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[Organization of medical rescue during catastrophes with limited effects occurring in urban areas].

OBJECTIVE: We conducted a survey regarding the organization of medical rescue during major events (catastrophes with limited effects) occurring in urban areas (Paris and immediate suburbs). The goal of this work was to study the availability of on site medical help and the real needs.Study design - Retrospective survey. METHODS: Thirty-eight major events were analysed between 1988 and 2000. The median number (25th-75th percentiles) of victims per event was 42 (21-68) (range 8 to 424). RESULTS: The median percentage of true emergencies (TE) was 5% with regard to the total number of victims per event. Thirty minutes after the event, 92% of the sites had a number of physician-manned ambulances greater than the number of severe victims. The median time to first evacuation was 79 (62-102) min. CONCLUSION: Disasters with limited effect occurrence in Paris and its immediate suburbs are characterized by a small percentage of TE and by a constant oversupply of medical means onsite. These observations led us to propose a new organization of medical rescue during this type of catastrophe, abandoning the classical notion of forward medical command post (FMCP) for a collection point of medical services (CPMS) consisting all means of evacuation (physician-manned and other ambulances). Also, a new type of victim identification, based on hospital base-station medical direction is discussed in this paper.

Aircraft↗

A disaster drill in Hong Kong.

This case report relates the course of a disaster drill held on 19 August 1994 in a regional acute hospital (Pamela Youde Nethersole Eastern Hospital) in Hong Kong. The Hospital Civil Disaster Contingency Plan (the Plan) was put to trial on that day. Volunteers were invited to become simulated casualties in the exercise. Briefing seminars had been conducted with clinicians of the Accident and Emergency department (A & E) and other departments of the hospital. The scenario was a man-made type disaster. A double-decker bus turned over and injured 19 people in that afternoon. All the victims were sent to A & E by ambulance. The Plan was activated and relevant units were mobilized according to the Plan. It took 45 minutes to complete the disaster exercise. Debriefing sessions reviewed difficulties encountered throughout the drill and possible remedies.

Disaster Planning↗

A model for activity intervention in disaster-stricken communities.

Environmental disasters cause deaths, injuries, and destruction of familiar surroundings. Social networks and routines that structure daily life are often left in disarray. To surmount subsequent crises, survivors must master painful feelings, solve problems, and accomplish important tasks, even while they are confused, bereaved, and displaced. Otherwise, coping failure leads to a vicious spiral of loss of self-esteem, distrust of the environment, and abandonment of social roles. Both crisis intervention and disaster literature advocate concrete and practical treatment measures. Activity intervention can prevent and reverse the destructive downward spiral by facilitating victims' most effective coping responses. This paper reviews the pertinent literature and sets forth a theoretical model of occupational therapy in post-disaster settings.

Adaptation, Psychological↗

EMS response to mass casualties.

Of the three phases of disaster response, the primary phase (immediate postincident to six hours thereafter) represents the core of the EMS-augmented response to save lives. Activities during this phase include triage, victim control and stabilization, communications, and transportation. To cope successfully with the mass casualties of an actual disaster, special emergency forces must be trained (and rehearsed) to act together as a team to treat the critically ill and injured.

Allied Health Personnel↗

Disaster nursing in the Oklahoma City bombing.

The Oklahoma City Federal Building disaster quickly changed a routine day of eye surgical procedures into a chaotic trauma center for the victims with not only eye injuries, but multiple deep lacerations and other injuries. The devastating and disruptive effect of the bombing was stressful for the nursing staff who became disaster survivors of the emotional trauma involved.

Blast Injuries↗

A typology for the classification of disasters.

A model that can be used to classify various types of dasasters is presented. The model allows for disasters to be classified along five criteria: (1) type of disaster (acts of God as opposed to man made), (2) duration of disaster, (3) degree of personal impact, (4) potential for occurrence, and (5) control over future impact. The point is made that the model can be utilized in identification of crucial elements of a disaster. The identification of such elements will, in turn, assist the human service provider in planning intervention activities that make sense in light of consequences (and potential future consequences) suffered by victims.

Adolescent↗