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At least 433 records · Page 24Linked to original sources
PubMedDate not supplied

Issues with the integration of technical information in planning for and responding to nontraditional disasters.

In the post-9/11 environment, it has become recognized that the response to man-made disasters (such as chemical spills, bioterrorism, and radiation dispersal) requires a much broader range of tools and technical knowledge than needed for natural disasters (i.e., hurricanes, earthquakes, or drought). This need also requires that those who develop technical information for disaster planning maintain a broader perspective of how the information will be used and what the priorities are for developing new information. In addition, the ability to communicate information within a context understandable to the "end user" has become more critical. The intent of this article is to present issues to help those who traditionally collect and interpret technical information (toxicology, risk assessment, mitigation planners, etc.) to better understand how their information is used in planning for and responding to incidents. These issues are similar to those experienced when trying to provide the users of information provided on material safety data sheets (MSDS) with an understanding of the value and limits of such information in decision making. Confounding the problem are the many sources that provide exposure limits and the limited amount of time the user has to understand the limits of the data during an emergency. While the Federal Response Plan integrates the efforts of multiple agencies, the "on-scene" responders are faced with trying to respond to contradictory strategies and applications of information. Sources of response technical information need to better communicate the limits of application/interpretation of that information in emergency situations.

Communication↗
PubMed1982

The MGM Grand Hotel fire: lessons learned from a major disaster.

Most community disaster plans are formulated to respond to disasters of moderate size. The MGM Grand Hotel fire in Las Vegas, because of its magnitude, had the potential to overwhelm completely the local medical resources. It did not, because of innovative responses to unforeseen problems based on sound disaster planning. Fortunately, disasters on the magnitude of this fire are rare, and few communities have ever faced the problem of dealing with thousands of casualties. The important lessons learned about perimeter control, command functions, helicopter evacuation, crowd control, and transportation priorities will benefit disaster planners in other communities.

Disasters↗
PubMed1993

The Avianca plane crash: an emergency medical system's response to pediatric survivors of the disaster.

OBJECTIVE: On January 25, 1990, a jetliner crashed on Long Island, New York. Twenty-two children survived the crash. The purpose of this study was to evaluate the emergency medical system's response to these pediatric survivors. METHODS: A questionnaire was sent to all local, acute care hospitals to determine their specific pediatric capabilities and to rank them as level I, II, or III pediatric centers; level I centers are tertiary care facilities. A second questionnaire was sent to all hospitals that received pediatric survivors to collect specific clinical information for each patient. Based on this clinical information a Pediatric Trauma Score (PTS) was assigned to each patient. Children with a PTS < or = 8 are considered to be at increased risk of trauma-related mortality. The assigned PTS was compared to the level of the pediatric center to which each patient was transported. RESULTS: Of 25 children on board the plane, 22 (88%) survived the crash; of 135 adults on board, 70 (52%) survived (chi 2 = 9.9, P = .002). Seven children had a PTs < or = 8; only 1 of these high-risk patients was transported directly to a level I pediatric center, and only 2 of the 5 high-risk children initially transported to level III facilities were transferred to higher level pediatric centers. CONCLUSIONS: Pediatric survivors were neither adequately triaged nor transported to appropriate facilities which could optimize their care. Possible explanations for this include: (1) unique features of the rescue operation, (2) limited pediatric training of prehospital personnel, and (3) deficiencies of the regional disaster plan. Emergency medical services systems and disaster plans can be made more responsive to children's needs by: (1) acknowledging that children have special needs requiring referral, (2) improving the training of prehospital personnel in pediatric emergency care, (3) classifying ill and injured children according to appropriate triage criteria, (4) recognizing existing tertiary care pediatric centers as the optimal location for the treatment of critically ill and injured children, and (5) designating these centers as the appropriate transport destination for critically ill and injured children.

Accidents, Aviation↗
PubMed1991

Swedish emergency hospitals' readiness for disaster; incidence, interest and training.

Disasters in Sweden are normally caused by human factors and these are dependent on the development of the community. The readiness of Swedish emergency hospitals to cope with disaster was investigated both in relation to real disasters and training with hospital disaster plans. An inquiry to the chief physician at every emergency hospital in Sweden, aiming to map the incidence of disasters and the availability of relevant further education, showed a low use of disaster plans in practice and little training in the use of them. It is necessary for several departments to take more responsibility for the disaster plans at emergency hospitals, through regular updating of disaster plans and training. This would minimise the number of people with injuries of both somatic and psychiatric origin in real disaster situations. It would be possible to maintain the readiness of Swedish hospitals to cope with disaster by developing a disaster medicine discipline and introducing selected teams of specialised staff at the emergency hospitals. These efforts together would maintain readiness to cope with disaster and stimulate interest in research, education and further education in the field of disaster medicine.

Disaster Planning↗
PubMedDate not supplied

The physician's role in Canada's disaster response system.

The most recent tragedy in Manitoba illustrates that disasters can strike any community. Within Canada, a tiered disaster response system exists. Even though physicians often play an integral role in the disaster plan, few participate in the planning process or even appreciate their potential role in the event a disaster should occur. Physician involvement would guarantee health matters be appropriately addressed resulting in reduced mortality and decreased morbidity. There are ample opportunities to become involved in disaster planning and response at all levels of government. The objective of this paper is to inform physicians about the disaster planning infrastructure that exists in Canada, show them where they may get involved, and urge them to do so.

Canada↗
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↗
PubMedDate not supplied

[Readiness of operating room for coping with mass disaster victims].

Mass disasters are sudden events which entail various damages and a large number of victims. For this purpose hospitals prepare disaster plans which give directions and define personnel duties in case of a disaster. In this paper an operating room disaster plan is presented which includes: organization of adequate and appropriate supplies; personnel duties and procedures during a disaster; and a continuous education programme in relation to the disaster plan for the staff.

Disaster Planning↗
PubMed2006

Direct patient care during an acute disaster: chasing the will-o'-the-wisp.

Well developed disaster plans are essential in today's atmosphere of natural and man-made disasters. We describe the problems faced by a community hospital on the Mississippi Gulf Coast during and in the wake of Hurricane Katrina. Because of significant damage to surrounding health care facilities, this hospital was called upon to provide care to a large section of the affected population. In spite of a previously successful disaster plan, a number of unforeseen difficulties were encountered. These included staff shortages due to inability of relief personnel to re-enter the affected area, insufficient power generation by hospital generators, breakdown in communication, fuel shortage, limited mortuary space, and stretching of emergency room resources. These unexpected developments emphasize the importance of contingency planning as part of disaster preparedness.

Communication↗
PubMed1994

Disasters within hospitals.

Hospital disaster planning should encompass events that affect the safety of the hospital environment and address those measures that ensure the availability of necessary services. Although most of the emphasis has been placed on general disaster planning, there is little written about disasters occurring within a hospital. In recent years, several incidents at our medical center involving fire, flood, and power failure resulted in a reevaluation of our preparedness to handle such situations. These experiences prompted this discussion and literature review of internal disaster plan because it is likely that at some time an internal emergency may occur.

Disaster Planning↗
PubMedDate not supplied

When disaster strikes: getting ready for the next big one: part I.

This two-part article deals with the role of the physician when disaster strikes. The first part concentrates on disaster planning and emergency preparedness as it pertains to the staff and the practice. It suggests points to consider in preparing a disaster plan for the practice or institution so that everyone knows what to do in the event of a crisis. This disaster plan is also a blueprint for recovery once the disaster has passed that will assure the financial health of the practice.

Communication↗
PubMedDate not supplied

Impact of Hurricane Ivan on pharmacies in Baldwin County, Alabama.

OBJECTIVE: To evaluate the impact of Hurricane Ivan, which made landfall east of Mobile, Alabama, on September 16, 2004, on pharmacies in the affected areas. DESIGN: Retrospective cross-sectional analysis. SETTING: Baldwin County, Alabama. INTERVENTIONS: Pharmacy community rapid-needs-assessment survey. PARTICIPANTS: 41 hospital and community (chain and independent) pharmacies. MAIN OUTCOME MEASURES: Posthurricane pharmacy hours of operations, prescription volumes, infrastructure damage, and prehurricane disaster planning. RESULTS: During the week of the hurricane, both chain and independent community pharmacies within the evacuation zone worked significantly fewer hours (46% and 49%, respectively) and dispensed significantly fewer prescriptions (37% and 52%) compared with the same week of the prior year. Overall, 40% of pharmacies depleted their supplies of certain medications (e.g., anxiolytics, antihypertensives). A total of 60% of the chain and independent pharmacies outside the evacuation zone closed because of loss of electricity, but pharmacies with a generator were significantly less likely to report having turned away patients. The proportion of pharmacies that had a disaster plan but turned away patients or rationed or ran out of medications was similar to that of pharmacies without a disaster plan. CONCLUSION: Although Hurricane Ivan primarily affected the operation of pharmacies within the evacuation zone, pharmacies in the surrounding area were also affected because of loss of power. Emergency management officials should evaluate the efficacy of specific guidelines outlined in disaster plans and identify ways to deliver essential medications to people in disaster-affected areas.

Alabama↗