American journal of disaster medicine
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Explosions and bombings remain the most common deliberate cause of disasters involving large numbers of casualties, especially as instruments of terrorism. These attacks are virtually always directed against the untrained and unsuspecting civilian population. ⋯ It needs to be realized that physicians should never be placed in a position of individually deciding to deny treatment to patients without the guidance of a policy or protocol. Emergency physicians, however, may easily find themselves in a situation in which the demand for resources clearly exceeds supply and for this reason, emergency care providers, personnel, hospital administrators, religious leaders, and medical ethics committees need to engage in bioethical decision-making.
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On one hand, there is an association between exposure to natural disasters and becoming mentally distressed, and on the other hand, there is also a relation between being mentally distressed and committing suicide; therefore, it is possible that one finds a relation between exposure to natural disasters and committing suicide. This review, therefore, will not only seek such relations in the literature but also try to highlight the most important methodological issues of finding such connection.
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Multicenter Study
Violence-related mortality and morbidity of humanitarian workers.
(1) To determine the rate of violence-related deaths, medical evacuations, and hospitalizations occurring to national and expatriate staff of participating humanitarian organizations; (2) to describe the distribution of all-cause and cause-specific mortality and morbidity of humanitarian workers with regard to possible risk factors. ⋯ Aid worker deaths in this group were more frequently caused by intentional violence than either accidents or coincidental illness. The rate of six intentional violence events per 10,000 person-years can be used as a baseline by which to track changes in risk over time.
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Contemporary events in the United States (eg, September 2001, school shootings), Europe (eg, Madrid train bombings), and the Middle East have raised awareness of mass casualty events and the need for a capable disaster response. Recent natural disasters have highlighted the poor preparation and infrastructure in place to respond to mass casualty events. In response, public health policy makers and emergency planners developed plans and prepared emergency response systems. Emergency response providers include first responders, a subset of emergency professionals, including firemen, law enforcement, paramedics, who respond to the incident scene and first receivers, a set of healthcare workers who receive the disaster victims at hospital facilities. The role of pediatric surgeons in mass casualty emergency response plans remains undefined. The authors hypothesize that pediatric surgeons' training and experience will predict their willingness and ability to be activated first receivers. The objective of our study was to determine the baseline experience, preparedness, willingness, and availability of pediatric surgeons to participate as activated first receivers. ⋯ A minority of pediatric surgeons feel prepared, and most feel they require more training. Current training methods may be ineffectual in building a prepared and willing pool of first receivers. Disaster planners must plan for healthcare worker related issues, such as transportation and communication. Further work and emphasis is needed to bolster participation in disaster preparedness training.