American journal of disaster medicine最新文献

{"title":"Development of a prototype dry decontamination method for particulate contamination: The DryCon system.","authors":"Barbara M Alexander,&nbsp;H Amy Feng,&nbsp;Gabriel Merk","doi":"10.5055/ajdm.2020.0375","DOIUrl":"https://doi.org/10.5055/ajdm.2020.0375","url":null,"abstract":"<p><strong>Objective: </strong>This article describes the development of a prototype dry decontamination system (DryCon) for use in the event of a contamination incident involving a particulate contaminant. Disrobing and showering is currently recommended almost exclusively in mass decontamination, although it may not be feasible when water is scarce, in cold weather environments, or when there may be compliance issues with the requirement to disrobe, ie, unwillingness to disrobe. During disrobing, dust particles could also re-aerosolize, leading to inhalation of contaminants.</p><p><strong>Design: </strong>The DryCon prototype uses air jets for dry decontamination. The system is portable and can run on building-supplied 220-V power or generator power. Multiple contaminated persons can be treated rapidly, one after the other, using this system.</p><p><strong>Setting: </strong>We tested DryCon in a controlled environment, using a manikin and three different types of fabric squares to investigate its effectiveness, with a decontamination time of 60 seconds.</p><p><strong>Main outcome: </strong>At the higher airflow tested, ie, 90 percent of full blower speed or approximately 540 cfm (15 m3/minute), mean decontamination efficiencies of 56.8 percent, 70.3 percent, and 80.7 percent were measured for firefighter (FF) turnout fabric, cotton denim, and polyester double knit fabric, respectively.</p><p><strong>Results: </strong>Removal of this easily re-aerosolized fraction of the contaminants helps protect contaminated people, as well as healthcare providers they come in contact with, from the potential risk of further inhalation exposures from the re-aerosolization caused by doffing clothing.</p><p><strong>Conclusion: </strong>The results demonstrate the promise of the DryCon system for use where water is not available, as a first step prior to wet decontamination, or in an industrial setting for post-work-shift decontamination. Further lab and field research will be necessary to prove the effectiveness of this technique in real-world applications and to determine if respiratory protection or other personal protective equipment (PPE) is needed during use of the DryCon system.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38805328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fire at the Oakland Ghost Ship Warehouse: A disaster life cycle-based analysis.","authors":"Frederick Tolle,&nbsp;Allison P Chen,&nbsp;Daniel J Barnett,&nbsp;Edbert B Hsu","doi":"10.5055/ajdm.2020.0378","DOIUrl":"https://doi.org/10.5055/ajdm.2020.0378","url":null,"abstract":"<p><strong>Objective: </strong>Structural fires remain a prominent threat to public health and safety even in several regions of the developed world, where rising housing costs force many to reside in unsafe environments. This case report of the Ghost Ship Warehouse fire in Oakland, California, highlights deficiencies in the emergency management system in the context of similar nightclub incidents to inform recommendations that might prevent such events from occurring in the future.</p><p><strong>Design: </strong>The characteristics of the Ghost Ship warehouse and circumstances surrounding the fire, as described in government documents and news media sources, were examined using the disaster life cycle framework. The Ghost Ship fire was also compared with two prior fire disasters at the Happy Land nightclub in New York City and Station nightclub in West Warwick, Rhode Island.</p><p><strong>Results: </strong>The following risk factors were identified as common features of deadly nightclub fires: large crowd size, limited access to exits, multiple code violations, lack of required permits, inadequate fire suppression systems, and poor building maintenance.</p><p><strong>Conclusions: </strong>To prevent the recurrence of such disasters, Oakland and other cities should adopt measures to improve interdepartmental communication; streamline reporting of fire and safety hazards, and allocate sufficient resources and staff capable of identifying hazardous buildings, performing inspections, and enforcing building and fire codes. Equally importantly, the urban affordable housing crisis needs to be adequately addressed to mitigate vulnerable populations living in unsafe dwellings that place them at risk of deadly fires.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38739766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and validation of a hospital emergency department preparedness questionnaire for radiation accidents, nuclear accidents, and nuclear terrorism in Iran.","authors":"Milad Ahmadi Marzaleh Co-First Author,&nbsp;Rita Rezaee Co-First Author,&nbsp;Abbas Rezaianzadeh,&nbsp;Mahnaz Rakhshan,&nbsp;Gholamhassan Haddadi,&nbsp;Mahmoudreza Peyravi","doi":"10.5055/ajdm.2020.0377","DOIUrl":"https://doi.org/10.5055/ajdm.2020.0377","url":null,"abstract":"<p><strong>Background and objectives: </strong>Radiation accidents can cause numerous challenges to hospitals, the appropriate medical responses to which may save the lives of countless people. The present study aimed at the design and validation of an Emergency Department preparedness questionnaire for hospital emergency departments (EDs) in the case of radiation accidents, nuclear accidents, and nuclear terrorism in Iran.</p><p><strong>Materials and methods: </strong>This multistage cross-sectional study was conducted in 2019. The questionnaire items were created with the reference to article reviews and expert judgement. The validity of the questionnaire was assessed through face, content, and construct validities. Additionally, its reliability was estimated using measures of internal consistency and stability, namely Cronbach's alpha and intraclass correlation coefficient (ICC). To this end, the questionnaire was completed by the ED staff in the hospitals of Iran.</p><p><strong>Results: </strong>The proposed 48-item questionnaire consisted of three themes: staff preparedness, stuff preparedness, and structure preparedness. The face and content validities were confirmed by expert judgement. All items remained with content validity ratio (CVR) > 0.7 and the mean content validity index (CVI) = 0.891. The overall Cronbach's alpha and ICC were 0.781 and 0.709, respectively for the whole questionnaire.</p><p><strong>Conclusion: </strong>Hospital ED preparedness in radiation and nuclear accidents requires readiness of staff, stuff, and structure of the ED, the consideration of which will properly respond to radiation and nuclear accidents. Thus, upstream organizations like the Ministry of Health and the Emergency Organization should oblige hospital EDs to make themselves be more prepared by codifying certain imperative laws and -policies.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38739765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pandemic influenza and major disease outbreak preparedness in US emergency departments: A survey of medical directors and department chairs.","authors":"Melinda J Morton,&nbsp;Thomas D Kirsch,&nbsp;Richard E Rothman,&nbsp;Marielle M Byerly,&nbsp;Yu-Hsiang Hsieh,&nbsp;John G McManus,&nbsp;Gabor D Kelen","doi":"10.5055/ajdm.2019.0341","DOIUrl":"https://doi.org/10.5055/ajdm.2019.0341","url":null,"abstract":"<p><strong>Study objectives: </strong>To quantify the readiness of individual academic emergency departments (EDs) in the United States for an outbreak of pandemic influenza. Methods, design, and setting: Cross-sectional assessment of influenza pandemic preparedness level of EDs in the United States via survey of medical directors and department chairs from the 135 academic emergency medicine departments in the United States. Preparedness assessed using a novel score of 15 critical preparedness indicators. Data analysis consisted of summary statistics, χ², and ANOVA.</p><p><strong>Participants: </strong>ED medical directors and department chairs.</p><p><strong>Results: </strong>One hundred and thirty academic emergency medicine departments contacted; 66 (50.4 percent) responded. Approximately half (56.0 percent) stated their ED had a written plan for pandemic influenza response. Mean preparedness score was 7.2 (SD = 4.0) out of 15 (48.0 percent); only one program (1.5 percent) achieved a perfect score. Respondents from programs with larger EDs (=30 beds) were more likely to have a higher preparedness score (p < 0.035), an ED pandemic preparedness plan (p = 0.004) and a hospital pandemic preparedness plan (p = 0.007). Respondents from programs with larger EDs were more likely to feel that their ED was prepared for a pandemic or other major disease outbreak (p = 0.01). Only one-third (34.0 percent) felt their ED was prepared for a major disease outbreak, and only 27 percent felt their hospital was prepared to respond to a major disease outbreak.</p><p><strong>Conclusions: </strong>Significant deficits in preparedness for pandemic influenza and other disease outbreaks exist in US EDs, relative to HHS guidelines, which appear to be related in part to ED size. Further study should be undertaken to determine the barriers to appropriate pandemic preparedness, as well as to develop and validate preparedness metrics.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38272369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pandemic preparedness and hard to reach populations.","authors":"David Vlahov,&nbsp;Micaela H Coady,&nbsp;Sandro Galea,&nbsp;Danielle C Ompad,&nbsp;Jeremiah A Barondess","doi":"10.5055/ajdm.2019.0344","DOIUrl":"https://doi.org/10.5055/ajdm.2019.0344","url":null,"abstract":"","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38272373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting ready for the next phase of the COVID-19 pandemic.","authors":"George W Contreras","doi":"10.5055/ajdm.2019.0336","DOIUrl":"https://doi.org/10.5055/ajdm.2019.0336","url":null,"abstract":"On March 3rd, there were 90,663 reported cases and 3,124 deaths worldwide and 103 cases and 6 deaths in the United States.1 On May 27th, there are now 5,626,047 cases and 352,235 deaths worldwide and 1,685,955 cases and 99,264 deaths in the United States.2 In New York State which represents the epicenter of the United States outbreak, there are currently 363,836 cases and 23,564 deaths...","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38280306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planning for the next influenza pandemic: Using the science and art of logistics.","authors":"O Shawn Cupp,&nbsp;Brad G Predmore","doi":"10.5055/ajdm.2019.0342","DOIUrl":"https://doi.org/10.5055/ajdm.2019.0342","url":null,"abstract":"<p><p>The complexities and challenges for healthcare providers and their efforts to provide fundamental basic items to meet the logistical demands of an influenza pandemic are discussed in this article. The supply chain, planning, and alternatives for inevitable shortages are some of the considerations associated with this emergency mass critical care situation. The planning process and support for such events are discussed in detail with several recommendations obtained from the literature and the experience from recent mass casualty incidents (MCIs). The first step in this planning process is the development of specific triage requirements during an influenza pandemic. The second step is identification of logistical resources required during such a pandemic, which are then analyzed within the proposed logistics science and art model for planning purposes. Resources highlighted within the model include allocation and use of work force, bed space, intensive care unit assets, ventilators, personal protective equipment, and oxygen. The third step is using the model to discuss in detail possible workarounds, suitable substitutes, and resource allocation. An examination is also made of the ethics surrounding palliative care within the construction of an MCI and the factors that will inevitably determine rationing and prioritizing of these critical assets to palliative care patients.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38272370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of long- and short-term experiences on stress during identification works of dead bodies: Rapid stress level measurement using voice.","authors":"Masakazu Higuchi,&nbsp;Isao Yamamoto,&nbsp;Yasuhiro Omiya,&nbsp;Mitsuteru Nakamura,&nbsp;Shuji Shinohara,&nbsp;Takeshi Takano,&nbsp;Kimiko Nakagawa,&nbsp;Hiroshi Ohira,&nbsp;Yoshihiro Yamada,&nbsp;Shinichi Tokuno","doi":"10.5055/ajdm.2020.0374","DOIUrl":"https://doi.org/10.5055/ajdm.2020.0374","url":null,"abstract":"OBJECTIVE The mental health issues of personnel dealing with the deceased at times of disasters is a problem and techniques are needed that allow for real-time, easy-to-use stress checks. We have studied techniques for measuring mental state using voice analysis which has the benefit of being non-invasive, easy-to-use, and can be performed in real-time. For this study, we used voice measurement to determine the stress experienced during body identification training workshops for dentists. We studied whether or not stress levels were affected by having previous experience with body identification either in actual disaster settings or during training. DESIGN Since participants training using actual dead bodies in particular are expected to suffer higher stress exposure, we also assessed their mental state pre- and post-training using actual dead bodies. RESULTS The results confirmed marked differences in the mental state between before and after training in participants without any actual experience, between participants who engaged in training using manikins before actual dead bodies and participants who did not. CONCLUSIONS These results suggest that, in body identification training, the level of stress when coming into contact with dead bodies varies depending on participants' experience and the training sequence. Moreover, it is believed that voice-based stress assessment can be conducted in the limited time during training sessions and that it can be usefully implemented in actual disaster response settings.","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38739767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Beirut blast 2020: Lessons learned from the Swiss Emergency Medical Team specialized \"Mother & Child\".","authors":"Olivier Hagon,&nbsp;Lionel Dumont","doi":"10.5055/ajdm.2020.0379","DOIUrl":"https://doi.org/10.5055/ajdm.2020.0379","url":null,"abstract":"<p><p>On August 4, 2020, Beirut was hit by a devastating explosion leading to mass casualties: thousands were injured and there were significant damages to residences, offices, and health structures. The Emergency Medical Team (EMT) specialized \"Mother and Child\" was deployed by the Swiss Humanitarian Aid in order to support local health facilities, empower local health professionals to resume clinical activities and ensure access, and continuity of patient care in particular in the fields of gynecology-obstetrics and pediatrics. This communication presents the particularities of an EMT deployment in an urban area of an upper middle-income country with some recommendations for such settings.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38805330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 experiment: Pandemic planning and preparedness lessons we must remember.","authors":"Eric P Wilkens,&nbsp;Gary M Klein","doi":"10.5055/ajdm.2019.0348","DOIUrl":"https://doi.org/10.5055/ajdm.2019.0348","url":null,"abstract":"It is apropos that this issue of American Journal of Disaster Medicine be dedicated to the past and current efforts of the many people concerned about our nation’s preparedness and its ability to itiate and sustain aneffective and robust response. As we enter the recovery phase of this current COVID-19 crisis, we must be ever mindful that we, as a people, easily forget devastating hardships of our past, which forces us to reinvent and relearn history...","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38280307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}