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 1,117 records · Page 62Linked to original sources
PubMed2006

Psychiatric morbidity following motor vehicle crashes: a pilot study from India.

BACKGROUND: Motor vehicle crashes can result in significant posttraumatic psychiatric morbidity. While the psychological impact of major disasters has been extensively studied in developing nations, psychological distress resulting from personal disasters such as road traffic crashes is sadly lacking. METHOD: Thirty inpatients who had been involved in a motor vehicle crash, either as a driver, passenger, or pedestrian, were assessed for psychiatric morbidity using the Hospital Anxiety and Depression Scale and the Impact of Events Scale. We also studied the influence of various sociodemographic factors and peritraumatic emotional experiences on the development of psychological symptoms. RESULTS: Of the 30 patients, 57% had anxiety or depressive symptoms, 30% had an anxiety or depressive disorder, and 20% had posttraumatic stress disorder. It was also observed that peritraumatic emotions seemed to determine the type and severity of psychiatric symptoms that patients experienced. CONCLUSIONS: This study found that more than half of the victims of motor vehicle crashes in the sample suffered from some form of psychiatric morbidity. With rising industrialization and motorization in developing countries, the number of victims of motor vehicle crashes is bound to increase. Adequate attention to psychiatric interventions in the provision of emergency and trauma services could help prevent significant disability.

Accidents, Traffic↗
PubMedDate not supplied

[Priority trends in the sphere of eye injuries].

Comprehensive recent research of eye traumatism is described, aspects related with changes in the trauma structure are defined and advanced methods of diagnostics as well as of therapeutic and surgical treatment in eye trauma are elucidated in the paper. It is pointed out that the above study results are valuable for rehabilitation of victims during peacetime, in emergency situations and in calamities; the contribution of civil ophthalmologic institutions to rendering a specialized medical care to victims of military conflicts is equally important. The case study comprises extensive research findings that can be used in the below cases requiring a specialized medical care: penetrating eye injuries, contusion, burn injuries of the eye, splintered trauma etc.; the current micro-surgery standards must be adhered to and the latest technologies must be used. Finally, the important role of and valuable contributions to the above research made by the Calamity Medicine Center ("Zashchita") are underlined.

Disasters↗
PubMed2003

Vaccines and bioterrorism: smallpox and anthrax.

Because of the success of vaccination and the ring strategy in eradicating smallpox from the world, smallpox vaccine has not been recommended for the United States civilian populations for decades. Given the low but possible threat of bioterrorism, smallpox vaccination is now recommended for those teams investigating potential smallpox cases and for selected personnel of acute-care hospitals who would be needed to care for victims in the event of a terrorist attack. Treatment and post-exposure prophylaxis for anthrax are ciprofloxacin or doxycycline. Anthrax vaccine alone is not effective for post-exposure prevention of anthrax; vaccination is accompanied by 60 days of antibiotic therapy. In addition to military use, anthrax vaccine is recommended for pre-exposure use in those persons whose work involves repeated exposure to Bacillus anthracis spores.

Anthrax↗
PubMed1996

On-site triage of avalanche victims with asystole by the emergency doctor.

Asystole in avalanche victims is generally due to asphyxia and not primarily to hypothermia. Hence, on-site establishment of death by asphyxiation would avoid evacuation risks to the rescue party, as well as high costs of transport to, and treatment at, frequently distant specialist centres in cases with a hopeless prognosis. This paper presents a novel differential diagnosis scheme based on burial duration (critical time 45 min) and core temperature (critical level 32 degrees C) of the person on extrication, as well as the presence or absence of an air pocket, facilitating on-site identification of asphyxiated victims. When information regarding an air pocket is uncertain in victims buried longer than 45 min, determination of serum potassium (critical level 10 mmol/l) at the nearest hospital becomes an alternative criterion for triage. The proposed guidelines aim to clarify field decision-making for the emergency doctor with respect to discontinuation of resuscitation and limitation of transferral for cardiopulmonary bypass core rewarming to those patients with presumptive reversible hypothermia.

Air↗
PubMed1982

Role of radiology in the study and identification of casualty victims.

Radiology is assuming an increasingly important role in the investigation of casualty victims. Radiographic screening for foreign bodies, personal effects, dental and surgical artifacts and occult skeletal injury has long been an established technique in forensic medicine. Positive radiographic identification of the victims by comparison with antemortem films and records is a more recent, important development. Large scale radiographic investigations may require improvised facilities posing unaccustomed technical and logistical problems. Radiologic experience gained from aviation accident investigation is found to apply in other casualty situations as well as in individual fatality investigations. Radiologic data may aid determination of the cause of incidents, resulting in improved safety procedures and design, as well as serving humanitarian and forensic functions.

Accidents, Aviation↗
PubMed1995

Secondary exposure of medical staff to sarin vapor in the emergency room.

OBJECTIVE: To clarify the risk of secondary exposure of medical staff to sarin vapor in the emergency room, and to warn emergency room staffs of the hazard. DESIGN: Retrospective observational survey. SETTING: Emergency department of a university hospital in a metropolitan area of Japan. PARTICIPANTS: Fifteen doctors treating victims of a terrorist attack with sarin in the Tokyo subways on the day of the attack. MEASUREMENTS AND RESULTS: Of the 15 doctors who worked in the emergency room treating the victims, 13 became simultaneously aware of symptoms during the resuscitation of two victims who were exposed to sarin. Among 11 doctors (73%) who complained of dim vision, the pupils were severely miotic (<2 mm) in 8 (73%). Other symptoms included rhinorrhea in eight (53%), dyspnea or tightness of the chest in four (27%), and cough in two (13%). Atropine sulfate was given to six, and pralidoxime was given to one of these six doctors. To decontaminate the emergency room of sarin vapor, ventilation was facilitated and all belongings of the patients were sealed up. None of the doctors noticed worsening of their symptoms thereafter. CONCLUSIONS: Careful attention to the risks of secondary exposure to toxic gas in the emergency room and prompt decontamination if such exposure should occur are necessary in the case of large-scale disasters caused by sarin.

Adult↗
PubMed1995

Individual identification of flood victims by DNA polymorphisms and autopsy findings.

On September 23rd 1993 Genova was flooded by heavy rainstorms and 4 people disappeared, including an elderly couple. Four days later a partially skeletonized body was found floating near the coast. No visual identification was possible. Autopsy findings were consistent with the medical history of a possible victim. DNA was extracted from a muscle sample and compared to paraffin embedded prostatic gland fragment taken by surgery. A positive identification could be made. On October 11th the body of a decomposed and partially skeletonized female was found. The visual identification was also uncertain and no clinical records were available. A blood sample from the son was obtained for maternal identification by the polymerase chain reaction.

Aged↗
PubMed2001

[Drinking habits and characteristics of urban male residents with high alcohol intake--analysis of temporary housing residents after the Great Hanshin Earthquake].

In December 1996, a health survey was conducted of 49,033 temporary housing residents of Kobe City, who were victims of the Great Hanshin Earthquake on Tuesday, January 17, 1995. A total of 33,414 residents (68.1% of those requested) filled in self-administered questionnaires. This study focused on males over 20 years old and examined factors related to increase in alcohol intake. A total of 14,179 men were analyzed, 67.4% of whom reported habitual drinking, and 32.1% an increase in their alcohol intake. The factors related to elevated alcohol intake were a low Breslow's health practice index, a high nervous complaint score and a low living score. In addition, the health practice index demonstrated an inverse link. There are many drinkers among urban residents and drinking related problems are easily evoked when living conditions worsen, as in the case of a natural disaster. Logistic regression analyses were used to predict which persons are likely to increase their alcohol intake. Significant predictors identified were the smoking habit, sleep disturbance, nervous complaints and the health practice index. It is important to ensure that this latter remains high to prevent the alcohol-related problems in urban residents.

Adult↗
PubMedDate not supplied

Precision of in-hospital triage in mass-casualty incidents after terror attacks.

INTRODUCTION: Proper management of mass-casualty incidents (MCIs) relies on triage as a critical component of the disaster plan. OBJECTIVE: [corrected] The objective of this study was to assess the precision of triage in mass-casualty incidents. METHODS: The precision of decisions made by two experienced triage officers was examined in two large MCIs. These decisions were compared to the real severity of injury as defined by the Israeli Defence Forces (IDF) classification of severity of injuries and the Injury Severity Score (ISS). RESULTS: Two experienced trauma physicians triaged a total of 94 casualties into 77 mild, seven moderate, and 10 severe casualties. Based on the IDF criteria, there were 74 mild, five moderate, and 15 severe casualties. Based on ISS scoring, there were 78 mild (ISS <9), five moderate (9 < or = ISS < 16), and 11 severe (ISS <16) casualties. Of 15 severely injured victims defined by the IDF classification of injury severity, the triage officers identified only seven (47%). CONCLUSION: Primary triage, even when carried out by experienced trauma physicians, can be unreliable in a MCI.

Efficiency, Organizational↗
PubMed2003

[Mass casualties after an explosion].

Because of the intifada, the Israeli-Palestinian conflict has become characterized by violence against civilians on both sides. Since the early 1990s, this conflict has seen directed operations performed by suicide attackers, whose goal is to kill civilians who are not direct participants in the confrontation. For urban and local hospitals this means that they must always be aware of being confronted with limited multiple-casualty incidents. This has required a restructuring of emergency plans at the scene and in the hospital. At the scene the incident is classified according to the number and degree of injury of the victims. The accumulation of such incidents made it necessary in Israel to change views of the system of triage, which has essential differences from the central European system. Apart from changing preclinical and clinical management algorithms, the surgeons specialized in casualties must be prepared for a new quality of injuries. Barotrauma of the lung and multiple, seemingly superficial injuries often only emerge later as life-threatening and lead to the paralysis of intensive care and surgical capacity.

Blast Injuries↗
PubMedDate not supplied

Emergency medical services during the siege of Sarajevo, Bosnia and Herzegovina: a preliminary report.

BACKGROUND: The siege of Sarajevo is a long-term, human-made, medical disaster of international significance. The delivery of emergency health care provided to the large civilian population held captive in that war zone for an extended time was studied. METHODS: In May 1993, a humanitarian and fact-finding visit to Sarajevo was conducted. Physicians, administrators, and public health officials were interviewed; epidemiological data were acquired--the resuscitation of war casualties at the two largest hospitals were observed; and local published reports and videotaped footage on the organization and delivery of prehospital and hospital care were reviewed. The videotapes also served to document war crimes. RESULTS: Daily bombardment and sniper fire directed at civilians have caused a steady stream of casualties (64,130, or an average of 119 killed or injured per day in 18 months). Eighty percent of the victims were civilian. Despite hazardous conditions from direct shelling, disruption of vital lifelines, and shortage of supplies, medicines, oxygen, and anesthetics, the physicians continue to provide at least a minimum standard of resuscitative care. Seventy percent of all war victims were transported to hospitals in private vehicles. Most casualties (93%) received some form of prehospital, basic first-aid from lay bystanders or first responders. From November 1992 to February 1993, 27,733 patients were treated in hospitals, resulting in 2,139 major surgical procedures. The primary cause of death in 71 of 273 victims was prolonged hemorrhagic, hypovolemic shock. Sixty-one percent of these victims died within 24 hours of injury. CONCLUSIONS: Continuous needs assessment of a civilian population in a war zone should be accompanied by rapid delivery of outside aid. International "peacekeeping" forces should protect hospitals and their staffs, and ensure the entry of supplies and evacuation of some patients. A public trained in life-supporting first-aid, and physicians and paramedics with experience in advanced life support may have enhanced lifesaving efforts in Sarajevo.

Adolescent↗
PubMed1984

Medical resources after nuclear war. Availability v need.

In defining capacity to "survive" a massive nuclear exchange, it is important to assess the medical resources that will be available in the post-nuclear war world. Approximately 80% of these resources--hospital beds and personnel, blood, drugs, and medical supplies--will have been destroyed, since they are located in or near the densely populated areas that constitute primary targets of attack. Casualty estimates published by federal agencies, together with data from the Hiroshima-Nagasaki experience, suggest the numbers and types of injuries that will afflict the US population. With a probable 48,000 surviving physicians to treat 32 million casualties, there will be one physician for every 663 patients. Of the trauma and burn victims, approximately 55% will require hospitalization; this will mean 64 patients for each available hospital bed. Data from recent wars have been utilized to determine the trauma-related blood requirements in the post-nuclear war world. Of the 64 million units of whole blood needed, only 14,000 will be available. Other medical resources will be in equally short supply. This disparity between need and availability indicates the difficulty of developing a meaningful medical response for the surviving injured.

Blood Transfusion↗
PubMed2001

[Risk of accidents for a Parisian pedestrian].

The risk of accident for a parisian pedestrian is of reduced frequency and of moderate severity (terrorism and natural disasters not included) according to the statistics of 1999. This is due to security measures and the excellent organisation of assistance to wounded persons. The improvement in protection of pedestrians, even the disabled and elderly persons will soon make Paris the best protected megalopolis of our continent. Pedestrians are involved in 28% of accidents on public streets with a mortality of 1.2%, with serious injuries in 12.6% of the cases. Injuries without collision occur in 57% of the cases. 18% of the wounded older than 75 years with 1.8% of deaths and 66% of severe injury. Accidents related to public transportation represent a very slight risk of 0.00044%. By modification of the concept of transportation and its materials over a five year period there is a decrease in the number of the victims (-3.75%), in spite of the increase of accidents (3.5%). For lone pedestrian being victims of aggression in public places, after a decrease of 10% in 1999, there is in 2001 an increase which raises the question of police proximity again. Over a five year period the RATP (subway authority) has noticed a 14.77% decrease of thefts and a 54.78% decrease in attacks... This makes the Parisian railnet (subway mostly) seven times less dangerous than the streets.

Accidents, Traffic↗
PubMed1995

Crush injury in pregnancy: an unusual experience in obstetrics.

BACKGROUND: Crush injury is the result of prolonged pressure to the limbs when individuals are trapped under the debris of earthquakes, bombings, and other disasters. Muscle integrity is compromised, and the local and systemic manifestations, including rhabdomyolysis, hyperkalemia, renal failure, and disseminated intravascular coagulation may be fatal. CASE: A 32-year-old woman, gravida 2, para 1, was trapped under fallen masonry at 6 weeks' gestation for approximately 6 hours. On initial examination, she showed early signs of hypovolemic shock and crush injury, including hyperkalemia. Prompt management with fluid therapy and careful monitoring led to a rapid recovery. Antenatal follow-up was routine and concluded in spontaneous delivery of a healthy infant. CONCLUSION: The unique physiology of the pregnant woman may affect the outcome of crush injury, and it presents a particular challenge to the trauma team. The obstetrician should be aware of its dangers and should be an active participant in the prompt management of pregnant victims of crush injury to ensure a satisfactory outcome for both mother and fetus.

Adult↗
PubMed1997

A research note about military-civilian humanitarianism: more questions than answers.

'Military-civilian humanitarianism'--or the coming together of military forces and civilian aid agencies to deal with the human suffering from complex emergencies--has numerous forms, but disenchantment has resulted from the Somalia and Bosnia syndromes. There is little political will at present, but evidence from the immediate post-Cold War era suggests how multilateral military operations could expand or contract in future to the benefit or peril of war victims. Partly a literature review but more importantly a framework for interpreting recent publications, this essay seeks to move beyond exchanging assertions. There is a contextualisation of recent literature; a definition of military-civilian humanitarianism; a discussion of possible military contributions to humanitarian action; a framework to assess the effectiveness of military-civilian humanitarianism; and a preliminary analysis of experience from northern Iraq, Somalia, Bosnia, Rwanda and Haiti. Caveat lector: At this point in time, there are still 'more questions than answers'.

Altruism↗
PubMed1991

Roles of a helicopter emergency medical service in mass casualty incidents.

The Connecticut helicopter emergency medical service (HEMS) has responded to 12 mass casualty incidents (MCI) in two years. Eight were drills and four were actual events. An MCI response plan was instituted prior to the onset of the HEMS program. All MCIs were reviewed to determine actual victims, knowledge of MCI prior to lift-off, and roles of the HEMS. The actual roles were compared with the pre-established roles. The four actual MCIs (building explosion, hotel fire, bus rollover and plane crash) were reviewed. Sixty-seven victims were involved. Prenotification occurred in one MCI. The roles of the HEMS in each MCI were: triage (n = 4), medical treatment (n = 4), transport (n = 3), augmented response (n = 1), and air surveillance (n = 0). The roles of HEMS response to MCI should be well-defined prior to an event. Air medical benefits include response within a large geographic area, highest level of prehospital medical care, identification of trauma receiving hospitals, and facilitation of transport.

Aircraft↗
PubMed2005

[Nerve gas--guidelines for care of victims of terrorism].

The threat from chemical warfare agents such as nerve agents against civilians has traditionally been considered irrelevant. Following the recent terrorist attacks in the US on 11 September 2001 and in Madrid, Spain on 11 March 2004, the threat from such weapons is taken seriously. Hospitals must therefore be prepared to take care of civilian victims. Emergency preparedness implies education and training of healthcare professionals, stocking of antidotes, and training of personnel. This involves decontamination of patients, establishment of routines to avoid contamination of hospitals, and the ability to determine if patients and first responders are contaminated with chemicals and to avoid such contamination. Treatment against nerve agents includes atropine, acetylcholinesterase reactivators (obidoxime or pralidoxime) and benzodiazepines (diazepam). Because these drugs are not sufficiently effective in protecting the brain, new and more effective countermeasures must be developed.

Antidotes↗
PubMed1989

Autopsy statistics on the relative frequency of acute myocardial infarction in the Japanese mental workers and the unemployed during the two oil-crises periods.

In order to investigate whether job induced emotional stress, arising from socioenvironmental disasters would act as a trigger for the onset of AMI, the author reviewed all pathological autopsies throughout Japan 15 years old and over. Data was obtained from publications of the "Annual of the Pathological Autopsy Cases in Japan" for the years 1966-1968 (a period of high economic growth), 1973-1975 (1974, the year of the first oil crisis), and 1978-1980 (1979, the year of the second oil crisis). Relative frequencies of AMI were significantly higher during the years of both oil crises than in both the preceding and following years (2.6% in 1973, 3.7% in 1974, 3.0% in 1975; 2.8% in 1978, 3.2% in 1979, and 2.0% in 1980), and in each of three years of the high economic growth period (1.9-2.2% in 1966-1968). The proportions of managers and officials among AMI victims were significantly higher in the years of both oil crises than in both the preceding and following years (13.4% in 1973, 17.5% in 1974, 12.5% in 1975; 11.6% in 1978, 15.8% in 1979, and 11.1% in 1980). Moreover, there was a significantly higher value in the year of first oil crisis than in each of three years of the high economic growth period (11.7-13.1% in 1966-1968). The proportions of "out of job" persons were also significantly higher in the years of both oil crises than in the preceding years (24.0% in 1973, 29.3% in 1974, 27.8% in 1975; 24.1% in 1978, 29.1% in 1979, and 27.4% in 1980). For 11,199 randomly selected autopsies, the proportions of AMI in the above two occupational groups were significantly higher in the years of both oil crises than in the preceding years. Moreover, the proportion of "out of job" persons was significantly higher in the year of first oil crisis than in each of three years of the high economic growth period. A similar trend was noted among professional and technical workers, with more AMI occurring in this group during the years of both oil crises than in both the preceding and following years but without statistically significant difference.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗