Disaster medicine and public health preparedness
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Disaster Med Public Health Prep · Apr 2016
Threat of Secondary Chemical Contamination of Emergency Departments and Personnel: An Uncommon but Recurrent Problem.
To analyze acute hazardous substance release surveillance data for events involving secondary contamination of hospital emergency departments (EDs). Secondary contamination of EDs may occur when a patient exposed to a hazardous chemical is not decontaminated before arrival at the ED and when ED staff are not wearing appropriate personal protective equipment. This can result in adverse health outcomes among department personnel, other patients, and visitors. Even events without actual secondary contamination risk can be real in their consequences and require the decontamination of the ED or its occupants, evacuation, or temporary shutdown of the ED. ⋯ These results suggest that although rare, incidents involving secondary contamination continue to present a hazard for emergency departments. Suggested best practices to avoid secondary contamination have been described. Hospitals should be made aware of the risks associated with secondary contamination and the need to proactively train and equip staff to perform decontamination.
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Disaster Med Public Health Prep · Apr 2016
Comparing the Accuracy of Three Pediatric Disaster Triage Strategies: A Simulation-Based Investigation.
It is unclear which pediatric disaster triage (PDT) strategy yields the best accuracy or best patient outcomes. ⋯ Our simulation-based comparison suggested that JumpSTART triage outperforms both Smart and CDM. JumpSTART outperformed Smart for RED patients and CDM for BLACK patients. For YELLOW patients, JumpSTART yielded more accurate triage results than did Smart triage or CDM.
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Disaster Med Public Health Prep · Apr 2016
Analysis of Layperson Tourniquet Application Using a Novel Color-Coded Device.
To determine whether a color-coded tourniquet designed for public use increases successful tourniquet application by laypeople. ⋯ The color-coded device did not significantly increase laypeople's proportion of successful tourniquet applications when compared with a standard black device. However, this study reproduced pilot study data showing that laypeople can successfully apply tourniquets about half the time if provided JiT instructions. Age, sex, race, income, and highest level of education were not found to impact one's ability to properly apply a tourniquet. Laypeople's willingness to apply tourniquets doubled to 80% after brief exposure to the device. These results affirm the feasibility of engaging laypeople as immediate lifesavers of trauma victims and justify further efforts to boost rates of proper application.
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Disaster Med Public Health Prep · Apr 2016
Baltimore's Unrest: Perspectives From Public Health and Emergency Physician Leaders.
The tragic April 19, 2015, death of an African American man injured while in police custody spurred several days of protest and civil unrest in Baltimore City. This article outlines the opportunity and role for a local health department during civil unrest, from the perspective of 2 emergency physicians who also led the Baltimore City Health Department through these recent events. Between April 27 and May 8, 2015, the Health Department was a lead agency in the unrest response and recovery activities. Similar to an emergency medical situation, a "public health code" is proposed as a model for centralizing, reacting to, and debriefing after situations of civil unrest.