American journal of disaster medicine
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Research and field experience have identified a global gap in postdisaster rebuilding of healthcare systems due to the current primary focus on returning devastated community infrastructures to predisaster conditions. Disasters, natural or man-made, present an opportunity for communities to rebuild, restructure, and redefine their predisaster states, creating more resilient and sustainable healthcare systems. ⋯ The Sustainable Healthcare Redevelopment Model can serve as a guideline for delivery of healthcare services following disaster or conflict and use of crisis as a window of opportunity to improve the healthcare delivery system and incorporate resilience into the healthcare infrastructure.
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Mass casualty incidents (MCIs) include natural (eg, earthquake) or human (eg, terrorism or technical) events. They produce an imbalance between medical needs and resources necessitating the use of triage strategies. Triage of casualties must be performed accurately and efficiently if providers are to do the greatest good for the greatest number. There is limited research on the validation of triage system efficacy in determining the priority of care for victims of MCI, particularly those involving chemicals. ⋯ Current literature does not provide needed evidence on the validity of triage systems for MCI in particular those involving chemicals. Well designed studies are needed to validate the reliability, sensitivity, and specificity of triage systems used for MCI including those involving chemicals.
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Randomized Controlled Trial
The effects of QuikClot Combat Gauze on hemorrhage control when used in a porcine model of lethal femoral injury.
The aims of the study were to 1) determine the effectiveness of QuikClot Combat Gauze (QCG); 2) determine the arterial blood pressure at which rebleeding occurs; 3) determine how much intravenous fluid could be administered before hemorrhage reoccurred, and 4) determine the number extremity movement on rebleeding when QCG was used. ⋯ QCG compared to a control was more effective in controlling hemorrhage, withstanding increases in systolic blood pressure, more latitude in resuscitation fluid, and movement (p < 0.05).
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Telemedicine and advanced technologies that ensure telepresence have become common practice and are an effective way of providing healthcare services. ⋯ Telemedicine has not been used thus in the management of disasters, despite its great potential. There is an acute need for establishing telemedicine programs in high risk areas for disasters, so that when these disasters strike, existing telemedicine networks can be used, rather than attempting to bring solutions into a chaotic situation postevent.
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To evaluate mental health outcomes among New Jersey shore residents with health impairments and disabilities after Hurricane Sandy. ⋯ Having physical impairments and health conditions were not directly related to adverse mental health outcomes following Sandy, but having sleep problems, pain, or suicidal thoughts were. Further research is needed to assess the health status of community residents with serious health impairments over time following disasters.