Prehospital and disaster medicine
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Prehosp Disaster Med · Sep 2009
Unintentional injury outcomes secondary to pedestrian traffic crashes: a descriptive analysis from a major medical center.
An environment in which traffic regulations are not strictly enforced often is characterized by carnage from motor vehicular crashes resulting in severe injuries with unacceptably high mortality. The descriptive demographics and injury characteristics of pedestrian road crash victims presenting to a tertiary medical center in southwestern Nigeria are presented in order to provide baseline epidemiology as a first step in determining areas of potential mitigation for care of unintentional injuries. ⋯ This raises serious questions about the prehospital- and hospital-based emergency services for vehicular road crash victims in this environment, and confirms the World Health Organization findings that Africa has the highest rate overall for unintentional injury deaths. A system-wide program must be put in place that addresses proven prevention measures across all sectors of the community.
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Prehosp Disaster Med · Sep 2009
A reassessment and review of the Bam earthquake five years onward: what was done wrong?
An earthquake measuring 6.6 on the Richter scale on 23 December 2003 devastated the city of Bam in southeastern Iran. During the response and recovery phases, considerable shortcomings were discovered. The dire situation in the affected area, a variety of urgently required interventions, and the large number of aid organizations involved brought about difficulties in management, coordination, and communication among authorities and aid organizations. This article highlights flaws in management in the various aspects of this disaster in order to assess what was done, and what should be done to overcome these shortcomings in future disasters. ⋯ A comprehensive disaster management plan must not be limited only to the response phase, but rather must include: preparedness, recovery with optimal legislation and budgeting, improvement of healthcare facilities, and organized communication channels between the different governmental departments. This important issue has been addressed, and a disaster management organization under the supervision of the President has been established, developing a national search and rescue strategy and protocol for unified managerial organization, an alert system, an international disaster command system (under which search and rescue and emergency medical service teams can be deployed, increasing the efficacy and coordination of the arrival of foreign teams and the construction field hospitals), and developing a flowchart to coordinate international agencies and the domestic authorities in charge. Continuous education, training of the general population, conducting periodic exercise drills, and provision for prepared task force mobilization in disaster management all are important aspects of the management of disasters due to natural hazards.
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Prehosp Disaster Med · Sep 2009
Evacuation and sheltering of hospitals in emergencies: a review of international experience.
A scoping exercise to establish how common hospital evacuations are, identify hospital evacuation policies and review case studies to identify triggers, processes and challenges involved in the evacuation of hospitals globally. ⋯ This study recommends the collection of case studies and the development of a database to assist with the research and development of well tailored hospital evacuation plans. These recommendations reflect and support the 2008-2009 World Disaster Reduction Campaign on Hospitals Safe from Disasters and the timely 2009 Global Platform priority that, Critical services and infrastructure such as health facilities and schools must be safe from disasters.
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Prehosp Disaster Med · Sep 2009
Training medical students in bag-valve-mask technique as an alternative to mechanical ventilation in a disaster surge setting.
The objective of this study was to evaluate the rapid training of medical students and their ability to provide effective manual ventilation using the bag-valve-mask technique. ⋯ Medical students can be rapidly trained and be utilized as a potential resource to carry out the potentially lifesaving task of manual ventilation using the BVM technique in a disaster situation in which the availability of mechanical ventilators and respiratory therapists may be limited.
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Prehosp Disaster Med · Sep 2009
How will military/civilian coordination work for reception of mass casualties from overseas?
In Maryland, there have been no military/civilian training exercises of the Medical Mutual Aid Agreement for >20 years. The aims of this paper are to describe the National Disaster Medical System (NDMS), to coordinate military and civilian medical mutual aid in response to arrival of overseas mass casualties, and to evaluate the mass-casualty reception and bed "surge" capacity of Maryland NDMS Hospitals. ⋯ The exercises facilitated military/state inter-agency cooperation, resulting in revisions to the Maryland Emergency Operations Plan across all key state emergency response agencies. The recommendations from these exercises likely apply to the vast majority of NDMS activities in the US.