American journal of disaster medicine
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The aim of this study was to characterize the public health emergency perceptions and willingness to respond (WTR) of hospital-based pediatric staff and to use these findings to propose a methodology for developing an institution-specific training package to improve response willingness. ⋯ Children represent a uniquely vulnerable population in public health emergencies, and pediatric hospital staff accordingly represent a vital subset of responders distinguished by specialized education, training, clinical skills, and disaster competencies. Even though the majority of pediatric hospital staff report WTR, nearly 15 percent for a pandemic influenza emergency and 25 percent for an RDD event would not respond if required. Other institutions can apply the methodology used here to identify particularly influential response willingness modifiers for pediatric care providers. These insights can inform customized preparedness training for pediatric healthcare workers, through identification of high-impact attitudes/beliefs, and training initiatives focused on addressing these modifiers.
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To describe factors associated with inpatient mortality in a field hospital established following the 2010 Haiti earthquake. ⋯ Following earthquakes in resource-limited settings, survivors may require care in field hospitals for injuries or exacerbation of chronic medical conditions. Planning for sustained post-earthquake response should address these needs and include pediatric-specific preparation and long-term critical care requirements.
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Recent evidence demonstrates that emergency department (ED) and inpatient hospital crowding contributes to unsafe patient care. The blizzards of 2010 produced conditions that prohibited the safe discharge of admitted inpatients and were identified as a major factor in crowding of the ED at Howard County General Hospital (HCGH). At one point, admitted patients occupied 35 of the 36 treatment beds in the ED. ⋯ During this call, HCFR and HCGH also coordinated the emergency transport of an interventional cardiologist through the blizzard to HCGH to perform emergency cardiac catheterization. At the end of the operational period, the ED had regained all but four beds pending inpatient admission. These efforts fortified a strong partnership between a community hospital and local fire department to facilitate the expeditious discharge and disposition of inpatients during the blizzards of 2010 to decrease crowding.
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The purpose of this study was to describe the impact of the 2009 H1N1 influenza pandemic on a pediatric emergency department (ED) at a freestanding children's hospital in the summer and fall of 2009. ⋯ The 2009 H1N1 influenza pandemic resulted in unprecedented patient volumes in this pediatric ED; however, patient acuity (based on admission rate) for patients with ILI was lower than patients with non-ILI. Pandemic influenza can overwhelm emergency care resources, even when the overall severity of illness is relatively low.
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Refugees in long-term camp-based settings are often provided health services through health systems parallel to national health systems. This article, through literature review, explores the question of health service delivery in the context of long-term refugee situations, examining in particular the impact on host national population. The objective is to identify data and themes in literature that shed light on the utilization of health services for refugees and host population. ⋯ Literature reports varied impacts of refugee hosting on host national population. The need for a contextual approach to understand the impact of refugee hosting is indicated through these findings. Some studies found that refugee hosting improved the quality and accessibility of health services and, in some cases, health outcomes for host national population; however, the data supporting integrating health services for refugees and host population are limited, and both reduce the strength of the integration argument. The overall body of evidence to reach conclusions on what is the ideal model of health service delivery for refugees and host population is limited. Improved data collection and analysis of utilization patterns for refugees and host population could strengthen program and policy design in this area.