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PubMed1996

Chronic emotional processing in survivors of the Herald of Free Enterprise disaster: the relationship of intrusion and avoidance at 3 years to distress at 5 years.

Thirty-seven survivors completed the Impact of Event Scale (IES), a measure of intrusive and avoidant activity, at around 3 yr following the Herald of Free Enterprise disaster. The aim of the present study was to examine the relationship between scores on the IES to scores on the Beck Depression Inventory (BDI) and the Spielberger State Anxiety Inventory (STAI-Y1) at around 5 yr subsequent to the event. Higher scores on the IES were able to predict higher scores on the BDI and the STAI-Y1 over and above scores on the 28-item General Health Questionnaire (GHQ-28) which was also administered at around 3 yr on from the event. Implications for cognitive-behaviour therapy are discussed.

Adult↗
PubMed1983

The definition and classification of disasters.

The universe, we are told, began with a big bang, and ever since, nature has provided a series of unexpected bangs and calamities of one type or another. Since the advent of the industrial revolution, man has been more or less controlling larger and larger amounts of energy. World population has rocketed. The interaction of crowded humanity and escalating energy has added a series of man-made disasters to the continuing natural calamities.

Classification↗
PubMed1988

An analysis of civil aircrash statistics 1977-86 for the purposes of planning disaster exercises.

Details of 473 aircrashes throughout the world for the period 1977-1986 were obtained from the Civil Aviation Authority. 114 occurred on or near and 359 away from airfields. In 188 there were survivors and in 285 none. On or near airfields it was more common to have survivors, and away from airfields more common to have none, yet crashes with survivors were more common away from airfields. In ten years there were only 3 crashes with more than 50 seriously injured live casualties. Acted out disaster exercises with mock casualties should not have more than 50 injured casualties, of whom not more than 20 should have serious injuries (i.e. need admission to hospital). The problems of crashes with much larger casualty figures should be worked through in table-top exercises.

Accidents, Aviation↗
PubMed1990

Acute haemodialysis during the Armenian earthquake disaster.

On the 7 December 1988 an earthquake struck a densely populated region in northern Armenia. Up to 50,000 people were killed and many thousands were seriously injured. At least 385 of these casualties developed acute renal failure secondary to crush syndrome and required dialysis. The Armenian renal unit at Yerevan, in common with units elsewhere, was already overstretched to cope with the dialysis requirements of their patients with chronic renal failure before the earthquake. Most of the patients requiring dialysis were transferred to other hospitals in the USSR but 120 patients remained in Yerevan, the majority at the regional renal unit, overwhelming the resources. We assisted by taking a team of dialysis personnel, equipped with portable haemodialysis machines, to Yerevan. We performed 57 haemodialysis sessions and treated 15 patients, 13 of whom ultimately survived. Valuable lessons were learnt about the medical management of disasters abroad.

Acute Kidney Injury↗
PubMed1991

Initial management of open fractures sustained in the M1 aircraft disaster. Nottingham, Leicester, Derby and Belfast (NLDB) Study Group.

There were 83 survivors of the M1 aircrash admitted to hospital; of these, 28 patients sustained a total of 40 open fractures. These open fractures were classified as 19 grade 3, 16 grade 2 and five grade 1. There were six upper limb fractures and 34 lower limb fractures. A high proportion of grade 3 open fractures were identified in this series (47 per cent) and one-half of these occurred at or below the ankle. This reflected the high energy and direction of the forces involved in the aircrash. The early results in terms of the incidence of wound infection (15 per cent), delayed wound healing (7.5 per cent) and skin flap necrosis (7.5 per cent) were similar to other series. The controversy over whether to leave grade 3 wounds open or closed was not clarified by this study, but the closure of grade 3 wounds after internal fixation is to be avoided. This study emphasizes the need for provision of adequate specialist manpower, equipment and resources to manage the unexpected major disaster successfully.

Accidents, Aviation↗
PubMed1994

The scud missile disaster in Al-Khobar, Saudi Arabia, 1991: the orthopaedic experience.

The orthopaedic experience of the scud missile disaster in Al-Khobar, Saudi Arabia during the Gulf war is reviewed. This was by far the most severe of 70 scud attacks. The majority of casualties had 'orthopaedic' injuries, fractures and soft tissue lacerations of the extremities and the back. Our experience confirmed the importance of the principles of planning triage beforehand and open wound treatment with secondary suture. Repeated ward rounds with reassessment of the patients proved beneficial. The ready availability of hospital beds in high-risk situations of regional war highly facilitated the management of mass casualties.

Adult↗
PubMed1993

Burn victims after a major disaster: reactions of patients and their care-givers.

There have been considerable advances in the physical management of burns, and there is a greater awareness of their psychological impact. However, much less attention has been given to the staff who have to deal with burn victims. Disasters are critical incidents which offer a magnified opportunity to appreciate with what care-givers have to cope and how they do so. This paper identifies how complex are the psychological and emotional reactions associated with burn care, and it advocates that more should be done, by means of debriefing, to cater for the needs of staff after critical incidents.

Accidents, Occupational↗
PubMed1994

Pediatric problems in upper Silesia--region of ecological disaster.

Increasing rates of infant mortality and child diseases in the Upper Silesian Industry Region are indices of the declared ecological disaster. The concentrations of 11 ecotoxins established in air and soil is related to the infant mortality rate, according to the degree of pollution. The percentage of infants with birthweight below 2500 g is the highest in the most polluted towns, such as Chorzów, Zabrze, Bytom. The dominating causes of infant mortality in Zabrze were infections and congenital anomalies among babies born with significantly lower birthweight. The parents of dead children have been resident for at least 15 years. In Katowice district (south-western area of Poland) there is an increasing frequency of chronic respiratory, cardiovascular, oncological and allergic diseases among children.

Abnormalities, Drug-Induced↗
PubMed1994

Experience with the cytological demonstration of smoker cells in the identification of disaster victims illustrated by the findings concerning the Lauda-Air airliner crash near Bangkok.

On 26 May 1991, a Lauda-Air airliner crashed after take-off at Bangkok from an initial height of approximately 8000 m. The plane came down in inaccessible jungle terrain, so that the difficulties of locating and salvaging the victims were considerably increased by the tropical conditions and the looting that had occurred. Identification of the victims took place in extremely adverse working conditions in the pathological department of the Police Hospital in Bangkok. The technique developed by the first author for the identification of persons in the light of their smoking habits by determining the existence of the so-called smoker cells was used to subdivide the entire autopsy material into 'smokers', 'non-smokers' and 'incidental or passive smokers'. This allows the division of mass disaster victims into smaller specific groups and the application of further identification procedures within these groups in a shorter time. The findings of the cytological examination carried out locally were compared with the police investigations regarding the individual victim's smoking habits, and the method quick and simple to use even in 'field conditions', proved highly efficaceous.

Accidents, Aviation↗
PubMed2006

A regional medical operations center improves disaster response and inter-hospital trauma transfers.

BACKGROUND: Delays in both inter-hospital trauma transfers and disaster response are common. We hypothesized patient flow could be improved by formal adoption of systems that improve cooperation and communication. METHODS: The regional trauma database of the Southwest Texas Regional Advisory Council for Trauma and the Regional Medical Operations Center (RMOC) database were queried to test the hypothesis. RESULTS: A total of 9507 trauma patients were transferred. Medcom resulted in decreased transfer process times. The RMOC was activated during Hurricanes Katrina and Rita. During two 24-hour periods, the RMOC coordinated the inter-hospital transfer of 781 patients and the movement of thousands of evacuees and special needs patients. CONCLUSIONS: Medcom, an organized system combining a communications center with formal trauma center cooperation, improves patient flow and reduces trauma transfer times. The RMOC, based on the same principles of cooperation and communication, allows for rapid transfer of hospitalized and special needs patients during disaster/mass casualty situations.

Databases as Topic↗
PubMed2006

Computer-simulated assessment of methods of transporting severely injured individuals in disaster--case study of an airport accident.

A system utilizing computer simulations was developed in order to compare (1) situations wherein critically wounded individuals are, at first, ranked and classified into subgroups based on criticalness of the wounds, and then be evaluated and re-ordered within the subgroups before transported to hospitals, with (2) those situations in which the conventional method of transport was employed. The objective of the study is to infer whether there is a further possibility for enhancing the possibility of the wounded individual's survival rate at the time of arrival at the hospital. The variables that are required to be entered include the number of patient subgroups, the number of patients in each of the subgroups, the total number of patients to be transported, the time required to assess the severity of each patient, the speed of the ambulance, the interval between the ambulances' arrivals and departures, and the distance between the site at which the transportation begins and the destination or the hospital. Utilizing the same system, a virtual simulation of a large-scale disaster at airport was used as sample data. As a result, it was confirmed that the survival rate would improve under certain conditions, if the values for some of the variables, such as geographic conditions, were altered and then calculated.

Accidents↗
PubMedDate not supplied

Integrating disaster preparedness into a community health nursing course: one school's experience.

It is not practical to wait for a disaster, whether natural or human-made, to learn how to respond and provide specialized care. The Long Island University School of Nursing in Brooklyn, New York, has developed a specific educational experience for undergraduate nursing students enrolled in community health. The course is offered in the senior semester and includes didactic material based on the International Nursing Coalition for Mass Casualty Education-recommended competencies. Students are given the opportunity to apply the learning and develop additional skills by participating in a mock drill. Although anecdotal comments from the students indicate that the coursework has been helpful, additional research is planned to evaluate the program.

Attitude of Health Personnel↗
PubMed2005

Impact of a flood disaster on sediment toxicity in a major river system--the Elbe flood 2002 as a case study.

The ecotoxicological implications of a flooding disaster were investigated with the exceptional Elbe flood in August 2002 as an example. Sediment samples were taken shortly after the flood at 37 sites. For toxicity assessment the midge Chironomus riparius (Insecta) and the mudsnail Potamopyrgus antipodarum (Gastropoda) were exposed to the sediment samples for 28 days. For a subset of 19 sampling sites, the contamination level and the biological response of both species were also recorded before the flood in 2000. The direct comparison of biological responses at identical sites revealed significant differences for samples taken before and immediately after the flood. After flood sediments of the river Elbe caused both higher emergence rates in the midge and higher numbers of embryos in the mudsnail. Contrary to expectations the toxicity of the sediments decreased after the flood, probably because of a dilution of toxic substances along the river Elbe and a reduction in bioavailability of pollutants as a result of increasing TOC values after the flood.

Disasters↗
PubMed2005

Implantation of radio frequency identification device (RFID) microchip in disaster victim identification (DVI).

The tsunami catastrophe of December 2004 left more than 200,000 dead. Disaster victim identification (DVI) teams were presented with the unprecedented challenge of identifying thousands of mostly markedly putrefied and partially skeletised bodies. To this end, an adequate body tagging method is essential. Conventional body bag tagging in terms of writing on body bags and placing of tags inside body bags proved unsatisfactory and problem prone due to consequences of cold storage, formalin (formaldehyde) embalming and body numbers inside storage facilities. The placement of radio frequency identification device (RFID) microchips inside victim bodies provided a practical solution to problems of body tagging and attribution in the DVI setting encountered by the Austrian DVI team in Thailand in early 2005.

Austria↗
PubMed2006

Swiss DVI at the tsunami disaster: expect the unexpected.

The conclusions reached while considering various aspects of the implemented strategy in the identification procedures in the wake of the tsunami disaster of December 26, 2004 are outlined. The lessons to be learned are discussed.

Disasters↗
PubMed2006

A failure of resilience: estimating response of New York City's public health ecosystem to sudden disaster.

Adapting methodology from resilience theory in ecology, we develop an empirical model of the response of the New York City public health ecosystem to sudden disaster. Contrary to cultural expectation, 'good' and 'bad' neighborhoods-starkly differentiated by public health status reflecting longstanding economic and racial segregation-respond similarly to challenge. This suggests that the difference in health between neighborhoods is primarily predicated on the extent to which they have been, and continue to be, exposed to differing patterns of stressors and affordances, rather than to any difference in underlying socio-economic vulnerability. Paradoxically, then, these urban neighborhoods constitute a single, highly interdependent, health ecosystem, despite substantial socioeconomic and racial segregation.

Disasters↗
PubMed2006

Supporting disaster healthcare professionals: a practical and virtual approach.

In this paper, we report on a questionnaire undertaken to evaluate an innovative programme of education for healthcare professionals in the field of aid and disaster healthcare that has been delivered by a partnership of three Higher Education Institutions (HEIs) across Europe since 1999. The development of this programme was a direct response to the stated needs of Non Government Organisations (NGOs) and military healthcare professionals as well as those aspiring to enter this complex area of healthcare. The aim of the project was to evaluate whether the programme was meeting the needs of students and to elicit what improvements could be made to the programme in order to enhance the learning experience. A questionnaire was developed to gather data across seven areas. It was subsequently analysed using the report and statistics features available within WebCT's Quiz/Questionnaire tool, in addition to the spreadsheet software MS Excel. The results of the questionnaire confirm that the programme, while successful in many ways, needs to be modified on a regular basis to reflect relevant worldwide changes and would benefit greatly from increased interaction between faculty and students.

Adult↗
PubMed2004

Psychopharmacological possibilities in the acute disaster setting.

This article focuses on possible psychopharmacological interventions in the immediate post disaster setting. As there is little evidence for the efficacy or effectiveness of such interventions-given the difficulty in performing randomized, double-blind, placebo controlled studies with these populations-the article will delineate the neurobiological basis for pathological sequelae and theoretical drug interventions targeting putative disease mechanisms.

Acute Disease↗