Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Disasters”

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 667 records · Page 37Linked to original sources
PubMedDate not supplied

Vulnerability of disabled and elderly in disasters: case-study of Israel during 'Desert Storm'.

Populations at risk in a disaster situation include the disabled and elderly. This large and growing segment of the population is in many ways more vulnerable than other people to safety and health hazards of disasters and has specific needs in emergency situations. The 'Desert Storm Operation' (Persian Gulf, January-February 1991) as it affected the elderly and disabled in Israel is described. Although the circumstances were rather specific, the increased vulnerability and some particular needs of this population were disclosed, and could be considered in the plans for preparedness for other types of disaster situations.

Adaptation, Psychological↗
PubMedDate not supplied

Effectiveness of a simple Internet-based disaster triage educational tool directed toward Latin-American EMS providers.

BACKGROUND: A previous survey demonstrated a lack of standardization related to disaster triage among Latin-American providers. OBJECTIVE: To assess the effectiveness of a short Internet-based educational intervention in disaster and mass-casualty triage. Using three Spanish Internet emergency medical services (EMS) forums, Latin-American providers were invited to participate in the study. The tool consisted of two educational modules: an introduction to disaster triage module and a START (simple triage and rapid treatment) module. Pre- and post-intervention tests were administered, each consisting of five standardized scenarios. Factorial analysis was used to measure the weight of each scenario. The first and fifth scenarios were identical for intraclass correlation. Skill retention was assessed through a one-month follow-up survey. Statistical analysis was performed using chi-square and Fisher's exact test. A total of 55 EMS providers participated in the study. Five of 55 (9.1%) participants correctly answered four or more scenarios on the pretest intervention, compared with 53 of 55 (96.4%) on the posttest [p < 0.001, relative risk 10.60 (95% CI 4.59-24.49)]. Similar findings were obtained for those accurately triaging all five scenarios, with zero of 55 (0%) in the pretest compared with 49 of 55 in the posttest (p < 0.001). Follow-up at one month was 69%. Four or more scenarios were correctly answered at follow-up by 34 of 38 (89.5%) respondents. No significant difference was noted compared with the immediate post-course survey (p = 0.18). Although initial ability of the cohort to accurately triage patients was suboptimal, a short Internet-based educational tool significantly impacted the cohort's ability to perform triage in a simulated patient environment. This improvement was maintained after one month.

Disaster Planning↗
PubMedDate not supplied

Issues with the integration of technical information in planning for and responding to nontraditional disasters.

In the post-9/11 environment, it has become recognized that the response to man-made disasters (such as chemical spills, bioterrorism, and radiation dispersal) requires a much broader range of tools and technical knowledge than needed for natural disasters (i.e., hurricanes, earthquakes, or drought). This need also requires that those who develop technical information for disaster planning maintain a broader perspective of how the information will be used and what the priorities are for developing new information. In addition, the ability to communicate information within a context understandable to the "end user" has become more critical. The intent of this article is to present issues to help those who traditionally collect and interpret technical information (toxicology, risk assessment, mitigation planners, etc.) to better understand how their information is used in planning for and responding to incidents. These issues are similar to those experienced when trying to provide the users of information provided on material safety data sheets (MSDS) with an understanding of the value and limits of such information in decision making. Confounding the problem are the many sources that provide exposure limits and the limited amount of time the user has to understand the limits of the data during an emergency. While the Federal Response Plan integrates the efforts of multiple agencies, the "on-scene" responders are faced with trying to respond to contradictory strategies and applications of information. Sources of response technical information need to better communicate the limits of application/interpretation of that information in emergency situations.

Communication↗
PubMed2000

Depression among victims of south Mississippi's methyl parathion disaster.

Human-induced disasters have long been considered responsible for a wide array of physiological, psychological, and economic distress. This study examined depressive symptoms among victims of south Mississippi's methyl parathion disaster. Results indicated that irrespective of the level of methyl parathion contamination in respondents' dwellings, more than half the victims interviewed reported depressive symptoms at levels suggesting probable clinical depression. Those at greatest risk of depressive symptoms were people who had been exposed to the neurotoxin for the longest period of time, among whom there was an overrepresentation of women and African Americans. Despite high statistical levels of depression, few victims used mental health services. Implications for social work's response to human-induced disasters are provided.

Adult↗
PubMed2005

Health care workers' ability and willingness to report to duty during catastrophic disasters.

Catastrophic disasters create surge capacity needs for health care systems. This is especially true in the urban setting because the high population density and reliance on complex urban infrastructures (e.g., mass transit systems and high rise buildings) could adversely affect the ability to meet surge capacity needs. To better understand responsiveness in this setting, we conducted a survey of health care workers (HCWs) (N =6,428) from 47 health care facilities in New York City and the surrounding metropolitan region to determine their ability and willingness to report to work during various catastrophic events. A range of facility types and sizes were represented in the sample. Results indicate that HCWs were most able to report to work for a mass casualty incident (MCI) (83%), environmental disaster (81%), and chemical event (71%) and least able to report during a smallpox epidemic (69%), radiological event (64%), sudden acute respiratory distress syndrome (SARS) outbreak (64%), or severe snow storm (49%). In terms of willingness, HCWs were most willing to report during a snow storm (80%), MCI (86%), and environmental disaster (84%) and least willing during a SARS outbreak (48%), radiological event (57%), smallpox epidemic (61%), and chemical event (68%). Barriers to ability included transportation problems, child care, eldercare, and pet care obligations. Barriers to willingness included fear and concern for family and self and personal health problems. The findings were consistent for all types of facilities. Importantly, many of the barriers identified are amenable to interventions.

Adolescent↗
PubMed1997

Radiographic identification of fragmentary human remains from a mass disaster.

Positive identification of human remains is one of the most important tasks in mass disaster management. Here we report on the use of radiography for positive identification of fragmentary human remains recovered from the scene of a terrorist bombing in the Jewish-Argentine Mutual Association Center in Buenos Aires, Argentina, in July 1994. Radiographic examination of all human remains from mass disaster scenes is recommended for identification purposes. Establishing a computerized data bank of antemortem information on missing persons and postmortem findings in disaster victims greatly facilitates and expedites the identification process.

Aged↗
PubMed2002

Healthcare system disaster preparedness, part 1: readiness planning.

Recent world events have raised the scope and intensity of disaster planning and readiness activities, including assessment, planning, implementation, and evaluation. In all efforts, the chief nurse executive is critical to the clinical operations and implementation of changes across a system, whether that system is a single hospital or a multiple site integrated healthcare system. In this article (part 1 of a 2-part series), the authors discuss the use of the nursing process as a framework to prepare for an all-hazards threat to disaster and mass casualty possibilities. They share one region's attempt to better integrate communication efforts across all care providers, including public health, county fire and rescue, state agencies, and hospital and service providers. Part 2 (October 2002) will discuss the role competencies of the nurse executive in disaster preparation.

Communication↗
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↗
PubMed1988

Medical simulation for disaster casualty management training.

A required, role-intensive leadership simulation in emergency and disaster medicine management for fourth-year medical students is described, and the value of an extended role-playing experience discussed. The week-long (120 hours) simulation exercise is designed to provide an opportunity for Federal medical students to experience a realistic combat or disaster environment similar to environments in which they may be required to operate medical support systems. Students function in a variety of roles and have the opportunity to place into practice all emergency medical knowledge and skills acquired throughout medical school. As a prerequisite to the exercise, students successfully complete a 3-week didactic course in Operational and Emergency Medicine which includes Advanced Cardiac Life Support (ACLS) and Advanced Trauma Life Support (ATLS) Provider Courses. By means of disaster simulation they refine medical skills, leadership style, substantially improve clinical judgment, and deal with the complexities of problems associated with their future roles as medical officers.

Disaster Planning↗
PubMed1995

Developing a simulated disaster.

Disaster drills are often accomplished through paper exercises and questionable preparation of staff. A successful simulated disaster involves creativity, planning, the players, disaster day and debriefing.

Disaster Planning↗
PubMed1997

Blood transfusion in disasters, war, and emergencies.

Historically, the needs of those wounded in war have led to many major advances in blood transfusion. The most important of these is probably the ability to draw blood in one location and transfuse it, at a later time, in a distant location. Another important lesson is the need for meticulous planning. Every hospital and blood center should have a disaster plan consisting of five components. What fluids to use, from where are they to be obtained, to what degree are they to be tested, how will they be transported to the disaster scene, and, once there, how will they be stored. Once drawn up, this plan must be regularly exercised and periodically revised. This will ensure rapid and efficient implementation when an emergency arises. Triage is vital in mass casualty situations, ensuring that scarce resources are used for those with the best chance of recovery. Although patients survive with low hemoglobin levels for considerable periods, speedy treatment of hypovolemia is imperative. When perflourochemicals and hemoglobin solutions are available for general clinical use, they will have a major role to play in disasters. Similarly, a simple method for the cryopreservation of red cells will allow stockpiles to be established. Unfortunately, none of these are presently available, although some are undergoing clinical trials.

Blood Preservation↗
PubMed2005

Assessing bioterrorism and disaster preparedness training needs for school nurses.

Meeting the complex needs of a school system and all its members in the event of a bioterrorism (BT) disaster demands a competent workforce. School nurses are in position to be key contributors to planning for and responding to potential BT and disaster events. As part of a state preparedness leadership institute, the BT and disaster preparedness needs of school nurses in a three-county area were assessed and the nurses' preferred method to meet those needs was determined. Using competencies derived from publications by the Centers for Disease Control and Prevention and National Association of School Nurses, a survey was created and mailed to school nurses (N = 125) in public and private k-12 schools. Eighty surveys were returned (64% response rate). Responses were analyzed according to BT and emergency preparedness competencies and skills required for the phases of emergency management: mitigation, preparedness, response, and recovery. Low confidence in preparedness capabilities across almost all categories was reported. High training need was identified across almost all competencies, with 63 percent to 70 percent requesting additional education related to emergency response, infectious disease, hazardous materials, and diagnostic criteria. Although two-thirds report having Internet access in their school office, traditional classroom instruction was overwhelmingly preferred (74%) for training.

Attitude of Health Personnel↗
PubMedDate not supplied

A regional burn center's response to a disaster: September 11, 2001, and the days beyond.

This report reviews the response of a regional burn center to the disaster that occurred in New York City at the World Trade Center on September 11, 2001. In addition, it assesses that response in the context of other medical institutions in the region. There were facilities in the region that had 120 burn care beds; only two-thirds of the burn-injured patients who required hospital admission were admitted to designated burn centers, and only 28% of burn-injured victims initially were triaged to regional burn centers. The care rendered at this center was made possible by a "disaster-ready" facility and supplementation of personnel from the resources provided by The National Disaster Medical System. The patient outcomes at this center exceeded that as predicted by logistic regression analysis.

Adult↗
PubMedDate not supplied

Triage accuracy at a multiple casualty incident disaster drill: the Emergency Medical Service, Fire Department of New York City experience.

We sought to evaluate the accuracy and speed for the triage of multiple patients during a disaster drill by Emergency Medical Service (EMS) personnel. During a disaster drill (train collision with blast injury and chemical release), the accuracy and speed of triage of 130 patient-actors by the Fire Department of New York City (FDNY) EMS personnel was evaluated using the Simple Triage and Rapid Treatment (START) triage system. All EMS personnel had been previously trained in START, but refresher training was not administered before the drill. Overall triage accuracy was 78%. In patients that had additional changes in their status during the triage process (injects), 62% were retriaged appropriately. Because of security and decontamination procedures, triage at the triage/treatment area began 40 minutes after the drill commenced. It took 2 hours and 38 minutes to completely clear the scene of all patients. On average, the time from the start of triage to transport was 1 hour and 2 minutes. Despite the fact that triage is a skill practiced by every EMS system in the country on a daily basis, few studies regarding triage accuracy are available. Limited data suggest that the triage accuracy rates using different triage strategy algorithms are approximately 45% to 55%. During this drill, FDNY-EMS triage accuracy using the START system exceeded these expectations. This study provides insight as to the triage experience of a large urban EMS system operating at a disaster drill.

Algorithms↗
PubMedDate not supplied

Psychiatric sequelae of disasters.

In addition to physical injuries, survivors of disasters also suffer psychological trauma. Resulting mental anguish and illness can be profoundly debilitating and complicate the recovery and rehabilitation process. Front-line trauma teams caring for survivors of disasters must know the risks, assessment, and appropriate response to psychological injury. This article reviews the development of understanding mental disturbance after disasters and current approaches to evaluation and treatment.

Analgesics, Opioid↗
PubMed2004

Surviving the Vajont disaster: psychiatric consequences 36 years later.

The aim of the present study was to assess the chronic psychiatric consequences of the Vajont disaster in a group of survivors still living in the valley 36 years after the event. Thirty-nine subjects were assessed by means of a semistructured interview to investigate the extent of the traumatic experience and a structured diagnostic interview for the diagnoses of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). The degree of traumatic exposure significantly predicts the presence of PTSD. The lifetime frequency of full PTSD was 26%, and a further 33% of the sample displayed partial PTSD. Lifetime MDD was present in 28% of the subjects, and its prediction factors were female gender and number of losses of first-degree relatives in the disaster. Trauma-related fears are very common in the sample. A large-scale disaster, such as that of the Vajont valley, affects the psychological health of survivors for decades.

Acute Disease↗
PubMed2004

The course of PTSD, major depression, substance abuse, and somatization after a natural disaster.

Flood research has used a variety of methods, yielding inconsistent findings. Universal definitions of illness are paramount to the science of psychiatric epidemiology of disasters. St. Louis area survivors (N = 162) of the Great Midwestern Floods of 1993 received a structured diagnostic assessment at 4 and 16 months postdisaster, with 88% follow-up. The purpose of the assessment was to examine predisaster and postdisaster rates of disorders and symptoms. Flood-related posttraumatic stress disorder was diagnosed in 22% and 16% at index and follow-up, respectively. Comorbidity with major depression determined whether the posttraumatic stress disorder would have remitted by 1 year later. Nearly one half of the men in the sample had a pre-existing alcohol use disorder. Virtually no new substance abuse followed the floods, and hence, substance abuse did not develop in response to the disaster or as part of coping with its aftermath. Somatization disorder was not observed; new somatoform symptoms represented a fraction of postflood somatic complaints. Findings are inconsistent with causal attribution of floods in the etiology of alcohol abuse and somatization. Methodological differences may account for much of the apparent discrepancy of these findings, with recent reports of increased alcohol use and somatic symptoms observed after other disasters.

Adolescent↗
PubMed2007

Psychological distress of rescue workers eight and one-half years after professional involvement in the Amsterdam air disaster.

This study examined specific and general psychological distress 8.5 years following the 1992 cargo aircraft crash in Amsterdam. Participants included 334 occupationally exposed fire fighters and 834 occupationally exposed police officers compared with reference groups of 194 fire fighters and 634 police officers who were exposed to duty-related stressors other than the disaster. On the standardized instruments of psychological distress, exposed fire fighters reported more somatic complaints and fatigue, while exposed police officers reported higher psychological distress on all aspects. The degree and type of exposure at the disaster site and other background factors were associated with several outcomes of psychological distress levels of exposed rescue workers. The disasters' aftermath of rumors about potential health consequences due to toxic exposure likely contributed to the long-lasting psychological distress of some of the rescue workers as well.

Accidents, Aviation↗