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At least 757 records · Page 42Linked to original sources
PubMed2006

Katrina, the tsunami, and point-of-care testing: optimizing rapid response diagnosis in disasters.

We assessed how point-of-care testing (POCT), diagnostic testing at or near the site of patient care, can optimize diagnosis, triage, and patient monitoring during disasters. We surveyed 4 primary care units (PCUs) and 10 hospitals in provinces hit hardest by the tsunami in Thailand and 22 hospitals in Katrina-affected areas. We assessed POCT, critical care testing, critical values notification, demographics, and disaster responses. Limited availability and poor organization severely limited POCT use. The tsunami impacted 48 PCUs plus island and province hospitals, which lacked adequate diagnostic instruments. Sudden overload of critical victims and transportation failures caused excessive mortality. In New Orleans, LA, flooding hindered rescue teams that could have been POCT-equipped. US sea, land, and airborne rescue brought POCT instruments closer to flooded areas. Katrina demonstrated POCT value in disaster responses. We recommend handheld POCT, airborne critical care testing, and disaster-specific mobile medical units in small-world networks worldwide.

Diagnosis↗
PubMed1982

Community perceptions of natural disasters and post-disaster mental health services.

This research was designed to examine the cognitive and affective responses of residential dwellers in the aftermath of a natural disaster (a flood). In a 2 X 3 factorial design, the effects of fear (High, Medium, and Low) and sex on perceptions of the disaster were assessed. The results indicated that respondents who were highly fearful of the disaster were more likely than moderate or low fear respondents to believe that: a) additional flooding would occur in their vicinity, and b) that they resided closer to the flood zone than they actually did. The policy implications of the results suggested that post-disaster mental health services might have to be extended to include residents of geographical areas not directly affected by natural or man-made disasters.

Arizona↗
PubMed2004

Autopsy findings from 111 deaths in the 1999 Athens earthquake as a basis for auditing the emergency response.

BACKGROUND: The aim of the study was to assess the emergency response to an earthquake. METHODS: This retrospective study, based on formal autopsy findings from 111 earthquake-related deaths, evaluated demographic data, circumstances of death, rescue time, mechanisms of injury, causes of death, Abbreviated Injury Scale (AIS 90) and Injury Severity Score (ISS) values, vital functions, co-morbidity and preventable deaths. RESULTS: The median extrication time for 99 of 102 victims buried or trapped in collapsed buildings was 2.1 (range 0.1-7.8) days. Deaths were cause by blunt injuries, asphyxia and myocardial infarction. Injuries impaired the airway, breathing, circulation, and brain or spinal functions in 10.5, 61.9, 46.6 and 57.1 per cent of the victims respectively. The 105 injured victims were classified into three main categories. The first comprised 36 victims (34.3 per cent) with injuries not compatible with life (ISS 75), the second included 38 victims (36.2 per cent) who suffered life-threatening injuries (ISS 9-74) but had no evidence of asphyxia, and the third category contained 31 victims (29.5 per cent) with findings of asphyxia and an ISS of 1-18. The reviewers concluded that 13 trauma-related deaths and 31 deaths from asphyxia were potentially preventable. CONCLUSION: A method based on detailed evaluation of deaths provided information with which to audit the emergency response to an earthquake.

Adolescent↗
PubMed2004

Severe acute respiratory syndrome and the delivery of continuing medical education: case study from Toronto.

INTRODUCTION: Severe acute respiratory syndrome (SARS) struck Toronto in the spring of 2003, causing many deaths, serious morbidity, forced quarantine of thousands of individuals, and the closure of all provincial hospitals for several weeks. Given the direction by public health authorities to cancel or postpone all continuing medical education (CME) courses, including those sponsored by the University of Toronto Faculty of Medicine, SARS has had a profound effect on the delivery of CME in Toronto and beyond. METHOD: Case study design using existing documents and self-report. RESULTS: The immediate, specific response of the University of Toronto CME program to SARS is described for the period from March 2003 to September 2003. DISCUSSION: During major outbreaks of infectious disease, continuing education providers should maintain regular contact with public health authorities and learners, enact a rational process for postponing or canceling courses, and implement a disaster plan flexible enough to ensure the deliver, of education using technological advances.

Education, Medical, Continuing↗
PubMed2002

Regional economic impacts of water management alternatives: the case of Devils Lake, North Dakota, USA.

Devils Lake, located in a closed basin in northeastern North Dakota has over a century-long history of highly fluctuating water levels. The lake has risen nearly 25 feet (7.7 m) since 1993, more than doubling its surface area. Rising water levels have affected rural lands, transportation routes, and communities near the lake. In response to rising lake levels, Federal, state and local agencies have adopted a three-part approach to flood damage reduction, consisting of (1) upper basin water management to reduce the amount of water reaching the lake, (2) protection for structures and infrastructure if the lake continues to rise, and (3) developing an emergency outlet to release some lake water. The purpose of this study was to provide information about the net regional economic effects of a proposed emergency outlet for Devils Lake. An input-output model was used to estimate the regional economic effects of the outlet, under two scenarios: (1) the most likely future situation (MLS) and (2) a best case situation (BCS) (i.e., where the benefits from the outlet would be greatest), albeit an unlikely one. Regional economic effects of the outlet include effects on transportation (road and railroad construction), agriculture (land kept in production, returned to production sooner, or kept in production longer), residential relocations, and outlet construction expenditures. Effects are measured as changes in gross business volume (gross receipts) for various sectors, secondary employment, and local tax collections. The net regional economic effects of the proposed outlet would be relatively small, and consideration of these economic impacts would not strengthen the case for an outlet.

Commerce↗
PubMed1992

A collaborative model of a county crisis intervention team: the Lake County experience.

A model is introduced for the classification of crisis intervention and disaster services as being clinic-based, ad hoc, school-oriented, disaster service based and integrative. An example is presented of an integrative-collaborative model that was developed in Lake County, Ohio to cope with situations of suicide, accidental death or natural disaster when they occur in rural areas and small towns. The Community Crisis Intervention Team (CCIT) was developed with characteristics specific to a collaborative model. The distinctive qualities of the CCIT are identified and discussed within the context of a case study of a postvention in a school setting following adolescent suicide.

Community Mental Health Services↗
PubMed1997

A synthesis of the findings from the Quake Impact Study: a two-year investigation of the psychosocial sequelae of the 1989 Newcastle earthquake.

This paper summarises the major findings from the Quake Impact Study (QIS), a four-phase longitudinal project that was conducted in the aftermath of the 1989 Newcastle (Australia) earthquake. A total of 3,484 subjects participated in at least one component of the QIS, comprising a stratified sample of 3,007 drawn from community electoral rolls and 477 from specially targeted supplementary samples (the injured, the displaced, the owners of damaged businesses, and the helpers). Subjects' initial earthquake experiences were rated in terms of weighted indices of exposure to threat and disruption. Psychological morbidity was measured at each phase using the General Health Questionnaire (GHQ-12) and the Impact of Event Scale (IES). Selected findings and key conclusions are presented for each of six areas of investigation: service utilisation during the first 6 months post-disaster; patterns of earthquake experience and short-term (6-month) psychosocial outcome; earthquake exposure and medium term (2-year) psychosocial outcome; vulnerability factors and medium-term psychosocial outcome; specific community groups at increased risk (e.g., the elderly and immigrants from non-English-speaking backgrounds); the effects of stress debriefing for helpers. Threshold morbidity (i.e., likely caseness) rates are also presented for a broad range of subgroups. In addition to presenting an overview of the QIS, this paper synthesises the major findings and discusses their implications for future disaster management and research from a mental health perspective.

Adult↗
PubMed1992

The "Scandinavian Star" ferry disaster 1990--a challenge to forensic odontology.

With 158 victims, the fire on board the "Scandinavian Star" was one of the world's worst ferry disasters. A team of identification experts, including dentists, were employed to secure evidence for identification and to remove the victims from the ferry. Four parallel teams, each with 2 dentists, examined and autopsied the victims at the Institute of Forensic Medicine, University of Oslo. Using the INTERPOL Disaster Victim Identification forms and aided by computers, all victims were identified within 17 days. Dental identity could be established in 107 cases (68%).

Adolescent↗