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PubMedDate not supplied

[Specialists teams for trauma-related disorders--in short supply in Sweden. There is a lack of both resources and effective therapeutic methods, a survey shows].

Psychological effects of serious traumas can cause severe personal suffering for the individual and will also mean a great economical loss för the individual and for the society in terms of decreased functioning due to illness. The Swedish National Center for Disaster Psychiatry has done a survey to investigate the public resources for acute psychosocial support and for treatment of disorders after psychological traumas. The organization of psychosocial support within the public health care system after major disasters is functioning all over Sweden. Twenty-seven clinics were identified. A majority of these clinics have specialized in the support and treatment of victims of war and torture. Fifty percent of the public medical service areas do not have specialist clinics for treatment of trauma related disorders. At many places there is a lack of specialist treatment resources for people who have developed disorders after experiences of assaults, serious accidents or other types of life threats or sudden loss. There is an obvious need of increased resources in this area.

Crisis Intervention↗
PubMedDate not supplied

Disaster intervention: long-term psychosocial benefits in Armenia.

This paper describes a unique situation in which disaster intervention following a massive earthquake led to significant, uninterrupted, psychosocial benefits to the entire country, and an intervention program that continues to evolve. The mental health program initially provided service to the victims, and then, training to local professionals during which personnel simultaneously conducted clinical research. Members of the mental health team made a life-long commitment to the country, and continue their activities to expand its impact on public health policy. The difficult history and life circumstances of the Armenian people provided the opportunity for disaster interventions to have extensive psychosocial benefits.

Adult↗
PubMed2003

Disasters and the public health safety net: Hurricane Floyd hits the North Carolina Medicaid program.

OBJECTIVES: We measured the effect of Hurricane Floyd on Medicaid enrollment and health services use in the most severely affected counties of North Carolina. METHODS: We used differences-in-differences models on balanced panels of Medicaid claims and enrollment data. RESULTS: Overall spending per enrollee showed little short-term effect but demonstrated a moderate increase 1 year after the storm. We found very modest short-term increases in Medicaid enrollment, a small long-term decrease in enrollment, and large increases in the long-term use of emergency room and outpatient services. CONCLUSIONS: Our findings suggest that hurricane victims experienced substantial changes in patterns of care that endured for much longer than the initial crisis period. These findings can have important implications for the management of disaster relief for this population.

Ambulatory Care↗
PubMed2006

Weapons of mass destruction: Overview of the CBRNEs (Chemical, Biological, Radiological, Nuclear, and Explosives).

The events of September 11, 2001, made citizens of the world acutely aware of disasters consequent to present-day terrorism. This is a war being waged for reasons obscure to many of its potential victims. The term "NBCs" was coined in reference to terrorist weapons of mass destruction, i.e., nuclear, biological and chemical. The currently accepted acronym is "CBRNE" which includes Chemical, Biological, Radiological, Nuclear, and Explosive weapons. Non-nuclear explosives are the most common terrorist weapon now in use. Nuclear and radiological weapons are beyond the scope of this publication, which focuses on the "CBEs", i.e. chemical, biological and explosive weapons. Although neurologists will not be the first responders to CBEs, they must know about the neurological effects in order to provide diagnosis and treatment to survivors. Neurological complications of chemical, biological and explosive weapons which have or may be used by terrorists are reviewed by international experts in this publication. Management and treatment profiles are outlined.

Biological Warfare↗
PubMedDate not supplied

Lessons in emergency evacuation from the Miamisburg train derailment.

Hazardous materials incidents result from the release of materials considered to be harmful or potentially harmful to human beings or the environment. This article describes a train derailment and subsequent hazardous materials release with the evacuation of approximately 50,000 citizens. The hazardous materials release took five days to control and resulted in 561 patient visits to local emergency departments for symptoms related to chemical exposure. The evacuation and emergency medical operations are described and serve as a model for developing community emergency preparedness plans and managing victims involved in hazardous materials incidents.

Accidents↗
PubMed1989

The stress upon rescuers involved in an oil rig disaster. "Alexander L. Kielland" 1980.

Nine months post-disaster, 134 rescuers involved in an off-shore oil rig disaster were investigated by using a structured self report questionnaire to chart their experience of coping with disaster impact stressors and their mental and physical health 9 months after the disaster. Of the 134 rescuers, 24 were categorized as professional rescuers, 101 as non-professionals and 9 could not be classified. Of the 212 victims, all oil rig workers, 89 (42%) were rescued. Seventy-six percent of the rescuers reported they had been exposed to danger during the rescue operation, and 62% found the experience to be the worst ever. Eighty to ninety percent felt they had coped fairly well with the task, and severely disturbed coping was reported to be below 10% for decision-making, ability to judge risk, capacity to function as leader, and finally ability to cooperate and act efficiently. For the non-professionals, severe disturbance in ability to plan before acting was reported by 10% and moderate disturbance was reported by 38%. The frequency of emotional stress reactions during the rescue work can be assessed from the fact that 64% to 52% reported discouragement, restlessness, uncertainty, anxiety and irritation. The stressors inherent in this type of disaster seem to satisfy the DSM III stressor criterion for post-traumatic stress disorder. Nine months after the disaster 24% reported their mental health to be poor due to the disaster impact, and only the most experienced rescuers had a low health risk compared to the others.

Adaptation, Psychological↗
PubMed1999

[The role of the veterinarian during natural disasters].

After a reminder of the main types of natural hazards that can lead to genuine disasters, the author examines the impact of such disasters on animal health. The conceptual approach to various groups of animals in a disaster situation is explained, as well as the direct and indirect effects of such disasters. Preparatory measures are presented within the general framework of prevention and forecasting, together with the veterinary measures to be implemented. Training of veterinarians and planning of activities are described in detail. A traditional approach to organising large-scale assistance is advocated, based on the competence of the personnel involved and a predefined hierarchical organisation. The author then describes veterinary actions to be taken in a disaster situation where emergency aid is required. Particular reference is made to providing assistance to save human lives, including search operations by dog teams for buried victims, and the subsequent phase of restoring human activities, during which assistance to animals is taken into account. Inter-ministerial co-ordination using crisis units and priority management implying real political choices are discussed. Finally, based on the example of the operational organisation of the French Civil Defence, the author describes the support available to Veterinary Services and the potential involvement of the profession, in particular veterinary officers attached to the emergency fire service.

Animals↗
PubMed1962

The city of Calgary plan for natural disaster.

THE DETAILS OF A PLAN TO COPE WITH ANY NATURAL DISASTER IN THE CITY OF CALGARY OR SURROUNDING AREA ARE PRESENTED IN TERMS OF: (1) the method of alerting personnel, (2) the mobilization of hospital authorities, additional hospital personnel, Civil Defence volunteers and Emergency Service facilities to deal with large numbers of injured victims; and (3) arrangements for the collection, feeding, clothing and temporary rehousing of those rendered homeless and deprived of the basic essentials of life.

Civil Defense↗
PubMed1991

Crisis intervention following disasters: are we doing enough? (A second look).

During mass casualty events the consequences of psychological trauma are an important cause of morbidity among survivors and rescue personnel. Data available from military and civilian disasters over the past 70 years has shown a fairly predictable ratio of acute and severe emotional trauma associated with mass casualty events. Long-term morbidity from psychological trauma can rival or exceed that of the physical injuries of survivors. Psychological intervention reduces this morbidity, and early psychological intervention is more effective before adverse psychological symptoms have fully developed. However, the widely accepted value of early psychological intervention is not universal, with controversy over the degree of emotional trauma expected after a large-scale catastrophic mass casualty event, as well as the number of victims and the effectiveness of immediate psychological intervention. Some research even suggests that there is only a minor risk of acute emotional trauma among survivors of a major disaster. The United States faces the possibility of mass casualties from national disasters--particularly earthquakes--and conventional warfare. It has been predicted that 100,000 major injuries requiring hospitalization and 20,000 deaths would result from the maximum plausible natural disaster incident in the United States. Pentagon planners expect thousands of servicemen to be evacuated to the United States for hospitalization on a daily basis during an overseas conventional war. With these estimates of potential casualties, it is imperative that this controversy be resolved as quickly as possible. The National Disaster Medical System recently established plans to provide immediate treatment for psychological trauma to disaster survivors and rescue personnel.(ABSTRACT TRUNCATED AT 250 WORDS)

Crisis Intervention↗
PubMed1989

Reactions to disaster at a distance. The first week after the earthquake in Soviet Armenia.

Armenian-American adolescents from a Los Angeles school were interviewed during the first week after the massive earthquake in Soviet Armenia in December 1988. The authors describe their observations: All the adolescents strongly identified with the victims and felt that the catastrophe personally affected them; they all rushed into hectic activities to escape intolerable grief reactions; there was strong group pressure to accelerate helping efforts; the catastrophe was experienced as fortifying group cohesion; and there was a distinct preference to preserve and strengthen communal values, even over and above helping the earthquake victims. In particular, the authors observed the phenomenon of "participation envy," a special form of survivor guilt involving envious resentment at being excluded from a unique and rallying communal experience.

Adolescent↗
PubMed1997

The lessons of Bhopal [toxic] MIC gas disaster scope for expanding global biomonitoring and environmental specimen banking.

Bhopal Toxic gas tragedy represents one of the worst chemical accidents of the world. Autopsy and toxicological studies, apart from presenting evidence of acute and even chronic cyanide toxicity, provided a unique example of the incriminated chemical being traced to the bodies of the victims. The entry of methyl isocyanate (MIC) into the blood stream was established by the presence of carbamoylated end-terminal amino acids of haemoglobin and other tissue proteins. The presence of MIC trimer and a few other identified as well as unidentified tank residue constituents in the blood and viscera further established a close nexus of the products of pyrolysis of MIC in the aerosol inhaled by the victims. The Bhopal studies exemplify the scope for biological monitoring (BM) and environmental specimen banking (ESB) in chemical accidents as part of the global efforts.

Accidents, Occupational↗