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American Journal of Disaster Medicine

Tanya Holt, Michael Prodanuk, Gregory Hansen
OBJECTIVE: Determining pediatric severity of illness in referring centers may be useful for establishing appropriate patient disposition and interfacility transport. For this retrospective review, the authors evaluated the Canadian Paediatric Triage and Acuity Scale (PaedCTAS) tool in regards to individual patient disposition and outcomes. METHODS: A disposition score using the PaedCTAS algorithm was retrospectively calculated from referring center data at the time our transport team was consulted...
2018: American Journal of Disaster Medicine
Emily E Zona, Alina J Morris, Susan M Briggs, Mark A Rockoff
One hundred years ago, a massive explosion occurred in the harbor of Halifax, Nova Scotia, destroying the city and killing more than 2,000 and injuring more than 9,000. It was the worst manmade explosion the world had ever seen, not exceeded until the atomic bomb blast over Hiroshima in 1945. An urgent appeal for assistance came from the survivors, and many volunteers responded. This report describes the prompt and remarkable medical relief effort of the citizens of Massachusetts to help their Canadian neighbors...
2018: American Journal of Disaster Medicine
Kevin M Duignan, Laura C Lamb, Monica M DiFiori, John Quinlavin, James M Feeney
OBJECTIVE: The objective of this study was to evaluate tourniquet use in the Hartford prehospital setting during a 34-month period after the Hartford Consensus was published, which encouraged increasing tourniquet use in light of military research. DESIGN: This was a retrospective review of patients with bleeding from a serious extremity injury to determine appropriateness of tourniquet use or omission. SETTING: Level II trauma center between April 2014 and January 2017...
2018: American Journal of Disaster Medicine
Holly B Herberman Mash, Carol S Fullerton, Robert J Ursano
OBJECTIVE: A series of sniper attacks in the Washington, DC, area left 10 people dead and three wounded. The authors examined the relationship of sniper-related television (TV) viewing, identification with victims, and peritraumatic dissociation to post-traumatic stress symptoms. METHODS: Participants were 1,238 DC residents (ages 18-90, M = 41.7; 51 percent female; 68 percent White) who completed an online survey including items assessing identification, amount of TV, peritraumatic dissociation, and post-traumatic stress symptoms...
2018: American Journal of Disaster Medicine
Joan M Culley, Sara Donevant, Jean Craig, Jane Richter, Abbas S Tavakoli, Erik Svendsen, Salvatore DiNardi
OBJECTIVE: Our objective was to validate a novel irritant gas syndrome agent (IGSA) triage algorithm for use in an emergency department (ED). We assessed efficiency, accuracy, and precision of our IGSA triage algorithm based on signs/symptoms of actual patients. DESIGN: After characterizing the signs/symptoms of an actual IGSA exposure event, we developed and validated the IGSA triage algorithm using a simulated computer exercise to compare the IGSA triage algorithm to the preferred hospital triage algorithm, the Emergency Severity Index (ESI)...
2018: American Journal of Disaster Medicine
Sandeep Singh, Balram Bhargava, Praveen Aggarwal, Renu Dhingra, Arun Kumar, Rakesh Lodha, Ramesh Agarwal, Jayant S Karve
AIM: Intraosseous (IO) access in adults is preferred using semi-automatic devices as it is difficult to penetrate the thick cortical layer of long bones using manual needles. The authors have developed an IO device which generates both rotational and axial thrust using a manual driver. This drilling mechanism addresses certain pain-points of current IO devices. The objective of this study was to evaluate the performance of this device in human cadavers. METHODS: The authors tested the ability of this device for IO access at proximal and distal tibia in 10 adult cadavers...
2018: American Journal of Disaster Medicine
Frederick B Rogers, William McCune, Shreya Jammula, Brian W Gross, Eric H Bradburn, Deborah K Riley, Jeffrey Manning
Described herein is the utilization of the hospital's Emergency Operations Plan and incident command structure to mitigate damage caused by the sudden loss of the heating, ventilation, and air conditioning system within the entire operating room suite. The ability to ameliorate a devastating situation that occurred during working hours at a busy Level II trauma center can be ascribed to the dedication of the leadership and clinical teams working seamlessly together. Their concerted efforts were augmented by adherence to an established protocol that had been thoroughly substantiated and practiced during numerous training simulations...
2017: American Journal of Disaster Medicine
Alexander Hart, Peter R Chai, Matthew K Griswold, Jeffrey T Lai, Edward W Boyer, John Broach
OBJECTIVE: This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. DESIGN: Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). SETTING: A Single Urban New England Academic Tertiary Care Medical Center. PARTICIPANTS: Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles...
2017: American Journal of Disaster Medicine
Eytan Ellenberg, Mark Taragin, Zvia Bar-On, Osnat Cohen, Ishay Ostfeld
IMPORTANCE: Medical impact of terror is a public health issue as the threat is growing all over the world. OBJECTIVE: Our objective was to compare the number of injured and incidents in the three different databases and reports [Global Terrorism Database (GTD), Israeli Security Agency (ISA) and National Insurance Institute (NII)] in Israel. DESIGN: Retrospective study. SETTING: Analyses of three different databases (GTD, ISA and NII) and basic comparison...
2017: American Journal of Disaster Medicine
Michael Naor, Samuel N Heyman, Tarif Bader, Ofer Merin
OBJECTIVE: The Israeli Defense Force (IDF) Medical Corps developed a model of airborne field hospital. This model was structured to deal with disaster settings, requiring self-sufficiency, innovation and flexible operative mode in the setup of large margins of uncertainty regarding the disaster environment. The current study is aimed to critically analyze the experience, gathered in ten such missions worldwide. METHODS: Interviews with physicians who actively participated in the missions from 1988 until 2015 as chief medical officers combined with literature review of principal medical and auxiliary publications in order to assess and integrate information about the assembly of these missions...
2017: American Journal of Disaster Medicine
Alexis Rump, Daniela Stricklin, Andreas Lamkowski, Stefan Eder, Michael Abend, Matthias Port
OBJECTIVE: In radiological emergencies, there is a risk of radionuclide incorporation. The radiological doses absorbed can be reduced by decorporation treatment. Antidote requirements depend on the scenario and treatment strategy ("urgent approach": immediate treatment of all patients with possible incorporation; "precautionary approach": treatment only after confirmation of incorporation). We calculated the number of daily antidote doses for different scenarios and the differences in outcome for both treatment strategies...
2017: American Journal of Disaster Medicine
Christy Anthony, Tito Joe Thomas, Bridget M Berg, Rita V Burke, Jeffrey S Upperman
OBJECTIVE: Recent incidents have demonstrated that the US health system is unprepared for infectious pandemics resulting in a pediatric surge. Development of efficient plans and a structured and coordinated regional response to pediatric pandemic surge remains an opportunity. To address this gap, we conducted a literature review to assess current efforts, propose a response plan structure, and recommend policy actions. DESIGN: A literature review, utilizing MEDLINE and PubMed, through March 2017 identified articles regarding infectious disease pandemics affecting the US pediatric population...
2017: American Journal of Disaster Medicine
Isabelle Imamedjian, Nisreen Hamza M Maghraby, Valérie Homier
OBJECTIVE: A hospital mass casualty simulation exercise testing feasibility of two city buses and a tent as a hybrid system for patient decontamination. DESIGN: Observational study of a single mass casualty simulation exercise involving patient decontamination SETTING: Held on May 26, 2016 at the Montreal General Hospital, a Level 1 Trauma center without a garage. PATIENTS, PARTICIPANTS: Twenty-one medical staff including nurses, doctors, and patient attendants, and 30 volunteer-simulated patients...
2017: American Journal of Disaster Medicine
Osama A Samarkandi, Anas A Khan, Waleed Alazmy, Abdullah M Alobaid, Adel S Bashatah
Sandstorms represent a major natural hazard in the Arabian Peninsula. Their pulmonary consequences can be life-threatening, especially to those with a history of allergies, asthma, and chronic obstructive pulmonary diseases. Novel presentations of respiratory diseases caused by sandstorms can now be traced to specific chemical and organic components of sandstorms. We present an update of the pathophysiology of pulmonary conditions based on the results of clinical and epidemiologic research as well as from greater knowledge of the complex chemical composition of sandstorms...
2017: American Journal of Disaster Medicine
Koichi Imai, Hidenobu Ochiai, Keisuke Murakami
OBJECTIVE: To verify the life jacket's airway-securing capacity to keep the nose and mouth out of the water in a flood disaster. DESIGN: Physical experiment. SETTING: University of Miyazaki. MATERIALS AND METHODS: We experimented with an open channel in which we created a wave and running water. In the channel, we observed a dummy attached to a balloon as a buoyant body. We used 170-, 220-, and 320-ml balloons. Experiment 1, we reproduced a tsunami...
2017: American Journal of Disaster Medicine
Audrey Dadoun, Elene Khalil, Ilana Bank
Medical triage is the process of determining the priority of patients' treatments based on the severity of their condition. Triage provides the healthcare provider the ability to identify the most urgent cases first, with the goal of maximizing each individual patient's outcome. When resources are challenged, such as in a disaster, the healthcare provider's goal becomes to maximize overall population survival. In this context, the triage process must identify patients who require resources urgently, as well as those who have the best chance of survival...
2017: American Journal of Disaster Medicine
Kay Vonderschmidt
This mixed methods study explored surge planning for patients who will need rehabilitative care after a mass casualty incident. Planning for a patient surge incident typically considers only prehospital and hospital care. However, in many cases, disaster patients need rehabilitation for which planning is often overlooked. The purpose of this study was to explore this hidden dimension of patient rehabilitation for surge planning and preparedness and ask: 1. To what extent can an analysis of standard patient acuity assessment tools [Simple Triage and Rapid Treatment and Injury Severity Score] be used to project future demand for admission to rehabilitative care? 2...
2017: American Journal of Disaster Medicine
J J Hoff, Gerard Carroll, Rick Hong
OBJECTIVE: We evaluated the use of the Simple Triage and Rapid Treatment (START) method by Emergency Medical Services (EMS) and hypothesized that EMS can categorize patients using the START algorithm accurately. DESIGN: Retrospective Chart Review. SETTING: Inner-city Tertiary-Care Institutional Emergency Department (ED). PARTICIPANTS: Patients ≥ 18 years transported by EMS with a START color of Red, Yellow, or Green during the state triage tag exercise, October 9-15, 2011...
2017: American Journal of Disaster Medicine
Hiroyuki Maeda, Hideaki Iwase, Akio Kanda, Itaru Morohashi, Kazuo Kaneko, Mutsuhiro Maeda, Yuki Kakinuma, Yusuke Takei, Shota Amemiya, Kazuyuki Mitsui
BACKGROUND: After an emergency or disaster, subsequent trauma can cause severe bleeding and this can often prove fatal, so promptly stopping that bleeding is crucial to preventing avoidable trauma deaths. A tourniquet is often used to restrict blood flow to an extremity. In operation and hospital, the tourniquet systems currently in use are pneumatically actuated by an air compressor, so they must have a steady power supply. These devices have several drawbacks: they vibrate and are noisy since they are pneumatically actuated and they are far from portable since they are large and heavy...
2017: American Journal of Disaster Medicine
Khaldoon H Alkhaldi, Meredith L Austin, Boris A Cura, Darrell Dantzler, Leslie Holland, David L Maples, Jamie C Quarrelles, Robert K Weinkle, Leonard J Marcus
The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes...
2017: American Journal of Disaster Medicine
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