American journal of disaster medicine
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Since 2004, the US Navy has provided ship-borne medical assistance during three earthquake disasters. Because Navy ship deployment for disaster relief (DR) is a recent development, formal guidelines for equipping and staffing medical operations do not yet exist. The goal of this study was to inform operational planning and resource allocation for future earthquake DR missions by 1) reporting the type and volume of patient presentations, medical staff, and surgical services and 2) providing a comparative analysis of the current medical and surgical capabilities of a hospital ship and a casualty receiving and treatment ship (CRTS). ⋯ Our data indicate that musculoskeletal extremity injuries in sex- and age-diverse populations comprised the majority of clinical diagnoses. Current capabilities and surgical staffing of hospital ships and CRTS platforms influenced their respective DR operations, including the volume and types of surgical care delivered.
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The objective of this study is to gain insight into the medical needs of disaster evacuees, through a review of experiential data collected in evacuation shelters in the days and weeks following Hurricanes Katrina and Rita in 2005, to better prepare for similar events in the future. Armed with the information and insights provided herein, it is hoped that meaningful precautions and decisive actions can be taken by individuals, families, institutions, communities, and officials should the Louisiana Gulf Coast-or any other area with well-known vulnerabilities-be faced with a future emergency. ⋯ The authors believe that much can be learned from studying data collected in evacuee triage clinics, and that such insights may influence personal and official preparedness for future events. In the Katrina-Rita evacuations, only paper-based data collection mechanisms were used-and those with great inconsistency-and there was no predeployed mechanism for close-to-real-time collation of evacuee data. Deployment of simple electronic health record systems might well have allowed for a better real-time understanding of the unfolding of events, upon arrival of evacuees in shelters. Information and communication technologies have advanced since 2005, but predisaster staging and training on such technologies is still lacking.
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On January 12, 2010, a 7.0 magnitude Richter earthquake devastated Haiti, leading to the world's largest humanitarian effort in 60 years. The catastrophe led to massive destruction of homes and buildings, the loss of more than 200,000 lives, and overwhelmed the host nation response and its public health infrastructure. Among the many responders, the United States Government acted immediately by sending assistance to Haiti including a naval hospital ship as a tertiary care medical center, the USNS COMFORT. ⋯ Volunteers' demographics, such as age and gender, as well as linguistic skills, work background, and prior humanitarian assistance experience varied. Volunteer efforts were critical in assisting with informed consent for surgery, family reunification processes, explanation of diagnosis and treatment, comfort to patients and families in various stages of grieving and death, and helping healthcare professionals to understand the cultural context and sensitivities unique to Haiti. This article explores key lessons learned in the use of volunteer interpreters in earthquake disaster relief in Haiti and highlights the approaches that optimize volunteer services in such a setting, and which may be applicable in similar future events.
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In a joint military/civilian exercise conducted in June 2010, military National Guard medical and decontamination response efforts proved to be paramount in supporting hospital resources to sustain an adequate response during a simulated terrorist event. Traditionally, hospitals include local responders in their disaster preparedness but overlook other available state and federal resources such as the National Guard. Lessons learned from the exercise included the value of regular joint disaster planning and training between the military and civilian medical sectors. ⋯ Involving the National Guard in community disaster planning provides a valuable medical support asset that can be critical in responding to multiple casualty events. National Guard response is inherently faster than its federal counterpart. Based on the findings from our joint exercise, states are encouraged to incorporate their corresponding National Guard in civilian critical medical infrastructure disaster preparedness activities, as the National Guard can be an integral part of the disaster response efforts in real multiple casualty events.
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Randomized Controlled Trial Comparative Study
A comparison of different types of hazardous material respirators available to anesthesiologists.
Despite anesthesiology personnel involvement in initial treatment of patients exposed to potentially lethal agents, less than 40 percent of US anesthesiology training programs conduct training to manage these patients.(1) No previous studies have evaluated performance of anesthesiologists wearing protective gear. The authors compared the performance of anesthesiologists intubating a high-fidelity mannequin while wearing either a powered air-purifying respirator (PAPR) or a negative pressure respirator (NPR). ⋯ The use of an NPR or PAPR does not preclude an anesthesiologist from successfully intubating, but practice is necessary. The slightly better performance with the NPR is weighed against the improved comfort of the PAPR and the fact that PAPR users could wear eyeglasses. Neither type of gear allowed the users to auscultate the lung fields to confirm correct endotracheal tube placement.