American journal of disaster medicine
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Mass casualty incidents and large-scale disasters involving children are likely to overwhelm a regional disaster response system. Children have unique vulnerabilities that require special considerations when developing pediatric response systems. Although medical and trauma strategies exist for the evaluation and treatment of children on a daily basis, the application of these strategies under conditions of resource-constrained triage and treatment have rarely been evaluated. ⋯ The variability, scale, and uncertainty of disasters call for a set of guiding principles rather than rigid protocols when developing pediatric response plans. The authors propose the following guiding principles in addressing the well-recognized, unique vulnerabilities of children: (1) terrorism prevention and preparedness, (2) all-hazards preparedness, (3) postdisaster disease and injury prevention, (4) nutrition and hydration, (5) equipment and supplies, (6) pharmacology, (7) mental health, (8) identification and reunification of displaced children, (9) day care and school, and (10) perinatology. It is hoped that the 10 guiding principles discussed in this article will serve as a basic framework for developing pediatric response plans and teams in developed countries.
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Disaster drills are a valuable means of training healthcare providers to respond to mass casualty incidents resulting from acts of terrorism or public health crises. We present here a proposed hospital-based disaster drill evaluation tool that is designed to identify strengths and weaknesses of hospital disaster drill response, provide a learning opportunity for disaster drill participants, and promote integration of lessons learned into future responses. ⋯ This evaluation tool will help meet the need for standardized evaluation of disaster drills. The modular approach offers flexibility and could be used by hospitals to evaluate staff training on response to natural or man-made disasters.
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Disaster medicine specialists, policy makers, and the public often feel frustrated when they encounter the complex legal framework that surrounds public health emergencies and disasters. Such a framework is particularly difficult to understand when one considers that the federal government has no express powers over public health or disaster management. ⋯ In order to clarify the state and federal responsibilities surrounding public health emergencies and disasters, this article explores necessary and pertinent legal topics. These topics include public health duties, public health disasters, state sovereignty, governmental coercion, de facto constitutional empowerment, separation of powers, limited powers, federalism, state police powers, general and federal declarations of emergencies, the Model State Emergency Health Powers Act (MSEHPA), and public health and national security.
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Despite an increasing reliance on outpatient clinics and other ambulatory care facilities, traditional hospitals play a crucial role in the US healthcare system. They provide emergency services on a walk-in basis and are staffed to address issues related to triage. In an era of heightened concern over bioterrorism and a potential influenza pandemic, hospital preparedness for responding to infectious disease outbreaks is essential. During such outbreaks, mental and behavioral health problems may constitute an important part of the demand placed on hospitals. There is now sufficient clinical experience regarding such problems, and tested recommendations are available for hospitals to implement in disaster planning and practice. ⋯ More research is needed to categorically examine the preparedness of hospitals for mental and behavioral health interventions during times of disaster.