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OCR for page 35
SPECIFIC RECOMMENDATIONS
ACCIDENT PREVENTION
Formation of a National Council on Accident Prevention at the Executive
level for coordination of information and advice on implementation of
measures and regulations now vested in scattered private, industrial,
and federal agencies, and for research, public education, and develop-
ment of improved standards in accident prevention.
EMERGENCY FIRST AID AND l\/IEDICAL CARE
First Aid
Extension of basic and advanced first aid training to greater numbers of
the lay population.
Preparation of nationally acceptable texts, training aids, and courses
of instruction for rescue squad personnel, policemen, firemen, and
ambulance attendants.
Ambulance Services
Implementation of recent traffic safety legislation to ensure completely
adequate standards for ambulance design, and construction, for ambu-
lance equipment and supplies, and for the qualifications and supervision
of ambulance personnel.
Adoption at the state level of general policies and regulations
pertaining to ambulance services.
Adoption at district, county, and municipal levels of ways and means
of providing ambulance services applicable to the conditions of the
locality, control and surveillance of ambulance services, and coordination
of ambulance services with health departments, hospitals, traffic authori-
ties, and communication services.
Pilot programs to determine the efficacy of providing physician-staffed
ambulances for care at the site of injury and during transportation.
Initiation of pilot programs to evaluate automotive and helicopter
ambulance services in sparsely populated areas and in regions where
many communities lack hospital facilities adequate to care for seriously
Injured persons.
Communication
Delineation of radiofrequency channels and of equipment suitable to
provide voice communication between ambulances, emergency depart-
ments, and other health-related agences at community, regional, and
national levels.
Pilot studies across the nation for evaluation of models of radio and
telephone installations to ensure effectiveness of communication facilities.
Day-to-day use of voice communication facilities by the agencies
serving emergency medical needs.
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OCR for page 36
Active exploration of the feasibility of designating a single nationwide
telephone number to summon an ambulance.
Emergency Departments
Initiation of surveys and pilot programs to establish patterns of and the
numbers and types of emergency departments necessary for optimal
care of emergency surgical and medical casualties in a selected number
of cities, groups of small communities, and sparsely populated areas.
Development of a mechanism for inspection, categorization, and
accreditation of emergency rooms on a continuing basis.
Federal fund support to design, construct, and, in part, operate model
emergency facilities of each type.
Interrelationships between the Emergency Department and the
Intensive Care Unit
Expansion of intensive care programs to ensure uninterrupted care
beyond the immediate measures rendered in emergency departments.
THE DEVELOPMENT OF TRAUMA REGISTRIES
Establishment of trauma registries in selected hospitals as a mechanism
for the continuing description of the natural history of the various forms
Ot Injuries.
Subsequent consideration of establishment of a national computerized
central registry.
Studies on the feasibility of designating selected injuries to be incor-
porated with reportable diseases under Public Health Service control.
HOSPITAL TRAUMA COMMITTEES
Formation of hospital trauma committees, on a pilot basis, in selected
hospitals.
CONVALESCENCE, DISABILITY AND REHABILITATION
Development of additional studies on the quantitation of degrees of
disability and the stages of convalescence at which return to productive
work is indicated.
Development of studies on rehabilitation with emphasis on measures
to be initiated in the earliest phases of treatment.
MEDICOLEGAL PROBLEMS
Judicial application of the principle of seeking impartial medical advice
in the determination of disability.
Replacement, on a national scale, of lay coroners by medical examiners
who are not only physicians but also qualified pathologists experienced
in medicolegal problems.
AUTOPSY OF THE VICTIM
Routine performance and analysis of complete autopsies of accident
. . .
victims.
36
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CARE OF CASUALTIES UNDER CONDITIONS OF
NATURAL DISASTER
Development of a center to document and analyze types and numbers of
casualties in disasters, to identify by on-site medical observation prob-
lems encountered in caring for disaster victims, and to serve as a national
educational and advisory body to the public and the medical profession
in the orderly expansion of day-to-day emergency services to meet the
needs imposed by disaster or national emergency.
RESEARCH IN TRAUMA
Increased federal and voluntary financial support of basic and applied
research in trauma.
Long-term financial support of specialized centers for clinical research
in shock and trauma.
Expansion of clinical research in war wounds.
Expansion within the U. S. Public Health Service of research in shock,
trauma, and emergency medical conditions, with the goal of establishing
a National Institute of Trauma.
37
Representative terms from entire chapter:
emergency departments
