American journal of disaster medicine
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The area between Newark and Elizabeth, NJ, contains major transportation hubs, chemical plants, and a dense population. This makes it "the most dangerous two miles in America," according to counterterrorism officials at the Federal Bureau of Investigation. This study compares medical response capabilities for terror and disaster in Newark, New Jersey's largest city, with those in Boston in view of that city's favorable response to the Marathon bombings in April 2013. Boston's numerous world-class medical facilities offer advantages unavailable in Newark and most other metropolitan locations. Thus, preparedness in Newark, despite its prime-danger designation, can also be instructive for many communities with similar medical resources. ⋯ Commonalities in Newark and Boston's exercise approaches suggest that Boston's successful response at the Marathon might be replicated at least in part if the Newark area were similarly challenged. Whether Newark and similarly enabled communities would respond with comparable efficiency remains conjectural. Still, maintaining rigorous preparedness efforts seems a self-evident imperative, especially in an area deemed among the country's most inviting terrorist targets.
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Telemedicine and advanced technologies that ensure telepresence have become common practice and are an effective way of providing healthcare services. ⋯ Telemedicine has not been used thus in the management of disasters, despite its great potential. There is an acute need for establishing telemedicine programs in high risk areas for disasters, so that when these disasters strike, existing telemedicine networks can be used, rather than attempting to bring solutions into a chaotic situation postevent.
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To evaluate mental health outcomes among New Jersey shore residents with health impairments and disabilities after Hurricane Sandy. ⋯ Having physical impairments and health conditions were not directly related to adverse mental health outcomes following Sandy, but having sleep problems, pain, or suicidal thoughts were. Further research is needed to assess the health status of community residents with serious health impairments over time following disasters.
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The Boston Marathon terrorist bombing that occurred on April 15, 2013 illustrates the importance of a cohesive, efficient management for the operating room and perioperative services. Conceptually, emotional intelligence (EI) is a form of social intelligence used by individuals in leadership positions to monitor the feelings and emotions of their team while implementing a strategic plan. ⋯ The application of EI in managerial decisions helped to ensure smooth transitions for victims throughout all stages of their perioperative care. EI provided the fundamental groundwork that allowed the operating room manager and nurse leaders to establish the calm and coordinated leadership that facilitated patient care and teamwork.
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Case Reports
Use of a fiber optic camera to perform a trauma assessment during a confined space rescue.
Accurate medical evaluation of victims injured during confined space rescues poses significant operational, medical, and logistical challenges for medical providers of all disciplines and experience levels. The Federal Emergency Management Agency (FEMA) teaches rescuers to begin their assessment as soon as verbal contact is obtained with the victim. While a significant amount of information can be obtained by talking to the victim, an accurate assessment of the victim's condition is often limited or impossible. Many professional rescue agencies currently use cameras to locate a victim's position or visualize obstacles that prevent the successful extraction of casualties. However, there is no published literature describing the use of a camera to complete a medical evaluation. ⋯ When evaluating a trauma patient, there is no substitution for visual inspection and physical diagnosis. The use of a fiber optic camera can assist rescuers and medical providers in obtaining the information they desire, and enable the completion of an accurate patient assessment. The camera may also provide psychological reassurance and ease anxiety, as well as generate prehospital images that can be transmitted to the receiving facility for use in preparation of the casualty. Emergency medical service providers, urban search & rescue teams, fire departments, and other professional rescuers should be trained on the use and limitations of fiber optic cameras during confined space rescues. Furthermore, regulatory agencies such as FEMA should consider integrating the use of fiber optic camera and audiovisual devices into the current training courses offered to professional rescuers.