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American Journal of Disaster Medicine

Adnan Todorovac, Louise Damsbo Simonsen, Ask Elklit
PURPOSE: This descriptive study explored barriers and difficulties faced by individuals with a physical disability (IPD) in Denmark in situations of disaster and in everyday problems. METHODS: Semistructured interviews were conducted with 12 IPD who had experienced a possible traumatic event. Due to a lack of participants who experienced a traumatic event, the authors expanded their recruitment strategy to include IPD, who had experienced other critical situations (eg, accidents and personal crises)...
April 2018: American Journal of Disaster Medicine
Elena Skryabina, Paul Riley, Gabriel Reedy, Richard Amlôt
OBJECTIVE: To review and analyze evaluation methods currently utilized in health emergency preparedness exercises (HEPE). DESIGN: This study, part of a larger scoping review that systematically collected and reviewed published evidence related to the benefits of HEPE, provides a further analysis of the evaluation methods utilized in such exercises. We separately analyzed discussion-based and operation-based exercises according to their purpose. This addresses a methodological limitation related to the poorly understood relationship between the purpose and context in which a specific evaluation method is selected to be used...
April 2018: American Journal of Disaster Medicine
Ltc Robert P Long, Ltc Stephanie M Gardner, James Burgert, Ltc Craig A Koeller, Ltc Joseph O'Sullivan, Dawn Blouin, Col Don Johnson
OBJECTIVE: Compare the maximum concentration (Cmax), time to maximum concentration (Tmax), mean concentration, rate of return of spontaneous circulation (ROSC), time to ROSC, and odds of ROSC when epinephrine is administered by humerus intraosseous (HIO) compared to intravenous (IV) routes in both a hypovolemic and normovolemic cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental study. SETTING: TriService Facility...
April 2018: American Journal of Disaster Medicine
Andrew Hashikawa, Megan Chang, Alan Sielaff, Stuart Bradin, Dianne C Singer, Amilcar Matos-Moreno, Sarah J Clark, Anna Daly Kauffman, Matthew M Davis
OBJECTIVE: Children in early learning settings are vulnerable to site-specific emergencies because of physical and developmental limitations. We examined parents' knowledge of disaster plans in their child's early learning settings. METHODS: In May 2015, we conducted a nationally representative online household survey, including parents of children ages 0-5 years in child care settings. Parents were asked about their center's disaster plans and key components: evacuation, special needs children, and disaster supplies...
April 2018: American Journal of Disaster Medicine
Sharon E Mace, Constance J Doyle, Kim Askew, Stuart Bradin, Mark Baker, Madeline M Joseph, Annalise Sorrentino
Although disasters can affect anyone in a given community or region, those with access and functional needs have the highest rates of morbidity and mortality during an emergency or disaster. There are many unique and complex issues that should be considered when planning and caring for these individuals in a disaster situation. Who are these individuals, what specific issues should be addressed when considering these members of the population, and what recommendations can be made to address their unique needs? How can we include them as part of the all-hazard, comprehensive approach to disaster management? The first part of this three-part series identifies who is included in this population and what are the legal considerations that arise in caring for, not only this unique group but also all the members of the community in a disaster...
April 2018: 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
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