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PubMed1980

Victim-tracking cards in a community disaster drill.

During a disaster drill at Detroit-Wayne County Metropolitan Airport in September 1978, an attempt was made to evaluate the effectiveness of triage by tracing the routes of "victims" using a system of tracking cards. The cards were placed with the victims during make-up and collected at the receiving treatment facility. The system, despite several problems encountered in its use, provided an accurate method for evaluating the manner in which "victims" were handled during the "rescue" effort.

Color↗
PubMed1987

A one-year psychological follow-up of the most severely burned victims of the Bradford fire.

The horrific disaster at the Valley Parade Football Stadium, Bradford, on 11 May 1985 left 53 people dead in the fire and many more seriously injured. This detailed study of five of the most seriously injured victims was started 3 weeks after the fire. Patients were interviewed and rating scales (Irritability Depression Anxiety Scale--IDA, Hamilton Depression Rating Scale--HDRS, Spielberger Anxiety Scale--STAI, Beck Depression Inventory--BDI, General Health Questionnaire--GHQ), were completed regularly, until the first anniversary of the disaster. Each victim showed some psychopathology over the study period. Depression and anxiety, the commonest reactions, were most troublesome at times of stress. While it is likely that the disaster itself predisposed the victims to these reactions, the contribution of the stressful events occurring around the time of the disaster cannot be ignored. These findings suggest that IDA, GHQ and STAI function as an effective screening triage for detecting those disaster victims who may need psychological help and support.

Adult↗
PubMed2004

Infectious disease risks from dead bodies following natural disasters.

OBJECTIVE: To review existing literature to assess the risks of infection from dead bodies after a natural disaster occurs, including who is most at risk, what precautions should be taken, and how to safely dispose of the bodies. METHODS: Disease transmission requires the presence of an infectious agent, exposure to that agent, and a susceptible host. These elements were considered to characterize the infectious disease risk from dead bodies. Using the PubMed on-line databases of the National Library of Medicine of the United States of America, searching was done for relevant literature on the infection risks for public safety workers and funeral workers as well as for guidelines for the management of the dead and prevention of infection. A small but significant literature was also reviewed regarding the disposal of the dead and the contamination of groundwater by cemeteries. RESULTS: Victims of natural disasters usually die from trauma and are unlikely to have acute or "epidemic-causing" infections. This indicates that the risk that dead bodies pose for the public is extremely small. However, persons who are involved in close contact with the dead-such as military personnel, rescue workers, volunteers, and others-may be exposed to chronic infectious hazards, including hepatitis B virus, hepatitis C virus, HIV, enteric pathogens, and Mycobacterium tuberculosis. Suitable precautions for these persons include training, use of body bags and disposable gloves, good hygiene practice, and vaccination for hepatitis B and tuberculosis. Disposal of bodies should respect local custom and practice where possible. When there are large numbers of victims, burial is likely to be the most appropriate method of disposal. There is little evidence of microbiological contamination of groundwater from burial. CONCLUSIONS: Concern that dead bodies are infectious can be considered a "natural" reaction by persons wanting to protect themselves from disease. However, clear information about the risks is needed so that responsible local authorities ensure that the bodies of disaster victims are handled appropriately and with due respect. This paper provides a source of information for those who are in the unfortunate position of managing those bodies.

Cadaver↗
PubMed2000

Depression among victims of south Mississippi's methyl parathion disaster.

Human-induced disasters have long been considered responsible for a wide array of physiological, psychological, and economic distress. This study examined depressive symptoms among victims of south Mississippi's methyl parathion disaster. Results indicated that irrespective of the level of methyl parathion contamination in respondents' dwellings, more than half the victims interviewed reported depressive symptoms at levels suggesting probable clinical depression. Those at greatest risk of depressive symptoms were people who had been exposed to the neurotoxin for the longest period of time, among whom there was an overrepresentation of women and African Americans. Despite high statistical levels of depression, few victims used mental health services. Implications for social work's response to human-induced disasters are provided.

Adult↗
PubMed2004

Post-disaster health effects: strategies for investigation and data collection. Experiences from the Enschede firework disaster.

BACKGROUND: Public health policy is increasingly concerned with the care for victims of a disaster. This article describes the design and implementation of an epidemiological study, which seeks to match care services to the specific problems of persons affected by a large scale incident. The study was prompted by the explosion of a firework depot in Enschede, the Netherlands. STUDY POPULATION: All those directly affected by this incident (residents, emergency services personnel, and people who happened to be in the area at the time), some of whom suffered personal loss or injury. The project investigates both the physical and psychological effects of the disaster, as well as the target group's subsequent call on healthcare services. STUDY DESIGN: A questionnaire based follow up survey of those directly affected and an ongoing monitoring of health problems relying on reports from healthcare professionals. The follow up survey started three weeks after the incident and was repeated 18 months and almost four years after the incident. The monitoring is conducted over a four year period by general practitioners, the local mental health services department, occupational health services, and the youth healthcare services department. It provides ongoing information. RESULTS AND CONCLUSIONS: The results of the study are regularly discussed with healthcare professionals and policy makers, and are made known to the research participants. The paper also explains the considerations that were made in designing the study to help others making up their research plans when confronted with possible health effects of a disaster.

Accidents↗
PubMedDate not supplied

The role of aeromedical transportation in global disaster health care.

There are several unique aspects of aeromedical transportation that render it vital to the overall management of disaster emergencies. Valuable time can be saved in moving medical expertise, supplies, and equipment into the disaster area as well as in moving victims out of the hazardous area quickly and in large numbers. Chaotic ground traffic at and near the disaster scene as well as environmental obstacles en route often may be avoided. Large numbers of disaster victims can be cared for efficiently en route by proportionately fewer health care personnel than is possible using traditional land carriers due to the concentration of many patients in one aircraft. Patients with similar injuries (e.g., burns) can be routed to and concentrated in centralized institutions that specialize in the care of those specific injuries. The plans for execution of the foregoing should include the use of military troop-transport aircraft that may be converted easily for patient transport. Also, military personnel should be involved, as they are part of a highly organized structure that can be mobilized more easily and swiftly than can most civilian organizations. The United States Air Force aeromedical evacuation policies and management structure is reviewed with attention directed toward additions and adaptations of this system needed to allow it to serve global disaster response. Such a highly evolved system will require a governing body with global reach for purposes of coordination and management. The resources for such a system currently exist but such an organization has yet to be formed.

Aircraft↗
PubMed1993

Peripheral victims of the Herald of Free Enterprise disaster.

We report on an unexpected phenomenon following the Herald of Free Enterprise disaster. A series of cross-channel ferry workers referred by their GPs to the Folkestone Mental Health Team, during the three years after the disaster, presented with post-traumatic stress disorder, despite having no direct contact with the disaster as survivors, bereaved relatives or helpers. A retrospective case study is described of 14 ferry crew members presenting with PTSD. Thirteen completed the GHQ60. Evidence is presented of severe functional impairment in this group. It is argued that these subjects are indirect victims of the Herald of Free Enterprise disaster. Ways in which the 'ripples outward' of a major marine accident might extend to such peripheral victims are discussed.

Adaptation, Psychological↗
PubMed2001

The Marmara earthquake: epidemiological analysis of the victims with nephrological problems.

BACKGROUND: Crush syndrome resulting from earthquakes is a major cause of morbidity and mortality, as seen during the catastrophic Marmara earthquake that struck Northwestern Turkey in August 1999. This report analyzes the epidemiological characteristics of the crush syndrome victims of this disaster. METHODS: In order to analyze the nephrological problems caused by this earthquake, questionnaires were prepared within the first week of the disaster and sent to 35 reference hospitals that treated the victims. Data obtained by these questionnaires are the subject of this report. RESULTS: Of the 5302 hospitalized patients in reference hospitals, 639 (12.0%) suffered from nephrological problems, and 477 (9.0%) needed dialysis support. Considering the patients with renal problems, there was not any significant difference in gender; however, the incidence of children younger than 10 years and the older population (older than 60 years of age) was significantly lower as compared with the resident population of the affected area (P < 0.001). Nonsurvivors were older (34.5 +/- 16.1 years) than survivors (31.2 +/- 14.4 years, P = 0.048), while no deaths were recorded under the age of 10. Most patients (70.1%) were admitted within the first three days after the earthquake, and the mortality rate among these victims was higher (17.7%) as compared with victims admitted thereafter (10.0%, P = 0.016). The average time period under the rubble was 11.7 +/- 14.3 hours, which was not significantly different between survivors and nonsurvivors, while the victims who required dialysis support spent shorter durations under the rubble, as compared with the ones who were not dialyzed at all (10.3 +/- 9.5 vs. 15.9 +/- 23.1 hours, P < 0.001). CONCLUSION: Victims of catastrophic earthquakes are characterized by a high incidence of renal problems and the need for dialysis support. The incidence of nephrological problems is lower in children, while the period of time under the rubble is not a prognostic indicator of survival.

Adolescent↗
PubMed1980

Minimizing the psychological effects of a wartime disaster on an individual.

In this paper, the psychological reactions of individuals and groups to a wartime disaster, such as nuclear explosion, are presented. The psychological literature on disasters is discussed. The presentation attempts to emphasize viewing the victims of a disaster as individuals responding in a normal way to an overwhelming experience, rather than labeling them as psychiatric patients. The various phases of a disaster are discussed with particular emphases on the preventive measures and leadership roles which may be taken by the physician. The development and treatment of situational psychoses, as well as neurotic reactions, are examined and the dynamics especially of long-lasting neurotic problems explored. The paper concludes by making specific recommendations regarding the establishment of disaster plans and training programs at each military facility. It is suggested that the use of such plans may help minimize the psychological effects of a wartime disaster on the individual.

Disasters↗
PubMed1992

The professional's psychological response in disaster: implications for practice.

1. Victims typically experience recurring and distressing thoughts about a disaster and attempt to avoid thoughts and behavior associated with the event. As one works through the stressful event, the victim vacillates between intrusion and avoidance, with the magnitude of those oscillations being much stronger at first. 2. Although health-care workers may respond effectively following a disaster, they are not immune to its stresses. They must attend to the victims, regardless of their own needs, taxing even the toughest of the tough. 3. A crisis team should be established to work with the staff before disaster strikes, to be highly visible during a disaster to maintain staff support and emotional stability. They should take an active role in organizing and conducting mandatory debriefing sessions after a disaster to ward off traumatic effects.

Adaptation, Psychological↗
PubMed2005

Cognitive paralysis in an emergency: the role of the supervisory attentional system.

Many witnesses attest that victims of a disaster often perish because they 'freeze' in the face of danger. It has been proposed that this cognitive paralysis occurs due to temporal and cognitive constraints on survival response times while leaving open the question of which cognitive component is implicated in this behavior. This paper proposes, firstly, that the temporal constraints which occur during an emergency inhibit the functioning of the supervisory attentional system (SAS), which leads to the victim showing: (1) an appropriate response, if trained; (2) stereotypical or otherwise irrational behavior, if untrained; or (3) cognitive paralysis. Secondly, that the main role of the SAS is to operate as a temporal buffer, enabling a survival response to be prepared prior to facing a life-threatening event and not as a real-time immediate responder. It is argued that the initial cognitive paralysis differs at the cognitive and neurological levels from the more prolonged hypoactive behavior commonly seen in victims rescued from disasters and which is considered to be a form of disassociative reaction.

Cognition↗
PubMed2006

Atypical patient profiles common after disasters.

Follow the "surge, sort, support" triage model to ensure a higher quality of care for victims of communitywide disasters. Alert your staff that up to 80% of your patients will be self-referred. A large number of patients will have unexplained physical symptoms. Have a separate space available to function as a support center.

Disasters↗
PubMed2005

Gray matter density reduction in the insula in fire survivors with posttraumatic stress disorder: a voxel-based morphometric study.

Voxel-based morphometry (VBM) is an objective whole-brain technique for characterizing regional cerebral volume and tissue concentration differences in structural magnetic resonance images. In the current study, we used VBM to examine possible cerebral gray matter abnormalities in patients with posttraumatic stress disorder (PTSD) due to fire. The subjects included 12 victims of a fire disaster with PTSD and 12 matched victims of the same fire without PTSD. Magnetic resonance images were obtained on a 1.5-Tesla General Electric scanner at Central South University, and an entire brain volume of 248 contiguous slices was obtained for each subject. Then, gray matter density in patients with PTSD and control groups was compared by using a VBM approach in SPM2. Group analysis was thresholded at P<0.001, uncorrected, at the voxel level. The following three regions of reduced gray matter volume were found in patients with PTSD compared with controls: left hippocampus, left anterior cingulate cortex (ACC), and bilateral insular cortex. It was concluded that there are structural abnormalities of the hippocampus, the ACC and the insular cortex in patients with PTSD due to fire.

Adult↗
PubMed1999

[Value of prophylactic investigation of thoracic organs in victims of the Chernobyl power plant disaster].

Relatively low morbidity of tuberculosis of the lung (2 per 1,500) and comparatively high morbidity of ling cancer were reported in 1995-1997 among the liquidators of Chernobyl nuclear power station disaster. Risk of malignant disease involved in X-ray check-ups of the chest has been identified. Low diagnostic value of photoroentgenography for lung tumors has been reported.

Humans↗
PubMed1991

[The status of immunity in the victims of industrial catastrophes and natural disasters].

The influence of industrial catastrophes or calamities upon human organism is accompanied by the affection of the immunity system. The structure and manifestations of immunity disorders depend on nature of the disturbing factors in every concrete catastrophe. The affections of the immunity system may lead to the formation of secondary immunodeficiency which will require additional medical assistance.

Accidents, Occupational↗