Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

高血压脑出血急诊救治现状与进展

高血压脑出血是指在高血压的情况下发生的脑实质内出血。目前急诊综合救治中内科药物和外科手术治疗为主要的两种方法。内科治疗只适用于轻度脑出血和有手术禁忌证及配合急诊外科手术的综合救治,外科手术多用在中、重度脑出血病人治疗中。近年来开展的一种在CT下三维定位脑内血肿清除术,以其定位准确,脑损伤小,在急诊救治方面取得了一定效果,有待于进一步发展。     

Things fall apart. The cultural complex in contemporary times1

These extraordinary months due to COVID-19 and the Black Lives Matter protests, set as they are against a backdrop of the increasingly worrying climate emergency, have brought fear, anxiety and discord across the globe. But we have also experienced a deepening of our understanding of our connectedness, protests against injustice, expressions of social concern and a demand for change. The concept of the cultural complex as developed by Singer & Kimbles (2004) offers a helpful means of connecting the psychology of the individual psyche and the political phenomena of power relations. Using a small example to illustrate how it might operate at a local level, I suggest that a fundamental shift is taking place raising profound levels of anxiety as we move from the known to the unknown. The bipolar nature of these complexes means the extremes are surfacing bringing fears of the very real possibility of more entrenched attacks on democracy from the far right and the hunkering down behind armed borders. But there is also hope that different ways of living together may be developing from the ground up, ways that are rooted in our sense of interdependence – with each other and our planetary home.     

抢救一例Rh阴性稀有血型危重孕妇的体会与思考

Rh阴性稀有血型危重患者的临床救治相当棘手。本文通过回顾对一名Rh阴性血型危重孕妇的临床救治经过,探讨了应急情况下Rh阴性血型危重患者的临床救治策略和采供血应急措施,建议我国尽快建立稀有血型血库和制定相关法律法规,为应急情况下抢救Rh阴性血型患者提供依据和保障。     

美国院前急救医患沟通＂十条金律＂解析

医患沟通的能力和技巧是院前急救人员必备的重要素养之一,与院前急救服务的效率和质量密切相关.在美国急救医疗服务体系中,普遍遵循医患沟通＂十条金律＂,包括：（1）保持职业化状态;（2）始终保持与患者目光接触;（3）给予患者恰当的称呼;（4）使用患者听得懂的语言;（5）保持恰当的语速、语调和语气;（6）与他人谈论患者病情务必谨慎;（7）当心自身的肢体语言;（8）给患者留下回答问题或反应的时间;（9）告诉患者病情真相;（10）注重与特殊群体的沟通.本文简要解析了＂十条金律＂的内涵与意义,对我国院前急救人员或有借鉴意义.     

我国传染病防治面临的形势与对策

长期以来由于种种原因对新发传染病和再发传染病防控方面存在许多问题,比如认识上不足、缺乏投入、设施陈旧、专业人员短缺、农村是薄弱环节等,在SARS暴发过程中表现更为严重,迫切地要求建立一完整套的、科学的、符合中国国情的应对各种新发或再发传染病的公共卫生应急系统.     

从突发公共卫生事件透视医院感染控制

通过突发公共卫生事件来审视目前我国医院感染管理工作中存在的一系列问题并提出了相应对策.     

Duty-Related Posttraumatic Stress Symptoms in 911 Telecommunicators: The Roles of Childhood Trauma Exposure and Emotion-Focused Coping

A history of childhood trauma exposure has been linked to the development of posttraumatic stress symptoms in adulthood following new exposure. Unhealthy coping behaviors that could develop or be utilized in response to early trauma could lend themselves to psychological issues in adulthood. Emotion-focused and problem-focused coping strategies in relation to stressful duty-related situations are examined as indirect pathways through which childhood trauma exposure could be associated with duty-related posttraumatic stress symptoms in 911 telecommunicators (N = 808). Multiple mediation models revealed that 3 of the 4 emotion-focused coping strategies, but not the problem-focused strategies, functioned as significant mediators in the association between childhood exposure and duty-related posttraumatic stress symptoms. Pairwise comparisons showed that self-controlling and escape-avoidance strategies were the strongest pathways of the indirect childhood trauma exposure–posttraumatic stress symptoms association. Implications of results regarding coping in response to new traumatic events in adulthood and potential research and intervention directions are discussed.     

Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial

Although single-session individual debriefing is contraindicated, the efficacy of group psychological debriefing remains unresolved. We conducted the first randomized controlled trial of critical incident stress debriefing (CISD) with emergency workers (67 volunteer fire-fighters) following shared exposure to an occupational potentially traumatic event (PTE). The goals of group CISD are to prevent post-traumatic stress and promote return to normal functioning following a PTE. To assess both goals we measured four outcomes, before and after the intervention: post-traumatic stress, psychological distress, quality of life, and alcohol use. Fire brigades were randomly assigned to one of three treatment conditions: (1) CISD, (2) Screening (i.e., no-treatment), or (3) stress management Education. Controlling for pre-intervention scores, CISD was associated with significantly less alcohol use post-intervention relative to Screening, and significantly greater post-intervention quality of life relative to Education. There were no significant effects on post-traumatic stress or psychological distress. Overall, CISD may benefit broader functioning following exposure to work-related PTEs. Future research should focus on individual, group, and organizational factors and processes that can promote recovery from operational stressors. Ultimately, an occupational health (rather than victim-based) approach will provide the best framework for understanding and combating potential threats to the health and well-being of workers at high risk for PTE exposure.     

Responding to Terrorism in the USA

Abstract

In this article, career firefighters from Oklahoma City, New York City, and Arlington County, VA, and volunteer firefighters from Pennsylvania, share their on-site experiences and the emotional aftermath of responding to terrorism. The authors acted as facilitators, compilers, and organizers so that major themes firefighters have raised are presented to inform the work of first responders and others seeking to understand the experiences of firefighters during and after terrorist incidents. The authors conclude by presenting survey data indicating high levels of firefighter job satisfaction and the major sources of emotional support they use following exposure to terrorism.