American journal of disaster medicine
-
To quantify the readiness of individual academic emergency departments (EDs) in the United States for an outbreak of pandemic influenza. METHODS, DESIGN, AND SETTING: Cross-sectional assessment of influenza pandemic preparedness level of EDs in the United States via survey of medical directors and department chairs from the 135 academic emergency medicine departments in the United States. Preparedness assessed using a novel score of 15 critical preparedness indicators. Data analysis consisted of summary statistics, chi2, and ANOVA. ⋯ Significant deficits in preparedness for pandemic influenza and other disease outbreaks exist in US EDs, relative to HHS guidelines, which appear to be related in part to ED size. Further study should be undertaken to determine the barriers to appropriate pandemic preparedness, as well as to develop and validate preparedness metrics.
-
The threat of suicide bombing attacks has become a worldwide problem. This special type of multiple casualty incidents (MCI) seriously challenges the most experienced medical facilities. ⋯ A predetermined metropolitan triage system which directs trauma victims of a MCI to the appropriate medical center and prevents overcrowding of the level I facility with less severe injured patients will assure that critically injured patients of a suicide bombing attack will receive a level of care that is comparable with the care given to similar patients under normal circumstances. Severe blast injury victims without penetrating injuries but with significant pulmonary damage can be effectively managed in ICUs of level II trauma centers.
-
Review
Disaster planning: potential effects of an influenza pandemic on community healthcare resources.
The federal government states that local communities are primarily responsible for public health planning and implementation during a severe pandemic. Accordingly, an assessment of the current healthcare capabilities in these communities and planning for deficiencies is required. This article assesses the impact and healthcare capabilities of a specific model local community in a mid-Atlantic state. ⋯ Both models reveal significant deficiencies that local communities may face. In the event of a severe 1918-type pandemic influenza or a mild influenza pandemic, many local community healthcare systems will likely have inadequate resources to respond to the crisis; such a healthcare emergency would likely overwhelm local community resources and current public health practices. Proper planning at the community level is critical for being truly prepared for such a public health emergency.
-
The goal of this study is to assess the European status in the case of mass casualties regarding legislation, responsibilities of ministries and organizations, education and training, material and equipment, and bottlenecks. ⋯ The following recommendations were given to the EU Commission: Organize focused experts meetings on the above mentioned subjects. Promote common exercises. Collect and promote best practices by supporting research for evidence-based results. Promote crossborder cooperation and possibly preplanned reinforcements.
-
Multicenter Study Comparative Study
Changes needed in the care for sheltered persons: a multistate analysis from Hurricane Katrina.
Following Hurricane Katrina, nearly 1,400 evacuation shelters were opened in 27 states across the nation to accommodate the more than 450,000 evacuees from the gulf region. The levee breaks in New Orleans and storm surge in Mississippi brought about significant morbidity and mortality, ultimately killing more than 1,300 people. The purpose of this study was to summarize the health needs of approximately 30,000 displaced persons who resided in shelters in eight states, including prescription medication needs, dispersement of durable medical equipment, and referrals for further care. ⋯ Hurricane Katrina illustrated the need to strengthen the healthcare planning and response in regard to sheltered persons with a particular focus on primary and preventive care services. This study has reemphasized the need for primary medical care and pharmaceuticals in sheltered persons and shown new data regarding the dispersement of durable medical equipment and the frequent need for healthcare beyond the shelter setting as evidenced by referrals.