Læknablaðið : fylgirit - 15.06.2002, Blaðsíða 22

POSTERS / ICELAND 2002: EMERGENCY MEDICINE BETWEEN CONTINENTS
nally. Rallye Rejviz (RR) since 1997 developed in an international
project, able not only to test the real practice of particular EMS
directly in the field, but also to compare particular national EMS
between counlries. Building on exisling experience, this project
aims to bring international emergency teams together in a non-
threatening environment to compare performances and exchange
information about techniques and approaches, whilst building
friendships and opportunities for cross-border cooperation.
Since 1997 experts from more than 10 countries have cooperated
on scenarios and programmes of the Rallye Rejviz. It serves not
only as a competition, but also as a workshop and conference for
the participants. RR has also its unique role as a meeting of the
“working class” of the EMS - connecting people who normally
would never meet each other. RR is also an opportunity to improve
the view of rescue services in the eyes of thousands of people via the
influence of the media. Data gained in RR will serve as a basis for
further research in EMS for companies involved with the
manufacture of ambulances and medical technology, and also for
those who prepare standards and algorithms for EMS.
Key words: Rallye Rej iz, EMS Competition, www.rallye-rejiz.cz
P 17 - International EM systems
Emergency Medicine Development in Poland
Jakubaszko J
Wroclaw Medical University, Dept. of Emergency and Disaster Medicine,
Wroclaw, Poland
Poland, as the first country in Central-Eastern Europe voting out its
communist government in 1989, is going through an extensive.
restructuring on essentially every level of its government, admini-
stration system, economy and services. These includes dramatic
health care structure reform and, within, emergency medical
system. Emergency medicine has been recognised as an important
part of medical practice and social security system. It was registered
as one of the basic medical disciplines in March 1999 and intro-
duced into academic education curriculum.
The government programme, “Integrated emergency medical
system,” started on October 1999, is realising basic components of
emergency medicine system as specialist training, modern EMS
and hospital emergency departments.
Same time - Polish Society for Emergency Medicine was estab-
lished and its lst International Congress “Emergency Medicine in
Middle and Eastern Europe”, supported by EuSEM, ACEP and
ERC, was held in Wroclaw, September 2000.
Parallel, after extensive work by experts, the “Act on National
Emergency Services” proposal was presented to Polish Parliament
in March 2001 and is going through an extensive legislature process.
All above may serve as a positive model for development of
emergency medicine for modern societies.
Presented article describes many years of experience of creator
groups and individuals when fighting for programme and its
realisation.
P 18 - Injury Prevention
Alcohol and tobacco use in elderly emergency department
patients: assessment of rates and medical care utilization
Girard DD, Partridge RA, Becker B, Bock B
Department of Emergency Medicine, Rhode Island Hospital/Brown Medical
School, United States
Objectives: Estimate the rates of alcohol and tobacco use among
independent elder patients presenting to the emergency depart-
ment (ED) and to assess the extent of health care utilization of this
population.
Methods: A convenience sample of independent, English speaking
elder patients (age>65 years) presenting to an urban academic ED
for evaluation and treatment. Patients were excluded from the
study if they were medically unstable or had a change in mental
status. Subjects completed questionnaires about their utilization of
the healthcare system. The Fagerstrom Test for Nicotine Depen-
dence and the Alcohol Use Disorders Identification Test (AUDIT)
scale were used to measure tobacco and alcohol use. Data was
analyzed using t-tests to compare independent variables.
Results: A total of 313 subjects completed the study. Mean age was
77.1 years; 46% were male and 54% were female. Thirty (9.6%),
were smokers. Of these, all were nicotine dependent by the
Fagerstrom test. Smokers did not visit a physician or the ED more
than non-smokers. One hundred eight (34.6%), drank alcohol at
least once a month. Twelve (3.8%), were alcohol dependent by the
AUDIT scale. Compared with alcohol non-dependent subjects,
these patients reported significantly fewer visits to their primary
care provider (3.1 vs. 4.2 annual visits, p=.003). Alcohol dependent
patients did not differ from non-alcohol dependent patients in self
reported general health, ED visits, hospital admissions and injuries
requiring treatment. Alcohol dependent patients were more likely
to be younger and unmarried.
Conclusions: Elder ED patients have low rates of nicotine and
alcohol dependence. Elder smokers do not utilize medical care
more than non-smokers. Elders with alcohol dependence are less
likely to visit a physician compared with non-alcohol dependent
subjects. Additional studies of elder ED patients who use tobacco
and alcohol may help improve health care utilization and identify
appropriate cessation interventions.
P 19 - Injury Prevention
Splenic laceration from in-line skating
Arpilleda JC
Rainbow Babies & Children's Hospital, United States
Introduction: In-line skating has become a popular and fast-growing
sport over the past 20 years. The steep increase in participation has
been associated with a concomitant increase in in-line skating
injuries. Previous studies examining the injuries associated with in-
line skating have emphasized extremity and head injuries.
Objective: To date there have been no reports of abdominal organ
injuries. This unusual case describes a patient who suffered severe
blunt abdominal trauma resulting in a splenic laceration while in-
line skating.
Case Report: A 15 yo male presented with a chief complaint of left
shoulder and left rib pain after falling from rollerblading. He was
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