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Disaster victim identification of military aircrew, 1945-2002.

BACKGROUND: Aviation accident fatalities are characterized by substantial tissue disruption and fragmentation, limiting the usefulness of traditional identification methods. This study examines the success of disaster victim identification (DVI) in military aviation accident fatalities in the Australian Defense Force (ADF). METHODS: Accident reports and autopsy records of aircrew fatalities during the period 1945-2002 were examined to identify difficulties experienced during the DVI process or injuries that would prevent identification of remains using non-DNA methods. RESULTS: The ADF had 301 aircraft fatalities sustained in 144 accidents during the period 1945-2002. The autopsy reports for 117 fatalities were reviewed (covering 73.7% of aircrew fatalities from 1960-2002). Of the 117 victims, 38 (32.4%) sustained injuries which were severe enough to prevent identification by traditional (non-DNA) comparative scientific DVI techniques of fingerprint and dental analysis. CONCLUSIONS: Many of the ADF fatalities who could not be positively identified in the past could be identified today through the use of DNA techniques. Successful DNA identification, however, depends on having a reference DNA profile. This paper recommends the establishment of a DNA repository to store reference blood samples to facilitate the identification of ADF aircrew remains without causing additional distress to family members.

Accidents, Aviation↗

[A data bank for the "Disaster Medicine" automated information retrieval system].

The article substantiate the necessity to improve the automatization of the information process in the system of medical support in extreme situations and thus to liquidate the disproportion between the medico-diagnostical and information accumulation storage facilities. These facts clearly define the importance of work which is being carried out by Medical Service towards an elaboration of the "Disaster Medicine" automated information retrieval system (AIRS). The data obtained as a result of AIRS processing could be directly used for reference or prediction purposes.

Databases, Factual↗

[Disasters in former East Germany--experiences and problems of the Leipzig "Identification" Task Group].

Mass-disasters with high numbers of victims are a real challenge to the specialists. The role of forensic experts is generally emphasized. The missions of the Leipzig Taskgroup for identification and the experience gained during them confirm, that special training necessary staff members is. Compared with the general signs of identity, like clothing, jewelry and accessories, scars etc., the marks of ears and observations of forensic odonto-stomatology provide good chances for identification. For forensic odonto-stomatology, we developed computer programs.

Accidents, Aviation↗

Inpatient triage for out-of-hospital disasters.

Due to Operation Desert Storm, St. Francis Medical Center established an inhouse triage system to make bed space rapidly available during out-of-hospital disasters. The authors discuss the use of physician bed monitors and discharge criteria and suggest the importance of hospital readiness.

Disaster Planning↗

Radiation disaster response: preparation and simulation experience at an academic medical center.

OBJECTIVES: A mass casualty disaster drill involving the simulated explosion of a radiation dispersal device (dirty bomb) was performed with the participation of multiple hospitals, emergency responders, and governmental agencies. The exercise was designed to stress trauma service capacities, communications, safety, and logistic functions. We report our experience and critique of the planning, training, and execution of the exercise, with special attention to the integrated response of the Departments of Nuclear Medicine, Health Physics, and Emergency Medicine. METHODS: The Health Physics Department presented multiple training sessions to the Emergency Medicine Department, Operating Room, and ancillary staff; reviewing basics of radiation biology and risk, protection standards, and detection of radiocontamination. Competency-based simulations using Geiger-Müller detectors and sealed sources were performed. Two nuclear medicine technologists played an important role in radiation discrimination-that is, assessment of radioactive contamination with survey meters and radionuclide identification based on gamma-spectroscopy of wipe smears from patients' clothing, skin, and orifices. Three Health Physics personnel and one senior Nuclear Medicine staff member were designated the radiation control officers for assigned teams triaging or treating patients. Patients were triaged and, when indicated, decontaminated. RESULTS: Within a 2-h period, 21 simulated victims arrived at our institution's Emergency Room. Of these, 11 were randomized as noncontaminated, with 10 as contaminated. Decontamination procedures were implemented in a hazardous materials (HAZMAT) decontamination trailer and, for the 5 patients with simulated serious injuries, in a designated trauma room. A full debriefing took place at the conclusion of the exercise. Staff largely complied with appropriate radiation protection protocols, although decontamination areas were not effectively controlled. The encountered limitations included significant lapses in communications and logistics, lack of coordination in the flow of patients through the HAZMAT trailer, insufficient staff to treat acute patients in a radiation control area, additional personnel needed for transport, and insufficient radiation safety personnel to control each decontamination room. CONCLUSION: Nuclear Medicine personnel are particularly well qualified to assist Health Physics and Emergency Medicine personnel in the preparation for, and management of, mass casualty radiation emergencies. Simulation exercises, though resource intensive, are essential to an institution's determination of response capability, performance, and coordination with outside agencies.

Academic Medical Centers↗

[Laboratory medicine in the field of emergency medicine and disaster medicine--Old-And-New tools of emergency medical service].

We reviewed the characteristics of the field of laboratory medicine concerning emergency medicine and disaster medicine. Gram's stain was apt to be made light of by clinicians, but it has been reviewed again. A modern sophisticated analysis system is expected for the consequence management of NBC terrorism and mass poisoning, but we would like to emphasize the importance of the basic physical strength of laboratory medicine, such as Gram's stain, to the meaning of old-and-new technology.

Clinical Laboratory Techniques↗

Tornado disaster--Kansas, 1991.

On April 26, 1991, 54 tornadoes swept across six midwestern states, causing 24 deaths and more than 200 injuries, requiring disaster-relief services for more than 8000 persons, and causing property damage of more than $250 million. In Kansas, one tornado, with wind speeds exceeding 260 mph, caused 17 deaths. The 46-mile path of the tornado led through Andover, Kansas (Butler County) (population: 4300), where the town's only outdoor warning siren failed. A mobile-home park (MHP) in Andover with 244 homes and one community storm shelter was struck by the tornado, resulting in the destruction of 205 (84%) of these homes. This report summarizes a poststorm survey, conducted by local health departments, the Kansas Department of Health and Environment, the American Red Cross, and CDC, to identify risk factors for injury and death among persons in the MHP.

Adult↗

Mini-marathon groups: psychological "first aid" following disasters.

Large group counseling sessions for soldiers following battle have been commonly used since World War II. The author conceptualizes and demonstrates how these mini-marathon sessions can be adapted to support all ages and types of civilians involved in disasters. Mini-marathons take about 3 hours and are divided into three sections: story sharing, symptom sharing, and suggestions for self-help, including sharing tales of heroism and survival. After an initial mini-marathon session, a second session may be held emphasizing creativity. The author also describes how mini-marathons can be adapted for therapists who will lead their own sessions.

Adaptation, Psychological↗

[Snow disaster in Aletai Region--its remote sensing monitoring model and evaluation method].

In this paper, a monitoring model of snow depth was built based on the 4 scenes of NOAA satellite digital images under sunshiny condition and the corresponding ground observation data from 20 meteorological stations during 2 snow disasters from 1996 to 1997 in North Xinjiang. The pixel-based snow coverage rate and snow spatial classification were studied by using linear mixture spectrum disassembling method, and two grid data layers based quantified indices used for estimating snow hazard grade of grassland and animal husbandry were put forward. The results indicated that by using the snow monitoring model and linear mixture spectrum disassembling method, the image cell based snow depth and snow coverage rate could be calculated, and the precision of snow classification could be improved. The image cell based snow hazard index could systematically express the spatial distribution of snow, grass, animal and climate conditions, and reflect the snow hazard grade of grassland and animal husbandry.

China↗

Health concerns associated with disaster victim identification after a tsunami--Thailand, December 26, 2004-March 31, 2005.

The number of persons confirmed dead from the Indian Ocean tsunami that struck on December 26, 2004, had exceeded 174,000 as of March 31, 2005; the majority of decedents were buried or cremated without being identified. In contrast, in Thailand, disaster victim identification (DVI) continues, with approximately 1,800 persons identified among the 5,395 persons confirmed dead; of the dead, approximately 50% were not citizens of Thailand. This large-scale, multinational effort faced immediate challenges, including establishment of four temporary morgues, implementation of safeguards against environmental and occupational health hazards, and coordination of forensic procedures and safety protocols among Thai and international forensic teams. Public health and other agencies performing large-scale DVI in temporary morgues might consider implementing the recommendations and procedures described in this report.

Disasters↗

Psychiatric disorders among emotionally distressed disaster victims attending primary mental health clinics in Ecuador.

Previous studies in developing countries have demonstrated post-disaster stress disorders in a substantial share of the people living through a natural calamity, but questions have remained as to the severity of these mental health problems. This article reports information derived from a 1987 study of Ecuadorian earthquake victims that shows many of the victims had diagnosable psychiatric disorders and provides insight into the nature of those disorders.

Adult↗

Disaster relief and initial response to the earthquake and tsunami in Meulaboh, Indonesia.

The Singapore Humanitarian Assistance Support Group deployed a team of 32 medical relief workers to Meulaboh, Indonesia to provide medical assistance for victims of the 26 December earthquake and tsunami disaster. The team was deployed at a primary healthcare clinic at an internally displaced persons' (IDP) camp and at the sole hospital's emergency and surgical departments. The team saw a total of 1841 patients, 1371 at the clinic and 446 at the hospital's emergency department, and performed surgery on 24 patients. Tsunami-related trauma cases accounted for 31.8% (142) of cases at the emergency department, 1.6% (22) of cases at the clinic, and 91.7% (22) of surgeries. This paper details the difficulties and lessons learnt by the team, including the lack of important resources for healthcare delivery. Water, sanitation, hygiene, and vector control were some of the problems faced, with the goal to provide the most effective public health for the greatest number of people given the limited resources available.

Disasters↗

Atypical patient profiles common after disasters.

Follow the "surge, sort, support" triage model to ensure a higher quality of care for victims of communitywide disasters. Alert your staff that up to 80% of your patients will be self-referred. A large number of patients will have unexplained physical symptoms. Have a separate space available to function as a support center.

Disasters↗

[Psychiatric disorders among victims of disasters in Ecuador].

Previous studies in developing countries have demonstrated post-disaster stress disorders in a substantial share of the people living through a natural calamity, but questions have remained as to the severity of these mental health problems. This article reports information derived from a 1987 study of Ecuadorian earthquake victims that shows many of the victims had diagnosable psychiatric disorders and provides insight into the nature of those disorders.

Adolescent↗

Mobile hospital provides care when disaster strikes.

When planning resources for disaster response, hospitals should: Understand the mission of the equipment to be used. Be able to provide training. Learn how to use the resources most efficiently.

Delivery of Health Care↗

[Mental disorders during and after natural disasters and catastrophies].

Analysis is made of mental disorders seen in 3431 victims followed up by psychiatrists in 11 large-scale catastrophies and natural disasters. Three periods of the development of the life-threatening situation were distinguished, during which one can see different states of mental disadaptation and morbid disorders. The clinical picture of such disorders is provided.

Accidents↗

[The radiological situation before and after Chernobyl disaster].

The nuclear reactor accident, which occurred on 26 April 1986 at Chernobyl, has been one of the greatest ecological disasters in human history. In our study we discussed the most recent data on the accident, and the natural and synthetic sources of radiation. According to the recent data, the air at Chernobyl had been contaminated with about 5300 PBq radionuclide activity (excluding rare gases), including 1760 PBq (131)I and 85 PBq (137)Cs. The highest radiation received by the liquidators (0.8-16 Gy), lower doses were received by the population which was evacuated or inhabited the contaminated areas (in which the level of (137)Cs activity deposited in the earth was 37 kBq/m(2)). In the European countries the highest mean radiation dose per year for the whole body in the first year after the accident was in Bulgaria (760 microSv), Austria (670 microSv) and Greece (590 microSv), while the lowest radiation dose was observed in Portugal (1.8 microSv) and Spain (4.2 microSv). In Poland the mean effective equivalent dose resulting from Chernobyl accident was 932 microSv and is close to the limited dose permitted in Poland, equalling 1 mSv/year. The highest radiation dose to thyroid was received by inhabitants of the states previously known as Bielskopodlaskie, Nowosadeckie and the north-east region of Poland. Lowest dose was received by inhabitants of the areas previously known as Slupski and Rzeszowski.

Air Pollutants, Radioactive↗