American journal of disaster medicine最新文献

{"title":"The telehealth advantage: Supporting humanitarian disasters with remote solutions.","authors":"Shuhan He, Sammer Marzouk, Adi Balk, Tehnaz Boyle, 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":"17 2","pages":"95-99"},"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":"16 1","pages":"35-41"},"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":"14 4 1","pages":"297-311"},"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":"16 1","pages":"25-34"},"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":"16 1","pages":"75-80"},"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":"16 1","pages":"43-48"},"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}

{"title":"Phases of psychological response in COVID-19: A preliminary heuristic.","authors":"George S Everly,&nbsp;Albert W Wu,&nbsp;James B Potash","doi":"10.5055/ajdm.2021.0381","DOIUrl":"https://doi.org/10.5055/ajdm.2021.0381","url":null,"abstract":"<p><strong>Objective: </strong>To explore the putative phases of the psychological response to disaster: preimpact, impact, heroic, honeymoon, disillusionment, and recovery, and make recommendations for corresponding interventions.</p><p><strong>Conclusions: </strong>Disasters such as the COVID-19 pandemic are often characterized by chaos and uncertainty. As a result, public health disaster planning and response represent formidable challenges. Although disasters can result from a wide array of hazards, regardless of the agent at work, they may follow a rather predictable trajectory of psychological phases. A heuristic of those phases can provide an opportunity for a more organized disaster mental health response and more efficient utilization of scarce resources.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"16 1","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38954627","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":"Early casualty estimates and medical help management after the M7.3 Kermanshah earthquake of November 12, 2017 in Iran.","authors":"Amir Mansour Farahbod,&nbsp;Max Wyss","doi":"10.5055/ajdm.2021.0386","DOIUrl":"https://doi.org/10.5055/ajdm.2021.0386","url":null,"abstract":"<p><p>Medical responses to fatal earthquakes have to be rapid to save lives. Here we report the QLARM alert that was issued less than an hour after the magnitude 7.3 Kermanshah, Iran, earthquake of 2017 and the following medical response. The near-real-time estimates of fatalities were 520, on average, and it took official and news reports about 2 days to settle on a minimum of 630 fatalities as a final count. The response of various Iranian agencies was rapid and effective, facilitated by the relatively small area of the disaster (radius of about 50 km). Although this disaster was not large enough to require international first responders to rush to the scene, it is clear that in very large earthquake disasters, a fast, accurately informed response saves lives. For international teams to be of optimal use, the locations and functionality levels of health facilities should be known. This information could be included in the earthquake alerts, but the necessary worldwide data on hospitals are currently not available.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"16 1","pages":"49-57"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38954953","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 Western Massachusetts hospital system's response to the COVID-19 pandemic.","authors":"Nikita Ramanathan,&nbsp;Reginald Alouidor,&nbsp;Kristina Kramer,&nbsp;Tyler Putnam","doi":"10.5055/ajdm.2021.0382","DOIUrl":"https://doi.org/10.5055/ajdm.2021.0382","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this paper was to outline a novel model created for the management of the critical care surge due to coronavirus disease 2019 (COVID-19) in a Western Massachusetts hospital.</p><p><strong>Setting: </strong>This model was created and implemented at a Western Massachusetts Level 1 Trauma and tertiary referral center.</p><p><strong>Conclusions: </strong>This article outlines a model devised by an interdisciplinary team for rapid expansion of critical care services by increasing allocated space, staffing, and supplies via modifications of existing systems of care to accommodate a predicted large critical care patient surge due to the COVID-19 pandemic. We predict that this model can be utilized and adapted for future critical care surges in times of similar pandemic situations.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"16 1","pages":"13-24"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38954629","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":"Decontamination effectiveness and the necessity of innovation in a large-scale disaster simulation.","authors":"Esli Osmanlliu,&nbsp;Ilana Bank,&nbsp;Elene Khalil,&nbsp;Peter Nugus,&nbsp;Margaret Ruddy,&nbsp;Meredith Young","doi":"10.5055/ajdm.2021.0388","DOIUrl":"https://doi.org/10.5055/ajdm.2021.0388","url":null,"abstract":"<p><strong>Background: </strong>Chemical, biological, radiologic, nuclear, and explosive (CBRNE) events threaten the health and integrity of human populations across the globe. Effective decontamination is a central component of CBRNE disaster response.</p><p><strong>Objective: </strong>This paper provides an objective determination of wet decontamination effectiveness through the use of a liquid-based contaminant proxy and describes the mobilization and adaptation of easily available materials for the needs of decontamination in pediatric victims.</p><p><strong>Methods: </strong>In this in-situ disaster simulation conducted at a pediatric hospital, decontamination effectiveness was determined through a liquid-based contaminant proxy, and standard burn charts to systematically estimate affected total body surface area (TBSA) in 39 adult simulated patients. Two independent raters evaluated TBSA covered by the contaminant before and after decontamination.</p><p><strong>Results: </strong>On average, simulated patients had 59 percent (95 percent CI [53, 65]) of their TBSA covered by the simulated contaminant prior to decontamination. Following a wet decontamination protocol, the average reduction in TBSA contamination was 81 percent (95 percent CI [74, 88]). There was high inter-rater reliability for TBSA assessment (intraclass correlation coefficient = 0.83, 95 percent CI [0.68, 0.92]. A modified infant bath was tested during the simulated decontamination of infant mannequins and thereafter integrated to the local protocol.</p><p><strong>Conclusion: </strong>Wet decontamination can remove more than 80 percent of the initial contaminant found on adult simulated patients. The use of a liquid-based visual tool as a contaminant proxy enables the inexpensive evaluation of decontamination performance in a simulated setting. This paper also describes an innovative, low-cost adaptation of a local decontamination protocol to better meet pediatric needs.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"16 1","pages":"67-73"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38964526","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}