American journal of disaster medicine
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In a joint military/civilian exercise conducted in June 2010, military National Guard medical and decontamination response efforts proved to be paramount in supporting hospital resources to sustain an adequate response during a simulated terrorist event. Traditionally, hospitals include local responders in their disaster preparedness but overlook other available state and federal resources such as the National Guard. Lessons learned from the exercise included the value of regular joint disaster planning and training between the military and civilian medical sectors. ⋯ Involving the National Guard in community disaster planning provides a valuable medical support asset that can be critical in responding to multiple casualty events. National Guard response is inherently faster than its federal counterpart. Based on the findings from our joint exercise, states are encouraged to incorporate their corresponding National Guard in civilian critical medical infrastructure disaster preparedness activities, as the National Guard can be an integral part of the disaster response efforts in real multiple casualty events.
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On January 12, 2010, a 7.0 magnitude Richter earthquake devastated Haiti, leading to the world's largest humanitarian effort in 60 years. The catastrophe led to massive destruction of homes and buildings, the loss of more than 200,000 lives, and overwhelmed the host nation response and its public health infrastructure. Among the many responders, the United States Government acted immediately by sending assistance to Haiti including a naval hospital ship as a tertiary care medical center, the USNS COMFORT. ⋯ Volunteers' demographics, such as age and gender, as well as linguistic skills, work background, and prior humanitarian assistance experience varied. Volunteer efforts were critical in assisting with informed consent for surgery, family reunification processes, explanation of diagnosis and treatment, comfort to patients and families in various stages of grieving and death, and helping healthcare professionals to understand the cultural context and sensitivities unique to Haiti. This article explores key lessons learned in the use of volunteer interpreters in earthquake disaster relief in Haiti and highlights the approaches that optimize volunteer services in such a setting, and which may be applicable in similar future events.
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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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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.
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Little work has been devoted to the links between natural disasters, subsequent Emergency Medical Services (EMS) network utilization, triage, and public awareness. The aim of this study was to investigate the types and distribution of emergency calls recorded after each South Florida hurricane during the 2005 season, identifying target areas for public health education, and emergency personnel use and training. ⋯ This study suggests that 911 calls regarding respiratory complaints, convulsions, seizures, and hazardous situations can be expected to significantly increase after a hurricane. Educational initiatives, EMS resource allocation, and modified triage systems designed to target these areas may limit EMS system-wide strain and improve health outcomes following natural disasters.