American journal of disaster medicine
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Randomized Controlled Trial Comparative Study
A comparison of different types of hazardous material respirators available to anesthesiologists.
Despite anesthesiology personnel involvement in initial treatment of patients exposed to potentially lethal agents, less than 40 percent of US anesthesiology training programs conduct training to manage these patients.(1) No previous studies have evaluated performance of anesthesiologists wearing protective gear. The authors compared the performance of anesthesiologists intubating a high-fidelity mannequin while wearing either a powered air-purifying respirator (PAPR) or a negative pressure respirator (NPR). ⋯ The use of an NPR or PAPR does not preclude an anesthesiologist from successfully intubating, but practice is necessary. The slightly better performance with the NPR is weighed against the improved comfort of the PAPR and the fact that PAPR users could wear eyeglasses. Neither type of gear allowed the users to auscultate the lung fields to confirm correct endotracheal tube placement.
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A core priority of all medical specialties includes information for members regarding inherent priorities and principles. The authors sought to investigate the priority and contribution of various medical specialties to the fields of bioterrorism, terrorism, disaster preparedness, and emergency preparedness. ⋯ Bioterrorism/terrorism and disaster/ emergency preparedness are priority topics of most medical specialties. This core priority is demonstrated by both the medical specialty resources in addition to the contribution of scientific articles from these medical specialties. This reflects the diverse medical care that is necessary for terrorist threats and the collaborative efforts that will help to make the medical response to these threats more cohesive.
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On January 12, 2010, one of the most destructive earthquakes in history struck the Haitian capital Port-au-Prince. This study aims to characterize the impact of the earthquake and humanitarian response on well being of the affected households as means of evaluating the effectiveness of response efforts. ⋯ The immediate impacts of injury and mortality had marginal influences on long-term household economic security, whereas displacement into camps was stongly associated with negative outcomes for income, employment, and food access.
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Since 2004, the US Navy has provided ship-borne medical assistance during three earthquake disasters. Because Navy ship deployment for disaster relief (DR) is a recent development, formal guidelines for equipping and staffing medical operations do not yet exist. The goal of this study was to inform operational planning and resource allocation for future earthquake DR missions by 1) reporting the type and volume of patient presentations, medical staff, and surgical services and 2) providing a comparative analysis of the current medical and surgical capabilities of a hospital ship and a casualty receiving and treatment ship (CRTS). ⋯ Our data indicate that musculoskeletal extremity injuries in sex- and age-diverse populations comprised the majority of clinical diagnoses. Current capabilities and surgical staffing of hospital ships and CRTS platforms influenced their respective DR operations, including the volume and types of surgical care delivered.
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The provision of critical care in any environment is resource intensive. However, the provision of critical care in an austere environment/mass disaster zone is particularly challenging. ⋯ Based primarily on our experiences at a field hospital in Haiti, we created a short guide to critical care in a mass disaster in an austere environment. This guide will be useful to the team of physicians, nurses, respiratory care, logistics, and other support personnel who volunteer in future critical care relief efforts in limited resource settings.