American journal of disaster medicine最新文献

{"title":"Regional pediatric disaster network guides statewide telehealth initiation during COVID-19 pandemic.","authors":"Brian S Marcus,&nbsp;Christopher Newton,&nbsp;Sarah A Rafton,&nbsp;Nancy Belcher,&nbsp;Jeb Shepard,&nbsp;Milissa Chanice,&nbsp;Todd Williams,&nbsp;Hal Quinn,&nbsp;Mary A King","doi":"10.5055/ajdm.2022.0430","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0430","url":null,"abstract":"<p><strong>Background: </strong>Telehealth emerged early as an important tool to provide clinical care during the COVID-19 pandemic, but statewide implementation strategies were lacking. Needs assessment: We performed a needs assessment at 15 pediatrics clinics in Washington regarding their ability to institute telehealth. Fourteen clinics (93 percent response rate) responded; none had ability to perform telehealth visits. Clinics needed the following specific support structures: (1) an easily implementable, low-cost system, and (2) parity billing for telehealth services. Disaster effort: Two weeks after the needs assessment was performed, we facilitated direct telehealth initiation support to 45 Washington clinics and created a coalition of statewide advocacy groups. These groups advocated for (1) a statewide solution for non-network or poorly resourced providers, which was delivered by the WA Health Care Authority, and (2) parity billing, which was delivered by emergency governor action.</p><p><strong>Conclusion: </strong>Engagement with our regional pediatric disaster network was essential in providing guidance and expertise in this needs assessment, telehealth initiation process, and subsequent advocacy efforts. The power we have as pediatricians to coordinate with regional experts helped improve access to telehealth across Washington.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353278","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":"Full-scale simulation exercise-A preparedness for trauma mass casualty incident: Nepal.","authors":"Ashis Shrestha,&nbsp;Sumana Bajracharya","doi":"10.5055/ajdm.2022.0427","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0427","url":null,"abstract":"<p><strong>Objective: </strong>This simulation exercise was conducted to test the functionality of the hospital incident command system, triage, treatment areas, and external coordination and communication.</p><p><strong>Design: </strong>This was an observational study. Coordination, logistic, technical design, staging, and evaluation of the exercise were planned for the exercise. The exercise was conducted in six hospitals. Observations were recorded, and a validated checklist was used to score.</p><p><strong>Setting: </strong>This was a semisurprise exercise in the hospital setup.</p><p><strong>Participants: </strong>Simulated patients and moulage were used for the exercise.</p><p><strong>Intervention: </strong>Full-scale simulation exercise.</p><p><strong>Main outcome: </strong>Gaps in knowledge and skills were identified in the running incident command center, skills of patient transferal from ambulance to triage area, and external coordination.</p><p><strong>Result: </strong>Out of a total score of 220 in the evaluation sheet, the mean score was 161 ± 3.2 (73.2 percent) and the median score was 161.5.</p><p><strong>Conclusion: </strong>Hospital incident command system, triaging, and patient transferal are the areas that can be improved in the future.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353269","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":"Disparities in disaster healthcare: A review of past disasters.","authors":"Angela Pettit Cornelius,&nbsp;Douglas Mark Char,&nbsp;Constance Doyle,&nbsp;Samantha Noll,&nbsp;Vivian Reyes,&nbsp;Jennie Wang,&nbsp;Sharon E Mace","doi":"10.5055/ajdm.2022.0431","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0431","url":null,"abstract":"<p><strong>Objective: </strong>To review the literature on the effects seen after disaster on those with poor social determinants of health (SDOH) and individual social needs.</p><p><strong>Design: </strong>The Disaster Preparedness and Response Committee of the American College of Emergency Physicians (ACEP) formed a work group to study healthcare disparities seen in disaster. This group was composed of six physicians on the committee, all of whom have extensive background in disaster medicine and the chair of the committee. A systematic literature review regarding past disasters and all the healthcare disparities seen was undertaken with the goal of organizing this information in one broad concise document looking at multiple disasters over history. The group reviewed multiple documents regarding SDOH and individual social needs for a complete understanding of these factors. Then, a topic list of healthcare disparities resulting from these factors was composed. This list was then filled out with subtopics falling under the header topics. Each member of the workgroup took one of these topics of healthcare disparity seen in disasters and completed a literature search. The databases reviewed include PubMed Central, Google Scholar, and Medline. The terms queried were disaster, healthcare disparities, disaster healthcare disparities, healthcare disparities associated with disasters, SDOH and disaster, special populations and disaster effects, and vulnerable populations and disaster effects. Each author chose articles they felt were most representative and demonstrative of the healthcare disparities seen in past disasters. These social determinant factors and individual social needs were then cross referenced in relation to past disasters for both their causes and the effect they had on various populations after disaster. This was presented to the ACEP board as a committee report.</p><p><strong>Results: </strong>All the SDOH and individual social needs showed significant negative effects for the populations when combined with a disaster event. These SDOH cut across age, race, and gender affecting a wide swath of people. Previous disaster planning either did not plan or under planned for these marginalized populations during disaster events.</p><p><strong>Conclusions: </strong>Disparities in healthcare are a pervasive problem that effects many different groups. Disasters magnify and more fully expose these healthcare disparities. We have explored the healthcare disparities with past disasters. These disparities, although common, can be mitigated. The recognition of these poor determinants of health can lead to better and more comprehensive disaster planning for future disasters. Subsequent research is needed to explore these healthcare disparities exacerbated by disasters and to find methods for their mitigation.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353273","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 Great Belt Bridge railway accident: Post-traumatic stress reactions among passengers and bereaved family members.","authors":"Ask Elklit,&nbsp;Lea Katrine Jørgensen","doi":"10.5055/ajdm.2022.0429","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0429","url":null,"abstract":"<p><strong>Objective: </strong>To identify the trauma sequelae after a major train disaster on the Great Belt Bridge in 2019 and to compare two different trauma measures.</p><p><strong>Design: </strong>Five (T1) and 13 (T2) months after the disaster, a questionnaire included both the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the new The International Classifications of Diseases (ICD-11) criterion stand-ards for post-traumatic stress disorder (PTSD). Also, anxiety and depression were measured on both occasions.</p><p><strong>Participants: </strong>All surviving passengers (N = 133) and the bereaved families (N = 8) were invited to participate through an electronic mailbox. At T1, 58 and 46 at T2 filled out all the questionnaires.</p><p><strong>Main outcome measures: </strong>The primary study outcome measures were the Harvard Trauma Questionnaire (HTQ) and the International Trauma Questionnaire (ITQ).</p><p><strong>Results: </strong>At T1, the HTQ screened 19 percent positive for PTSD, while the ITQ screened 15.5 percent. At T2, the numbers were 26 percent for the HTQ and 10.9 percent for the ITQ. At T1, 22.8 percent were screened positive for moderate or severe depression and 8.6 percent fulfilled the criteria for an anxiety diagnosis. The numbers at T2 were 19.5 percent for depression and 10.9 percent for anxiety.</p><p><strong>Conclusions: </strong>There is a remarkable lack of train accident/disaster passenger studies. A large subgroup suffered from several psychological disorders both 5 and 13 months after the disaster. The two diagnostic systems used (DSM-IV and ICD-11) both -identified a considerable number of passengers in need of treatment; the latter identifying fewer than the former. Effective outreach procedures are recommended in the future.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353272","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 telehealth advantage: Supporting humanitarian disasters with remote solutions.","authors":"Shuhan He,&nbsp;Sammer Marzouk,&nbsp;Adi Balk,&nbsp;Tehnaz Boyle,&nbsp;Jarone Lee","doi":"10.5055/ajdm.2022.0423","DOIUrl":"https://doi.org/10.5055/ajdm.2022.0423","url":null,"abstract":"Telehealth support can rapidly and significantly increase access to healthcare. For example, during the COVID-19 pandemic, telehealth not only supported patients with COVID symptoms but also improved access to the entire continuum of care, from critical care to mental health services.","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10316149/pdf/nihms-1912966.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital solution for COVID-19 isolation facility.","authors":"Gidon Berger,&nbsp;Netanel A Horowitz,&nbsp;Yael Shachor-Meyouhas,&nbsp;Vardit Gepstein,&nbsp;Khetam Hussein,&nbsp;Avi Weismann,&nbsp;Gila Hyams,&nbsp;Yuval Geffen,&nbsp;Michal Mekel,&nbsp;Michael Halberthal","doi":"10.5055/ajdm.2021.0384","DOIUrl":"https://doi.org/10.5055/ajdm.2021.0384","url":null,"abstract":"<p><strong>Objective: </strong>In response to the coronavirus disease 2019 (COVID-19) pandemic, the Israeli government strategy initially focused on containment. The Ministry of Health mandated isolation of COVID-19 patients in hospitals and instructed healthcare institutions to make necessary arrangements. As the second Israeli hospital to establish a COVID-19 department, this article describes our experience in its rapid establishment, while maintaining normal medical center activities.</p><p><strong>Setting: </strong>Establishing the COVID-19 department involved planning, set-up, and implementations phases, each one based on knowledge available regarding the pandemic and established medical standards for isolation and protection of patients and staff. Wherever possible, new innovative technologies were utilized to provide maximum protection for both patients and staff, together with special online training that was developed for medical teams.</p><p><strong>Results: </strong>A COVID-19 department was successfully established on the hospital campus, remote from other ongoing patient activities. A novel methodology of disease-adapted medicine was implemented successfully among the department's medical staff, who underwent training tailored to expected clinical scenarios. The COVID-19 department is receiving patients, with no contamination of medical personnel to date. A recent survey of COVID-19 patients revealed a very high patient satisfaction rate.</p><p><strong>Conclusion: </strong>Based on the experience described herein and lessons learned, the hospital is preparing for a potential large-scale COVID-19 wave, aimed at full readiness through utilization of a fortified underground emergency hospital to treat up to 900 COVID-19 patients, and establishment of versatile in-hospital infrastructure for quick conversion from standard conditions to COVID-19 appropriate conditions.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38954952","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 Review of Interventions for Non-Communicable Diseases in Humanitarian Emergencies in Low-and Middle-Income Countries","authors":"R. Leff, Anand Selvam, Robyn Bernstein, L. Wallace, Alison Hayward, Pooja Agrawal, Denise Hersey, C. Ngaruiya","doi":"10.1101/2021.12.05.21267308","DOIUrl":"https://doi.org/10.1101/2021.12.05.21267308","url":null,"abstract":"Background: Low-and middle-income countries (LMICs) not only experience the largest burden of humanitarian emergencies but are also disproportionately affected by non-communicable diseases (NCDs). Interventions addressing NCDs require humanitarian entities to consider complex challenges such as continuity of care, diagnostics, logistics and cost of care for recurrent or expensive treatments, yet primary focus on the topic is lacking. We conducted a systematic review on the effects of humanitarian disasters on NCDs in LMICs with the primary aim of identifying studies on epidemiology, interventions, and treatment. Key interventions were identified and their effects on populations in disaster settings were reviewed. Methods: A systematic search was conducted in MEDLINE, MEDLINE (PubMed, for in-process and non-indexed citations), Social Science Citation Index, and Global Health (EBSCO) for indexed articles published before December 11, 2017. Publications reporting on interventions targeting NCDs during disasters in LMICs were included if they incorporated core intervention components as defined by the United States Department of Health and Human Services. Two separate screeners independently evaluated the titles, abstracts and full text of the eligible articles, with vetting by a third reviewer. Key intervention components including target population, phase of crisis, and measured outcomes among others were extracted into a template and synthesized using a thematic analysis approach. The full systematic review is registered at PROSPERO(CRD42018088769). Results: Of 85 articles eligible for the full systematic review, only seven articles describing interventions met inclusion criteria. Studies focused reporting on the response (n=4) and recovery (n=3) phases of disaster, with no studies reporting on the mitigation or preparedness phases. Successful interventions conducted extensive pre-deployment risk assessments to assess the burden and distinct epidemiology of NCDs amongst affected populations, worked in close cooperation with local health services, assessed individual needs of sub-populations in disaster regions in the response phase, promoted task shifting between humanitarian and development actors, and adopted flexibility in guideline implementation. Training and capacity building of staff were found to be essential elements of successful interventions due to an assessed lack of experience of healthcare workers in disaster settings with NCDs and successfully allowed for incorporation of community health workers. Conclusions: We found only limited interventions designed to address NCDs in humanitarian emergencies, with a particular dearth of studies addressing the mitigation and preparedness phases of humanitarian response. Delivering interventions for NCDs in humanitarian emergencies requires improved collaboration between humanitarian and development actors in addition to improved NCD training and capacity building amongst healthcare workers in ","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49174543","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":"Maintaining trauma center operational readiness during a pandemic.","authors":"Alexander C Cavalea,&nbsp;Robin McGoey,&nbsp;Rebecca W Schroll,&nbsp;Patrick R McGrew,&nbsp;Jonathan E Schoen,&nbsp;Lance E Stuke,&nbsp;Chrissy Guidry,&nbsp;Alan B Marr,&nbsp;Juan C Duchesne,&nbsp;John P Hunt","doi":"10.5055/ajdm.2021.0383","DOIUrl":"https://doi.org/10.5055/ajdm.2021.0383","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic is a slow-moving global disaster with unique challenges for maintaining trauma center operations. University Medical Center New Orleans is the only level 1 trauma center in New Orleans, LA, which became an early hotspot for COVID-19. Intensive care unit surge capacity, addressing components including space, staff, stuff, and structure, is important in maintaining trauma center operability during a high resource-strain event like a pandemic. We report management of the trauma center's surge capacity to maintain trauma center operations while assisting in the care of critically ill COVID-19 patients. Lessons learned and recommendations are provided to assist trauma centers in planning for the influx of COVID-19 patients at their centers.","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38954951","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":"Lessons from a suicide attempt by intra-abdominal ricin injection.","authors":"Ayana Dvir,&nbsp;Zahi Dagan,&nbsp;Avi Mizrachi,&nbsp;Arik Eisenkraft","doi":"10.5055/ajdm.2021.0389","DOIUrl":"https://doi.org/10.5055/ajdm.2021.0389","url":null,"abstract":"<p><p>A 19-year-old woman was admitted to the emergency department 7 hours after a suicide attempt with an intra-abdominal injection of self-prepared ricin solution. In the following 6 days, she has developed multiorgan-failure, and despite all intensive care interventions-including plasma exchange, high-frequency ventilation, and continuous renal replacement -therapy-she passed away. We describe in detail the chain of events and discuss shortly the known literature about this rare poisoning.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38954956","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":"Medical planning for disaster response: Identifying risk factors for developing adult respiratory distress syndrome among trauma patients.","authors":"Ryan J Keneally,&nbsp;Mark C Hubbard,&nbsp;Katrina Hawkins,&nbsp;Danielle Davison,&nbsp;Jeffrey S Berger","doi":"10.5055/ajdm.2021.0385","DOIUrl":"https://doi.org/10.5055/ajdm.2021.0385","url":null,"abstract":"<p><strong>Introduction: </strong>Adult respiratory distress syndrome (ARDS) is a well-described complication of critical illness. We hy-pothesized that rates of comorbid diseases in a population may influence the risk for developing ARDS in trauma pa-tients. This can help plan medical responses.</p><p><strong>Methods: </strong>Patients from the 2017 National Trauma Databank were analyzed. Inclusion criteria were an injury sever-ity score (ISS) of ≥ 2 and 1 or more documented days of mechanical ventilation. Data were analyzed using χ², Student's t test, Mann-Whitney U test, or logistic regression as indicated.</p><p><strong>Results: </strong>Diabetes (odds ratio [OR] 1.33, 95 percent confidence interval [CI] 1.17-1.52), smoking (OR 1.26, 95 per-cent CI 1.13-1.40), transfusion (OR 1.20, 95 percent CI 1.09-1.32), ISS (OR 1.02, 95 percent CI 1.02-1.03), male gen-der (OR 1.22, 95 percent CI 1.10-1.35), decreasing Glasgow coma score (OR 1.04, 95 percent CI 1.03-1.05), and in-creasing abbreviated injury score of the thorax (OR 1.12, 95 percent CI 1.09-1.16) were associated with an increase in risk for developing ARDS.</p><p><strong>Conclusion: </strong>Diabetes and smoking are risk factors for developing ARDS after trauma. Medical response planning in countries with high rates of diabetes mellitus or smoking should take into account a greater need for intensive care and longer patient admissions to field hospitals.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38954954","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}