American journal of disaster medicine最新文献

{"title":"Advances in prehospital hemorrhagic shock management since Paris' terrorist attacks in 2015: A before-and-after retrospective study.","authors":"Christophe Thiery, Daniel Jost, Isabelle Klein, Frédérique Dufour-Gaume, Olivier Stibbe, Bertrand Prunet","doi":"10.5055/ajdm.2021.0408","DOIUrl":"10.5055/ajdm.2021.0408","url":null,"abstract":"<p><strong>Background: </strong>In France, in 2015, prehospital emergency doctors were faced with civilian casualties in hemorrhagic shock resulting from terrorist attacks with automatic rifle fire and explosive weapons. The present study aimed to evaluate the impact of these attacks on the advanced life support (ALS) team's practices and equipment and on physician training in the prehospital management of traumatic hemorrhagic shock.</p><p><strong>Methods: </strong>This before-and-after multicenter study evaluated professional practices based on a questionnaire sent to emergency department heads and medical practitioners in 370 ALS teams in metropolitan France.</p><p><strong>Results: </strong>We analyzed 672 responses from 209 (56.5 percent) ALS teams in 91 of 95 emergency medical services (EMS) headquarters. Of these 91, 73 (80.2 percent) had a protocol in use for managing traumatic hemorrhagic shock after the attacks, compared with 45 (49.5 percent) who had protocols in use before the attacks (p < 0.001). Ultrasound equipment was available in 49 (53.8 percent) of the EMS headquarters after the attacks, compared to 39 (42.9 percent) before (p < 0.001). Limb tourniquets were available in 90 (98.9 percent) EMS headquarters after the attacks, versus 27 (29.7 percent) before (p < 0.001). Tranexamic acid was available in 88 (96.7 percent) EMS headquarters after the attacks, versus 71 (78 percent) before (p < 0.001). During the post-attack period, training in war medicine did not affect individual practices, neither for using the shock index or the Focused Assessment with Sonography for Trauma (FAST) nor the tourniquet. However, this training was associated with more frequent use of hemostatic dressings (p = 0.002).</p><p><strong>Conclusion: </strong>Following the attacks in Paris and Nice, ALS teams received additional equipment and training to prepare for future mass causality events.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40320892","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":"Fear of COVID-19 among nonsmokers and smokers/former smokers: Implications for health promotion practice.","authors":"Blake T Hilton,&nbsp;Brandt J Wiskur,&nbsp;Michael W Brand,&nbsp;Julio I Rojas,&nbsp;Raina D Leckie,&nbsp;Maria Trapp,&nbsp;Katrin Gaardbo Kuhn","doi":"10.5055/ajdm.2022.0446","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0446","url":null,"abstract":"<p><strong>Introduction: </strong>Fear of COVID-19 may differ for individuals with compromised health and those with unhealthy behaviors, placing them at greater risk. Based on previous analysis of academic medical center faculty and staff, the authors predicted that workers who were smokers/previous smokers would express the greater fear of COVID-19 relative to nonsmokers.</p><p><strong>Methods: </strong>The present study used the Fear of COVID-19 Scale to assess fear among nonsmokers (n = 1,489) and smokers/previous smokers (n = 272) from a larger population of academic medical center members (N = 1,761). This study assessed nonsmokers' and smokers/previous smokers' demographic and background variables on Fear of COVID-19 scores.</p><p><strong>Results: </strong>In this academic community, smokers/previous smokers had higher fear of COVID-19 scores than did nonsmokers (p < 0.05). Smokers/previous smokers differed from nonsmokers on three Fear of COVID-19 scale items (most afraid of COVID-19, fear of losing life, and physiological fear of COVID-19).</p><p><strong>Discussion/conclusions: </strong>These results provide a better understanding of how fear of COVID-19 can differ based on one's smoking status. These findings inform public health smoking cessation efforts aimed at reducing morbidity and mortality, both in response and secondary to COVID-19 exposure.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945805","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":"Hospital COVID-19 preparedness: Are (were) we ready?","authors":"Mei Zhao,&nbsp;Hanadi Y Hamadi,&nbsp;D Rob Haley,&nbsp;Jing Xu,&nbsp;Ajani Aj Dunn,&nbsp;Aaron Spaulding","doi":"10.5055/ajdm.2022.0449","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0449","url":null,"abstract":"<p><strong>Background: </strong>Terrorist attacks and natural disasters such as Hurricanes Katrina and Harvey have increased focus on disaster preparedness planning. Despite the attention on planning, many studies have found that hospitals in the United States are underprepared to manage extended disasters appropriately and the surge in patient volume it might bring.</p><p><strong>Aim: </strong>This study aims to profile and examine the availability of hospital capacity specifically related to COVID-19 patients, such as emergency department (ED) beds, intensive care unit (ICU) beds, temporary space setup, and ventilators.</p><p><strong>Method: </strong>A cross-sectional retrospective study design was used to examine secondary data from the 2020 American Hospital Association (AHA) Annual Survey. A series of multivariate logistic analyses were conducted to investigate the strength of association between changes in ED beds, ICU beds, staffed beds, and temporary spaces setup, and the 3,655 hospitals' characteristics.</p><p><strong>Results: </strong>Our results highlight that the odds of a change in ED beds are 44 percent lower for government hospitals and 54 percent for for-profit hospitals than not-for-profit hospitals. The odds of ED bed change for nonteaching hospitals were 34 percent lower compared to teaching hospitals. Small and medium hospitals have significantly lower odds (75 and 51 percent, respectively) than large hospitals. For ICU bed change, staffed bed change, and temporary spaces setup, the conclusions were consistently significant regarding the impact of hospital ownership, teaching status, and hospital size. However, temporary spaces setup differs by hospital location. The odds of change is significantly lower (OR = 0.71) in urban hospitals compared with rural hospitals, while for ED beds, the odds of change is considerably higher (OR = 1.57) in urban hospitals compared to rural hospitals.</p><p><strong>Conclusion: </strong>There is a need for policymakers to consider not only resource limitations that were created from supply line disruptions during the COVID-19 pandemic but also a more global assessment of the adequacy of funding and support for insurance coverage, hospital finance, and how hospitals meet the needs of the populations they serve.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945806","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":"Effectiveness of the Global Surgical and Medical Support Group (GSMSG) activities in Ukraine.","authors":"Aaron Epstein,&nbsp;Francesca Voza,&nbsp;Enrique Ginzburg","doi":"10.5055/ajdm.2022.0442","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0442","url":null,"abstract":"<p><strong>Objective: </strong>Targeting of healthcare infrastructures in Ukraine has served as a tactical warfare strategy. The goal of the Global Surgical and Medical Support Group (GSMSG) is to provide sustainable, high quality medical and surgical care in war zones.</p><p><strong>Interventions: </strong>GSMSG deployed United States (US) Special Operations veterans and highly specialized licensed medical experts. Training of Ukrainian civilians was implemented.</p><p><strong>Results: </strong>Over 20,000 Ukrainians trained and over 100 major surgeries performed with assistance of world experts. Specialized medical equipment was also provided.</p><p><strong>Conclusion: </strong>GSMSG lays the groundwork for effective, high quality, and sustainable surgical interventions into a nation in conflict.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9951677","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":"Emergency department active shooter training: A survey of current practices in 2020.","authors":"Gregory Jasani, James MacNeal, Jon Mark Hirshon","doi":"10.5055/ajdm.2021.0410","DOIUrl":"10.5055/ajdm.2021.0410","url":null,"abstract":"<p><strong>Background: </strong>Shooting events in hospitals are increasing in frequency, with the emergency department (ED) being the most common site of such events. EDs must be prepared for shooting events, but current practices surrounding active shooter preparation are unknown.</p><p><strong>Objective: </strong>To determine what active shooter training emergency medicine physicians are receiving.</p><p><strong>Methods: </strong>A survey was developed to assess current practices around active shooter preparation in EDs. The survey was distributed to members of the American College of Emergency Physicians' Emergency Medicine Practice Research Network. All members of the Emergency Medicine Practice Research Network are currently practicing emergency medicine physicians.</p><p><strong>Results: </strong>There were 194 respondents. The most common form of training received was online (76/194), followed by lecture (50/194). Only 39 respondents had participated in an active shooter drill. Sixty-five respondents (33 percent) reported having never received any formal active shooter training.</p><p><strong>Conclusion: </strong>There is a wide array of active shooter training that emergency medicine physicians are receiving, with nearly one-third receiving no training at all.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40320894","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":"A novel medical apparatus for the containment and evaluation of a pediatric patient under suspicion for highly communicable infectious disease.","authors":"Lori Pandya,&nbsp;Geoffrey Lowe,&nbsp;Vincent J Wang","doi":"10.5055/ajdm.2022.0447","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0447","url":null,"abstract":"<p><strong>Background: </strong>Highly communicable infectious diseases (HCIDs) such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Ebola are a containment challenge for the emergency department (ED). Donning and doffing personal protective equipment is necessary to protect healthcare workers but is time consuming and rife with errors. Furthermore, children present an additional containment challenge since they are often unable to follow directions or be separated from family members. To address these challenges, a novel child-friendly medical apparatus was developed for the rapid containment and evaluation of a HCID patient in the ED.</p><p><strong>Objectives: </strong>The primary objective was to determine if routine emergency triage procedures (vital signs and basic physical examination) can be performed using this medical apparatus. The secondary objective was to determine if invasive procedures (bag-valve-mask ventilation and endotracheal intubation) can be performed.</p><p><strong>Design: </strong>This was a prospective pilot study. A clear acrylic apparatus was built containing arm ports with gloves, simulating a specialized HCID barrier. Emergency physicians attempted routine triage procedures on a healthy volunteer and invasive procedures using a simulation mannequin through this apparatus.</p><p><strong>Results: </strong>Twenty-four physicians were enrolled. All physicians (100 percent) successfully obtained vital signs, auscultated heart/lung sounds, completed bag-valve-mask ventilation, and performed intubation through the apparatus.</p><p><strong>Conclusions: </strong>This novel apparatus is a feasible tool in the rapid evaluation of a HCID patient in the ED. A future study is needed to assess protection and training using this apparatus.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945802","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":"Explaining factors affecting the participation of nongovernmental organizations (NGOs) in disaster management: A systematic review.","authors":"Hassan Khaledi,&nbsp;Rita Rezaee,&nbsp;Milad Ahmadi Marzaleh,&nbsp;Mahmoudreza Peyravi","doi":"10.5055/ajdm.2022.0444","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0444","url":null,"abstract":"<p><strong>Background and objective: </strong>Numerous disasters have occurred over the recent years. Moreover, there has been a considerable rise in the number of victims, injured people, and damages caused by disasters worldwide. Governments cannot meet needs alone due to the complicated nature of crises and accidents. Therefore, nongovernmental organizations (NGOs) and communities must assist the states during disasters. The present study aimed to derive the factors affecting the participation of NGOs in disaster management using a systematic review in 2022.</p><p><strong>Design: </strong>This systematic review was done using ISI, Science Direct, Scopus, PubMed/MEDLINE, ProQuest, and Cochran Library based on the preferred reporting items for systematic reviews (PRISMA) standard from January 1, 2000 to December 31, 2021. The articles were selected based on the search keywords (population, intervention, comparison, outcome (PICO)). After studying the titles, abstracts, and full texts of the articles, the factors affecting the participation of NGOs in disaster management were derived.</p><p><strong>Results: </strong>The final assessment was done on 13 articles. Cooperation and coordination with other organizations, education, communication between NGOs, social empowerment, access to adequate references, and flexibility were the criteria with the highest frequency.</p><p><strong>Conclusion: </strong>As multiple NGOs take part in responding to disasters and performing relief operations, establishing a unified command and supervision system for effective coordination and collaborations among NGOs and other stakeholders is highly suggested. Further research is needed to develop a -measurement tool for assessing the effectiveness of NGOs' activities during disasters.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945803","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":"Displacement after disaster: Challenges and opportunities responding to Puerto Rican evacuees in Central Florida after Hurricane Maria.","authors":"Tanya Buhler Corbin","doi":"10.5055/ajdm.2022.0438","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0438","url":null,"abstract":"<p><p>Major disasters often displace populations, requiring coordinated response efforts from governmental and voluntary organizations to support and assist an influx of evacuees. Despite the frequency and significance of this occurrence, this aspect of disaster management has received limited scholarly attention, with research predominantly focusing on response and recovery at the impacted disaster sites. This study investigates disaster management and support offered to Puerto Rican evacuees arriving in Central Florida after Hurricane Maria. A multiagency resource center (MARC) was established at the Orlando Airport to support evacuees, facilitating a network of agencies to coordinate response efforts. The analysis uses data obtained through in-depth, semistructured interviews from members of the Orlando metropolitan area disaster response community who worked at the MARC center, and content analysis of state and local government documents. The results identify challenges and successes and common themes in disaster support for displaced evacuees after disasters. Results confirm some conventional wisdom about disaster response, such as persistent significant challenges related to shelter and housing, and offer new insights about how to successfully support displaced evacuees, particularly using MARCs. This study provides foundational knowledge to inform future research and contributes to the development of successful support for those who are displaced after disaster.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9468841","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":"Field hospitals' diagnostic radiology standards in low-resource settings.","authors":"Hisham Ali Dinar,&nbsp;Amel Faisal Hassan Alzain","doi":"10.5055/ajdm.2022.0434","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0434","url":null,"abstract":"<p><strong>Objective: </strong>To review the current standards being followed for diagnostic radiology at low-resource settings.</p><p><strong>Design: </strong>A systematic review was conducted.</p><p><strong>Setting: </strong>Low-resource field hospitals were reviewed.</p><p><strong>Patients and participants: </strong>All patients who were diagnosed using imaging in field hospitals were included in this review.</p><p><strong>Interventions: </strong>Only standard care diagnostic imaging was reviewed.</p><p><strong>Results: </strong>Scanty evidence on the standard quality control for mobile health unit (MHU) in low-resource settings is observed. The lack of evidence makes it inconclusive to decide if suboptimal quality of care is being provided to patients at the MHUs or if the quality is optimal. Multiple international societies such as the Radiological Society of North America and European Society of Radiology do provide extensive guidelines and algorithms for radiologists under normal conditions in the hospital. However, no such guidelines were found for MHUs. The most significant contributions that have been done in the guidance and quality control of the MHUs have been done by the World Health Organization with their emergency medical team guidelines and publications.</p><p><strong>Conclusions: </strong>MHUs are critical interventions introduced to mitigate crises and manage health campaigns. Diagnostic imaging also plays a pivotal role in ensuring successful patient management in the MHUs. No international or local diagnostic imaging standard for quality control was found in the evidence. Investigations to access the feasibility of different quality control standards in the MHUs are warranted.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9512884","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":"Characteristics of chemical attacks.","authors":"Emel Altıntaş,&nbsp;Ali Kaan Ataman","doi":"10.5055/ajdm.2022.0439","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0439","url":null,"abstract":"<p><strong>Background: </strong>The use and storage of chemical weapons in war was banned. However, chemical weapons continue to be used in wars. Therefore, in this study, we tried to identify the chemical agents used by defining the characteristics of chemical attacks.</p><p><strong>Method: </strong>We designed our study using the international dataset that can be accessed from www.start.umd.edu/gtd/. Chemical attacks between 1970 and 2020 were recorded in terms of decade, type of attack, success, suicidal purpose, property damage, number of deaths and injuries, and agents used.</p><p><strong>Results: </strong>A total of 347 attacks were reported. The highest number of attacks was 162 (46.7 percent), which occurred between 2010 and 2020. Among the chemical agents used, acidic substances (39, 11.2 percent), chlorine gas (32, 9.2 percent), and tearing agents (24, 6.9 percent) were found to be the most common. When the distribution of the five most common chemical agents by years was examined, it was found that the use of chlorine gas gradually increased in the last three decades. In the last decade, it was found that the use of mustard gas increased, whereas cyanide was not used.</p><p><strong>Conclusion: </strong>In the last decade, we found that chemical attacks have increased more, especially chlorine and mustard gas were predominantly used.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9512886","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}