Disaster medicine and public health preparedness
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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.
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Disaster Med Public Health Prep · Feb 2016
Disaster-Related Injury Management: High Prevalence of Wound Infection After Super Typhoon Haiyan.
After Super Typhoon Haiyan, a category 5 tropical cyclone, insufficient resources were available for medical management. Many patients in the Philippines were wounded as a result of the disaster. We examined the prevalence, risk factors, and consequences of disaster-related wounds and wound infection in the post-disaster period. ⋯ In the post-disaster situation, many wound infections required definitive care. Wound infection was associated with inadequately cared for wounds and foreign-body-contaminated wounds.
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Disaster Med Public Health Prep · Feb 2016
Evacuation of Intensive Care Units During Disaster: Learning From the Hurricane Sandy Experience.
Data on best practices for evacuating an intensive care unit (ICU) during a disaster are limited. The impact of Hurricane Sandy on New York City area hospitals provided a unique opportunity to learn from the experience of ICU providers about their preparedness, perspective, roles, and activities. ⋯ ICU providers who evacuated critically ill patients during Hurricane Sandy had little prior knowledge of evacuation processes or vertical evacuation experience. The weakest links in the patient evacuation process were communication and the availability of practical tools. Incorporating ICU providers into hospital evacuation planning and training, developing standard evacuation communication processes and tools, and collecting a uniform dataset among all evacuating hospitals could better inform critical care evacuation in the future.