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PubMedDate not supplied

[Disaster planning--lessons learned from the fire disaster in Gothenburg].

The tragic fire disaster in Sweden 1998, killing 63 and wounding 213 teenagers was the result of arson fire in the basement of an overcrowded discotheque. Since the disaster occurred in a major city with substantial resources, all the injured could be hospitalised within two hours. The load on four local hospitals was initially severe due to the large number of injured. The patients suffered from inhalation injuries of different severity, whereas 25 of them also had deep skin burn injuries. Thirteen of the most severe burn injuries were transported to burn units in other parts of Sweden and to Norway. The vast psychosocial rehabilitation program initiated by health care staff, religious communions, schools and the community, has continued over the past years. This fire disaster emphasises the need for extensive preparation not only in the rescue and medical services, but also in many other areas of society.

Adolescent↗
PubMed1984

Major disaster planning.

In 1983 a coach crash brought a hospital's major disaster plan into operation. The surgical aspects of the plan were assessed to see how well they matched up to three major aims: saving life, relieving pain and distress, and completing primary treatment of open wounds within eight hours of the accident. The last goal was not met for most of the 21 victims, mainly children with multiple deep dirty abrasions and extensive tissue loss. Having determined that none of the victims were in immediate danger the surgeons reassessed the priorities--in several cases disturbing dressings for a third or fourth time. The total time spent in theatre (in five theatres) was 37 hours, as opposed to the original estimated 10-15 hours. The experience gained in this accident suggests that a disaster plan should indicate the number of patients a single hospital can admit and that a senior surgeon should act as a coordinator and get surgeons working as soon as patients arrive, keeping two theatres reserved for lifesaving surgery. In this way primary treatment of wounds may be completed within eight hours of injury and the risk of infection reduced.

Accidents, Traffic↗
PubMed2003

Are your disaster plans ready, really ready?

When a real disaster takes place, a hospital has a chance to really test the effectiveness of its disaster plan. Here is a detailed report on what happened when such an incident occurred.

Disaster Planning↗
PubMed1982

A metropolitan airport disaster plan--coordination of a multihospital response to provide on-site resuscitation and stabilization before evacuation.

At the John F. Kennedy International Airport in New York City, disaster planning has been an integral part of the airport operations for the past 20 years. The medical component of this disaster planning has focused around the Medical Office at JFK. Through this office, on-site emergency medical teams have been established and trained from all ranks of airport personnel. Following the crash of a Boeing 727 aircraft in 1975, a new concept was added to disaster planning for JFK, which involves bringing the hospital, its facilities, and its personnel to the scene. A new piece of equipment, known as Emergency Mobile Hospital, was developed with the cooperation of the airlines, the operating authority of the airport, and other interested parties. Two such vehicles are now in constant readiness at the airport, and together provide two operating rooms, 12 monitored ICU beds, a 16-bed burn unit, and 72 other beds to be used for on-site stabilization of critically ill patients, before transfer to a definitive care facility. Under the auspices of a single area medical school (New York Medical College) and its affiliated departments of surgery, trauma teams are made available to be airlifted to the scene within 30 minutes of notification. Additional medical teams from other medical school hospitals serve as backup support. The principle of bringing the hospital to the emergency, and of assembling trauma teams for the initial phase, remains the same for Kennedy Airport as for that of any other metropolitan airport.

Accidents, Aviation↗
PubMed1986

Disaster planning for air crashes. A retrospective analysis of Delta Airlines flight 191.

The effectiveness of previously untested disaster plans was demonstrated during the aftermath of the crash of Delta Airlines Flight 191 at D/FW International Airport on Friday, August 2, 1985. These plans, in effect for years and subjected to periodic review, were as yet untried before this first disaster at D/FW International since its opening. This paper outlines the disaster plans, the actual problems encountered, the logistics of a disaster of this kind, and insights gained from the experience.

Accidents, Aviation↗
PubMed1988

An analysis of civil aircrash statistics 1977-86 for the purposes of planning disaster exercises.

Details of 473 aircrashes throughout the world for the period 1977-1986 were obtained from the Civil Aviation Authority. 114 occurred on or near and 359 away from airfields. In 188 there were survivors and in 285 none. On or near airfields it was more common to have survivors, and away from airfields more common to have none, yet crashes with survivors were more common away from airfields. In ten years there were only 3 crashes with more than 50 seriously injured live casualties. Acted out disaster exercises with mock casualties should not have more than 50 injured casualties, of whom not more than 20 should have serious injuries (i.e. need admission to hospital). The problems of crashes with much larger casualty figures should be worked through in table-top exercises.

Accidents, Aviation↗
PubMedDate not supplied

Fear of terrorism and preparedness in New York City 2 years after the attacks: implications for disaster planning and research.

OBJECTIVES: To help improve disaster planning and research, we studied psychosocial predictors of terrorism fear and preparedness among New York City residents after the World Trade Center disaster (WTCD). METHOD: We conducted a random cross-sectional survey of 1,681 adults interviewed 2 years after the WTCD. Participants were living in New York City at the time of the attack and exposed to ongoing terrorist threats. RESULTS: We found 44.9 percent (95% confidence interval [CI] = 41.9-47.9) of residents were concerned about future attacks and 16.9 percent (95% CI = 14.7-19.3) reported a fear level of "10" on a 10-point analog scale. Furthermore, 14.8 percent (95% CI = 12.8-17.0) reported they had made some plans for a future attack, a significant increase from the previous year. In addition, although 42.6 percent (95% CI = 39.6-45.7) indicated that they would likely wait for evacuation instructions following a chemical, biological, or nuclear attack, 34.4 percent (95% CI = 31.5-37.3) reported they would evacuate immediately against official advice. Predictors of high terrorism fear in a multivariate model included Hispanic ethnicity (odds ratio [OR] = 2.0, P = .006), lower education (OR = 4.4, P < .001, and OR = 3.7, P < .001, respectively, for nonhigh school and high school graduates, compared with college graduates), being exposed to stressful life events (OR = 1.6, P = .048), having current posttraumatic stress disorder (3.1, P < .001), having a fear of death (OR = 2.5, P = .002), and reporting a likelihood of fleeing an attack against advice (OR = 1.5, P = .034). The best predictors of preparedness in a multivariate model was being between 30 to 64 years old (30-44 years old, OR = 2.6, P = .001; 45-64 years old, OR = 1.8, P = .03, respectively, compared with 18-29 years old), having higher exposure to the WTCD (moderate exposure, OR = 1.7, P = .05; high exposure, OR = 2.4, P = .002; very high exposure, OR = 4.1, P < .001), respectively, compared with no little WTCD exposure), and having greater exposure to other lifetime traumatic events (high traumatic event exposure, OR = 2.1, P = .005, compared with no exposure). CONCLUSION: Our study suggests that among those exposed to ongoing terrorism threats, terrorism fear and preparedness were related to socioeconomic factors, mental health status, terrorism exposure levels, and exposure to stressful life events.

Adolescent↗
PubMed2006

Disaster planning for peritoneal dialysis programs.

Because of increased intensity of hurricanes in the Gulf Coast region of the United States, peritoneal dialysis (PD) programs have been disrupted and patients relocated temporarily following these catastrophic events. We describe the disaster planning, implementation, and follow-up that occurred in one such PD program in New Orleans following Hurricane Katrina. Each year at the beginning of the North American hurricane season, the PD program's disaster plan is reviewed by clinic staff and copies are distributed to patients. Patients are instructed to assemble a disaster kit and are provided with contact numbers for dialysis suppliers and for a PD program in their planned evacuation city. In July 2005, this disaster plan was tested when an early tropical storm and hurricane entered the Gulf and several patients briefly relocated or evacuated because of power loss and then returned without incident. However, when Hurricane Katrina, a category 5 storm, was predicted to strike the metropolitan area, patients were notified by telephone to evacuate, and contact information, including their evacuation city and telephone and cellular phone numbers, was obtained. Patients were also reminded to take all medications, bottled water, antibacterial soap, hand sanitizer, and 4-5 days of PD supplies. Following the storm, telephone and cellular phone services were severely disrupted. However, text messaging was available to contact patients to confirm safety and to provide further instructions. Arrangements with the major dialysis suppliers to ship emergency supplies to new locations were made by the PD nurse and the patients. Only 2 of 22 patients required hospitalization because of complications resulting from evacuation failure, contamination, and inability to perform dialysis for a prolonged period of time. Both of these patients were quickly released and have continued PD. Following the event, all patients remained on PD, and most have planned to return to their home PD program. Thorough preparation, planning, practice, and implementation and effective communication are necessary to prevent complications in PD patients who are affected by disasters. With advdnce preparation, maintenance of communication with health care providers, and planning for alternative sites of care, patients can be safely maintained on PD without complications following catastrophic natural disasters.

Communication↗