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PubMedDate not supplied

Emergency department management of nerve agent exposure.

Nerve agents are toxic chemicals developed for use by the military, but used by terrorists against civilian populations. As threats of terrorism increase, it is possible that health care providers will be confronted with multiple victims of nerve agent exposure. Nerve agents are highly toxic forms of organophosphate poisons that potentially could cause harm to anyone who comes in contact. Emergency personnel need to be familiar with the agents, know how to prepare for encountering and treating victims, and know how to protect all people involved from further poisoning.

Antidotes↗
PubMed2003

Terrorist bombing at the USA Embassy in Nairobi: the media response.

BACKGROUND: On 7th August 1998, a terrorist bomb destroyed the American Embassy in Nairobi, killing and injuring thousands of people. OBJECTIVES: To describe the media component of the (larger) mental health response, and evaluate the impact of the intervention. DESIGN: Descriptive cross sectional study. SETTING: Nairobi, three months after the explosion. SUBJECTS: Residents of Nairobi and outlying areas, exposed to the bomb blast and who received Radio and TV coverage about the explosion. INTERVENTIONS: Radio and TV broadcasts, starting hours after the explosion and continuing for two weeks thereafter. RESULTS: Of a sample of 400 respondents interviewed, 172 reported they were affected by the bomb blast, either directly or through friends and relatives. TV and radio had the highest reach, (89% and 85%) respectively. Seventy per cent felt the programmes gave victims hope and 90% felt the programmes should continue, as they were helpful to the needy. CONCLUSION: The media is a controversial, sometimes overused and at times underused resource in Disaster Management. Judicious use of the media was shown to be helpful in this study. Literature supports media interventions in disaster. Doctors working in disaster areas need to understand the media and to prepare for its use as it compliments other interventions.

Adult↗
PubMed2002

Sharing stories, healing shattered lives.

Because of our capacity to provide crisis-oriented mental health services in the field throughout the city, we have played a role as one element of New York's emergency mental health response system. Our goal in the aftermath of September 11, 2001, is to allow the victims to tell their stories. By sharing their stories, individuals start the process of moving from helpless victims to proactive survivors.

Aircraft↗
PubMed1989

Technological disaster--survival and bereavement.

Differences between natural and man-made disaster are described, deleterious psychological effects of technological components catastrophe appearing to be longer lasting. The psychological components of the experience of survival are outlined, and the concept of post-traumatic stress disorder located within this. Bereavement reactions, complicated by enhancement of the factors accompanying sudden, violent death, are also described, and risk factors noted. Finally, the development of community-based preventative mental health programmes which are acceptable to victims are detailed, emphasising restoration of the victims' sense of control over their own lives and the value of self-help. The role of counselling and specialist treatment is placed in this context.

Bereavement↗
PubMed2006

Peacekeeping and stability operations: a military surgeon's perspective.

Military surgeons serve a unique role in peacekeeping and stability operations and in response to natural disasters. Military medical units are the best medical resource to respond early in times of cri-sis but are often less equipped for prolonged missions and subsequent management of the chronic health care needs of the masses. Because endemic and host-nation diseases often add complexity to the management of these cases, military surgeons must perform operations outside the scope of their usual civilian practice. The primary medical mission is to treat the peacekeeping force, but the reality lies in eventually treating the refugees and victims of hostile conflict, including women, small children, and the elderly. This article explores the unique features of a surgeon's role in the support of these missions.

Disasters↗
PubMed1999

The relationship between trauma and personality in victims of the Boeing 737-2D6C crash in Coventry.

The aims of this paper were to (a) ascertain the extent of psychological distress and (b) identify the association between personality variables and psychological distress among individuals who had been exposed to an aircraft disaster in Coventry, U.K. Hundreds of people escaped death but were exposed to the impact of the disaster when a Boeing 737-2D6C 7T-VEE crashed into a woodland area on the edge of a large housing estate in Coventry, U.K. in 1994. Eighty-two residents were randomly chosen for interviews in which they were assessed using the Impact of Event Scale, the General Health Questionnaire, and the Eysenck Personality Questionnaire-R Short Scale (EPQ-R). The results showed that the Coventry residents' scores reached similar levels of intrusion and avoidance compared with standardized samples and the Lockerbie samples. Fifty-two percent reached the GHQ case level score, which was again similar to the Lockerbie residents. The Coventry residents were significantly less extroverted and neurotic than standardized samples. Stepwise multiple regression showed that there were associations between intrusion and neuroticism and intrusion and extroversion, as well as between avoidance and neuroticism.

Adult↗
PubMed2007

Thermal and electrical injuries.

Through progress in wound management, resuscitation, intensive care treatment, and a coordinated rehabilitation process, modern burn care has been able to deliver substantial increases in survival and improvement in functional outcomes for burn victims. The development of regionalized burn centers has contributed greatly to this progress. As the field of burns matures, burn centers are preparing to meet future challenges through collaborative efforts in disaster management and outcomes research.

Anemia↗
PubMed1999

Argentine Jewish community institution bomb explosion.

BACKGROUND: Descriptive study of physical injuries and implemented organization from a nearby, unwarned university hospital after the July 18, 1994, bombing of the seven-story Argentine Israeli Mutual Association (AMIA) building in Buenos Aires. Data were obtained from hospital medical records. RESULTS: A total of 86 victims arrived at the emergency department, 2 victims were dead on arrival, 41 victims were admitted, and 43 victims with minor injuries were assisted and allowed to go home. The explosion caused a total of 86 deaths and left more than 200 people injured. Mortality rate among hospitalized survivors was 8.3% and among critically injured victims was 28.6%. CONCLUSION: The total collapse of a multiple-story building immediately kills most of its occupants. In the present study, the few surviving victims were located at the lower floors. The majority of hospitalized victims were outside the building at the moment of the blast. Rapid overcrowding of the emergency department with minor and moderate injuries that do not require hospitalization should be anticipated by disaster management plans. Centralization of severely injured patients in critical areas seems appropriate, because this method keeps major cases from spreading through different wards.

Adolescent↗
PubMed2006

Lessons in posttraumatic stress disorder from the past: Venezuela floods and Nairobi bombing.

Identification and treatment of posttraumatic stress disorder (PTSD) are important following a disaster. Insights into how these aims can be achieved may be obtained from previous disasters. This article describes mental health initiatives following the 1999 flooding in Vargas State, Venezuela, and the 1998 U.S. Embassy bombing in Nairobi, Kenya. Following the Vargas State floods, a specialist mental health center devoted to the diagnosis, treatment, and follow-up of PTSD was established. Awareness and acceptance of the clinic was promoted by media campaigns and community-based activities. After 18 months, approximately 5000 people had been screened, of whom 62% were diagnosed with PTSD and treated. Moreover, the clinic's activities had expanded to include treatment of other medical conditions and assistance with nonmedical needs. Following the Nairobi bombing, a mass media campaign was initiated to create awareness of PTSD symptoms and help victims come to terms with their experience. This campaign was found to be well received and helpful. In addition, counselors were trained to support people living or working close to the blast. These examples show that mental health initiatives are feasible after a disaster and highlight a number of issues: (1) The intervention should be tailored to the needs of the target population; (2) Communication should be simple and appropriate; (3) Community-based activities are valuable in promoting awareness and acceptance of mental health initiatives; (4) Reducing the stigma often associated with mental health problems is important; and (5) The mass media can be helpful in promoting awareness of mental health issues following major trauma.

Community Mental Health Centers↗
PubMedDate not supplied

Terrorism and the international classification of functioning, disability and health: a speculative case study based on the terrorist attacks on New York and Washington.

PURPOSE: To argue that there is a need for a standard classification of functional status to track the consequences of large scale human disasters, such as the terrorist attacks on New York and Washington on September 11, 2001; and that the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) can meet that need. METHOD: The need for tracking functional status following the September 11 attacks is assessed, and three hypothetical case studies of victims of terrorist attacks are presented and coded using a clinical short form of the ICF. RESULTS: It is demonstrated that typical clinical case histories can be coded to the ICF and that the resulting information is useful for tracking the functional consequences of large scale terrorist attacks on civilian populations. CONCLUSIONS: ICF research, development, and training should proceed with the goal of implementing the classification in professions and settings concerned with the functional consequences of terrorist attacks and other human disasters.

Activities of Daily Living↗
PubMedDate not supplied

[An algorithm of computerized processing of molecular-genetic data for personality identification based on the outcome of events involving numerous victims].

Computerized systems of data processing are a high-efficiency tool for the storage and processing of big volumes of molecular genetic data as well as for the forensic medical identification of personality in events involving enormous unidentified bodies coming from zones of calamity or natural disaster. Described in the paper is a sequence of actions undertaken by the expert when the DNAdacto and mDNAbase soft tools are in use. The algorithm of computer-based expert analysis of typing of chromosome and mitochondrial DNA was tested at the 124th Central laboratory of medical-criminal identification of Russia's defense ministry; it was proven to be highly effective for identification made in events with numerous unidentified bodies.

Algorithms↗