American journal of disaster medicine
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Emergency management of trauma in the developing world is at a nascent stage of development. Industrialized cities, rural towns, and villages coexist, with an almost complete lack of organized trauma care. There is no leading national agency to coordinate the various components of a trauma system, and no mechanism for accreditation of trauma centers and professionals exists. ⋯ However, communicable diseases, maternal and child health, and population control continue to be government priorities, far ahead of trauma care, in countries like India. New initiatives under the National Health Policy 2002 were expected to result in improvements in the systems, but grossly inadequate funding allocation made any significant impact on the outcome impossible. Strengthening in several areas is severely needed to achieve a reasonable level of efficiency, despite significant efforts on the part of the private sector to develop trauma care systems.
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To assess hospital employees' attitudes and needs regarding work commitments during disasters. ⋯ The majority of hospital workers surveyed were willing to report to work in response to some types of disasters but not others, and some indicated they might not be available at all due to conflicting emergency response obligations.
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The Haddon Matrix offers a classic epidemiological model for studying injury prevention. This methodology places the public health concepts of agent, host, and environment within the three sequential phases of an injury-producing incident-pre-event, event, and postevent. This study uses this methodology to illustrate how it could be applied in systematically preparing for a mass casualty disaster such as an unconventional sarin attack in a major urban setting. ⋯ The majority of factors identified in all phases were modifiable, primarily through educational interventions focused on individual healthcare providers and first responders. The Haddon Matrix provides a viable means of studying an unconventional problem, allowing for the identification of modifiable factors to decrease the type and severity of injuries following a mass casualty disaster such as a sarin release. This strategy could be successfully incorporated into disaster planning for other weapons attacks that could potentially cause mass casualties.