American journal of disaster medicine
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To examine patterns of visits by residents of northern Israel displaced during the Israel-Lebanon War of 2006 to an urgent care system in central Israel and to compare these patterns with those of local patients. ⋯ Patterns of common discharge diagnoses were generally similar between northern and local residents, with the exception of fewer injury-related visits and more anxiety-related visits. Urgent care appears to have served an important function for displaced individuals during this war, mostly for routine medical needs.
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Mass disaster medicine is characterized by the need to manage limited resources that are far inadequate to meet the population's demands. Under these hectic conditions, lack of specific medical equipment is expected and requires improvisation using available items. ⋯ Creative solutions were found to several problems in a variety of medical fields: blood transfusion, debridement and coverage of complex wounds, self-production of orthopedic hardware, surgical exposure, and managing maxillofacial injuries. We hope that the methods described will help to inspire medical teams working in disaster regions.
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While many hospitals have developed preliminary emergency department and in-patient surge plans, the ability to surge is often limited by critical resources. The resource which is often the most limited is usually the human resource and within this category the limiting factor is almost universally nursing. As a result, nursing shortages can result in an inability of a hospital or emergency department to create surge capacity to deal with large numbers of ill or injured patients. Utilizing paramedics in acute-care hospitals or at alternate care sites could serve as expansion staff to supplement existing nursing staff allowing fewer nurses to care for a larger numbers of patients during a disaster, act of terrorism, or public health emergency. While the procedures performed for nursing do vary from hospital to hospital, there are national certifications for both emergency nursing (CEN) and critical care nursing (CCRN) that can be used to establish a standard for comparison. ⋯ With appropriate training and orientation, paramedics may be used in an in-patient setting to augment emergency and critical care nursing staff during a disaster, act of terrorism, or public health emergency.
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Although children and infants are likely to be victims in a disaster and are more vulnerable in a disaster than adults, disaster planning and management has often overlooked the specific needs of pediatric patients. The authors discuss key components of disaster planning and management for pediatric patients, including emergency medical services, hospital/facility issues, evacuation centers, family separation/reunification, children with special healthcare needs (SHCNs), mental health issues, and overcrowding/surge capacity. ⋯ The second part addresses the appropriate setup and functioning of evacuation centers and family separation and reunification. The third part deals with special patient populations: children with SHCNs and mental health issues.
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Army action against terrorism in Pakistan led to the largest human migration in this century. About 3.4 million people (internally displaced persons, IDPs) were displaced. The authors visited all major camps and some houses in Mardan area and interviewed IDPs and doctors at these camps and areas to identify medical needs and current state of provision of medical care. ⋯ The medical issues and requirements for these IDPs living in camps were totally different from a disaster like earthquake. Global response to this disaster was slow and less effective. The need for a WHO coordination center for creating quick and urgent response for such kind of disasters in future is emphasized in this article.