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PubMed2000

The Department of Veterans Affairs' role in Federal Emergency Management.

The Veterans Health Administration (VHA) has been increasingly called on to provide disaster relief health care personnel and other emergency assistance since the role of the Department of Veterans Affairs in emergency management was expanded by the Federal Response Plan in 1992. This article briefly reviews the VHA's emergency management functions currently specified by the Federal Response Plan and its present activities in procuring and maintaining antidotes, antibiotics, and other pharmaceutical stockpiles to be used in response to terrorist incidents involving weapons of mass destruction. In view of VHA's national scope and extensive assets, its administration by the government, and its critical role in health professional training, there are several additional ways that VHA could economically augment the federal government's efforts to better support and prepare local jurisdictions for disasters or incidents involving weapons of mass destruction, if the required authorization and funding were provided.

Civil Defense↗
PubMed2001

Wilderness mortalities: a 13-year experience.

STUDY OBJECTIVE: To analyze the epidemiology of wilderness mortalities in a localized area with diverse terrain. METHODS: We conducted a retrospective review of the Pima County (Arizona) Sheriff's Office (PCSO) search and rescue logs and case reports, hospital records, and autopsy reports for all wilderness deaths from 1980 to 1992. The study group comprised all victims of injury or illness in Pima County wilderness who died during a 13-year period in a location remote enough so that standard ground-based emergency medical services units could not extract the body. RESULTS: One hundred fatalities occurred during the 13-year study period. There were 59 unintentional traumas, 18 suicides, 9 homicides, 12 medically related deaths, and 2 deaths of unknown causes. Toxicology tests performed on body fluids yielded positive findings for alcohol in a total of 50 (50%) cases and positive findings for drugs of abuse in 12 (12%) cases. It was estimated that alcohol was "a very probable" or "a probable" causative factor in 23 (40%) of the 59 unintentional trauma deaths, and in 1 (8.3%) of the 12 medically related deaths. Fifty-five (55%) deaths were witnessed events, with 45 (80%) of these victims reported as dying immediately or before arrival of search and rescue personnel. Ten (10%) victims received resuscitation in the field, and according to a review of hospital charts and autopsy reports, only 2 victims had a potentially survivable injury or illness. CONCLUSION: Many wilderness mortalities are related to incidents involving alcohol. Once the accident or injury has occurred, the majority of deaths are immediate, or at least before the arrival of medical personnel. Higher levels of medical care would not have improved the outcomes of those who did survive long enough to receive medical care. Therefore, primary efforts to reduce mortalities in the wilderness should be directed toward prevention, especially diminishing alcohol use in wilderness areas.

Adolescent↗
PubMed2006

Reconstruction of New Orleans after Hurricane Katrina: a research perspective.

Four propositions drawn from 60 years of natural hazard and reconstruction research provide a comparative and historical perspective on the reconstruction of New Orleans after Hurricane Katrina. Decisions taken over its 288-year history that have made New Orleans so vulnerable to Katrina reflect a long-term pattern of societal response to hazard events--reducing consequences to relatively frequent events, and increasing vulnerability to very large and rare events. Thus Katrina's consequences for New Orleans were truly catastrophic--accounting for most of the estimated 1,570 deaths of Louisiana residents and $40-50 billion in monetary losses. A comparative sequence and timing of recovery provides a calendar of historical experience against which to gauge progress in reconstruction. Using this calendar, the emergency post-disaster period appears to be longer in duration than that of any other studied disaster. The restoration period, the time taken to restore urban services for the smaller population, is in keeping with or ahead of historical experience. The effort to reconstruct the physical environment and urban infrastructure is likely to take 8-11 years. Conflicting policy goals for reconstruction of rapid recovery, safety, betterment, and equity are already evident. Actions taken demonstrate the rush to rebuild the familiar in contrast to planning efforts that emphasize betterment. Because disasters tend to accelerate existing economic, social, and political trends, the large losses in housing, population, and employment after Katrina are likely to persist and, at best, only partly recover. However, the possibility of breaking free of this gloomy trajectory is feasible and has some historical precedent.

Cities↗