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Author (down) Zoraster, R.M.; Chidester, C.; Koenig, W. openurl 
  Title Field triage and patient maldistribution in a mass-casualty incident Type Journal Article
  Year 2007 Publication Prehosp Disaster Med Abbreviated Journal  
  Volume 22 Issue 3 Pages 224-229  
  Keywords major incident report  
  Abstract INTRODUCTION: Management of mass-casualty incidents should optimize outcomes by appropriate prehospital care, and patient triage to the most capably facilities. The number of patients, the nature of injuries, transportation needs, distances, and hospital capabilities and availabilities are all factors to be considered. Patient maldistributions such as overwhelming individual facilities, or transport to facilities incapable of providing appropriate care should be avoided. This report is a critical view of the application of the START triage nomenclature in the prehospital arena following a train crash in Los Angeles County on 26 January 2005. METHODS: A scheduled debriefing was held with the major fire and emergency medical services responders, Medical Alert Center staff, and hospitals to assess and review the response to the incident. Site visits were made to all of the hospitals involved. Follow-up questions were directed to emergency department staff that were on duty during the day of the incident. RESULTS: The five Level-I Trauma Centers responded to the poll with the capacity to receive a total of 12 “Immediate” patients, 2.4 patients per center, the eight Level-II Trauma Centers responded with capacity to receive 17 “Immediate” patients, two patients per center, while the 25 closest community hospitals offered to accept 75 “Immediate” patients, three patients per hospital. These community hospitals were typically about one-half of the size of the trauma centers (average 287 beds versus 548, average 8.7 operating rooms versus 16.6). Twenty-six patients were transported to a community hospital >15 miles from the scene, while eight closer community hospitals did not receive any patients. CONCLUSIONS: The debriefing summary of this incident concluded that there were no consistently used criteria to decide ultimate destination for “Immediates”, and that they were distributed about equally between community hospitals and trauma centers.  
  Address  
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  Publisher Place of Publication Los Angeles County Emergency Medical Services, Commerce, California 90022-5152, USA. rzoraster@ladhs Editor  
  Language Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1049-023X (Print) ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number refbase @ admin @ Zoraster2007 Serial 6846  
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Author (down) Zoraster, R. openurl 
  Title Disaster triage: is it time to stop START? Type Journal Article
  Year 2006 Publication American Journal of Disaster Medicine Abbreviated Journal  
  Volume 1 Issue 1 Pages 7-9  
  Keywords triage  
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  Language Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1932-149X (Print) ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number refbase @ admin @ Zoraster2006 Serial 6817  
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Author (down) Zompetti, J.; Lain, B. openurl 
  Title Kritiking as Argumentative Praxis Type Journal Article
  Year 2005 Publication Speaker & Gavel Abbreviated Journal  
  Volume 42 Issue Pages 13-27  
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  Notes Approved no  
  Call Number refbase @ user @ zompetti_kritiking_2005 Serial 15113  
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Author (down) Zjao, L.; Deek, F.P. openurl 
  Title User Collaboration in Open Source Software Development Type Journal Article
  Year 2004 Publication Electronic Markets Abbreviated Journal  
  Volume 14 Issue 2 Pages 89-103  
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  Notes Approved no  
  Call Number refbase @ user @ zhao2004 Serial 664  
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Author (down) Zirkle, L.G.J. url  doi
openurl 
  Title Injuries in developing countries--how can we help? The role of orthopaedic surgeons Type Journal Article
  Year 2008 Publication Clinical Orthopaedics and Related Research Abbreviated Journal Clin Orthop Relat Res  
  Volume 466 Issue 10 Pages 2443-2450  
  Keywords Bone Nails/economics; Databases, Factual; *Developing Countries/economics; Education, Medical; *Fracture Fixation, Intramedullary/economics/education/instrumentation; Fractures, Bone/*surgery; Health Services Accessibility; Healthcare Disparities; Humans; *International Cooperation; Musculoskeletal System/*injuries; *Organizations, Nonprofit; *Physician's Role; Poverty; Program Development; Prosthesis Design  
  Abstract Each year nearly 5 million people worldwide die from injuries, approximately the number of deaths caused by HIV/AIDS, malaria, and tuberculosis combined. Ninety percent of these injuries occur in developing countries and that number is growing. Road traffic accidents account for 1.2 million of these 5 million deaths. For each death from trauma, three to eight more are permanently disabled. Orthopaedic surgeons should consider the victims of this epidemic by using their ability and capacity to treat these injuries. SIGN (Surgical Implant Generation Network, Richland, WA, USA) builds local surgical capability in developing countries by providing training and equipment to surgeons for use in treating the poor. It assists in treating long-bone fractures by using an intramedullary nail interlocking screw system. C-arm imaging, unavailable in many of these hospitals, is not necessary to accomplish interlocking. Surgery is performed primarily by local surgeons who record their cases on the SIGN surgical database. Discussion of these reports provides a means of communication and education among surgeons. This database demonstrates the capability of these surgeons. It also demonstrates that the SIGN intramedullary nail is safe for use in the developing world as it has been successful in treating 36,000 trauma patients.  
  Address Surgical Implant Generation Network, 451 Hills St., Suite B, Richland, WA 99354, USA. signcom@sign-post.org  
  Corporate Author Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0009-921X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:18685912 Approved no  
  Call Number refbase @ user @ Serial 10237  
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