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PubMed1984

The importance of autopsy examination in major disasters.

It is appreciated that there are national and jurisdictional variations in regard to post-mortem dissections following accidental death. The purpose of this paper is to plead that, since there will be nationals of many states involved in an aircraft disaster, there should be a uniform system of forensic investigation on a world wide basis. The justification for this recommendation is illustrated through the investigation of accident causes and through the solution of the many problems relating to the settlement of probate which arise in accidental death. The causes of accidents which may be discovered by autopsy include crew incapacitation and criminality of all types. The emergency status may also be revealed and the type of accident, particularly whether in a controlled or uncontrolled phase, may become clear. The medico-legal problems to be resolved include those concerning payment of insurance policies, including the degree of life expectancy, and especially the disposal of estates when members of a family apparently die together. The resulting payments to beneficiaries may be quite different depending on the quality of the autopsy. These investigations are complementary to, and do not interfere with, the identification process but they are time consuming and expensive.

Accidents, Aviation↗
PubMed1984

The coroner's role in mass disaster.

This paper deals with the various phases of a mass disaster investigation from the Coroner's point of view. The phases are described under the headings of: Phase 1: Recovery from the scene. Phase 2: Reception of the dead at the mortuary. Phase 3: Reception of relatives of the dead at the mortuary. Phase 4: Identification of the dead. Phase 5: Autopsy. Phase 6: Co-ordination and co-operation with other agencies. The setting up of a Casualty Bureau and a suggested plan for a temporary central facility is also discussed. The vital importance of some pre-planning is referred to, including the involvement of fingerprint officers, forensic odontologists, photography, safe custody of property.

Autopsy↗
PubMed1984

A failure to communicate: the need for standardization of procedures for the exchange of identification information of crime and mass disaster victims.

A case is presented illustrating some of the difficulties presently encountered by Medical Examiners and law enforcement agencies in obtaining information necessary for the identification of foreign-born homicide victims. In 1982, the semiskeletonized remains of a 30 year old female citizen of the People's Republic of China were discovered in a vacant lot of a Chicago suburb. The victim had been reported missing four months previously. Although dental restorations were present, most of the work had been done several years prior to her coming to the United States. Attempts to obtain these records through diplomatic channels were unsuccessful due largely to the inexperience of both the U.S. and P.R.C. agencies involved in handling such requests. Although positive identification was eventually established by other means, the abortive attempt to obtain dental records resulted both in delay of the homicide investigation and in undue stress on the victim's family. This case demonstrates the need for the development of more rapid and effective exchange of identification information on victims of crime and mass disaster by a system analogous to that presently used to exchange information on criminals on an international scale.

Adult↗
PubMed1981

[Ethical problems in mass burn disasters (author's transl)].

Severe mass burn disasters may result in disproportions between capacities and facilities of medical aid with the consequence of a planned delayed treatment for poor risk injured persons according to triage. The ethical background and minimal prerequisites to such practice, within the limitations of the state of emergency are explained.

Burns↗
PubMed1980

An organizational concept for pathologic identification in mass disasters.

The process of identifying the victims of a mass disaster can be simplified if approached in a logical manner. The organizational concept used by the Armed Forces Institute of Pathology divides the process into four phases--preliminary evaluation, data collection, data analysis, and conclusion. Much flexibility is retained within each of these phases to enable general application, but major emphasis centers upon quality control. This control consists of multiple checks during the phases of data collection and analysis and confirmation of each identification by all available methods. An intensive effort must be made to obtain complete antemortem records and descriptions as soon as possible, for no identification will be possible without this comparison data. The values of a logical organizational flow are increased efficiency and accuracy of identification.

Accidents, Aviation↗
PubMed1994

[Disasters. Assistance plans].

A disaster is defined as a unseasonable event that provoke such an amount of victims that the health care capacity of the community is exceeded. The aim of this paper is to review the health attention during an emergency period, whose pre-hospital and hospital services are inherent to critical care medicine. The reduction in victim's morbidity and mortality depends on the opportuneness and efficacy of pre-hospital care. Trained personnel is required to establish command posts, perform the rescue, categorize seriousness of victims to receive priority health care and transport to better equipped health centers. At the hospitals an emergency team must elaborate, publish and periodically review emergency care plans and eventually coordinate actions with other community organizations. The diverse phases of the plan must be specified, including preparatives, alerting of involved services, victim care, and reestablishment of normal duties when the emergency situation ceases. As complement, the hospital must have security and evacuation plans to face own emergency situations such as fires, explosions and inundations.

Disaster Planning↗
PubMed1995

Short tandem repeat typing of bodies from a mass disaster: high success rate and characteristic amplification patterns in highly degraded samples.

We have used a PCR-based DNA-typing method, involving the coamplification of four tetrameric short tandem repeat loci, in the analysis of a large number of severely degraded tissue samples taken from the scene of a mass disaster in which bodies were exposed to extreme thermal, physical and chemical insult. Analysis of the amplified DNA in a number of the samples revealed uniquely sized artifact PCR products resulting from the amplification of degraded genomic DNA as well as characteristic patterns in the amounts of PCR products generated from differently sized loci. This system has proved to be very reliable and robust, and we were successful in typing all of the four loci in 66% of the samples tested and at least one locus in 83% of the cases. A PCR-based sex test also proved to be very effective when applied to the degraded samples.

Alleles↗
PubMed1993

[Panic anxious-depressive states in children and adolescents who have experienced natural disasters and catastrophes].

744 children and adolescents at the age of 1-17 years who underwent disasters (earthquakes) and catastrophes were observed. In 216 cases anxious-depressive conditions of different duration were revealed. These disorders were divided into 3 groups: the neurosis of fear (42.1%), phobia-like states of the type "panic disorders" (31.0%) and mixed somatogenic and psychogenic disorders of "panic type" (26.9%). The least favorable prognosis was noted in the 3d group. The questions of drug therapy and psychotherapy of every type of these disorders are discussed.

Accidents↗
PubMed1994

[Contents and updating of disaster plans].

The disaster contingency plans of 62 hospitals with surgical, acute emergency functions were evaluated. Most plans were incomplete with regard to continued and extended activity or evacuation of the entire hospital in the event of war. Only 13% had adequate plans for internal accidents or situations with reduced of lost supply of vital resources such as water, medical gases or electricity. Plans for serious accidents in peacetime were to some degree deficient with regard to important aspects of the organization of the hospital in an emergency situation. Efforts to improve this crucial planning work are discussed.

Accidents↗
PubMed1994

[Form and readability of disaster plans].

We have evaluated the disaster contingency plans for 62 out of 69 Norwegian hospitals with surgical, acute emergency functions. Page volume varied from 2-115, mean 33 pages. Only nine hospitals had pocket size printed documents (A5). At the rest of the hospitals the plans had an A4-format and consisted of photocopied pages. Illustrations were few and of low quality. Too much text contained general information with no practical relevant instruction. Readability varied for different groups of health workers. Doctors received the best instructions for their tasks. Hospitals should seek professional assistance to edit, illustrate and produce the plans, and a certain degree of standardization of the plans should be aimed at. National health authorities should encourage the hospitals in this work.

Disaster Planning↗
PubMed1993

Planning for medical support of disasters.

Disaster health care plans require that planners consider personnel, equipment, supplies (including pharmaceuticals), and logistical support for transportation, food, water, and resupply. The authors believe that military Table of Organization and Equipment (TOE) hospitals have the potential to be invaluable sources of personnel, equipment, and supplies. They recommend that TOE organizations plan Military Mobilization Teams (MMTs) that are lightweight, rapidly deployable, and easily supported. In addition, MMTs can serve as the advance party units around which more complex health care organizations can be developed. The same MTTs have potential military uses such as mobilization in stages.

Disaster Planning↗
PubMed1993

Public health consequences of a flood disaster--Iowa, 1993.

Unprecedented amounts of rain in the spring and summer of 1993 led to disastrous flooding and crop damage in nine Midwestern states. In Iowa (1990 population: 2,777,000), extensive flood damage occurred in all 99 countries. On July 11, 1993, the Iowa Department of Public Health (IDPH) requested assistance from CDC to assess the adverse public health impact of the flooding and to plan the public health response to the disaster. CDC assisted IDPH in performing an initial rapid statewide public health assessment and establishing weekly surveillance to monitor ongoing or anticipated flood-related health problems. This report summarizes the methods of the assessment and surveillance and preliminary findings.

Disasters↗
PubMed1996

Illnesses and injuries reported at Disaster Application Centers following the 1994 Northridge Earthquake.

The 1994 Northridge, California, earthquake caused extensive structural damage and disrupted lives for thousands of residents. Local resources treated those initially injured. Many victims were unable or unwilling to reenter their dwellings. Record numbers of victims spent many hours at Disaster Application Centers (DACs) applying for financial assistance and other services. This created a concern for the provision of primary health care services at these centers. Under the Federal Response Plan, registered nurses, nurse practitioners, and physician assistants from the Department of Veterans Affairs treated 17,883 patients at the DACs. This report documents the injuries and illnesses sustained by the public and response workers at the DACs. The findings demonstrate that this care eased the burden on the local health care system. This article illustrates applications for estimating health services needs and demands at similar mass gatherings that might be experienced in response to catastrophic events and in U.S. military operations involving humanitarian relief missions.

California↗
PubMed1997

Tornado disasters and stress responses.

Each year, a number of tornados rip through Kentucky, leaving fear, destruction, and human injury in their path. Persons who endure these catastrophes often experience a variety of stress responses. The psychological and medical sequelae include depression, acute and post-traumatic stress disorders, substance abuse, anxiety, and somatization. It is especially important for the Kentucky practitioner to be able to recognize and screen for pathology following a tornado disaster in order to provide leadership in ascertaining treatment for such stress responses.

Animals↗
PubMedDate not supplied

The medical bequest of disaster at sea: Commodore Anson's circumnavigation 1740-44.

Anson's circumnavigation was characterised by his indomitable leadership which enabled men to triumph over medical and environmental disasters responsible for appalling suffering and loss of life. The medical bequest of the Anson voyage was not only the detailed descriptions of nutritional deficiency diseases in their various guises, but in the spirit of inquiry it generated, the recognition of a need for research and continuing postgraduate education and the requirement for evidence-based medicine. The controversy it aroused resounded until the twentieth century.

Deficiency Diseases↗
PubMed1998

Caring for children affected by disaster.

The child and adolescent psychiatrist must play an essential role in the wake of disaster. The focus of the community and the world understandably turns to the physical devastation wrought, and emergency and medical efforts take center stage. Physical evidence of the past may be lost, but the child psychiatrist is able to maintain focus on what cannot be seen. He or she may be the only one to advocate the child's emotional needs. It may be too difficult for others who lack the specialized expertise of mental health training to attend to both the child's physical and emotional needs, and it may be impossible for those without medical training to impress on medical personnel the importance of emotional issues. The child and adolescent psychiatrist, with his or her understanding of medical, mental health, and developmental concerns, is well positioned to support the child, the child's community, and the helpers whose own responses may complicate recovery.

Adolescent↗