Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Disaster Planning”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed1992

Anatomy of a burns disaster: the Miri Bank explosion.

A bank explosion in a neighbouring country over 1000 km away resulted in ten badly burned victims being airlifted to the Burns Centre, Singapore General Hospital (BCSGH) for treatment. The severely injured included patients with 90%, 80%, 74%, 66%, 45%, 33% and 31% burns. Nine had respiratory burns (four severe, one moderate, four mild). One patient died, thus, the mortality rate for the six most severely injured was 16.7%. This differs from predicted mortality rates of 78% according to McCoy or 54% according to Thompson, Herndon et al. The factors contributing to this result were the small size of the disaster, the use of an established Burns Mass Disaster plan and an individual management policy that incorporates carefully monitored fluid resuscitation, recognition of respiratory burns with early treatment by intubation thus pre emptying complications, early surgery and a multidisciplinary approach to complications such as infection and renal failure. The average length of stay was 43 days (range 5-122 days). The cost of the hospitalisation of the ten casualties was $312,317.00.

Adult↗
PubMedDate not supplied

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↗
PubMed2006

Are community health centers prepared for bioterrorism?

Community health centers (CHCs) are essential in the delivery of primary care services to underserved populations. Given the critical function of CHCs, surprisingly little is known about their role in preparing for or responding to acts of terrorism. This survey-based study examines the state of CHCs in terrorism preparedness and assesses their training needs. Of the administrators who responded to the survey, 87% indicated that their centers had an emergency response or disaster plan. Of those, 78% indicated they had updated their plans within the past year. Among those who had a written plan, 41% addressed bioterrorism preparedness, 38% had contingencies for a mass influx of patients, and 3% indicated that their plans addressed increasing operational capacity. Additionally, while 48% reported having assessed the education and training needs of their professional staff in the area of disease surveillance and reporting, only 24% had assessed these needs in relation to bioterrorism. Our findings suggest that CHCs have made great strides in preparing for some emergencies but that preparedness does not yet extend to specifically include terrorism events. Policy and practice recommendations are included to more fully develop CHCs as a resource.

Bioterrorism↗
PubMed1989

Emergency medical services for treatment of mass casualties.

The French emergency medical system (EMS) is the Service d'Aide Médicale Urgente (SAMU). In case of mass casualties, involving 100 simultaneous victims, SAMU has developed a disaster plan, "The White Plan." This plan is closely correlated to the Red Plan of the Fire Department, to provide advanced life support (ALS) at the incident site, followed in a continuum by medical transport and hospitalization in the appropriate services. To obtain the best chance of survival and recovery, there must be optimal coordination among all rescuers. This objective was approached by adopting a formal protocol designed for each city. In France, the medical organization for the treatment of casualties is operated by anesthesiologists who are qualified to perform ALS, preanesthetic evaluation en route, anesthesia for the multitrauma patient, and postanesthetic resuscitation in a continuum from the accident scene to the ICU.

Disaster Planning↗
PubMedDate not supplied

Vertical evacuation drill of an intensive care unit: design, implementation, and evaluation.

Hospital disaster plans should be developed to cover any potential event that could require the immediate evacuation of all patients. Intensive care unit (ICU) patients present multiple challenges for planners: reliability of hospital elevators, manpower needed to transport patients, and the time needed for stabilization before patient transfer. If the ICU is located on an upper floor of the hospital and patients have numerous life-support interventions in place, a vertical evacuation can require more resources than anticipated. A study was done using 12 moulaged patients who were carried down 4 flights of stairs. The lessons learned from the drill are reported.

Disaster Planning↗
PubMed2003

Two New York City hospitals' surgical response to the September 11, 2001, terrorist attack in New York City.

BACKGROUND: We describe the surgical response of two affiliated hospitals during the day of, and week following, the September 11th, 2001 terrorist attack at the World Trade Center in New York City. The city of New York has 18 state designated regional trauma centers that receive major trauma victims. The southern half of Manhattan is served by a burn center, two regional trauma centers, and a community hospital that is an affiliate of one of the regional trauma centers. This report accounts for the surgical response by a regional trauma center (Hospital A, located 2.5 miles from the World Trade Center) and its affiliate hospital (Hospital B, located 5 city blocks from the World Trade Center) on September 11th when two commercial jets crashed into the Twin Towers at the World Trade Center mall. METHODS: Hospital A maintained a concurrent log of patients received during the first 5 hours, the first day, and the first week after the disaster which was kept by the Surgical Triage Officer. The trauma registry completed and verified this data by September 18th. Hospital B collected its data by hand counting and verification by chart review. Both hospitals, A and B, had established disaster plans that were implemented. RESULTS: Nine hundred eleven patients were received by two affiliated hospitals from the World Trade Center attack. Seven hundred seventy six patients (85%) were walking wounded, sustaining mild inhalation and eye irritant injuries. One hundred thirty five (15%) were admitted with 18 (13%) of these undergoing surgery. Twenty two of the 23 transfers were from the community hospital to specialized orthopedic or burn centers. Of the 109 patients admitted to Hospital A, 30 were to the surgical service. The mean ISS score of these patients was 12. There were 4 deaths (within minutes of arrival at the hospital) and 6 delayed deaths (day 1-14). Excluding walking wounded and DOAs, the critical mortality rate was 37.5% overall. CONCLUSION: The September 11th, 2001, terrorist attack in New York City, involving two commercial airliners crashing into the World Trade Center, led to 911 patients received at two affiliated hospitals in lower Manhattan. One hospital is a regional trauma center and one was an affiliate community hospital. Eighty five percent of the patients received were walking wounded. Of the rest, 13% underwent surgical procedures with an overall critical mortality rate of 37.5%.

Aviation↗
PubMed2004

A survey assessment of the level of preparedness for domestic terrorism and mass casualty incidents among Eastern Association for the Surgery of Trauma members.

OBJECTIVE: The goal of this survey was to establish a benchmark for trauma surgeons' level of operational understanding of the command structure for a pre-hospital incident, a mass casualty incident (MCI), and weapons of mass destruction (WMD). The survey was distributed before the World Trade Center destruction on September 11, 2001. METHODS: The survey was developed by the authors and reviewed by a statistician for clarity and performance. The survey was sent to the membership of the 2000 Eastern Association for the Surgery of Trauma spring mailing, with two subsequent mailings and a final sampling at the Eastern Association for the Surgery of Trauma 2001 meeting. Of 723 surveys mailed, 243 were returned and statistically analyzed (significance indicated by p < 0.05). RESULTS: No statistical difference existed between level of designation of a trauma center (state or American College of Surgeons) and a facility's level of pre-paredness for MCIs or WMD. Physicians in communities with chemical plants, railways, and waterway traffic were statistically more likely to work at facilities with internal disaster plans addressing chemical and biological threats. Across all variables, physicians with military training were significantly better prepared for response to catastrophic events. With the exception of cyanide (50%), less than 30% of the membership was prepared to manage exposure to a nerve agent, less than 50% was prepared to manage illness from intentional biological exposure, and only 73% understood and were prepared to manage blast injury. Mobile medical response teams were present in 46% of the respondents' facilities, but only 30% of those teams deployed a trauma surgeon. Approximately 70% of the membership had been involved in an MCI, although only 60% understood the command structure for a prehospital incident. Only 33% of the membership had training regarding hazardous materials. Of interest, 76% and 65%, respectively, felt that education about MCIs and WMD should be included in residency training. CONCLUSION: A facility's level of pre-paredness for MCIs or WMD was not related to level of designation as a trauma center, but may be positively influenced by local physicians with prior military background. Benchmark information from this survey will provide the architecture for the development and implementation of further training in these areas for trauma surgeons.

Attitude of Health Personnel↗
PubMed1993

Providing home care during civil unrest.

The Visiting Nurse Association of Los Angeles responded to the possibility of civil unrest during the Rodney King trial by drafting a plan for disaster readiness. Both management and staff worked together to prepare the agency for the continuation of services during civil unrest or other possible disasters.

Civil Disorders↗
PubMed1996

The impact of flooding on the delivery of hospital services in the southeastern United States.

A survey and three case studies were conducted of hospitals in Alabama, Georgia, and Florida affected by flooding in July 1994. Our findings suggest that the existence or quality of hospital or community plans for disaster did not seem related to the effect of the flood or the hospitals' response to flooding. Recommendations for preparation and problem avoidance in future flood disasters are provided.

Academic Medical Centers↗
PubMed1980

Minimizing the psychological effects of a wartime disaster on an individual.

In this paper, the psychological reactions of individuals and groups to a wartime disaster, such as nuclear explosion, are presented. The psychological literature on disasters is discussed. The presentation attempts to emphasize viewing the victims of a disaster as individuals responding in a normal way to an overwhelming experience, rather than labeling them as psychiatric patients. The various phases of a disaster are discussed with particular emphases on the preventive measures and leadership roles which may be taken by the physician. The development and treatment of situational psychoses, as well as neurotic reactions, are examined and the dynamics especially of long-lasting neurotic problems explored. The paper concludes by making specific recommendations regarding the establishment of disaster plans and training programs at each military facility. It is suggested that the use of such plans may help minimize the psychological effects of a wartime disaster on the individual.

Disasters↗
PubMed1983

Experiences in medical coverage of airport disasters at Logan International Airport in Boston.

Experiences in providing medical coverage for airport disasters at Logan International Airport (LIA) in Boston are presented from 1963-1982. The paper traces the history of the medical facility at LIA and describes the factors to be considered in planning disaster coverage at a major airport. It analyzes the aircraft accidents that have occurred at LIA using the type of accident as a guide for medical planning. It delineates the various phases of aircraft emergency procedures and the medical action that follows such occurrences. Various components of medical action, from the time of notification to rescue and triage, are presented discussing the need for each component. The Medical Action Flow chart and alternate schematic arrangements for rescue, triage, and evacuation are presented in sketches. The need for an overall Medical Command and the concepts of Primary Triage and Secondary Triage are explained.

Accidents, Aviation↗
PubMed2006

Analysis of patients treated during four Disaster Medical Assistance Team deployments.

To aid disaster planning, a retrospective review of patients seen by New Mexico 1 Disaster Medical Assistance Team (NM-1 DMAT) after four disasters was conducted. Data analyzed included age, gender, past medical history, chief complaint, diagnosis, diagnostic testing, treatment, triage category, disposition, and time to presentation after the disaster. Data were analyzed for differences between patients presenting early vs. late after a disaster and to test if availability of diagnostic testing changed patient disposition. The results showed that the majority of patients presented with upper respiratory tract infection symptoms, wounds, and musculoskeletal pain. The needs of patients were similar whether they presented early or late. The same proportion of patients was transferred to hospitals when diagnostic testing was available vs. not available, despite a higher level of acuity when diagnostic testing was available. In conclusion, DMATs should be prepared to see high volumes of low acuity patients. Patient needs do not change with time. Diagnostic testing may be useful.

Adolescent↗