee says Congress should establish a pool of $50 million to reimburse hospitals for uncompensated emergency and trauma care.Also, in the next 5 years Congress should provide $88 million to foster coordination and “regionalization” of emergency care and $187.5 million to address shortcomings in emergency pediatric care, the reports conclude.Regional coordination urgedRegionalization would involve directing patients not to just the nearest medical center, but to the nearest facility in the region equipped to handle patients’ specific needs. It “can improve health outcomes, mitigate overcrowding, and reduce costs,” according to the IOM news release.Regionalization would also eliminate the need for every hospital to maintain on-call services for every specialty, which would help address staff shortages caused by decreasing numbers of specialists willing to take emergency calls, the news release said.Hospital-Based Emergency Care says the VHA is “well positioned to enhance regional response, particularly since its hospitals are required by law to maintain excess capacity.” Therefore, the report says, federal organizations should work with states to integrate the VHA into regional disaster planning.To remedy overcrowding and ambulance diversions, the committee asked that the Joint Commission on Accreditation of Healthcare Organization (JCAHO) reinstate strong guidelines to reduce crowding, “boarding” patients in halls or exam rooms until beds become available, and diverting ambulances when EDs are overcrowded. It also called on the Centers for Medicare and Medicaid Services to convene a working group to develop standards to address the situation.Further, the reports note, overcrowding and ambulance diversions are caused by lack of coordination and communication between facilities. Patient admission and transport should be better coordinated across municipalities, the reports conclude.In recommending using queuing theory to help improve efficiency, the committee highlighted its ability to smooth the peaks and valleys of patient admissions, which can eliminate bottlenecks, improve care, and lower costs.The 23-hour observation unit, or clinical decision unit, the reports say, can help ED staff with patient triage, which can help reduce ED crowding. And dashboard systems can help coordinate patient flow.DHS reports on preparedness for catastrophesIn another lengthy report, the Department of Homeland Security (DHS) on Jun 16 assessed the nation’s preparedness for catastrophes such as a major terrorist attack or a category 5 hurricane. The assessment included all 56 states and territories, as well as 75 urban areas.The assessment was ordered by President Bush and Congress in the wake of Hurricane Katrina, according to a DHS news release. Last February the agency released a report based on preparedness self-assessments by states and major cities; the new report represents the findings of expert “peer review teams” that visited the states and cities and checked their plans against national standards.Among the key findings in the Nationwide Plan Review for states and urban areas are:Most planning processes are not adequate as defined in the National Response Plan (NRP).A common deficiency in state and urban areas is the absence of a clearly defined command structure.The ability to give the public accurate, timely information should be strengthened.Significant weaknesses in evacuation planning are of profound concern.Resource management is the “Achilles heel” of emergency planning.Among the key findings for the federal government are:Clear guidance needs to be developed on how state and local governments can coordinate operations with federal partners according to the NRP.Collaboration between government and non-governmental organizations should be strengthened at all levels.Federal, state, and local governments should work with the private sector to optimize transportation of people with disabilities before, during, and after an emergency.The federal government should provide leadership, guidance, and resources necessary to build a shared national homeland security planning system.See also:IOM’s “Future of Emergency Care” seriesNational Academies Jun 14 press releaselast_img read more

How will the new season pan out?

first_img The pressure is clearly on Brendan Rodgers after last season’s failure to build on the 2014 title near-miss. Now in his fourth season, Rodgers has recruited extensively for a second summer in succession and needs a quick return. Much attention will centre on £32million striker Christian Benteke and Rodgers also needs Daniel Sturridge back fit and firing. James Milner, Danny Ings, Nathaniel Clyne and Roberto Firmino look like astute signings but Rodgers – now without Sterling and Steven Gerrard – needs the mix to work quickly. WHO WILL BE IN RELEGATION TROUBLE? There will be much anticipation at Bournemouth and fellow promoted clubs Norwich and Watford but for them the primary objective must simply be to avoid the bottom three. Leicester, Aston Villa, Newcastle and Sunderland – after largely unimpressive seasons last time – could all be in the battle with them. WHAT OF PRESSURE CLUBS NEWCASTLE, WEST HAM AND ASTON VILLA? Newcastle fans may not have seen the back of unpopular owner Mike Ashley but they will hope that an apparent change in tone from him might result in more of an emphasis on results than purely the balance sheet. Former England boss Steve McClaren will also have a point to prove on his return to the Premier League. For West Ham the season is a crucial one as they prepare for a new life in the Olympic Stadium from next year. Having consolidated in the top flight they have decided to move on from the dependable Sam Allardyce, but it remains to be seen if Slaven Bilic can take them to the next level. Villa have flirted with relegation for too long. Tim Sherwood’s injection of enthusiasm was enough to save them – and take them to the FA Cup final – last season but, with uncertainty still over their ownership, they lack stability and the departures of Fabian Delph and Benteke leave a hole. The start of the Barclays Premier League season this weekend brings with it its usual mix of excitement and intrigue. Here, Press Association Sport looks at some of the main talking points ahead of the campaign. DO CHELSEA REMAIN THE TEAM TO BEAT? Jose Mourinho’s men enter the new season as clear favourites and with some justification after winning the title at a canter last season. The Blues were criticised for their style at times but results are what matter the most and Mourinho knows how to get them. Their squad remains formidable and if Radamel Falcao can show some pre-2014 form they could be even stronger. WHERE WILL THE CHALLENGE COME FROM? Manchester City will be determined to bounce back after last season’s tame surrender. The capture of Raheem Sterling improves their squad and they will be expecting to challenge strongly. Their neighbours United will also look to step up after regaining top-four status and a summer of strengthening. Arsenal look better for the signing of Petr Cech but they may still be a top-line striker short. Liverpool and Tottenham can only be regarded as outsiders. IS STERLING WORTH THE MONEY? The negativity generated by Sterling’s attempts to engineer a move away from Liverpool obscured analysis of his talent. His form fell away late last season but he has already shown he is one of the most exciting attacking talents to emerge in England for some time. If he can get back to his best City have acquired a potentially brilliant match-winner, but there is some way to go to justify the £49million fee. WHAT WILL HAPPEN AT OLD TRAFFORD? United are now entering the third season of the post-Sir Alex Ferguson era and many are wondering if this giant of English football is now ready to start challenging for honours again. The uncertainty over the future of David de Gea aside, United look stronger with Bastian Schweinsteiger and Morgan Schneiderlin joining their midfield ranks. Memphis Depay is also an exciting prospect and the steely winning mentality of Louis van Gaal is a growing factor as his methods take root. Question marks still remain over the defence, however. WHAT WILL HAPPEN AT ANFIELD? Press Associationlast_img read more

House panel approves debate for impeachment vote

first_imgThe House Rules committee has approved six hours of debate ahead of Wednesday’s impeachment hearing.The measure was approved late Tuesday night by a party-line vote of nine to four who approved the legislation.President Trump is accused of abusing his powers as president and obstruction of Congress after withholding funds from Ukraine in order to get information regarding relations of political rival, Joe Biden’s son.The move will clear the way for the panel to debate and then vote on whether President Trump committed a crime and whether or not he should be impeached.If the House decides to impeach President Trump, they then will decide if he should also be removed from office.last_img

Kaieteur/ISL retain Budh-Dave Anandjit memorial title

first_imgBy Frederick HalleyTORONTO, Canada – Two -time champions, Kaieteur Sports Club, teamed up with International Sports Club (ISL) to retain honours in the third annual Budh-Dave Anandjit memorial cricket match, played recently at the Ashtonbee ground, Scarborough.With victory very much in their sights in fading light, the Kaieteur/International side were declared winners after reaching 157 for one in 20 overs, replying to Southerners 164 for eight in the allotted 25 overs. Satyanand Sarju, the only player to be dismissed, led the way with an attacking 48, which included two sixes and four fours, while other worthwhile contributions came from Joyd Anandjit who slammed two sixes and five fours in 43, before retiring while Chinta Anandjit’s 39 (retired) was laced with two sixes and a four.The lone wicket for Southerners was claimed by skipper, Hardat Ramcharran, for 13 Runs. Southerners had earlier won the toss and opted to take first strike, reaching a challenging 164 for eight in 25 overs. Siew Deonarine hit a top-score of 54 (one six and four fours) retired and received admirable support from Neil Roopal with 28 (two fours) and Terry Mathura, who retired on 23 with three fours. Bowling for Kaieteur/ International, Ompaul Singh, Omesh Dass and Nate Anandjit claimed two wickets each.Prior to the commencement of the game, both teams and spectators observed a minute’s silence in memory of the late Bud-Have Anandjit. The game was once again organised by Kaieteur’s Vish Jadunauth, Bay Khemraj and Omesh Dass and among those in attendance were Liz Anandjit, the late Anandjit’s wife and his elder brother, popularly known as “KP”.Budh-Dave Tewari Anandjit, the former long-standing stalwart executive and member of the Scarborough Cricket Association (SCA) passed away on July 22, 2014 at the age of 53.Anandjit, who was the brother of Davteerth Anandjit, the former president of the Guyana Cricket Umpires Council (GCUC), served the Scarborough Cricket Association (SCA) with distinction for over two decades, having joined the body in 1990.Prior to that, he was a member of the Raiders and Ramblers Cricket Clubs and a founding-member of International Sports Club (ISL) in 1988.During his sojourn in the SCA, Anandjit served in various capacities, but will be fondly remembered for his association with the development of several talented youth cricketers. As a Level Two coach, Budh-Dave concentrated heavily on teaching the youths the game of cricket in the SCA and Toronto & Districts (T&D).Anandjit was also a Level Two umpire and officiated in several games in the SCA and the Ontario Softballl Cricket League (OSCL) over the years. He also played for Golden Touch in the OSCL tournaments.The late Guyanese was also credited with being the first player to hit six sixes in an over in Scarborough while his club ISL achieved the unique distinction of winning three consecutive Premiere League titles. He was also part of the winning combination when Kaieteur captured the title.Born at Wash Clothes, Mahaicony Creek, East Coast Demerara, Guyana, Anandjit later moved to Courbane Park, Annandale and attended Queen’s College in Georgetown before he migrated to Canada in 1983.The union between himself and Liz Anandjit produced three children in Pretima, Jodh and Jaya Anandjit and apart from Davteerth, his other siblings are Bram, Silla, Subhas, Gyan, Monsranie, Tara, Kulwant, Chinta, Nate and ‘Chano’.last_img read more

ITTF OPEN: Nigerian Debutant, Ojomu, Sparkles in Budapest

first_imgAjoke Ojomu started her debut at the 2019 World Championships on a good note after recording a convincing 4-1 win over Luxembourg’s Sarah Meyer in the group opener in Budapest.The 19-year-old was on the winning side in the explosive encounter and she was so excited about the feat.“I could not believe I just recorded my first game at the World Championship because I was a bit confused when the match started. I could not understand how to return my opponent service as it was a bit odd playing against a player that used pimples in her forehand. But after losing the first game, my coach told me how to demystify her which I followed and this really gave me the confidence to complete the win. This is a major boost to me personally and I dedicate this win to my mother, who has been very supportive and all those who have always been there for me when I was not making the senior team,” the Nigeria national champion said.“I know I still have a lot to offer and this win has indeed inspired me to aim high in this tournament. I have also realized that winning points with service is very vital for every player and we were not used to this in Nigeria and I am praying and hoping that I improve my ranking with this competition. The support from my teammates has been awesome because their experience in the game was also helpful to me,” she added. The battle for places in the main draw for African players will be determined today when the final group matches are played while Africa’s trio of Aruna Quadri of Nigeria and Egypt’s Omar Assar and Dina Meshref are awaiting their continental counterparts to join them in the elite stage of the championship which will commence on Tuesday April 23.Share this:FacebookRedditTwitterPrintPinterestEmailWhatsAppSkypeLinkedInTumblrPocketTelegramlast_img read more

Kabali: Music album of Rajinikanth’s gangster film to be launched on June 11

first_imgThe much awaited audio launch of superstar Rajinikanth-starrer Tamil gangster drama Kabali will reportedly take place here on June 11, a source said.ALSO READ:Kabali becomes the first Tamil film to be dubbed in MalayALSO READ: Rajini sir came up to me and said you are a fantastic actor, says Radhika Apte”June 11 has been locked as the date for the audio launch. By then, Rajinikanth sir should be back from his holiday in the US. The makers had earlier planned on June 9 but postponed it by two days to have it on a weekend,” a source from the film’s unit told IANS.The grand event will take place at YMCA grounds in the city. Directed by Pa Ranjith, the film will narrate the journey of a gangster.In the film, Rajinikanth will be seen as 32-year old and 60-year old sporting two different avatars.Recently, the editor of the film Praveen KL, in an interview with Indiaglitz, revealed that the film opens with Kabali (Rajinikanth) coming out of a prison after serving a period of 25 years. The film will then follow his journey of him becoming the biggest don in Malaysia.  Also starring Radhika Apte, Dinesh, Dhansikaa, Kishore, Kalaiarasan and Taiwanese actor Winston Chao, the film is slated for theatrical release on July 1.Produced by Kalaipuli S Thanu, the film has music by Santosh Narayanan.last_img read more