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"Surge" hospitals, which can handle an influx of patients during a large-scale disaster, are being considered by some who think the healthcare industry's plans for such catastrophes need work, says Jim Bentley, left, senior vice president for strategic policy planning of the American Hospital Association.
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The problems and errors in personal identifications in rescue work after accidents with a large number of human victims are considered. The order of actions of forensic medical experts in personal identification in emergency situation is proposed.
On August 24, 2005, Tropical Depression 12 became Tropical Storm Katrina, the 11th named storm of the 2005 Atlantic hurricane season. Late on August 25, Katrina made initial landfall in south Florida as a category 1 hurricane on the Saffir-Simpson Hurricane Scale. Katrina strengthened rapidly upon reaching the Gulf of Mexico, attaining category 5 intensity. On August 29, Hurricane Katrina struck the Gulf Coast near the Louisiana-Mississippi border as a category 3 hurricane. The effect of earlier category 5 wind speeds on Gulf waters and the massive size of the storm combined to create devastating storm-surge conditions for coastal Mississippi, Louisiana, and Alabama and damage as far east as the Florida panhandle. Storm-induced breeches in the New Orleans levee system resulted in the catastrophic flooding of approximately 80% of that city. Hurricane Katrina was the deadliest hurricane to strike the United States since 1928. Preliminary mortality reports indicate approximately 1,000 Katrina-related deaths in Louisiana, 200 in Mississippi, and 20 in Florida, Alabama, and Georgia.
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This presidential inaugural address was delivered during the installation ceremony at NMA's 107th convention and scientific assembly in Dallas, TX, by NMA President Albert W. Morris Jr., MD, August 8, 2006.
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One approach to reducing avoidable mortality from coronary artery disease is to provide resuscitation capability in the community. In Manitoba this is the function of the Heart-Alert program, sponsored by the Manitoba Heart Foundation. The program is based on public and professional education dealing with the recognition and immediate care of cardiac emergencies, including cardiopulmonary resuscitation (CPR). The three components to the program are (a) training in basic CPR for all health care and community rescue groups; (b) training in definitive CPR for physicians, critical care nurses and advanced emergency medical technicians; and (c) education of the public to recognize the signs of impending or actual cardiac emergencies and to take appropriate action to summon quickly an emergency rescue team.The initial emphasis of the program has been on developing an organizational structure and a training network for basic CPR. A corps of instructor-trainers and instructors has been certified to implement CPR training in the medical and community target groups. Developmental problems include problems of quality control, of providing for self-sustaining and continued expansion, and of evaluation of the overall results.It is suggested that widespread implementation of CPR training is facilitated by the incorporation of CPR into existing training activities, particularly those of the medical, nursing and other health care disciplines, those of community protection agencies such as police, fire and ambulance departments, and those of volunteer groups concerned with rescue work and first-aid. If the impetus, organizational structure and instructor training are provided by a strategic agency, wide dissemination of CPR training is then possible at relatively modest cost.
Safety at a disaster scene is a subject rarely considered by medical personnel when preparing for rescue work. As no one can predict accurately the nature of the hazards rescuers may have to face, a common attitude is to ignore the subject and trust to common sense and good judgment to cope with the situation when it arises.
To obtain an objective judgement on the efficiency of emergency help, 106 emergency patients who died during a six month period were subjected to an examination in which all aspects of their treatment, beginning at the scene of the emergency and lasting until their death were documented. It could be shown that 8.5% of the examined patients would have had a chance for survival if proper and optimal treatment had been given, despite the effects of their injuries. Only by improving knowledge of first-aid procedures can an increase in the efficiency of emergency measures be attained as will be proven in this paper. Intensive schooling is necessary not only for the layman and ambulance orderlies but for doctors who are to be employed in rescue work in particular. The present criteria (one-year clinical activity and competency are by no means sufficient as a foundation.
The main task of regional catastrophe medicine service in liquidation of medical consequences of emergency situations is the immediate adequate reaction which is aimed at minimizing the sanitary loss. This task can be effectively solved only on condition of permanent improvement of interaction between the managing and managed systems of public health and coordination of their actions with those of nonmedical services. An important role is played by the actualized (constantly renewed) data bases "Potentially Hazardous Objects", "Regional Infrastructure", "Medicosanitary Means", etc., which help simulate various emergency situations with due consideration for the season, time of the day, and socioeconomic features of a region in order to create variants of effective work of all services engaged in the liquidation of medical consequences.