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PubMed2002

60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001.

Results for 160 samples of disaster victims were coded as to sample type, disaster type, disaster location, outcomes and risk factors observed, and overall severity of impairment. In order of frequency, outcomes included specific psychological problems, nonspecific distress, health problems, chronic problems in living, resource loss, and problems specific to youth. Regression analyses showed that samples were more likely to be impaired if they were composed of youth rather than adults, were from developing rather than developed countries, or experienced mass violence (e.g., terrorism, shooting sprees) rather than natural or technological disasters. Most samples of rescue and recovery workers showed remarkable resilience. Within adult samples, more severe exposure, female gender, middle age, ethnic minority status, secondary stressors, prior psychiatric problems, and weak or deteriorating psychosocial resources most consistently increased the likelihood of adverse outcomes. Among youth, family factors were primary. Implications of the research for clinical practice and community intervention are discussed in a companion article (Norris, Friedman, and Watson, this volume).

Databases, Factual↗
PubMed2005

Psychosocial implications of disaster or terrorism on children: a guide for the pediatrician.

During and after disasters, pediatricians can assist parents and community leaders not only by accommodating the unique needs of children but also by being cognizant of the psychological responses of children to reduce the possibility of long-term psychological morbidity. The effects of disaster on children are mediated by many factors including personal experience, parental reaction, developmental competency, gender, and the stage of disaster response. Pediatricians can be effective advocates for the child and family and at the community level and can affect national policy in support of families. In this report, specific children's responses are delineated, risk factors for adverse reactions are discussed, and advice is given for pediatricians to ameliorate the effects of disaster on children.

Child↗
PubMed2002

PTSD symptoms of mothers following occurrence of a disaster affecting their children.

This study investigated the PTSD symptoms of 37 mothers whose adolescent children had been directly involved in a disaster, the Jupiter sinking in 1988. This group included mothers whose children were (a) not diagnosed with Posttraumatic Stress Disorder and (b) were diagnosed with Posttraumatic Stress Disorder. The measure used was the Posttraumatic Stress Disorder Symptom Scale. Women whose children were involved in the disaster presented PTSD symptoms. 35% (n = 13) were diagnosed with PTSD 3 mo. after the disaster, and 89% (n = 3) of them were diagnosed with PTSD 6 yr. afterward. This effect was greater in the subgroup whose children had developed traumatic stress disorder following the disaster.

Child↗
PubMed1996

Disaster preparedness of poison control centers in the United States.

OBJECTIVE: To assess the state of disaster readiness of poison control centers, a survey questionnaire was sent to all 96 institutional poison control center members of the American Association of Poison Control Centers in the US, both certified and noncertified programs. DESIGN: The data reported are the results and responses from 76 of 96 (79.2%) poison control centers. RESULTS: Fifty-four percent of responding centers have written disaster plans, with 25% having drills to practice the plans. Of the centers that do not have a written plan, the majority have policies and procedures in place to address physical plant damage, increased phone traffic, loss of phone systems and malfunction of computers. Eighty-six percent of respondents have a back up generator, and 82% have an uninterruptable power supply in place. Fifty-four percent have a back up phone system and 33% have cellular phone capacity. Forty-six percent of responding centers have arrangements with other agencies in the event of a disaster. Only half of the managing directors of the responding centers believe their center can meet the public's needs in the event of a disaster.

Disaster Planning↗
PubMed2006

Negligible risk for epidemics after geophysical disasters.

After geophysical disasters (i.e., earthquakes, volcanic eruptions, tsunamis), media reports almost always stress the risk for epidemics; whether this risk is genuine has been debated. We analyzed the medical literature and data from humanitarian agencies and the World Health Organization from 1985 to 2004. Of >600 geophysical disasters recorded, we found only 3 reported outbreaks related to these disasters: 1 of measles after the eruption of Pinatubo in Philippines, 1 of coccidioidomycosis after an earthquake in California, and 1 of Plasmodium vivax malaria in Costa Rica related to an earthquake and heavy rainfall. Even though the humanitarian response may play a role in preventing epidemics, our results lend support to the epidemiologic evidence that short-term risk for epidemics after a geophysical disaster is very low.

Disasters↗
PubMedDate not supplied

Disaster preparedness: an indictment for action by nursing educators.

America is under constant threat of terrorist attack. The events of September 11, 2001, demonstrate the reality of the threat, as does the magnitude of the impact the attacks had on the healthcare systems of New York City and Washington, DC. Healthcare facilities and continuing education programs should incorporate training in nuclear, biological, and chemical disaster preparedness to provide the essential foundations for safe and effective health care. Advance training in disaster preparedness provides nurses with valuable training to fill the nationwide need for prepared first responders. American nurses have always responded selflessly to help in times of disaster and the country will be looking to nurses to respond to any future disasters.

Attitude of Health Personnel↗
PubMed1991

When disaster strikes. The concerns of staff nurses.

1. This study determined how involvement with an earthquake affected patient care delivery and ascertained what nurses need to continue providing safe and efficient care in future disasters. 2. Although 60% of the staff had experienced a previous disaster, the literature described that learned coping does not automatically "transfer" to present loss experiences. 3. Providing staff with debriefing sessions and other support groups is helpful in the post-trauma period. At all levels, there is a need to communicate concerns and to be involved in disaster drills and other disaster preparedness sessions.

Adaptation, Psychological↗
PubMed1999

Mental health disaster response: nursing interventions across the life span.

In the aftermath of a natural disaster, adult survivors often move through the following phases of disaster response: Heroic Phase, Honeymoon Phase, Disillusionment Phase, and Reconstruction Phase. Understanding age-related responses to traumatic events such as a tornado enables mental health clinicians to individualize appropriate interventions and prevent or diminish emotional sequelae such as post-traumatic stress disorders. Psychiatric-mental health nurses are encouraged to attend local Red Cross disaster training to be prepared should the need arise for mobilization of mental health disaster response teams in your community.

Adolescent↗
PubMed2003

Serum potassium in the crush syndrome victims of the Marmara disaster.

BACKGROUND: Hyperkalemia is a major cause of mortality in the patients who suffer from crush syndrome in the aftermath of major earthquakes. The aim of this study is to investigate the frequency and effects of hyperkalemia in the 639 victims of catastrophic Marmara earthquake that struck northwestern Turkey, in August 1999. PATIENTS AND METHODS: Within the first week of disaster, questionnaires were sent to 35 reference hospitals that treated the victims. Information on serum potassium which was provided in 595 out of 639 questionnaires was submitted to analysis. RESULTS: In the patients who were admitted within the first 3 days of the disaster (n = 401) serum potassium was 5.4 +/- 1.3 mEq/l, which was higher than in those admitted thereafter (n = 171) (4.5 +/- 1.1 mEq/l) (p = 0.02). Considering the whole series, males (p = 0.01), patients needing dialysis support (p < 0.001) and non-survivors (p = 0.001) were characterized by higher serum potassium at admission. Seventy patients' serum potassium was above 7 mEq/l, while 22 patients were hypokalemic (< 3.5 mEq/l). Admission potassium correlated with many clinical and laboratory variables indicating the severity of the trauma, and a logistic regression model with clinical and laboratory parameters upon admission, revealed potassium as the most significant predictor of dialysis needs in the victims admitted within the first 3 days (p = 0.008, OR = 3.33). Among the victims who were admitted to hospitals 1 week after the disaster, 8 had serum potassium levels above 6.5 mEq/l; among 4 of them were complicated by hyperkalemia even higher than 7.5 mEq/l. These findings undeline the importance of hyperkalemia during clinical course. CONCLUSION: The most important and fatal medical complication in crush syndrome patients is hyperkalemia. Risk of fatal hyperkalemia continues even after hospitalization. Empirical therapy at the scene is indicated especially in male victims with severe soft tissue traumas. Early detection and treatment of hyperkalemia may improve the final outcome of renal disaster victims.

Adolescent↗
PubMed1999

Disaster mental health services: a personal perspective.

1. Services that may be provided by psychiatric-mental health nurses following a disaster include education, intervention, problem solving, advocacy, and referral. 2. Nurses providing disaster mental health services must be flexible and creative. Strong observational skills and teamwork are also essential characteristics in disaster settings. 3. Psychiatric-mental health nurses who wish to receive training for disaster mental health volunteer opportunities should contact their local chapter of the American Red Cross.

Clinical Competence↗
PubMedDate not supplied

Disaster planning at a Friesen concept hospital.

Disaster planning is a task which will probably never be "completed", since to be effective, a disaster plan must constantly be reviewed and modified. The Hospital Disaster Working Committee at the Ottawa General Hospital has so far been presented with both challenge and opportunity. The challenge is to make best use of our new facility, while coping with the changes which a new site predicates. The opportunity is to take advantage of the past experience of our own people and others who are involved in disaster planning, and make a strong beginning.

Disaster Planning↗
PubMed1987

Beyond the disaster plan.

Many medical group disaster plans fail to consider the survival of the organization in the aftermath of extensive damage, instead concentrating only on safety issues at the time of the disaster. To assure a smooth recovery, a disaster plan must include consideration of organizational responsibilities, operational analysis, information flow, economic and financial recovery, and insurance. This comprehensive guide will take the medical group administrator step by step through development of an effective contingency plan for full organizational recovery from a disaster, whether it be relatively minor or monumental.

Disaster Planning↗
PubMedDate not supplied

Principles of disaster management. Lesson 2: Program planning.

Many of the problems that develop in disaster management can be avoided with good program planning. Assessment following a disaster is essential. Needs assessment is essential in the early phases of a disaster and situation assessments become more important as the disaster process continues. Both are dynamic and continuous processes. Program planning requires setting policies, goals, and objectives with the end result of selection of strategies to accomplish the mission. Implementation of the strategies requires identification of funding sources, allocation of the resources, development management, and monitoring of the progress. Together, these elements should result in a balanced and successful program.

Budgets↗
PubMed1999

[Repeated amenorrhea in an adolescent girl in the course of flood disaster in Kłodzko Region, July 1997].

OBJECTIVES: A natural disaster has been defined as a disruption of human ecology that exceeds the capacity of the community to function normally. DESIGN: After the flood disaster in Kłodzko Region, July 1997, the major problem in female adolescents was observed: secondary amenorrhea. MATERIALS AND METHODS: 17 female adolescents, aged 13-18, which injured from the flood disaster with secondary amenorrhea were investigated. A control random group consists of 17 girls diagnosed before oral contraception. Diagnostic work-up includes history, physical and psychological examinations, hormonal profiles, transvaginal ultrasonography, color Doppler analysis of utero-ovarian arterial blood flow. RESULTS: FSH, LH, E2 plasma levels and LH/FSH ratio were significantly lower in the amenorrheic group compared to normal girls. Prolactin serum levels after metoclopramid administration were significantly higher in the amenorrheic group. Lower impedance to blood flow in the intraovarian arteries have been shown. Psychosomatic disorders related to hypothalamic amenorrhoea were diagnosed. CONCLUSIONS: Psychosocial stress observed during the flood disaster caused hypogonadotropic hypogonadism amenorrhoea in the female adolescents.

Adolescent↗
PubMedDate not supplied

KAMEDO--a Swedish Disaster Medicine Study organization.

Kamedo is a Swedish Disaster Medicine study organization that sends observers to disaster areas anywhere in the world to study recent events, collect useful information, and identify problems relative to the practice of Disaster Medicine. The results of these investigations are published in the KAMEDO Reports, and the English versions will be published in Prehospital and Disaster Medicine. Three of the recent reports follow: 1) KAMEDO Report 69: Ebolus Virus Epidemic in Zaire, 1995; 2) KAMEDO Report 70: The German Rescue and Emergency Organizations: a) Industrial Chemical Fire, Memmingen, Germany 23 January 1997; b) Fire at the Düsseldorf Airport, 01 April 1996; and c) Bus Accident on the Autobahn in Rosenheim, Germany; and 3) Terrorist Attack with Sarin, 20 March 1995. In addition, a catalog listing all of the KAMEDO Reports available in English is provided.

Accidents↗
PubMed1998

[Emergency measures on drinking water sanitation for mitigation of flood and waterlogging disasters].

This article reports the emergency measures for mitigation during flood and waterlogging disasters to ensure drinking water sanitation and to prevent infectious disease outbreaks. Five preparatory and preventive measures for flood and waterlogging disasters include the construction of dual-purpose water supply installation for ordinary and disaster use, the storage of qualified technicians and materials (or their inventories), and the formulation of predetermination programme for disaster relief, ect.

China↗
PubMed2000

[Survey on postmortem examination to police surgeons and emergency physicians. Possibility of physicians' assist in mass-disaster].

We conducted a questionnaire survey of police surgeons and emergency physicians, inquiring about their experience of medicolegal investigation of death and their willingness to join a death investigation team in a major disaster. The questionnaire also asked about their knowledge about and interest in the forensic specialist system established by the Japanese Society of Legal Medicine. Police surgeons were generally willing to join an investigation team only if a disaster occurred in or close to their hometown, because they could not afford more than several days away from patient care. Although many of the emergency physicians were willing to join a death investigation team, they had difficulty in doing so without permission or orders from their employer or the authorities concerned. The survey found that the percentage of aged police surgeons was increasing among those surveyed. This fact, in combination with the current emphasis of postgraduate education on specialty training, threatens to cause a substantial lack of physicians available for medicolegal investigation of death. Therefore, it is urgently necessary to establish a system of training resident and emergency physicians in medicolegal investigation of death. In addition to providing postgraduate training in medicolegal investigation of death to prospective trainees who are emergency physicians at major hospitals in potential disaster-stricken areas, the medical school should incorporate forensic medicine in postgraduate training programs so that they can actively perform death investigation on disaster victims dying before or after arrival at their hospitals. Furthermore, the forensic community should make every effort to increase the number of autopsies in each department of forensic medicine and to expand the medical examiner system throughout Japan that is currently in practice only in the Metropolis of Tokyo and Yokohama, Nagoya, Osaka and Kobe Cities in order to incorporate forensic training in the postgraduate clinical training programs that will become compulsory in 2004.

Attitude of Health Personnel↗
PubMed1999

Essential factors for effective psychological response to disasters and other crises.

Few human experiences contain the intensely concentrated horror, terror, and awesome power associated with a disaster. Nature's destructive forces and events in which humans rage out of control against one another can serve as trigger mechanisms for overwhelming psychological reactions in the survivors, community members, and rescuers. Appropriate crisis intervention strategies and tactics are often thrown off balance, delayed, and made more complex by the sheer magnitude of the catastrophe. Few guidelines for effective community crisis or disaster response team activities in a disaster have been written to date. This article will help to fill-in the information gaps and enhance a psychological team's ability to provide better crisis intervention services during disasters.

Crisis Intervention↗