American journal of disaster medicine最新文献

Background: Armed forces hospitals are often called upon to provide medical aid to civilians during natural calamities. Though children are often the most vulnerable segment of population in these events, research that addresses their unique needs and the role of armed forces hospitals remains sparse.

Objectives: We examined pediatric morbidity and mortality at a flooded armed forces hospital. Factors that affected outcomes were identified.

Methods: 158 patients were evacuated en masse from a children's hospital in northern India that was submerged by flood to an adjacent partially inundated armed forces hospital specializing in military medicine and adult trauma. The children were provided case-based clinical care as per existing disaster management protocol. Geoclimatic vulnerability factors, morbidity/mortality, and medical and logistical challenges for future intervention were investigated.

Results: One pediatrician who provided initial triage was joined by two others after 48 hours. A limited load of adult patients permitted more resources for the children, majority (49 percent) of whom were neonates. Intensive care was necessitated for 32 (20.2 percent) cases, with half managed in adult ICU. Overall in-hospital mortality was 5.7 percent. Experienced staff, cross-specialty multitasking, and innovative and noncensorious leadership were identified as assets amidst resources compromised by flooding. Clear delineation of primary caregiver role of pediatrician at outset, pediatric emergency care training, pediatric triage, resource allocation for thermoregulation, oxygen therapy and ventilation, earmarking centers for transfer of cases, and safe transportation to the centers were identified as areas meriting further attention.

Conclusion: Armed forces hospitals in vulnerable geoclimatic zones must address pediatric concerns in disaster management plans.

Surveillance is the backbone of any response to an infectious disease outbreak, and comprehensive evaluation of surveillance systems is crucial. However, structured evaluations of surveillance systems during the COVID-19 pandemic are scarce. We conducted an after action review (AAR) of the performance of the COVID-19 surveillance system in Quang Ninh Province, Vietnam, during 2020 using the COVID-19-specific AAR methodology developed by the World Health Organization in combination with guidance from the US Centers for Disease Control and Prevention (CDC). We conducted a stakeholder survey, document reviews, and key informant interviews with staff from Quang Ninh CDC's COVID-19 surveillance system. The COVID-19 surveillance system was based on the pre-existing surveillance system in the province. The system's strengths were early preparation for emergency response, strong governance and central coordination, and multidisciplinary collaboration. Stakeholders agreed that the system proved useful and adaptive to the fast-evolving COVID-19 situation but was weakened by overly complex systems, redundant administrative processes, unclear communication channels, and lack of resources. Overall, the surveillance systems in Quang Ninh province proved effective in containing COVID-19 and adaptive in a fast-changing epidemiological context. Several recommendations were made based on identified areas of concern that are of relevance for COVID-19 surveillance systems in Vietnam and similar settings.

Background: On February 6, 2023, a series of mega-earthquakes (MEs) struck the southern parts of Turkey and northern Syria. In the first 16 days after the Turkey MEs (TMEs), the Tokushukai Medical Assistant Team (TMAT) backed by its infrastructure visited Turkey to support a local hospital. With the goal of helping local communities and working with local supporters and authorities, Turkey is on a mission to positively impact people's lives.

Methods: Data collected covered the TMAT support period in February 2023. All patients admitted to a hospital were registered through the Minimum Data Set (MDS) of the Emergency Medical Team (EMT) Coordination Cell (EMTCC).

Results: A total of 561 patients were hospitalized during the 16-day mission. A review of the MDS data showed a de-crease in the number of inpatients. The number of diseases directly related to the disaster was confirmed to be due to a gradual decrease in TME aftershock. However, the number of patients with nondisaster-related disease remained stable.

Conclusion: The experience of EMT in the initial relief of MEs that struck Turkey and Syria on February 6, 2023 showed that a mobile type 1 EMT in the early stage while rebuilding the infrastructure is essential. From the analysis of patient profiles, it is clear that knowledge and experience of skin diseases is needed in the first minutes of MEs. In addi-tion, it has become clear that to ensure the quality of MDS for further analysis and to improve the efficiency and effec-tiveness of EMS, it is essential to have recorders in the EMS. These MDS recorders, called descriptors, must be isolated from the treating medical staff to eliminate subjectivity and ensure data accuracy.