85 Bed hospital is equal to 400 victims.
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Disasters↗
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[Emergency aid for earthquake victims].
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Disasters↗
[On the devastating effect of tsunami and principles of organization of medical assistance to victims].
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Disasters↗
[Rescue of shipwreck victims].
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Accidents↗
Colorado nurses aid flood victims.
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Colorado↗
[Disasters in former East Germany--experiences and problems of the Leipzig "Identification" Task Group].
Mass-disasters with high numbers of victims are a real challenge to the specialists. The role of forensic experts is generally emphasized. The missions of the Leipzig Taskgroup for identification and the experience gained during them confirm, that special training necessary staff members is. Compared with the general signs of identity, like clothing, jewelry and accessories, scars etc., the marks of ears and observations of forensic odonto-stomatology provide good chances for identification. For forensic odonto-stomatology, we developed computer programs.
Accidents, Aviation↗
Health care facility preparation for weapons of mass destruction.
Weapons of mass destruction (WMD) are a threat that all health care facilities must be prepared for. Every health care facility is a vital part of the community response system and must be ready to respond. A terrorist attack using WMD can occur in any location, urban or rural. Private vehicles or buses may transport the majority of patients, with only a small percentage arriving by emergency medical services. Most will go to the hospitals closest to the incident, even if this results in overcrowding. Others will go directly to their private physicians' offices or primary hospitals, even if these facilities are not part of the local disaster plan. Most of these victims will not be decontaminated before arrival. If a hospital allows any of these patients in, the staff may become ill from the toxic exposure and the facility may require closure for decontamination. Since the risk is universal, all health care facilities must plan for the care of victims of a WMD incident. They must plan for communications that allow local government to transmit alerts regarding the emergency. Health care facilities must also communicate their status and emergency needs to local officials during the emergency. They must be prepared to establish a single entry control point and attempt to secure all other entrances. They must be able to establish a patient decontamination team from on-duty staff with only a few minutes' notice at any time of the day or night.
Biological Warfare↗
[Panic as a mass phenomenon].
One of the greatest challenges in emergency medicine and in particular for emergency staff are disasters with huge amounts of victims. The development of a panic is a rare, but nonetheless an extreme escalation of an emergency situation. This paper describes the psychological and anthropological background of panic reactions and gives a summary of the current evidence in research. Accordingly, panic may be defined as the conclusive endpoint of an internal assessment that the probability to influence ones own survival in a life-threatening situation is close to zero. The possibilities and limitations of behavioral modifications according to strategies that are derived from cognitive and behavioral psychotherapy are discussed. It is crucial to detect situations at risk early and to correctly assess one's abilities for intervention. This ability can be learned with the help of assessment of behavior and self-programming. These methods may help emergency physicians to better assess the risk for the development of a panic following a disaster and thus may be useful in its prevention.
Emergency Medical Services↗
DVI System International: software assisting in the Thai tsunami victim identification process.
DVI System International is software that operates on the PC-Windows platform. It is capable of managing aspects of identification in day-to-day cases and major disasters, where it has particular advantages when victims of several nationalities are involved. The system uses Interpol forms as standard protocols for input and transfer of antemortem and postmortem information. Following the Thai Tsunami Disaster of 26 December 2004, Interpol recommended that its member country Thailand use DVI System International software, as it is one of the few internationally approved systems. This paper focuses on the concepts upon which the dental forms, F1 and F2, of the DVI System International are designed, describes how it works and some of the adjustments implemented during the ongoing Thai Tsunami Victim Identification process.
Database Management Systems↗
Penetrating axillary trauma in a survivor of the World Trade Center disaster.
Penetrating axillary trauma is classically associated with gunshot wounds or stab wounds, and it is a cause for concern because of the high risk of vascular injury. We report a case of penetrating axillary trauma to a victim of the World Trade Center disaster. In this case report, we discuss the CT and angiographic findings of both blunt and penetrating axillary injury, and present a diagnostic algorithm.
Journal Article↗
Chernobyl operators: criminals or victims?
The blame for the 1986 Chernobyl disaster has been variously attributed to the operating personnel, the plant management, the design of the reactor, and the lack of adequate safety information in the Soviet nuclear industry. This paper considers a number of design faults, operational shortcomings and human errors that combined in the accident. It examines the sequence of events leading up to the accident, design problems in the reactor and cooling rods, and the course of the accident itself. It considers the ergonomics aspects, and expresses the view that the main cause of the accident was inadequate human-machine interaction. Finally, it stresses the continuing inadequacies of the Soviet nuclear system, and emphasizes that unless the ergonomics lessons are fully learned, a similar disaster could still occur.
Journal Article↗
Successful coupling of community attachment of health science students with relief work for drought victims.
CONTEXT: Recurrent drought is a major disaster affecting many countries. As a result of poor rain fall a major drought was forecast for Ethiopia in 2003. The country appealed for support to avert drought-related health problems. University of Gondar decided to respond to the appeal by sending students and staff to selected drought-affected areas. OBJECTIVES: To illustrate how an institution has turned the response to a natural disaster into a service-learning educational opportunity while maintaining equilibrium between the two. METHODS: The drought relief response of the institute was twined with the regular team-training programme and academic schedule of senior health science students and 190 of them were transferred to deployment sites. FINDINGS: Students provided support for the national effort of reducing drought-related morbidity and mortality by participating in multifaceted public health and relief activities, and fulfilled their regular learning objectives at the same time. DISCUSSION: This project demonstrated the use of a natural disaster as a learning method to expose students to a more realistic array of health problems and human conditions. It also demonstrated the feasibility of addressing social responsibility, while fulfilling academic responsibility through community-based approach. CONCLUSION: Service-learning is a valuable learning method. Balancing the service and teaching objectives and maintaining the quality of both can be attained through careful twining of the objectives of both components.
Community-Institutional Relations↗
[Organization of the emergency physician and rescue service with special reference to mass injuries].
When a large number of casualties has occurred due to accidents or other medical disasters the normal individualized emergency physician and rescue service has to be rearranged within a short period of time. It is essential to achieve informations as detailed as possible about the number of victims and the kind of the disaster situation. A physician especially trained for such instances should be informed immediately and take over the responsibility as leading emergency physician for the management of the large scale emergency situation. After proper screening has been performed to sort out these patients who have high treatment priority the leading emergency physician has to coordinate the medical treatment of the victims provided by the other emergency physicians. The location where the accident occurred has to be structured and the transportation of the patients into the hospitals has to be arranged. In addition back-up facilities are to be activated to gain a large number of personNel l and ambulance transportation facilities. By following these logistical scheme it becomes possible to handle large scale accidents within a reasonable period of time.
Disasters↗
Characteristics of acute stress symptoms and nitric oxide concentration in young rescue workers in Taiwan.
Disaster workers as well as victims are at increased risk for acute stress disorder (ASD). The present study was undertaken to study the course of the stress response in a group 187 young, male military personnel who served as rescue workers for 3 days after an earthquake in central Taiwan. A control group of 83 young, male military personnel who remained on the base was also studied. The initial evaluation took place within 16 days of the earthquake. Participants were interviewed using the Mini International Neuropsychological Interview. Thirty-one individuals met DSM-IV criteria for ASD at the initial evaluation. These 31 individuals were interviewed a second time 1 month after the earthquake. Plasma samples were also collected and assayed for nitric oxide (NO). The point prevalence rates of ASD 2 weeks after the earthquake in the initial evaluation were 9 and 16% in the rescue worker and control groups, respectively. At 1 month, the prevalence was substantially lower, in the range of 2-3%. Significant inverse correlations were observed between severity of stress symptoms and the plasma concentration of NO in the rescue worker group (r=-0.36 to -0.64, n=17, P<0.05). We conclude that young military personnel without formal training in rescue operations are at risk for ASD, but their risk appears to be no higher than that in a similarly composed control group of young military personnel. Longitudinal studies with plasma measures of NO are needed to clarify its potential role in the development and course of ASD and related syndromes.
Acute Disease↗
Psychological assessment of postdisaster class action and personal injury litigants: a case study.
The case study method is used to describe psychological assessments undertaken with victims of a combined natural/technological disaster for litigation purposes. A class action suit was filed in which the authors determined levels of traumatic stress in 27 plaintiffs as a group and relative to each other. The process was effective--the case was settled out of court in favor of the litigants. Individual litigants were satisfied with monetary awards received.
Adult↗
The impact of skin banking and the use of its cadaveric skin allografts for severe burn victims in Singapore.
The skin banking programme was set-up in Singapore in 1998 to provide a ready source of allografts for patients with severe burns. The process and problems in establishing a local skin bank will be described together with a retrospective review of skin allograft recipients to determine the efficacy of the programme. For the skin bank set-up, pertinent issues related to legislation, methods, logistics, quality assurance and donation rate are discussed. In this retrospective review, a comparison between patients who had early complete excision with skin allograft transplantation and those who received conventional staged excision and coverage, was analysed in terms of clinical profile and outcome using statistical methods. The former group presented a significant reduction of mortality rate and hospital stay by 29% and 10 days, respectively. The establishment of the skin bank has helped in the management of severe burn patients by facilitating early excision and allografting. In a Burn Centre, therefore, it is essential to have an ample supply of skin allograft for burn victims in readiness for mass disaster situations.
Adolescent↗
Encoded evidence: DNA in forensic analysis.
Sherlock Holmes said "it has long been an axiom of mine that the little things are infinitely the most important", but never imagined that such a little thing, the DNA molecule, could become perhaps the most powerful single tool in the multifaceted fight against crime. Twenty years after the development of DNA fingerprinting, forensic DNA analysis is key to the conviction or exoneration of suspects and the identification of victims of crimes, accidents and disasters, driving the development of innovative methods in molecular genetics, statistics and the use of massive intelligence databases.
DNA Fingerprinting↗
Impact of multiple traumatic experiences on the persistence of depressive symptoms--a population-based study.
The objective of this population-based study was to determine whether traumatic experiences in general, and multiple traumatic experiences in particular, are associated with persistent self-rated depressive symptoms in adult Finnish subjects over 2 years of follow-up. The study sample included 1405 subjects aged 25-64 years. Subjects (n = 217) who were depressed both at baseline in 1999 and on follow-up 2 years later in 2001 (having persistent depressive symptoms) were compared with subjects (n = 987) having no depressive symptoms either at baseline or on follow-up. All six categories of traumatic experiences (wartime experience, natural disaster, life-threatening accident, victim of violent crime, domestic violence and childhood sexual abuse) pertained to the respondents' whole life span. Odds ratios, adjusted for significant covariates, were obtained from multiple logistic regression models that estimated the likelihood of persistent depressive symptoms in different trauma categories. Persistent depressive symptoms had a significant positive graded relationship with the number of traumatic experiences. The adjusted odds of persistent depression was 6.05 (95% CI 1.76-20.7) for men and 6.99 (95% CI 2.69-18.2) for women in those with three or more traumatic experiences compared with those with no such experiences at all. Multiple traumatic experiences substantially increase the likelihood of persistent depressive symptoms. Mental health intervention, as early as possible, may serve to prevent the chronicity of depressive reactions among victims of multiple traumas.
Adult↗