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The effect of a class IV hurricane on emergency department operations.

The objective of this study was to determine the impact on emergency department (ED) operations of Hurricane Hugo, a class IV hurricane that struck Charleston, South Carolina, on September 21, 1989. The study design was a retrospective record-based descriptive study and mail survey of the ED of a 300-bed regional medical center directly in the path of the storm. During the 3 weeks after the storm, ED patient volume increased 19% over that of the 3 weeks before the storm. Increased visit volumes were evident for at least 3 months. Compared with a similar period of the previous year, there was an increase in the proportion of patients seen for lacerations of all types, puncture wounds, stings, and falls. Sixty-two percent of physician offices were still closed 7 days after the storm. The direct effects of a class IV hurricane on ED operations included major alterations in the volume and types of patient visits. Because of the evacuation of approximately 40% of the coastal population and storm damage hindering travel, the increase in visit volume was less in magnitude but of longer duration has been reported in class III hurricanes.

Data Collection↗

Definition and classification of disasters: introduction of a disaster severity scale.

In disaster medicine, a meaningful definition of the word disaster is lacking. A simple definition, using only two criteria, is proposed. Added to this, a classification scheme is formulated. Based on this definition and classification, a disaster severity scale is introduced. The methodology used is described, and the significance of these proposals is discussed.

Disaster Planning↗

An introduction to disaster medicine in Europe.

Disaster medicine, which is based primarily on military and emergency medicine, is a young branch on the old tree of medicine. It touches on various disciplines within and outside the medical field. The subject is being taught on the academic and postacademic levels at many universities throughout Europe. The first chair in disaster medicine was established in Linkoping, Sweden; the second is now in Amsterdam, The Netherlands. Some aspects of disaster medicine specifically oriented toward Europe are presented.

Disaster Planning↗

Hospitals respond to water loss during the Midwest floods of 1993: preparedness and improvisation.

The Midwest floods of 1993 presented multiple emergency preparedness challenges to the six metropolitan medical centers in Des Moines, Iowa. As floodwaters overcame the Des Moines Water Treatment Plant, medical centers were faced with the task of responding to imminent water loss and its associated impact on patient care services and facility operations. Many clinical services were cancelled or diverted to alternate facilities. Ancillary resources were identified and implemented to maintain essential operations. Through effective emergency preparedness and creative improvisation, medical centers were able to overcome the initial crisis, sustain primary services, and ensure continued quality patient care. The article describes how sudden and prolonged water loss affected Des Moines hospitals. It also discusses aspects of hospital emergency preparedness that contributed to successful response.

Continuity of Patient Care↗

Katrina's dance.

Explore the source record for details and available documents.

Altruism↗

Medical management after indoor fires: a review.

UNLABELLED: Fires involving mass burn casualties require extreme efforts and flexibility from the regular health care system. The café fire in Volendam, which occurred shortly after midnight on the first of January 2001, resulted in the worst indoor mass burns incident in Dutch history. During the extensive medical evaluation of this disaster, it became obvious that information on similar incidents is relatively scarce in the literature. This article systematically reviews the existing information in the medical literature on indoor fires and provides findings and knowledge used in the evaluation of the medical management after indoor fires and for future mass burn casualty preparedness, mitigation and response. METHODS: A literature review was undertaken for burn disasters with characteristics similar to the indoor Volendam fire disaster. In all fires, the following aspects were investigated: characteristics of the fire; the initial emergency response; triage and on-site treatment; primary and secondary distribution; hospital admission; severity of the sustained injuries and mortality. RESULTS: A total of nine similar indoor fires were selected. The number of people involved was reported in seven fires (range 137-6000). All reports provided the mortality rate (range 1.4% to over 50%). Data regarding the emergency response could be collected in half of the studies. On-scene triage was performed in five fires. The number of hospitals participating in the primary distribution ranged from 1 to 19. Except for the Volendam fire, all patients were primarily distributed to general hospitals. CONCLUSION: Characteristics of indoor fires, which are relevant for disaster preparedness, mitigation and response are not frequently reported in medical literature. The current articles on indoor fires, mainly report on numbers of casualties and the mortality. Limited data are available to provide insight in the characteristics of management and medical treatment and to come up with suggestions for improvement of future burn incidents management. The evaluation of disasters should be based on uniform methods and structured reports and effective record keeping is essential to achieve this.

Burns↗

Rebuilding New Orleans after Katrina, part 2.

Hurricane Katrina occurred on August 29, 2005, followed by Hurricane Rita on September 24, with destruction extending along the Gulf Coast to Beaumont, Texas. Reentry into New Orleans began in mid to late September last year and occurred in stages, with the least devastated areas being gradually reopened first. People began trickling back in until the city was finally fully opened in December except for the Ninth Ward and East New Orleans.

Case Management↗

Tsunami: response to a disaster.

On December 26, 2004, a devastating earthquake occurred in the Indian Ocean very near to Sumatra's coast. The Belgian Association for Pediatrics assembled a medical team of 30 volunteers from 4 hospitals to assist with disaster relief. They traveled to Indonesia, set up a rudimentary care facility, and worked with teams from many countries. In a disaster situation, critically ill children who require mechanical ventilation and inotropic support, perish for lack of equipment or adequate follow-up care. Disaster teams are told to focus on surgery, infected wounds, dehydration, and oral rehydration. This article tells one story of disaster relief efforts and proposes an established team of pediatricians to respond to disaster situations in the future.

Belgium↗

The human factors in a disaster.

Although natural disasters are claiming fewer lives now than even as recently as 30 years ago, they remain responsible for many premature deaths, most in third-world countries. This article highlights the relationship of human factors that can be found with third-world disasters and reviews interventions that have been used to reduce illness, injuries and deaths.

Developing Countries↗

Research issues in preparedness for mass casualty events, disaster, war, and terrorism.

This article provides a perspective on the types of research questions that might be explored and strategies used in relation to disaster,terrorism, and mass casualty events. Research is addressed in the context of three areas of focus: issues related to the health care provider; issues affecting the patient, individual, family, and community; and issues related to the health care system.

Disaster Planning↗