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Psychological distress among American Red Cross disaster workers responding to the terrorist attacks of September 11, 2001.

This study investigated American Red Cross disaster workers' symptoms of distress and posttraumatic stress resulting from exposure to disaster stimuli during their response to the September 11, 2001 terrorist attacks. A sample of 3055 Red Cross disaster workers was surveyed 1 year after the terrorist attacks regarding demographic characteristics, function during the response, and exposure to disaster stimuli. Participants were grouped by function and self-reported exposure, with the hypothesis that workers in Direct Services and/or those reporting to be directly exposed to disaster stimuli would experience greater levels of posttraumatic stress symptoms and distress than workers in indirect services or reporting no exposure. Findings revealed that while there were significant differences between both Function and Exposure groups on dependent measures, the multivariate eta2 was very small for both and did not meet medium effect size criteria. The results indicated that workers directly exposed to disaster stimuli reported no more distress than those who were not directly exposed.

Demography↗

The Canadian Red Cross plasmapheresis donor safety program: changes in plasma proteins after long-term plasmapheresis.

The Canadian Red Cross Blood Services have been harvesting plasma from whole blood by plasmapheresis procedure for the last 10 years. To date, we have performed approximately 230,000 procedures. To determine whether this procedure is a health hazard to an individual, a donor safety program was established in 1979 at the National Reference Laboratory. Serum levels of total protein, albumin, and immunoglobulins are monitored at intervals set by the Bureau of Biologics, Health and Welfare Canada. In this communication, we present a 10-year evaluation of this program. A comparison of the protein concentration distributions between first-time and long-term plasmapheresis donors showed no significant differences. Therefore, we have demonstrated that the donors are not at risk as the result of changes in the measured plasma protein levels following plasmapheresis procedure as performed over the last 10 years at The Canadian Red Cross Blood Services.

Blood Donors↗

The Red Cross.

Explore the source record for details and available documents.

Humans↗

South African Red Cross Flying Doctors Service quality and safety in the rural and remote South African environment.

CONTEXT: The South African Red Cross Air Mercy Service and its Flying Doctors Service provides health care to far flung and disadvantaged communities in South Africa. PURPOSE: The purpose of this article is to highlight the importance and effectiveness of the service in providing health care to a range of people who have poor or no access to certain health services in South Africa. METHODS: Data and information was collected from records and statistical data of our service. Data was evaluated and compiled into a report highlighting the achievements of this organisation from its infancy to the present day. FINDINGS: The Flying Doctor and Health Outreach Programme has made a difference in improving health care by providing specialist services, transport of patients and training of medical personnel in outlying areas of South Africa that have poor access to health care. Emergency Air Ambulance and Rescue Services have proven to be supportive in providing rapid advanced life support and rescue services to patients in emergency situations. Many lives have been saved through this service. CONCLUSION: The South African Red Cross Air Mercy Service plays a crucial role in delivering specialised health care to disadvantaged communities in South Africa.

Air Ambulances↗

Detection of bacterial contamination in apheresis platelet products: American Red Cross experience, 2004.

BACKGROUND: Routine quality control (QC) testing for bacterial contamination in apheresis platelet (PLT) products was implemented in all 36 regional blood centers of the American Red Cross in March 2004. STUDY DESIGN AND METHODS: PLT samples were cultured under aerobic conditions until the end of the product shelf life or when a positive reaction was indicated. To confirm the initial positive reaction, a new sample was taken from the unit for reculturing. All positive culture bottles were referred for bacterial isolation and identification. Bacterial testing data along with apheresis PLT collection information were collected for analysis. Reports and investigations of potential septic reactions to apheresis PLTs were reviewed. RESULTS: In the first 10 months of bacterial testing, 226 of 350,658 collections tested initially positive. Sixty-eight were confirmed on resampling to be bacterially contaminated for an overall confirmed-positive rate of 0.019 percent or 1 in 5157. Staphylococcus spp. (47.1%) and Streptococcus spp. (26.5%) were the most frequently isolated bacteria; Gram-negative bacteria accounted for 17.6 percent of the confirmed-positive products. Of the 354 apheresis PLT products derived from all 226 initial test-positive cases, 38 (10.7%) were transfused by the time the initial positive reaction was indicated. None of these transfused products, however, had a confirmed-positive bacterial screen and no patient who had been transfused with an unconfirmed-positive product had evidence of a septic transfusion reaction. Three high-probability septic transfusion reactions to screened, negative components were identified. In all three cases, a coagulase-negative Staphylococcus was implicated. CONCLUSION: Our experience demonstrates that bacterial testing of apheresis PLT products as a QC measure was efficiently implemented throughout the American Red Cross system and that this new procedure has been effective in identifying and preventing the transfusion of many, although not all, bacterially contaminated PLT units.

Adolescent↗

[Sanitary and relief activity of the Polish Red Cross in the repatriation and displacement action in the Western Pomeranian region].

The final period of World War II and the first months of peace were the time of massive migration of Polish and German population. The first stage of the Poles' repatriation from the territories taken over by the USSR to the liberated parts of Poland underwent in an organizational chaos, which resulted from poor coordination between the institutions responsible for this operation. In principle, the National Repatriation Office was in charge of the repatriation action. However, where the NRO had no branches or wanted a joint action, the Polish Red Cross took a vital part in sanitary and relief activities. They were particularly crucial in the western and northern regions of Poland, which faced three massive migration currents: the influx of Polish repatriates from the USSR, the return of concentration camp prisoners, POWs and slave workers from Germany and the displacement of the German population. Colonel Jan Ciałowicz gave a brief résumé of the role the Polish Red Cross played in the repatriation and displacement action: "... At the time when the foundations of the State of Poland were created in the Western Pomeranian Region, the Polish Red Cross was dressing, feeding and treating those who needed it most desperately, taking special care of the repatriates and children."

Emigration and Immigration↗

Triage of war wounded: the experience of the International Committee of the Red Cross.

The hospitals of the International Committee of the Red Cross are often faced with situations in which the number of war wounded requiring surgical attention overwhelms the available facilities. Hospital organization, equipment and changes of attitude necessary for health professionals are considered with respect to triage. Practical aspects of assessment and categorization of the wounded are considered in the light of a large experience; relocation and reassessment of those who do not warrant immediate surgery benefit patients and hospital staff alike. The importance of adherence to an emergency plan and respect for the decisions of the person in charge of the triage are emphasized. The difficult and stressful nature of triage of war wounded should always be taken into account.

Africa↗

Red Cross and federal government held liable for hemophiliacs' HIV infection.

After eight years of litigation, on 21 June 2000 three hemophiliacs infected with HIV finally won a judgment against the Canadian Red Cross Society and the federal government. An Ontario trial court ruled the Red Cross and the government were negligent for having delayed the implementation of heat treatment for blood products, which resulted in the plaintiffs' infections. Since starting their lawsuits in 1992, two of the three plaintiffs died of AIDS before the trial judgment. But the damage awards were criticized by the plaintiffs' lawyer.

Canada↗

Post-tsunami medical care: health problems encountered in the International Committee of the Red Cross Hospital in Banda Aceh, Indonesia.

INTRODUCTION: When the Tsunami struck Asia on 26 December 2004, Aceh, Indonesia suffered more damage than did any other region. After the Tsunami, many humanitarian organizations provided aid in Aceh. For example, the International Committee of the Red Cross (ICRC), along with the Indonesian and Norwegian Red Cross opened a field hospital in Banda Aceh on 16 January 2005. This study describes the illnesses seen in the out-patient department/casualty department (OPD/CD) of the ICRC hospital nine weeks after the Tsunami. It describes the percentage of people seen for problems directly related to the Tsunami, and includes a basic screening for depression and post-traumatic stress disorder (PTSD). METHODS: A prospective, five-day study was performed from 01-05 March 2005. Patients registering in the ICRC field hospital in Banda Aceh were considered for the study. Data collected included: (1) age; (2) gender; (3) diagnosis in the OPD/CD; and (4) whether or not the problem was related directly to the Tsunami. Seven basic questions were asked to screen for depression and PTSD symptoms. RESULTS: Twelve percent of the problems seen in the OPD/CD nine weeks after the Tsunami still were related directly to the Tsunami. Sixty-three percent of patients in the study were male. The medical problems included: (1) urological (19%); (2) digestive (16%); (3) respiratory (12%); and (4) musculoskeletal (12%). Although <2% of patients were diagnosed with a mental health problem, 24% had at least four or more of the seven depression/PTSD symptoms addressed in the study. CONCLUSIONS: Post-earthquake and post-tsunami health problems and medical needs differ from those found in conflict zones. After the Tsunami, both surgical and primary healthcare teams were needed. Many problems were chronic medical problems, which may be indicative of the lack of healthcare infrastructure before the Tsunami. The findings suggest that mental health issues must be taken into consideration for future planning. The ethical issues of performing research in complex emergencies also need further development at the international level.

Adult↗

Meeting psychological needs after Chernobyl: the Red Cross experience.

The explosion that took place in reactor number 4 of the Chernobyl Nuclear Power Plant on April 26, 1986 triggered the worst civilian nuclear disaster ever reported. Following requests for assistance by the Red Cross National Societies of Belarus, Ukraine, and Russia, the International Federation of Red Cross Societies set up the Chernobyl Humanitarian Assistance and Rehabilitation Program in 1990. Although the initial needs assessment mission mentioned psychological needs as an area of interest, it was not until 1997 that the first Psycho-Social Support pilot project started in Belarus. Objectives and strategy for the psycho-social support program are detailed, as well as the challenges currently faced by the program. The specific role of the media is also reviewed. Finally, the lessons learned from this experience are reviewed, and suggestions are made for future disaster planning.

Anxiety↗

Patterns of age- and sex-specific prevalence of major blood-borne infections in United States blood donors, 1995 to 2002: American Red Cross blood donor study.

BACKGROUND: The American Red Cross has been maintaining a research database of all blood donations, including all testing results for infectious disease markers, since 1995. This study analyzes the temporal trends of major blood-borne infections among blood donors. STUDY DESIGN AND METHODS: Temporal trends for age- and sex-specific prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis infections in US blood donors were analyzed based on linear trend or time series model or other models as appropriate. RESULTS: From 1995 to 2002, significant declines have been observed for infections that used to be at relatively higher levels. Declines in prevalence were slower among first-time donations than repeat donations. There was an increase in prevalence of anti-HCV among first-time male donors of 50 to 59 years of age. Anti-HIV prevalence appeared to have increased among first-time male donors of 30 to 39 years of age since 2000. CONCLUSION: Different sex and age groups showed various patterns of decline and even signs of increase. The increasing prevalence among some age and sex groups may merit further investigation.

Adult↗

Unrelated umbilical cord blood transplantation in children: experience of the Hong Kong Red Cross Blood Transfusion Service.

OBJECTIVE: To review the outcome of unrelated umbilical cord blood transplantation in children using cord blood from the Hong Kong Red Cross Blood Transfusion Service. DESIGN: Retrospective study. PATIENTS: Records of eight patients who received unrelated umbilical cord blood transplants between 1999 and 2003 were reviewed. MAIN OUTCOME MEASURES: Engraftment of haematopoietic cells and graft-versus-host disease after transplantation. RESULTS: The median age of the patients was 4.9 years (range, 1.0-9.4 years). Five patients had acute leukaemia, one had non-Hodgkin's lymphoma, one had X-linked adrenoleukodystrophy, and one had mucolipidosis. The infused umbilical cord blood units contained a median of 6.7 x 10(7) /kg nucleated cells and 4.0 x 10(5) /kg CD34-positive cells. Neutrophil engraftment was achieved at a median of 13 days (range, 11-19 days) and, for seven patients, platelet engraftment was achieved at a median of 39 days (range, 24-98 days). Acute graft-versus-host disease occurred in all patients (grades I to III). One of the patients died because of encephalitis; of the other seven, five developed chronic graft-versus-host disease of the skin. At a median follow-up of 2 years, the four patients with leukaemia and the one with non-Hodgkin's lymphoma remained in continuous complete remission; the patient with adrenoleukodystrophy showed stabilisation of neurological condition. CONCLUSION: The Hong Kong Red Cross Blood Transfusion Service Cord Blood Bank stored cord blood units of good quality for transplantation, the outcome of which was comparable to that of bone marrow transplantation.

Blood Banks↗

Assessment of motivations for return donation among deferred blood donors. American Red Cross ARCNET Study Group.

BACKGROUND: The recent addition of a computerized donor deferral registry to American Red Cross blood donation procedures has enabled blood center staffs to identify, before donation, persons who attempt to donate despite previous deferral. The current study investigated reasons that deferred donors return to donate, despite having been notified that they are ineligible. STUDY DESIGN AND METHOD: Anonymous mail surveys requesting demographic information, details of last donation or attempted donation, and assessments of incentives for donating were sent to 311 donors presenting inappropriately at blood drives and 849 matched controls in three American Red Cross regions between April and July 1996. RESULTS: Responses were received from a total of 113 deferred donors and 388 matched controls. Analysis of the 49 permanently deferred donors indicated that they were more likely than controls to donate blood to receive test results or to be awarded community service credit. Responses also revealed that some deferred donors may return to donate blood because of a misunderstanding of the deferral message or erroneous recruitment by blood center staff. CONCLUSION: There is a need before donation for the provision of educational materials regarding the window period of infection and for careful consideration of the use of incentives to attract donors to blood centers. It is also important to provide to donors a clear and consistent message regarding their test results and deferral status.

Altruism↗

A decade of rare donor services in the United States. Report of the American Red Cross Rare Donor Registry (1981-1990).

Between 1981 and 1990, the American Red Cross Rare Donor Registry supplied 9,872 units of red cell components with rare phenotypes to blood centers in the United States and abroad. Approximately 51% were from donors with high-frequency antigen-negative phenotypes and 49% were from donors with multiple antigen-negative phenotypes. Since 1989, the disease category requiring the largest number of units has been sickle cell disease. Strategies to ensure that the Registry will have adequate resources to meet future requirements include testing selected donors for rare phenotypes and blood conservation programs, such as intraoperative salvage and the treatment of anemia of chronic renal failure with recombinant erythropoietin.

Anemia, Sickle Cell↗

At risk with the Red Cross. Interview by Craig Little.

The founding of the International Red Cross drew its inspiration from a single, bloody battle in northern Italy. The multicomponent organization is more than 125 years old and still very active where there are war wounds to bind and natural disasters to relieve.

Humans↗

Mental health service use among American Red Cross disaster workers responding to the September 11, 2001 U.S. terrorist attacks.

In this article, we explored 1) the extent of mental health (MH) service use by American Red Cross disaster relief workers, both before (lifetime) and 1 year after the September 11, 2001 terrorist attacks, and 2) demographic, disaster and MH variables predicting (1-year) post-September 11 MH service use in this population. A sample of 3015 Red Cross disaster workers was surveyed 1 year after the attacks, regarding demographic characteristics, MH service use before and since the attacks, and posttraumatic stress disorder (PTSD) symptoms. Findings revealed that while 13.5% used MH services before the attacks, 10.7% used services after. Variables increasing the likelihood of MH service use after the attacks included the following: no previous MH treatment, younger age, being divorced/widowed, and higher PTSD intrusion or hyperarousal symptoms. Findings support other recent research on MH service use after the September 11 attacks.

Disasters↗