American journal of disaster medicine
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In September 2004, two consecutive hurricanes (Hurricane Frances and Hurricane Jeanne) made landfall in Stuart, FL, and created healthcare needs that overtaxed the capacity of the local healthcare system. To determine the character and structure of the response to these hurricanes, researchers from the University of New Mexico, Center for Disaster Medicine conducted both a structured written survey of employees and a guided group interview with healthcare system management. The written survey queried staff on topics related to their ability and willingness to get to work and stay at work during the storms. ⋯ Employees were willing and able to provide the necessary care for patients during the hurricanes, overcoming many physical and emotional barriers that arose during the month-long response. These barriers included concern for the safety of family and pets, inoperable or insufficient communication methods, and damage to employees' personal property and homes. Recommendations for healthcare system preparedness and response were formulated by the researchers based on this healthcare system's successful response to back-to-back hurricanes, including recommendations for interacting with disaster medical resources.
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To assess the impact of a structured intervention, the "primary intervention for memory structuring and meaning acquisition" (PIMSMA) performed randomly in the emergency department with survivors of suicide bombing attacks, on their medium-term mental health outcome. ⋯ The PIMSMA approach is as good as the nonspecific supportive treatment performed routinely in the ED with all survivors of traumatic events of any origin. Further studies are needed to establish valid, evidence-based treatment approaches for the acute aftermath of exposure to severe potentially traumatic events.
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The 1995 Kikwit Ebola outbreak in the Democratic Republic of the Congo is one of the first Ebola outbreaks to be treated in a hospital setting and is one of the most well-studied Ebola epidemics to have occurred to date. Many of the lessons learned from identifying, containing, and treating the epidemic are applicable to future viral outbreaks. This article looks at the characteristics of the Ebola virus and health system issues, which affected the healthcare providers' ability to contain and treat the virus. It specifically examines factors such as the disease characteristics, surge capacity, supply issues, press involvement, and the involvement of voluntary organizations.
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Multicenter Study
Ready, aye ready? Support mechanisms for healthcare workers in emergency planning: a critical gap analysis of three hospital emergency plans.
In response to the 2003 global outbreak of severe acute respiratory syndrome (SARS), and the threat of pandemic influenza, Canadian hospitals have been actively developing and revising their emergency plans. Healthcare workers are a particularly vulnerable group at risk of occupational exposure during infectious disease outbreaks, as seen during SARS and as documented/reported in the recent National Survey of the Work and Health of Nurses (Statistics Canada, 2006). Approximately one third of Canadian nurses identified job strain and poor health, related to their work environment. Three years after SARS, this article presents a critical analysis of the gaps of three hospital pandemic influenza plans in the context of established organizational supports for healthcare workers. ⋯ Since the 2003 SARS outbreak, hospitals have invested in pandemic planning, as evidenced by the comprehensive plans examined here. Organizational support mechanisms for healthcare workers were included in these hospital plans; however, the gaps identified here may have serious implications for employee health and safety, and overall response during a large scale infectious disease outbreak. The authors provide a number of recommendations for consideration in infectious disease pandemic plan development to better support the healthcare workers in their roles as first responders.
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Mass casualty incidents and large-scale disasters involving children are likely to overwhelm a regional disaster response system. Children have unique vulnerabilities that require special considerations when developing pediatric response systems. Although medical and trauma strategies exist for the evaluation and treatment of children on a daily basis, the application of these strategies under conditions of resource-constrained triage and treatment have rarely been evaluated. ⋯ The variability, scale, and uncertainty of disasters call for a set of guiding principles rather than rigid protocols when developing pediatric response plans. The authors propose the following guiding principles in addressing the well-recognized, unique vulnerabilities of children: (1) terrorism prevention and preparedness, (2) all-hazards preparedness, (3) postdisaster disease and injury prevention, (4) nutrition and hydration, (5) equipment and supplies, (6) pharmacology, (7) mental health, (8) identification and reunification of displaced children, (9) day care and school, and (10) perinatology. It is hoped that the 10 guiding principles discussed in this article will serve as a basic framework for developing pediatric response plans and teams in developed countries.