American journal of disaster medicine
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Tsunamis have the potential to cause an enormous impact on the health of millions of people. During the last half of the twentieth century, more people were killed by tsunamis than by earthquakes. ⋯ There are few resources in the public health literature that describe the characteristics and epidemiology of tsunami-related disasters, as a whole. This article reviews the phenomenology and impact of tsunamis as a significant public health hazard.
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To identify strategies with tactics that enable point-of-care (POC) testing (medical testing at or near the site of care) to effectively improve outcomes in emergencies, disasters, and public health crises, especially where community infrastructure is compromised. ⋯ Careful implementation of POC testing will facilitate evidence-based triage, diagnosis, treatment, and monitoring of victims and patients, while advancing standards of care in emergencies and disasters, as well as public health crises.
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Text messages are useful for timely communication during public health emergencies and for transmitting health data in infrastructure-limited settings. Little is known about the feasibility of two-way short message service (SMS) communication to collect public health preparedness and surveillance data. The authors aimed to determine the feasibility and acceptability of using two-way SMS texts to collect situational assessment (SA) data in simulated disaster events during a university-based pilot study. ⋯ Using two-way SMS communication for surveillance and reporting was feasible among a group of motivated students. Similar methods may provide timely data during public health critical events.
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High-frequency percussive ventilation (HFPV) has been used for the management of patients with smoke inhalation injury for more than 20 years and is considered a standard of care at many burn centers. Because the ventilator is powered by air and oxygen rather than electricity, prehospital use has been limited by large-volume medical gas requirements. Since 2003, Operations Iraqi Freedom and Enduring Freedom have created a need for long-range aeromedical transfer of service members with severe burn and inhalation injuries. ⋯ Because C-17 aircraft have a built-in medical oxygen supply, transcontinental patient transport using HFPV has become feasible. In this study, the authors report their initial experiences with the aeromedical transportation of 33 burn patients over a combined distance of 174,145 air miles using HFPV. HFPV is safe and efficacious for transcontinental flight when used by an experienced medical transport team.
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In the event of a catastrophic disaster, healthcare resources may be completely overwhelmed. To address this, the federal Agency for Healthcare Research and Quality has recommended using "crisis standards of care"during such an event. These standards would recommend allocating scarce medical resources to do the greatest good for the greatest number of patients. ⋯ In extreme circumstances, these protocols recommend withdrawing ICU resources from sicker patients in favor of more salvageable patients. However, if providers were to follow the earlier protocols in a disaster and withdraw and reallocate ICU care, criminal or civil liability could result. Two legal solutions to avoid this potential for liability have been suggested in this article.