Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Disaster Victims”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,081 records · Page 60Linked to original sources
PubMed2002

The public health consequences from acute chlorine releases, 1993-2000.

Chlorine, a commonly used hazardous substance, can be harmful to human health when improperly released. Data from the Agency for Toxic Substances and Disease Registry's Hazardous Substances Emergency Events Surveillance system were used to conduct a retrospective analysis on the public health consequences from acute chlorine release in 16 states during 1993 through 2000. There was an overall decline in the number of chlorine events during the period analyzed; however, chlorine events were more likely to result in events with victims, evacuations, and decontaminations when compared with nonchlorine events (relative risk [RR] = 4.5, 95% confidence interval [CI] = 4.1 to 5.0; [RR] = 4.8, CI 4.3 to 5.3; and [RR] = 2.0, CI 1.7 to 2.4, respectively). Most chlorine victims were employees and members of the general public. The predominant symptoms sustained were respiratory and eye irritation. Equipment failure and human error were the most frequent factors leading to an event. Continuous employee training and preventive equipment maintenance can help prevent chlorine releases from occurring and minimize exposure to the general public.

Chlorine↗
PubMed2005

Hospital planning for acts of terrorism and other public health emergencies involving children.

In today's world the increased potential of terrorist attacks places unique burdens and consequences on health care workers. Hospitals and hospital personnel must now be prepared to react immediately to such events. They must also implement, in advance, policies to protect their own health care personnel while providing care to victims. In this review, we discuss the four major forms of mass casualty terrorism (biological, chemical, nuclear, and thermomechanical) including clinical signs and symptoms for each, the impact on health care personnel, and special considerations for children. We will then outline key principles of hospital preparation with regard to paediatrics in anticipation of such emergencies.

Child↗
PubMed2003

Caring for victims of nuclear and radiological terrorism.

As primary care providers, we must consider the manifestations of radiation sickness and syndromes when managing radiological injuries. Assessment and treatment regimens include unique sample handling requirements to avoid self-contamination and further contamination of the environment. Addressing psychological aspects and the needs of pediatric and geriatric populations is also important for effective treatment.

Decontamination↗
PubMed1991

A brief discussion of the development of Native owned health provider agencies in Alaska within the context of anticipated health and systems issues.

The Self-Determination Act brought about an explosive growth of tribally run programs in Alaska during the 1970s at the same time that the Alaska Native Claims Settlement Act was being implemented. Tribes demonstrated great creativity in blending IHS with other sources of funds to develop more effective and more acceptable delivery of services to their people. Further, the tribes in Alaska have demonstrated great aptitude in developing effective lobbying techniques with the United States Congress, such that they have actually been able to increase their funding base beyond what was assumed at the time of takeover from the IHS. However, several problems loom on the horizon. First, there is the problem of cost shifting within the IHS which contains the potential that tribes opting not to take advantage of the Self-Determination Act may be victimized by those who do. Second, there is the problem of too few resources to serve too many patients, which from time to time, propels the Indian Health Service toward an attempt to change the rules with respect to eligibility for services. Finally, the ability of the Indian Health Service (and by extension, its contract tribes) to provide an adequate level of services to American Indian and Alaska Native clients is being dramatically eroded by the same inflationary forces that are driving the larger system of health care in the United States toward the brink of disaster.

Alaska↗
PubMed1992

Traumatized children and the news media: clinical considerations.

Child victims of catastrophic incidents are often deluged by the news media and by the consequences of instant celebrity status but little is known about the effects of such publicity on these children. Several possible negative consequences for the children are discussed, as are some potential benefits. Suggestions are made for measures to minimize potential trauma arising from media attention.

Adaptation, Psychological↗
PubMed2006

Development of a statewide hospital plan for radiologic emergencies.

Although general guidelines have been developed for triage of victims in the field and for hospitals to plan for a radiologic event, specific information for clinicians and administrators is not available for guidance in efficient management of radiation victims during their early encounter in the hospital. A consensus document was developed by staff members of four Connecticut hospitals, two institutions of higher learning, and the State of Connecticut Department of Environmental Protection and Office of Emergency Preparedness, with assistance of the American Society for Therapeutic Radiology and Oncology. The objective was to write a practical manual for clinicians (including radiation oncologists, emergency room physicians, and nursing staff), hospital administrators, radiation safety officers, and other individuals knowledgeable in radiation monitoring that would be useful for evaluation and management of radiation injury. The rationale for and process by which the radiation response plan was developed and implemented in the State of Connecticut are reviewed. Hospital admission pathways are described, based on classification of victims as exposed, contaminated, and/or physically injured. This manual will be of value to those involved in planning the health care response to a radiologic event.

Connecticut↗
PubMed2005

The Göteborg discotheque fire: posttraumatic stress, and school adjustment as reported by the primary victims 18 months later.

BACKGROUND: On October 29, 1998, around 400 young people were gathered in an old warehouse in Göteborg, Sweden, for a discotheque party. A fire erupted and spread explosively. Adolescents were exposed to dreadful scenes inside and outside the building. In all, 63 young people were killed and 213 physically injured. An 18-month follow-up with 275 adolescents (126 girls) who survived the fire, regarding the effects of the fire on symptoms of posttraumatic stress, school adjustment and performance, is reported. METHODS: Impact of Events Scale (IES), Clinician Administered Posttraumatic Stress Scale (CAPS) and an interview concerning background factors and issues of public and personal support. RESULTS: The level of posttraumatic stress was generally high, and highest among adolescents with an immigrant background. In all, 25% of the participants met DSM-IV criteria for PTSD. Twenty-three percent of the participants reported having either dropped out of school or repeated a class because of the fire. Students' ratings of how their own school handled the situation, and school absenteeism, were related to ratings of their own performance in school as well as to the level of posttraumatic stress. CONCLUSIONS: Traditional talking cures were more sought out by girls than boys. Broad-scale interventions must be complemented with special treatment opportunities for the most severely afflicted. Victims who suffer from high levels of posttraumatic stress need special support for a long period of time to minimise the effects on scholastic achievement and adjustment. Studies of the effects of traumatic events on child and adolescent development should measure school-related effects better than has hitherto been the case.

Adaptation, Psychological↗
PubMed2002

Treatment modalities and outcome of the renal victims of the Marmara earthquake.

BACKGROUND/AIMS: Treatment of renal problems during natural catastrophes is highly complicated both for medical and logistic reasons. The therapeutic interventions applied to and the outcome of 639 victims with acute renal problems during the catastrophic Marmara earthquake have been the subject of this study. METHODS: Questionnaires regarding information about 63 clinical and laboratory variables were sent to 35 reference hospitals that treated the victims. Information considering therapeutic interventions and outcome obtained through these questionnaires was submitted to analysis. RESULTS: At least one form of renal replacement therapy was administered to 477 (74.6%) of the 639 victims. Of these, 437, 11, and 4 were treated solely by intermittent hemodialysis, continuous renal replacement therapy, and peritoneal dialysis, respectively; 25 victims needed more than one dialysis modality. In total, 5,137 hemodialysis sessions were performed. Also, 2,981, 2,837 and 2,594 units of blood, fresh frozen plasma, and human albumin were administered, respectively. Transfusion of these products was usually associated with higher rates of dialysis needs and mortality. Ninety-seven patients (15.2%) died. The mortality rate of dialyzed victims was higher as compared to nondialyzed ones (17.2 vs. 9.3%, p = 0.015). CONCLUSIONS: Massive amounts of dialysis treatment as well as blood and blood product transfusions can be necessary in the treatment of catastrophic earthquake victims with nephrological problems. Despite the potential risk of a high mortality, in the case of appropriate and energetic medical interventions, reasonable final outcomes can be achieved.

Acute Kidney Injury↗
PubMed2001

Evaluation of trauma registry data in Asir region.

OBJECTIVE: To analyze and report trauma registry data; to assess the validity, reliability, and feasibility of the trauma registry; and to discuss lessons learned from this event. METHODS: A pre-designed trauma registry data was used for all injured patients admitted to Asir Central hospital after being involved in a major motor vehicle accident. A survey team registered and analyzed the trauma registry data using the statistics software SPSS for windows. RESULTS: Eighty-five patients were admitted to the hospital with different injuries. All victims were males with a mean age of 27 years. Injuries were dominated by musculo-skeletal trauma followed by neurotrauma, thoracic, and abdominal trauma respectively. Pre-hospital data was deficient and most of the hospital in-patient's information was taken from the nurse's notes. Standard elements of the trauma registry were found essential for optimal trauma care. Morbidity was related mainly to neurological trauma. Mortality was related to head injury followed by thoracic and abdominal injuries. CONCLUSION: Trauma registry was valid, reliable, and feasible. A national trauma registry program should be established. Trauma registry, prehospital care, and disaster planning and management should be integral parts of a regionalized trauma care system. Successful trauma care systems have shown significant reductions in morbidity and mortality from trauma.

Accidents, Traffic↗
PubMed2006

Forensic findings from the Nairobi U.S. Embassy terrorist bombing.

BACKGROUND: The 1998 terrorist bombing of the US-Embassy in Nairobi resulted in the highest number of civilian deaths ever recorded from a single urban terrorist bombing in global history. OBJECTIVE: To present forensic findings from the Nairobi terrorist bombing and discuss some contributory factors to the high-fatality witnessed. DESIGN: Desriptive retrospective study. SETTING: Office of the Chief Government Pathologist of Kenya. RESULTS: A total of 211 persons were confirmed to have died as a direct result of the bomb blast. Out of the 201 cases examined in this paper, 198 (99%) died on the day of the blast. Sixty percent of the deceased were males and 85% were aged between 21 and 50 years. Most of the deceased were visually identified (95%). The rest required fingerprinting (3%), DNA testing (2%), and forensic odontology (1%). Ninety six percent of the victims (194 cases) had primary blast injuries. The typical triad of blast fragmentation injuries was found in only 47% of the cases. Eighty nine percent (179 cases) had injuries in multiple anatomical regions. The most common cause of death was head injury (30%). CONCLUSION: The anatomical pattern of injuries and other pathological findings among fatalities from this terrorist bombing are similar to those recorded from other bombing incidents worldwide. Contributory factors to the high fatality include the collapse of a densely populated building, the TNT-equivalent force of the bomb, the confined site of detonation, and probably the lack of a proper disaster response system.

Adolescent↗
PubMed1989

SARA (Superfund Amendments and Reauthorization Act), Title III: implications for emergency physicians.

Practically every community has one or more industries that use or produce hazardous chemicals. The release of these chemicals into that community's environment has the potential of causing serious health problems. Previously, physicians have not had information about what hazardous chemicals were in their community or a warning that release of a hazardous chemical had occurred. The Emergency Planning and Community Right-to-Know Act of 1986, known as Title III of the Superfund Amendments and Reauthorization Act (SARA), now mandates that every facility using, storing, or manufacturing hazardous chemicals make public its inventory and report every release of a hazardous chemical to public officials and health personnel. Every facility also must cooperate with physicians who are treating victims of exposure. Emergency physicians, both in their role in their community's emergency medical services system and as physicians in emergency departments, will soon be involved in many aspects of SARA's numerous ramifications. This report is intended to familiarize the emergency physician with the basic components of Title III of SARA.

Accidents, Occupational↗
PubMed2006

Phases of earthquake experience: a case study of the June 2000 south Iceland earthquakes.

A case study of the impact factors of stress and relief in the wake of the south Iceland earthquakes in 2000 is presented. By applying axial coding analysis, the isolated concurrent and interplaying sociostructural impact factors were added sequentially to a time axis based on interviews with sufferers, as well as observations and a survey analysis. The data were obtained through a field survey using standardized questionnaires as well as numerous personal in-depth interviews, photographs, and field notes. An exposition of the different phases of the earthquake experience is presented, reflecting the victims' conscious and/or unconscious efforts to bring life back to "normal," though constantly burdened by a perceived lack of understanding of their experiences by "outsiders." The process was characterized by six main stress factors and three noteworthy mitigating factors. The findings are important for vulnerability and risk assessment as well as for planning pre-, pro-, and postearthquake reactions in the affected areas.

Anxiety↗
PubMedDate not supplied

Developing an emergency department based Special Operations Team: Robert Wood Johnson University Hospital's experience.

Robert Wood Johnson University Hospital initiated an emergency department based Special Operations Team as a way to help prepare staff for the care of hazardous material incidents (HAZMAT) victims and the unexpected consequences of a mass casualty incident. The team evolved over a period of 5 years and is now able to provide significant educational offerings, policy and procedure review and participation in extensive planning efforts in the hospital and community. This article will review the process and present future goals of the team.

Academic Medical Centers↗
PubMed2003

[Expert work during technogenc emergency situations (Report I)].

The authors discuss the organizational principles of the work of expert institution and its subdivisions with reference to technogenic catastrophes accompanied with mass human victims. The problems of interaction of the representatives from different structures and departments taking part in the work at the place of event are considered in terms of forensic medicine. The attention is concentrated on the problems of expert institution readiness to work under conditions of extreme situations depending on the medicotactical characteristics of defeat focus.

Disasters↗
PubMedDate not supplied

Urban search and rescue medical teams: FEMA Task Force System.

Recent national and international disasters involving collapsed structures and trapped casualties (Mexico City; Armenia; Iran; Philippines; Charleston, South Carolina; Loma Prieta, California; and others) have provoked a heightened national concern for the development of an adequate capability to respond quickly and effectively to this type of calamity. The Federal Emergency Management Agency (FEMA) has responded to this need by developing an Urban Search and Rescue (US&R) Response System, a national system of multi-disciplinary task forces for rapid deployment to the site of a collapsed structure incident. Each 56-person task force includes a medical team capable of providing advanced emergency medical care both for task force members and for victims located and reached by the sophisticated search, rescue, and technical components of the task force. This paper reviews the background and development of urban search and rescue, and describes the make-up and function of the Federal Emergency Management Agency (FEMA) Task Force medical teams.

Emergency Medical Services↗
PubMed2006

Trauma response to the Asian tsunami: Krabi Hospital, Southern Thailand.

The date 26 December 2004 saw a massive tidal wave propagated from a 9.0 Richter scale suboceanic earthquake off the coast of Sumatra in South-East Asia. It swept across the Indian Ocean over a matter of hours leaving destruction in its wake. In Southern Thailand, Krabi Hospital, that province's major tertiary health centre, received the majority of the region's tsunami victims. Well-rehearsed contingency plans were in place to cope with 10, 20 and 40 trauma victims in the case of an extreme event. By the end of 26 December some 500 injured people had been treated at Krabi Hospital: well in excess of the 'worst case scenario' planning. Over the following days a total of 1357 tsunami victims were treated. Over the course of the day victims were able to move through the hospitals' system and gain appropriate treatment. This was achieved through the almost superhuman dedication of the hospitals' well-trained nursing and medical staff. In addition to this were large numbers of both Thai and foreign volunteers, who aided people with basic necessities such as providing them with food, water and clothing as well as simple human comfort, some also acting as translators for the health-care workers and the masses of injured and displaced people. Makeshift wards were constructed in halls and little used areas of the hospital, using army style stretchers to accommodate the wounded. Even though the disaster contingency plans at Krabi Hospital were utterly overrun, the fact that well-thought out and practised strategies were in place saved incalculable lives. The message is clear: practised responses to mass trauma situations will save lives and allows health-care teams to coordinate well in the face of overwhelming odds without panic. All centres should routinely practise disaster response through scenario-based training.

Disaster Planning↗
PubMedDate not supplied

The Bhopal syndrome: persistent questions about acute toxicity and management of gas victims.

A review of the health effects of the 1984 gas leak from the Union Carbide plant in Bhopal, India, shows continuing morbidity of a multisystemic nature in the exposed population. Scientific debates about the causes of the accident, the spectrum of health effects, and toxicology are presented with a view to understanding the toxic substances released in the gas cloud and their roles in the causation of health effects. Clinical dilemmas, medical management, and public health issues are also discussed.

Accidents, Occupational↗
PubMed2005

Some mathematical problems in the DNA identification of victims in the 2004 tsunami and similar mass fatalities.

DNA is a major and essential identification tool for mass fatality incidents including the hundreds of thousands of victims of the 2004 Indian Ocean tsunami. Mathematical complications characteristic of this sort of mass fatality include prevalence of related victims, the many races represented among the victims, and various identification modalities in tandem with DNA. Four mathematical problems of interest are discussed in this paper. (1) Other quantifiable factors (i.e. geography) can be formally accounted for by including a likelihood ratio that can be thought of as reducing the "effective number of victims." (2) When a victim is found and tentatively identified as V, but then it comes to light that the victim has a relative W who is also missing, confidence in the identity is depressed. To account for the existence of W, increment the effective number of victims by the likelihood ratio supporting W as the identity of the victim. (3) When several apparently related victims are found, their mutual identities should be calculated simultaneously. Compared to one-at-a-time, serial identifications, this is both logical and may lead to much more confidence in the identities. (4) Although there may be many different population groups represented among the missing, it is generally sufficient to consider population statistics for only a few of them in deciding whether to declare an identification.

DNA↗