No abstract

Hazardous materials events are rare causes of EMS activation in the United States. The majority occur in non-industrial venues and involve two or fewer patients. Scene time frequently is delayed due to multiple barriers. Cardiac arrest is rare but occurred after EMS arrival in one-fifth of patients.

BackgroundThe Chief Medical Officer of England has highlighted the need to tackle carbon monoxide (CO) poisoning with over 40 deaths and 4000 hospital attendances a year. The Be Gas Safe Programme, the first national programme to distribute CO alarms, was delivered by the Royal Society for the Prevention of Accidents (RoSPA) for the Gas Safe Charity between 2012 and 2014. The programme aimed to equip consumers to deal with dangers that lead to carbon monoxide poisoning.DescriptionThe programme was delivered through Over 70 local partnerships across the UK who included local authorities, the NHS, fire services, housing agencies, children’s and older people’s charities and the police. They identified vulnerable households in their communities to receive CO alarms and safety information. Each partnership also received a briefing pack. A website was developed providing resources, links and useful information.Results13,000 CO alarms were distributed giving families protection for up to 7 years. At least 130,000 people benefitted from local education activities and media coverage reached over 3 million people. Evaluation included a survey and case studies of families whose lives have been saved either by being prompted to have their appliances serviced or because the CO alarm providing early warning. It showed a significant increase in awareness of the dangers and prevention measures.ConclusionsCarbon monoxide alarms are a last line of defence and are no substitute for regular servicing and good ventilation. However, research shows that combining provision of equipment with safety education is more effective than adopting one of these approaches alone. Providing practical protection for a limited number of families most at risk helped to maximise opportunities to educate a wider audience

BackgroundInjuries in children aged under 5 years most commonly occur in the home and disproportionately affect those living in the most disadvantaged communities. The ‘Safe at Home’ (SAH) national home safety equipment scheme, which ran in England between 2009 and 2011, has been shown to reduce injury-related hospital admissions, but there is little evidence of cost-effectiveness.Materials and methodsCost-effectiveness analysis from a health and local government perspective. Measures were the incremental cost-effectiveness ratio per hospital admission averted (ICER) and cost-offset ratio (COR), comparing SAH expenditure to savings in admission expenditure. The study period was split into three periods: T1 (years 0–2, implementation); T2 (years 3–4) and T3 (years 5–6). Analyses were conducted for T2 versus T1 and T3 versus T1.ResultsTotal cost of SAH was £9 518 066. 202 223 hospital admissions in the children occurred during T1-3, costing £3 320 000. Comparing T3 to T1 SAH reduced admission expenditure by £924 per month per local authority and monthly admission rates by 0.5 per local authority per month compared with control areas. ICER per admission averted was £4209 for T3 versus T1, with a COR of £0.29, suggesting that 29p was returned in savings on admission expenditure for every pound spent on SAH.ConclusionSAH was effective at reducing hospital admissions due to injury and did result in some cost recovery when taking into admissions only. Further analysis of its cost-effectiveness, including emergency healthcare, primary care attendances and wider societal costs, is likely to improve the return on investment further.