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PubMed2005

Role-tailored software systems for medical response to disasters: enhancing the capabilities of "mid-tier" responders.

WIISARD (Wireless Internet Information System for Medical Response in Disasters) is developing wireless technology to coordinate and enhance the care of mass casualties at disaster sites. Mid-tier personnel (area supervisors) play a critical role in disaster response, supervising care processes in the triage, Treatment and Transport areas of the attack site. The design of a software tool to support mid-tier activities focuses on providing supervisors aggregate information on patient conditions and needs, real-time data on ambulance availability and location, and hospital status and on coordinating care delivery among triage, treatment and transport areas.

Computer Systems↗
PubMedDate not supplied

When disaster strikes: getting ready for the next big one: part II.

This two-part article deals with the role of the physician when disaster strikes. This second part expands on the role of the physician andpractice in the community and details how the physician and staff can work within the network of the medical societies, hospital systems, government agencies, and others in the event of a far-reaching disaster such as Hurricane Katrina or September 11. It also discusses what the physician can do to educate patients as to how to prepare to meet a disaster.

Bioterrorism↗
PubMed1991

Mental health issues related to the development of a national disaster response system.

With the creation of the National Disaster Medical System (NDMS), the federal government has moved to develop a national medical plan for responding to major mass casualty situations resulting from either a civilian disaster which overwhelms state and local resources or an overseas conventional conflict. To date, the mental health aspects of this plan have received little attention. This article discusses the rationale for adding a comprehensive mental health component to NDMS within the context of the complementary needs of disaster survivors and rescuers.

Disaster Planning↗
PubMed1991

[Dental identification in ferry disaster outside Zeebrugge].

The Herald of Free Enterprise disaster on the 6th of March 1987 just outside Zeebrugge harbour was without any doubt a disaster of major proportions. The identification of the victims had to be done in three phases each of them with its own specific work and problems. As the process of identification of bodies is an exacting science, and forensic odontology is known to be among the most reliable scientific methods in mass disasters, it is easily understood that forensic odontology took an active part in all three phases of the identification process.

Disasters↗
PubMed1991

Disaster management. Organizations and academic perspective.

The world has to cope with the results of an increasing number of disasters. If the planning and preparation for these disasters are to be effective, then national and international organizations are necessary to integrate the sources of advice and relief. Studies of disaster management have consistently highlighted coordination of resources as an essential element of effective response. These organizations, both governmental and voluntary, aim to do just that, and awareness of them and their work will add support.

Aircraft↗
PubMed1991

Natural disasters.

This article presents the health effects of some of the more important acute natural disasters and outlines requirements for effective medical response to these events (table 7). In summary, although all disasters are unique in that they affect regions of the world with differing social, economic, and health backgrounds, there are similarities among disasters, which, if recognized can optimize the management of health relief and the use of resources.

Adolescent↗
PubMed1991

Field management and critical care in mass disasters.

As previously discussed, the majority of injury cases do not necessarily involve dramatic life-saving actions, but rather very rudimentary, promptly applied precautions. For most victims of trauma, therefore, we offer reassurance and simple compassion in their time of need. One of the more important lessons to be learned here is that, beyond prehospital injury "management" or "treatment," we should always remember to provide the best possible prehospital injury care. By responding as soon as possible and by delivering reassurance and compassion to those who are injured and frightened, we are providing one of the most sacred aspects of the Hippocratic mission. Despite wonderful technologic advances and the need for aggressiveness in disaster management, these humanistic values must always be maintained by those to whom care is entrusted. Successful transport of disaster victims, whether in the prehospital phase or during interhospital transfer, requires careful attention to treatment priorities, such as simple measures for airway control and ventilation, and care to prevent further injuries by appropriate immobilization techniques. The use of fully equipped teams of multidisciplinary critical care specialists in mass disaster situations is in its infancy. It is clear that with properly adapted hardware and personnel trained to function in adverse environments while effectively delivering intensive care to a large number of patients with a variety of clinical syndromes, survival can be significantly increased for the most acutely ill.

Burns↗
PubMed1990

Post-traumatic stress disorder in disaster survivors.

In spite of the difficulties inherent in the study of traumatic stress in disaster victims, the benefit of obtaining more knowledge on the subject is potentially great, especially considering the numbers of individuals affected. Recent estimates of the frequency of world-wide traumatic events have determined that almost two million households annually experience damages and/or injuries from fire, floods, hurricanes, tornadoes, and earthquakes alone. The population that is at risk is expected to grow exponentially with our expanding technology, making it even more vital to acquire knowledge to help the growing number of future disaster victims. Additionally, disaster research can contribute to a better understanding of PTSD and human coping processes that can be generalized to more ordinary stress situations. In the meantime, survivors of major catastrophes who experience acute symptoms of PTSD such as insomnia, nightmares, and jumpiness should be observed for nonresolution of symptoms over time, especially if there is a premorbid history of psychopathology or character problems. Otherwise, survivors may benefit from reassurance that PTSD symptoms are common in the short-term postdisaster period and that they can usually be expected to dissipate with time.

Adaptation, Psychological↗
PubMed1990

[Communication networks in great natural disasters].

A great natural disaster destroys every energy supplies and the communication network necessary for the organisation of health care (telephone, telex) is entirely or partially not functioning. It becomes impossible to be informed about the hospitals and others sanitary availabilities in the disaster area. Our personal experience, during the El Asnam's and Mexico's earthquakes demonstrates the necessity to maintain a functioning network for sanitary use. The unique possibility is the availability of portable, battery operated radio-transmitters. It is necessary to have these equipment in all hospitals and health centers in the area of a previsible disaster. A good scheduled training is necessary for the medical and paramedical personal of these areas.

Communication↗
PubMedDate not supplied

Stress among disaster nurses and relief workers.

Proximity to massive destruction, death and mutilation place disaster health workers in a high-risk group for stress. The following article looks at the problems of stress reactions--which may occur during the disaster impact or long after these workers have returned to their regular employment. It also presents strategies for stress prevention before, during and after the disaster.

Disasters↗
PubMed1988

Medical evaluation of the victims of the 1986 Lake Nyos disaster.

A cloud of carbon dioxide gas, with an estimated volume of 1 km3 was released from Lake Nyos, a volcanic crater lake in Cameroon, Africa, causing 1700 to 2000 human fatalities as well as killing thousands of livestock and wild animals. At the request of the Cameroonian Government, the Office of Foreign Disaster Assistance of the U.S. Department of State sent a multidisciplinary team which included 2 forensic pathologists to assist the Government of Cameroon in investigating this natural disaster. The medical evaluation was concentrated in 3 areas: the autopsy of human and animal fatalities, examination and interview of survivors, and examination of the scene of the disaster. Toxicologic specimens were obtained at autopsy, and numerous samples of lake water were collected. The autopsy findings were consistent with asphyxia. The results of chemical analyses excluded many volatiles but not carbon dioxide as the toxic agent. The exact source of this gas continues to be a subject of a heated geologic debate, but fermentation of organic materials in the lake water has been eliminated on the basis of C14 isotope studies. This investigation underlines the value of forensic pathologists in epidemiological studies and in the examination of living persons.

Animals↗
PubMed1988

[Primary mental health care for the victims of the disaster in Armero, Colombia].

Seven to eight months after the disastrous volcanic mudslide that destroyed the town of Armero, Colombia, 200 victims were screened up by means of the Self-Reporting Questionnaire (SRQ) for emotional disorders identification. In order to assess disorders' specific nature, a 104-victim subsample was interviewed by psychiatrists. The most frequent diagnosis ranged among (a) Post-traumatic stress syndrome, (b) Depressión, and (c) Generalized anxiety disorder. Our findings help us to point out that (1) In a developing country a higher prevalence of well-defined emotional disorders among victims of any first-magnitude disaster is to be detected at such a level it can safely be said a real epidemic is to be tackled with, (2) Basically, the identified symptomatology confines itself to anxiety-depression disorders, (3) SRQ is indeed an apt instrument for disasters victims screening, and (4) Mental health specialized resources proved to be insufficient for an adequate coverage of the needs of the affected communities to be performed. As far as mental health is concerned, if the necessary services are to be offered so that all aspects involved are taken care of, it is imperative that victims be attended to by primary care workers. So far, mental health primary care area is still lacking a systematical research within a disaster situation framework. We understand that our paper may serve as an initial orientation for this care strategy being duly implemented and furthered up.

Adolescent↗
PubMed1977

[Development and trial of a civic disaster plan (author's transl)].

Because of the changing complexities of the world the potential for disaster changes from day to day. It is, therefore, the responsibility of every community to plan for possible disasters and to alter their plans as the disaster potential for their community changes. "Exercise London" showed that a workable community plan can be prepared, and illustrated the errors that can occur in handling a large number of casualties. These errors are now being corrected and, when it seems feasible, another exercise will be carried out.

Canada↗
PubMed1983

The Laingsburg flood disaster.

In January 1981 natural floods occurred in large areas of the semi-arid Karoo area. In terms of loss of human life the town most affected was Laingsburg, where over 100 persons were drowned. Most of the bodies were swept downstream in the abnormally swollen river and were never recovered. A flood disaster of this dimension is rare in South Africa. There were very few injuries associated with the disaster and no epidemic diseases followed in its wake, but there were certain aspects of medical services related to the disaster worth recording.

Disasters↗
PubMed1980

Developing an emergency medical disaster plan for an airport.

The development of the Emergency Medical Disaster Plan for Minneapolis-St. Paul International Airport as a model for other major hub airports is discussed. Conformance with federal regulations and the need to closely coordinate activities with both on-airport personnel and off-airport facilities are considered and incorporated into the plan. Manpower sources are reviewed and methods are developed for the efficient handling and treatment of disaster victims. Essential services for an emergency are categorized and their responsibilities designated. Centers of control for support personnel and vehicles are established. Consideration is also given to the special requirements of friends and relatives of the victims and of the news media. Conducting disaster drills as a means to evaluate and improve the basis plan is also examined.

Aircraft↗
PubMed1980

Mobilization of trauma teams for aircraft disasters.

With more survivors of air crashes involving jumbo jets, an improved plan for life-saving emergency care at the crash site is discussed. The concept of airlifting predesignated Trauma Teams to the crash site from large medical centers within a radius of 100 miles is discussed. The "work-shop" for these teams is described in detail, providing an operating and intensive care facility at the scene of the disaster. It is shown how this kind of planning can be applied to natural disasters with multiple casualties as well as to airport disasters.

Aircraft↗
PubMed1994

Wireless communication technology applied to disaster response.

Communication during disasters is frequently inadequate. In addition to having competent communication skills, medical responders must have access to adequate, effective, and reliable communications equipment. Wireless communication technologies are rapidly evolving. The medical community needs a basic understanding of existing and emerging technologies to fully exploit these new resources. Wireless communication technologies for disaster response include radio pagers, radios, cellular telephones, satellite communications, and personal communication services. This article explores concepts of each of these technologies, basic descriptions of current and future equipment, applications of the equipment to medical disaster response, and advantages and disadvantages of each technology.

Disasters↗
PubMed1994

Post-traumatic stress disorder in victims of disasters.

Disasters can produce significant, lasting psychological sequelae. Much of the disaster work that mental health professionals can do falls outside of the more traditional roles usually taken by mental health professionals. These roles include reaching out to survivors through a variety of modes and rarely waiting for them to seek traditional forms of help. Much of what can be done does not require labeling individuals as disordered but may be done within the overall response of the community to the survivors on a variety of levels. To be most effective, we need to be involved in planning efforts that can be activated when disaster strikes, rather than being reactive to the situation after it has occurred. The potential range of responses can challenge the professional who wants to help his or her community when it has been affected.

Adaptation, Psychological↗