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PubMed2005

Identification and posttraumatic stress disorder symptoms in rescue workers in the Marmara, Turkey, earthquake.

After the 1999 Marmara Turkey earthquake, 434 volunteer rescue workers and 154 soldiers who were control subjects completed the Questionnaire for Identification with Deceased Victims and the Impact of Event Scale-Revised (IES-R). Identification with the Deceased as Oneself, Identification with the Deceased as a Friend, Identification with the Deceased as a Family Member, and IES-R Intrusion, Avoidance, and Hyperarousal subscale scores were significantly higher in rescue workers. Identification-Self, Identification-Friend, and Identification-Family correlated with the IES-R subscale and total scores. The set of identification variables was significantly associated with group membership before, but not after, IES-R scores were controlled. Findings suggest that identification with deceased victims, not rescue work per se, is the risk factor of concern for posttraumatic stress disorder in rescue workers.

Adult↗
PubMed1997

[Experiences of treatment of mass burn casualties].

A fire in Karamay, Xinjiang on December 8, 1994, took a toll of 323 deaths at the site of the disaster, including 208 children, 75 teenagers and 40 adults. 135 burn patients were admitted to the hospital (including 41 children, 62 teenagers, and 32 adults). They were classified as extremely serious 9, serious 35, moderate 64 and mild 27. Among them 77 patients were complicated by inhalation injury, and tracheostomy was performed for moderate serious cases within 24 hours. Escharectomy and skin-grafting were done for III degree burn wound of hands, and early wound infection was effectively controled. Because of efficient organization, the rescue work and treatment were successful.

Adolescent↗
PubMed2004

Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan.

This study investigated the prevalence of posttraumatic stress disorder (PTSD) among professional and non-professional rescue workers involved in the 1999 Chi-Chi Earthquake in Taiwan. One month following the disaster, 252 rescue workers (167 professional rescue workers, 85 non-professional volunteers) were surveyed with the Chinese version of the Davidson Trauma Scale (DTS-C) and the Chinese version of the SPAN (SPAN-C). Non-professional rescuers had significantly higher scores than professional rescuers on both the DTS-C and the SPAN-C. The prevalences of PTSD, as defined by a DTS-C score > or = 44, among professional and non-professional rescuers were 19.8% and 31.8%, respectively. Among the three subscales of the DTS-C, only scores on the numbness/avoidance subscale were significantly higher in the non-professional than in the professional rescue workers. The results of this study suggest that disaster rescue work is associated with a high level of stress even for highly trained professionals and may lead to mental health problems.

Adult↗
PubMed2003

Posttraumatic distress and coping strategies among rescue workers after an earthquake.

Disaster workers are at high risk for developing psychiatric morbidity. This study examined the prevalence rates of psychiatric and posttraumatic distress and the relationship between psychiatric and posttraumatic morbidity and coping strategies among rescue workers following an earthquake in Taiwan on September 21, 1999. Eighty-four male firefighters who had been exposed to earthquake rescue work were assessed 5 months after the event. The Chinese Health Questionnaire (CHQ), the Impact of Event Scale (IES), and the Ways of Coping Questionnaire (WCQ) were used to assess psychiatric morbidity, posttraumatic morbidity, and coping strategies. The observed prevalence rates were 16.7% and 21.4% for general psychiatric morbidity and posttraumatic morbidity, respectively. Results from multivariate logistic regression indicated that job experience and confrontive coping were significant predictors of psychiatric morbidity, while job experience, distancing, escape-avoidance, and positive reappraisal were significant predictors of posttraumatic morbidity. Rescue workers with longer job experience were at the highest risk for developing psychiatric and posttraumatic distress.

Adaptation, Psychological↗
PubMed2003

Protective equipment affects balance abilities differently in younger and older firefighters.

INTRODUCTION: Firefighters must work on roofs, in smoky places, and on slippery surfaces while using fire-protective clothing and a self-contained breathing apparatus (SCBA), together termed "fire-protective equipment" (FPE). The aim of this study was to investigate the effects of FPE on the functional and postural balance abilities of younger and older firefighters. METHODS: The subjects were professional firefighters in age groups 33-38 and 43-56 yr. Postural balance was tested with a force platform, and functional balance was measured during walking on a wooden plank with and without FPE. RESULTS: Wearing FPE significantly impaired both postural and functional balance. Postural balance with eyes closed was more negatively affected among the older subjects than the younger ones. Among the older subjects, the mean values for mediolateral velocity were 3.4 +/- 0.8 and 4.8 +/- 2.1 mm x s(-1) without and with FPE, respectively. The corresponding figures for velocity moment were 11.4 +/- 5.1 and 20.7 +/- 15.1 mm2 x s(-1). In the younger age group, the corresponding results were 3.6 +/- 1.0 and 4.1 +/- 1.4 mm x s(-1), in mediolateral velocity and 10.8 +/- 5.0 and 13.9 +/- 8.1 mm2 x s(-1) in velocity moment. SCBA was the most significant single piece of equipment to decrease performance in the functional balance test. CONCLUSIONS: These findings should be taken into consideration for preventing balance-related injuries in firefighting and rescue work, especially for older firefighters. Furthermore, balance should be considered in developing FPE and training protocols for firefighter fitness.

Adult↗
PubMedDate not supplied

Challenges of major incident management when excess resources are allocated: experiences from a mass casualty incident after roof collapse of a military command center.

During a military exercise in northern Norway in March 2000, the snow-laden roof of a command center collapsed with 76 persons inside. Twenty-five persons were entrapped and/or buried under snow masses. There were three deaths. Seven patients had serious injuries, three had moderate injuries, and 16 had minor injuries. A military Convalescence Camp that had been set up in a Sports Hall 125 meters from the scene was reorganized as a causality clearing station. Officers from the Convalescence Camp initially organized search and rescue. In all, 417 persons took part in the rescue work with 36 ambulances, 17 helicopters, three ambulance airplanes and one transport plane available. Two ambulances, five helicopters and one transport aircraft were used. Four patients were evacuated to a civilian hospital and six to a field hospital. The stretcher and treatment teams initially could have been more effectively organized. As resources were ample, this was a mass casualty, not a disaster. Firm incident command prevented the influx of excess resources.

Cold Climate↗
PubMed2003

Evaluation of performance and load in simulated rescue tasks for a novel design SCBA: effect of weight, volume and weight distribution.

A self-contained breathing apparatus (SCBA) with an innovative rucksack shape that provides a better distribution of its weight over the middle and lower parts of the back (device C: 6l, 13.7 kg) was compared with two conventional SCBA which differed from each other in volume and weight (A: 6l, 15 kg, B: 6.8l, 11.7 kg). Twelve fire-fighters (27-49 yr) performed three exercises while using the three SCBA in a systematically permuted sequence. The exercises consisted of simulated rescue work under natural climatic conditions in a dwelling on the second floor and several typical elements of severe fire-fighting actions. Duration, heart rate, breathing frequency, rectal temperature, and sweat loss were recorded. Perceived exertion was rated and the carrying features of the SCBA were subjectively evaluated. The exercise was executed faster with the rucksack device, heart rates were then lower and the carrying features were evaluated as better. Thus, the weight of the SCBA was shown to be less important than its distribution.

Adult↗
PubMed2003

The discotheque fire in Gothenburg 1998. A tragedy among teenagers.

The fire disaster in Gothenburg, Sweden, 1998 killing 63 and wounding 213 teenagers was caused by arson committed by a youth from the same community. The fire was started in the basement of an overcrowded discotheque and made, due to unfortunate circumstances, devastating progress. The ensuing rescue work performed by other youth, fire fighters, police and medical staff was prompt and must be seen in the light of a very difficult situation. As a result of these orchestrated efforts and the fact that this disaster occurred in a major city with substantial resources, all the injured were able to be hospitalized within 2h. The load on four local hospitals was initially severe due to the large number of injured and the limited number of staff on night duty. The situation was contained by relocating patients from the intensive care units to ordinary wards and by transporting several of the most severe burn injuries by helicopter to burn units in other parts of Sweden and to Norway. Hundreds of relatives and friends gathered at the local hospitals. This was a new experience for the hospitals and staff, involving many positive aspects as well as some negative aspects such as violence, threats and rumors. As a result of the large number of injuries vast psychosocial rehabilitation program was initiated by health care staff, religious communions, schools and the community, has continued over the past years. Such a disaster emphasises a requirement for extensive preparation not only in the rescue and medical services, but also in the ways and areas to rehabilitate patients in society.

Adolescent↗
PubMed2003

Long-term psychological outcome for non-treatment-seeking earthquake survivors in Turkey.

This study examined the incidence of posttraumatic stress disorder (PTSD) and depression in 586 earthquake survivors living in prefabricated housing sites a mean of 20 months after the 1999 earthquake in Turkey. The estimated rates of PTSD and major depression were 39% and 18%, respectively. More severe PTSD symptoms related to greater fear during the earthquake, female gender, older age, participation in rescue work, having been trapped under rubble, and personal history of psychiatric illness. More severe depression symptoms related to older age, loss of close ones, single marital status, past psychiatric illness, previous trauma experience, female gender, and family history of psychiatric illness. These findings suggest that catastrophic earthquakes have long-term psychological consequences, particularly for survivors with high levels of trauma exposure. These findings lend further support to the need for long-term mental health care policies for earthquake survivors. Outreach service delivery programs are needed to access non-treatment-seeking survivors with chronic PTSD.

Adult↗
PubMed2001

The effects of group psychological debriefing on acute stress reactions following a traffic accident: a quasi-experimental approach.

The purpose of this study was to evaluate the effects of a Group Psychological Debriefing (GPD) on acute stress reactions and perceptions following a traumatic situation. A group of military personnel (N = 9) and a group of voluntary civilian firefighters (N = 9) were exposed to severe stress during rescue work in a tunnel following a fatal traffic accident. Both groups participated in an operational debriefing and received brief stress management counseling after the incident. In addition the military personnel also participated in a structured 2.5 hour GPD after the accident. Two weeks later both groups completed the Coping Style Questionnaire (CSQ-30), the Impact of Event Scale (IES), the Post Traumatic Symptom Scale (PTSS-10), the General Health Questionnaire (GHQ-30) and questions about stress and coping after the incident. Lower frequency of symptoms were found in the GPD compared to the non-debriefed group measured by the PTSS-10. Single item analyzes of the scale revealed lower levels of symptoms related to emotional arousal in the GPD participants. Furthermore, the GPD participants revealed more positive personal outcomes than the non-debriefed group after the accident. The total PTSS-10 score and mental preparedness were the two variables that were best able to classify participants as belonging to the two groups, thus indicating significant clinical differences between the debriefed and non-debriefed group and the potential usefulness of PTSS-10 scale as a brief screening inventory after traumatic events.

Accidents, Traffic↗
PubMed2006

Physiological responses of firefighters and performance predictors during a simulated rescue of hospital patients.

There is incomplete information about how physically demanding rescue work may be. The aim therefore of this paper was to examine the physiological responses of firefighters during a simulated rescue of hospital patients and to relate the firefighters' performance to their endurance, strength and working technique. Fourteen part-time male firefighters with a maximal oxygen uptake (VO(2max)) of 4.4 +/- 0.3 l/min (mean +/- SD) served as subjects in this study. First, each firefighter ascended six floors (a 20.5 m vertical ascent) carrying tools, wearing protective clothing and a breathing apparatus, an extra mass of 37 kg. He thereafter 'rescued' six persons by dragging each person on a fire-sheet on a flat floor. The technique used was recorded and the O(2) uptake and the heart rate were measured continuously during the whole operation. The blood lactate concentration and the subjective rating of perceived exertion were measured during and just after the rescue. The VO(2max) and the muscle strength were measured in the laboratory. The whole operation was carried out in the course of 5-9 min. The operation was a virtual all-out effort and the peak blood lactate concentration was 13 +/- 3 mmol/l. The peak oxygen uptake was 3.7 +/- 0.5 l/min (84% of the VO(2max)) during the operation. Large and heavy firefighters carried out the task faster than smaller ones. The VO(2max) in absolute terms and the dragging technique used were both related to the rescue performance. Rescuing patients at a hospital was physically very demanding and the time needed to complete the task depended on the VO(2max) in absolute values and the working technique used. A minimum VO(2max) of 4 l/min for firefighters was recommended.

Adult↗
PubMed1990

[Aviation support of measures for rendering medical care to the victims of natural disasters, accidents and catastrophes].

The unpredictable character of natural calamities and technological accidents makes some specific demands on the organization and planning of the wide range complex of social measures to abolish their awful and tragic consequences. Analysing and summarizing the reviews and reports of international congresses on the emergency and catastrophic medicine and their own experience, the authors accentuate attention on the advantages and capabilities of aerial transport in delivering of medical personnel, all necessary equipment to the zones of mass sanitary losses and its really essential role in rapid aeromedical evacuation of injured. The authors scrutinize in details the structural scheme of organization of patient's search-and-rescue work and suggest, that main principles of planning and management of search-and-rescue operations in aviation could be applied in a decision of problems, which arise in medical assistance to the victims of the natural disasters and accidents.

Accidents↗
PubMed1986

The Bhopal tragedy--what has Swedish disaster medicine planning learned from it?

On December 3, 1984, a leak of methylisocyanate (MIC) from a chemical plant in Bhopal, India, affected 150,000 to 200,000 people. More than 10,000 people were severely injured and approximately 2,500 died. In this article a survey of symptoms, treatment, and rescue work is given. On the basis of this, we discuss ways to help reduce the effects of a major release of an irritant gas. People living in the vicinity of potential health hazards need information on how to behave in case of accidents. Rescue workers and medical personnel must be trained to operate under "toxic conditions." There must be planning for treatment of thousands of patients at the same time, a circumstance that will often require temporary "satellite hospitals" to be opened. As symptoms and injuries are of the same kind, even if the magnitude and the effect may differ, treatment can, in many ways, be standardized. Therefore members of the health care team, irrespective of their daily different specialty fields, can work with the most urgent missions.

Accidents, Occupational↗
PubMed1996

Voluntary and professional disaster-workers: similarities and differences in reactions.

Forty-three rescuers responding to a bus crash that killed 12 children and 4 adults and injured many more answered questionnaires at 1 and 13 months following the crash. This study compared the responses of the voluntary and professional helpers, using the Impact of Event Scale (IES) and the General Health Questionnaire (GHQ). For all helpers taken together, the decline in IES-intrusion and IES-total scores was significant from 1 to 13 months. The voluntary helpers reported significantly more intrusion and avoidance on the IES at 1 month than professional helpers, and for avoidance the voluntary helpers still evidenced a significantly higher score than professional helpers at 13 months. The GHQ scores at 13 months reflected that the long-term negative impact of the event was low.

Accidents, Traffic↗
PubMedDate not supplied

Social desirability bias in personality testing: implications for astronaut selection.

The assessment of personality is recognized by space agencies as an approach to identify candidates likely to perform optimally during spaceflights. In the use of personality scales for selection, the impact of social desirability (SD) has been cited as a concern. Study 1 addressed the impact of SD on responses to the Personality Characteristic Inventory(PCI) and NEO-FFI. This was achieved by contrasting scores from active astronauts (N=65) with scores of successful astronaut applicants (N=63), and between pilots applicants (N=1271) and pilot research subjects (N=120). Secondly, personality scores were correlated with scores on the Marlow Crown Social Desirability Scale among applicants to managerial positions (N=120). The results indicated that SD inflated scores on PCI scales assessing negative interpersonal characteristics, and impacted on four of five scales in NEO-FFI. Still, the effect sizes were small or moderate. Study 2 addressed performance implications of SD during an assessment of males applying to work as rescue personnel operations in the North Sea (N=22). The results showed that SD correlated negatively with cognitive test performance, and positively with discrepancy in performance ratings between self and two observers. In conclusion, caution is needed in interpreting personality scores in applicant populations. SD maybe a negative predictor for performance under stress.

Astronauts↗