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At least 325 records · Page 18Linked to original sources
PubMed1995

Public health, epidemiology and war.

The delivery of humanitarian aid in wartime is difficult. However, it is essential that aid is provided in the most effective manner possible, targeted on those most in need whilst minimizing waste. Furthermore the delivery of aid should be sensitive to the future needs of the communities in conflict. This requires information on the needs of the vulnerable population. There is little experience of collecting data on the impact of war on a civilian population. The war in Bosnia disrupted surveillance of communicable disease. The local authorities were assisted by the World Health Organization in re-establishing surveillance. The data generated was valuable in planning interventions to minimise the possibility of major outbreaks of infection, reduce the impact of infectious disease and in guiding the humanitarian aid effort. The experience described suggests that public health surveillance of the civilian population in wartime is possible and useful. Besides the need for planning, the public health doctor in wartime has a role as an advocate for those suffering; this function can be carried out much more effectively if it is based on objective data collection rather than hearsay.

Bosnia and Herzegovina↗
PubMedDate not supplied

An introduction to disaster medicine in Europe.

Disaster medicine, which is based primarily on military and emergency medicine, is a young branch on the old tree of medicine. It touches on various disciplines within and outside the medical field. The subject is being taught on the academic and postacademic levels at many universities throughout Europe. The first chair in disaster medicine was established in Linkoping, Sweden; the second is now in Amsterdam, The Netherlands. Some aspects of disaster medicine specifically oriented toward Europe are presented.

Disaster Planning↗
PubMed1990

Nurses respond to Hurricane Hugo victims' disaster stress.

Hugo, a class IV hurricane, hit South Carolina September 22, 1989, and left behind a wake of terror and destruction. Sixty-one nursing students and five faculty were involved in disaster relief with families devastated by the hurricane. A review of the literature led these authors to propose a formulation of the concept of disaster stress, a synthesis of theories that explains response to disaster as a crisis response, a stress response, or as posttraumatic stress. With the concept of disaster stress serving as a theoretical foundation, the nurses observed, assessed, and intervened with one population of hurricane Hugo victims, noting their immediate psychosocial reactions and coping mechanisms. Victims' reactions to disaster stress included confusion, irritability, lethargy, withdrawal, and crying. The most frequently observed coping strategy of these hurricane Hugo victims was talking about their experiences; other coping tactics involved humor, religion, and altruism.

Aged↗
PubMed1994

Assessing humanitarian needs--Afghanistan.

During 5 weeks of 1993, 10,000 people were wounded and over 800 killed in Kabul, capital city of Afghanistan. 50,000 refugees have fled Kabul for the countryside, or the safety of Pakistan. In the Bosnian conflict 55,000 people have been injured over the past 2 years. At the present rate, Kabul will reach this total within 6 months. My brief in Kabul was to visit as many hospitals and polyclinics as possible, talk to the staff, and find out whether there is a need for MERLIN (Medical Emergency Relief International) to intervene in this area. This intervention would be in the form of a short mission of 3-4 months duration, deploying a trauma team, immunisation programme or supplies facility. It was essential to assess the trauma facilities and document what supplies and staff were needed.

Afghanistan↗
PubMed2006

Coping motives and trait negative affect: testing mediation and moderation models of alcohol problems among American Red Cross disaster workers who responded to the September 11,2001 terrorist attacks.

This study explored the mechanism by which trait negative affect and alcohol coping motives are associated with alcohol-related problems in a sample of American Red Cross workers who participated in the relief operation following the attacks in New York City, the Pentagon, and the Pennsylvania crash site on Sept. 11th 2001. The results supported the mediation but not moderation model of coping motives. The support for the mediation model was fairly strong, including small to moderate associations between negative affect and alcohol problems, moderate to strong associations between negative affect and coping motives, and evidence of coping motives mediating the negative affect to alcohol problems relationships. The association between negative affect and coping motives was stronger among younger participants.

Adaptation, Psychological↗
PubMed2006

A Katrina experience: lessons learned.

PURPOSE: Almost no data exist on how best to respond to the medical needs of civilians displaced by natural disasters. After Hurricane Katrina destroyed the Gulf Coast and seriously damaged the infrastructure of Jackson, Miss, the University of Mississippi Medical Center (UMMC) was challenged with serving a large group of evacuees at a major Red Cross evacuation shelter near our campus. We reviewed our experiences and share lessons learned. METHODS: This is a retrospective review of administrative and clinical records for patients served by a medical clinic established emergently after Hurricane Katrina. RESULTS: Red Cross regulations precluded their volunteers from providing medical care other than first aid. Faced with numerous evacuees seeking medical assistance, UMMC established an ambulatory clinic at the shelter. The majority of patients had multiple medical problems, no medical insurance, and limited ability to purchase medications. The greatest need was for management of chronic illnesses. The clinic provided 2394 patient visits and filled more than 4902 prescriptions over 17 days. CONCLUSION: While medical facilities have emergency response plans for epidemics and mass trauma, little attention has focused on plans for care of evacuated populations. Shelter operators should consider advance coordination of medical care with existing health care systems. Medical facilities along evacuation routes should be aware that they may be asked to provide care for sheltered evacuees.

Academic Medical Centers↗
PubMed2004

Combat trauma experience with the United States Army 102nd Forward Surgical Team in Afghanistan.

BACKGROUND: The United States Army 102nd Forward Surgical Team (FST) was deployed to Kandahar Airfield, Afghanistan, from August 2002 to March 2003, in support of Operation Enduring Freedom. The unit's primary mission was to provide trauma surgical support to units of the 101st and 82nd Airborne Divisions, to coalition special operations units, and to allied Afghan militia forces. The FST's mission was expanded to include humanitarian assistance. METHODS: The mission was accomplished in the austere environment of Kandahar Airfield, Afghanistan. The FST was set up in a corner of the abandoned Kandahar International Airport terminal. The team's supporting facility was a 44-bed combat support hospital at Bagram Airbase near Kabul. Patients arrived by ground ambulance, local transportation, and MediVac helicopter. Evacuation of casualties, when necessary, was by fixed-wing aircraft. Patient data were retrospectively reviewed. RESULTS: The team performed 112 surgeries on 90 patients during the course of 7 months. Three patients were female (all children). Twenty patients were <19 years old. Trauma accounted for 78% of cases; the remainders were nontrauma or elective cases. Sixty-seven percent of these surgeries were performed on Afghan militia and civilians, 30% on United States soldiers, and 3% on other coalition forces. Mechanism of injury included gunshot wounds (34%), blasts (18%), motor vehicle crashes (14%), stab wounds (5%), and other trauma (7%). By physiological system, the trauma cases were broken down into extremity (44%), head and neck (17%), multisystem (13%), trunk (8%), and vascular (3%). CONCLUSIONS: "Damage control" operations necessitating multiple trips to the operating room were the norm. Hypothermia from blood loss was often exacerbated by exposure before evacuation and prolonged transport in helicopters. This was aggressively treated with passive, conductive, and active rewarming techniques. Stabilization and evacuation to higher echelons of care was common.

Adolescent↗
PubMed2006

Use of an innovative design mobile hospital in the medical response to Hurricane Katrina.

On August 29, 2005, Hurricane Katrina caused widespread devastation to the Gulf Coast region of the United States. Although New Orleans had extensive damage from flooding, many communities in Mississippi had equal damage from storm surge and wind. Because the medical resources in many of these areas were incapacitated, resources from North Carolina were deployed to assist in the medical mission. This response included the initial use of Carolinas MED-1, a mobile hospital that incorporates an emergency department, surgical suite, critical care beds, and general treatment and admitting area. This asset, along with additional state resources, provided comprehensive diagnostic and definitive patient care until the local medical infrastructure was rebuilt and functional. The use of a mobile hospital may be advantageous for future deployments to large-scale disasters, especially when integrated with specialty teams.

Disasters↗
PubMed2006

Improving hospital surge capacity: a new concept for emergency credentialing of volunteers.

In the event of a large-scale terrorist attack, natural disaster, or other public health emergency, hospitals could not absorb the thousands of victims generated by the catastrophe. Even if hospitals can increase bed capacity by 20% to 30%, as some suggest, the problem of staffing these beds remains unresolved. One possibility is to rapidly increase hospital staff by providing emergency credentialing to volunteer health care professionals. Several organizations and systems currently exist that can deliver medical providers to a stricken area. Unfortunately, all of these have serious limitations that would make it difficult for hospitals to use the health care workers provided by such entities. We propose a unique concept that will allow hospitals to rapidly expand their staff with practitioners that meet their credentialing requirements. The concept is a database created by each hospital in a community that includes credentialed physicians, nurses, behavioral health professionals, and ancillary staff. The database will be limited to physicians with full privileges and all licensed hospital employees in good standing not currently facing disciplinary issues or practice restrictions. The individual databases would then be combined and stored on a single computer system housed at the county health care agency or other mutually acceptable organization, with copies sent back to participating hospitals and the state. After a large disaster, health care workers from unaffected areas, including other states, can approach affected hospitals and volunteer their services. Practitioners listed on the database could be given privileges in their specialties for 72 hours. This process is accurate, inexpensive, efficient, sustainable, and Joint Commission on Accreditation of Healthcare Organizations compliant and permits the immediate credentialing of large numbers of medical volunteers.

Credentialing↗
PubMedDate not supplied

Rebuilding New Orleans after Katrina, part 2.

Hurricane Katrina occurred on August 29, 2005, followed by Hurricane Rita on September 24, with destruction extending along the Gulf Coast to Beaumont, Texas. Reentry into New Orleans began in mid to late September last year and occurred in stages, with the least devastated areas being gradually reopened first. People began trickling back in until the city was finally fully opened in December except for the Ninth Ward and East New Orleans.

Case Management↗
PubMed2005

The human factors in a disaster.

Although natural disasters are claiming fewer lives now than even as recently as 30 years ago, they remain responsible for many premature deaths, most in third-world countries. This article highlights the relationship of human factors that can be found with third-world disasters and reviews interventions that have been used to reduce illness, injuries and deaths.

Developing Countries↗
PubMedDate not supplied

Earthquakes in El Salvador: a descriptive study of health concerns in a rural community and the clinical implications--part II.

Results reported in Part I of the Earthquakes in El Salvador series (see Disaster Management & Response 2003;1:105-9) indicated clinically relevant findings. The findings indicated a need for greater public health action within all five categories reviewed: healthcare, access to healthcare, housing, food, water and sanitation. Significant results between urban and rural communities indicated a need for broader community aid, public health and sanitation services to rural areas. Faster and more efficient disaster management and care services throughout the San Sebastian community were also necessary modifications.

Adult↗
PubMedDate not supplied

Challenges of international disaster relief: use of a deployable rapid assembly shelter and surgical hospital.

Surgical care is an important service to provide to victims of a disaster. A specialized response team has been created by the National Disaster Medical Treatment division of the Federal Emergency Management Agency to respond when local hospital facilities are either unavailable or unusable. When a major earthquake destroyed Bam, Iran, in December 2003, the US Government mobilized the International Medical Surgical Response Team-East and deployed a team of 57 health care providers to aid in rescue and response efforts. The challenges of designing, maintaining, and keeping a Deployable Rapid Assembly Shelter/Surgical Hospital are described.

Disasters↗
PubMedDate not supplied

Nursing students' perceptions about disaster nursing.

Man-made or natural disasters are occurring more frequently in the United States and around the world. It is important that all nurses in all specialties be prepared to care for people affected by disasters. This article reports a descriptive study that sought to explore nursing students' perceptions about disaster nursing and to use the findings to suggest recommendations for building the discipline of disaster nursing. Results of this study indicate that nursing students had the following gaps of knowledge regarding disaster nursing: (1) an incomplete definition of disaster nursing; (2) lack of recognition about the importance of knowing community resources, having mock disaster drills, and utilizing disaster planning models; and (3) lack of perception that all nurses could play a significant role in disaster situations. The authors recommend that disaster nursing be taught by nursing faculty as a specialty in nursing programs.

Adult↗