Abstracts from the 14th World Congress for Disaster and Emergency Medicine. May 16-20, 2005. Edinburgh, Scotland.
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Triage for the neurosurgeon is a misnomer. The neurosurgeon's role within a mass-casualty situation is one of a subspecialist surgeon instead of a triage officer. Unfortunately because of the events of September 11, 2001, civilian neurosurgeons and other medical specialists have been questioning their role within a mass-casualty situation or, worse, a situation created by biological, chemical, or nuclear weapons. There is no single triage system used exclusively within the United States, and different systems have differing sensitivities, specificities, and labeling methods. The purpose of this article is to discuss varying aspects of triage for both military personnel and civilians and suggest how the neurosurgeon may help shape this process within his or her community. Furthermore, the effects of biological, chemical, and nuclear weapons will be discussed in relation to the triage system.
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The boxing day tsunami of 26 December 2004 caused devastation and loss of life around the Indian ocean. International disaster victim identification efforts were centred in Thailand, with many odontologists from over 20 countries contributing to the examination of deceased, collection of antemortem information, comparison and reconciliation of data. The contribution of forensic odontology to the identification process conducted in Thailand in response to the tsunami devastation is presented in a composite of short reports focused on the five phases associated with disaster victim identification. To date 1,474 deceased have been identified. Dental comparison has been the primary identifier in 79% of cases and a contributor in another 8%, a total of 87%.
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The decision to evacuate in advance of a major storm requires the ED manager to make a number of critical decisions. The decisions must be made well in advance of anticipated landfall, to ensure that patients and staff can get to safety. Determine which patients should be admitted, which should be transferred, and which must remain where they are. Have alternative facilities lined up ahead of time, should the need arise to transfer your patients.
If a nearby facility is anticipating a disaster, don't wait until it hits to prepare to receive its patients. Put all of your physicians on call, and schedule them for additional shifts. Determine the conditions you most likely will treat, and pre-order medication and supplies accordingly. Encourage your community to create a central communications center to coordinate all hospital transfers.
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