Disaster Medicine and Public Health Preparedness最新文献

Objectives: The project aimed to characterize the exposure to seismic hazard in the emergency area of a high-complexity hospital in Cali, Colombia.

Methods: The occupancy of the emergency area was analyzed over 6 months, determining the value of material elements exposed to the seismic hazard. Four phases were executed: search for pre-existing information, occupancy analysis, evaluation of exposed assets, and results analysis. The information was analyzed using a Geographic Information System (GIS), which allowed the visualization of demographic behavior in different locations and times.

Results: The results confirmed that the seismic hazard is high, exacerbated by local geomechanical characteristics. It was observed that the average occupancy of most studied areas exceeded capacity. The value of the exposed assets was estimated at COP 3 221 008 640 (USD 959 844.76), the demolition value at COP 10 582 770 000 (USD 3 153 613.49), and the reconstruction value at COP 30 293 640 275 (USD 9 027 356.03). In the worst-case scenario, the losses were equivalent to 12.4% of the hospital's annual budget.

Conclusions: The data allow the hospital to take preventive measures and educate the staff to identify and mitigate critical areas. It also contributes to the knowledge of the approximate value of economic losses and the impact of potential human losses.

Objectives: The mental health of paramedics is critical for disaster response in order to provide rapid and effective interventions. This study aimed to determine the prevalence of post-traumatic stress disorder (PTSD) and related individual and occupational factors in Turkish paramedics during the eleventh month of the COVID-19 pandemic.

Methods: The "Sociodemographic Information Form," "Life Events Checklist," and "Post-Traumatic Stress Disorder Checklist" were used to collect data from 440 randomly selected paramedics in this cross-sectional study.

Results: The prevalence of PTSD was 59.8% in the 11^th month of the COVID-19 pandemic. Multiple regression analysis revealed that approximately 25% of the total PTSD score could be independently explained by paramedics' general health situation and sociodemographic characteristics; 27% by crisis management skills, long working hours, a lack of equipment, and intensive work; and 40% by past traumatic experiences due to difficult life events during their professional practice, such as responding to gunshot wounds, becoming a victim of a gunshot attack, or sexual assault (P < 0.05).

Conclusions: Integrating a mental health monitoring system into the health and safety program, providing paramedics with supervision and psychological assistance, and engaging them in disaster preparedness planning would be beneficial.

Mental health is deteriorating quickly and significantly globally post-COVID. Though there were already over 1 billion people living with mental disorders pre-pandemic, in the first year of COVID-19 alone, the prevalence of anxiety and depression soared by 25% worldwide. In light of the chronic shortages of mental health provider and resources, along with disruptions of available health services caused by the pandemic and COVID-related restrictions, technology is widely believed to hold the key to addressing rising mental health crises. However, hurdles such as fragmented and often suboptimal patient protection measures substantially undermine technology's potential to address the global mental health crises effectively, reliably, and at scale. To shed light on these issues, this paper aims to discuss the post-pandemic challenges and opportunities the global community could leverage to improve society's mental health en masse.

Objective: This article describes an innovative program to provide safe, evidence-based psychiatric care at the Baltimore Convention Center Field Hospital (BCCFH), set up for COVID-19 patients, to alleviate overextended hospitals.

Methods: This article describes the staffing and workflows utilized at the BCCFH including universal suicide risk assessment and co-management of high acuity patients by an NP-led psychiatry service.

Results: The Columbia-Suicide Screening Rating Scale (C-SSRS) proved feasible as a suicide screening tool. Using the SAFE-T protocol, interdisciplinary teams cared for moderate and low risk patients. The NP psychiatry service evaluated over 70 patients, effecting medication changes in more than half and identified and transferred several decompensating patients for higher-level psychiatric care. Group therapy attendees demonstrated high participation. There were no assaults, self-harm incidents, or suicides.

Conclusions: The BCCFH psychiatry/mental health program, a potential model for other field hospitals, promotes evidence-based, integrated care. Emphasizing safety, including suicide risk, is crucial within alternate care sites during disasters. The engagement of dually-certified (psychiatric and medical) nurse practitioners boosts safety and provides expertise with advanced medication management and psychotherapeutic interventions. Similar future sites should be ready to handle chronically ill psychiatric patients, detect high-risk or deteriorating ones, and develop therapeutic programs for patient stabilization and support.

The impact of disasters on the health and wellbeing of children is well documented, with children identified as bellwethers of community recovery. It has also been demonstrated that building community-wide resilience benefits from being approached through a child-centric model of community participation. While much of this work has been focused on the USA, there is a need to develop models to adapt these approaches in international environments. Small Island Developing States (SIDS) are particularly at risk for disaster events. SIDS tend to have less diverse economies and a high dependence on climate-sensitive sectors that are vulnerable to disasters. The National Center for Disaster Preparedness at Columbia University along with Save the Children created The Resilient Children, Resilient Communities Initiative to build child-focused resilience within communities. The Initiative, which has already been applied to sites in the USA, is being adapted for the context of Dominica. The Initiative focuses on child-serving institutions and uses a Community Preparedness Index to quantify the current inventory of policies and practices related to children. The Initiative aims to implement strategies to improve the ability of the community to meet the needs of children in a disaster. This paper explores the application of these concepts surrounding the Initiative.

Increasing transboundary crises necessitate the development of crisis management capabilities that transcend boundaries. In such situations, inter-governmental and cross-functional collaboration has become a common practice to address the complexities of governance challenges. This study employs Social Network Analysis to examine the structure, function, and evolution of policy collaboration networks in China in response to COVID-19 and SARS. Since the SARS outbreak, China has embraced a collaborative governance approach, considering the transboundary nature of COVID-19. This approach has led to the involvement of numerous specialized organizations engaged in economic and social development, contributing to the establishment of a larger and more loosely connected collaboration network. While the health department bears the primary responsibility for coordinating public health emergency management, diverse organizations with social governance and economic management functions have also emerged as key actors, providing crucial anti-epidemic information, knowledge, and resources to address this significant cross-border crisis.

Disasters, armed conflicts, and disease outbreaks often overwhelm normal corpse-handling capacities, highlighting the importance of mass fatality management in emergency preparedness and response. This paper examines principles, practices, and challenges of ensuring dignified corpse management after catastrophic events leading to sudden mass fatalities. It draws insights from Nepal's experience with the 2015 earthquakes, as well as other recent disasters worldwide. The discussion reveals planning and policy gaps that undermine the dignity of the deceased and prolong trauma for survivors. Recommendations are provided for improving global preparedness to accord proper respect to the dead amid immense tragedy. As climate change escalates disasters, all vulnerable nations must enhance their capacities for systematic and empathetic mass fatality management. Even when protocols exist, overwhelmed systems lead to a breakdown in practical implementations, violating cultural norms. By building robust preparedness through strategic plans, training, infrastructure, and international cooperation, we can preserve humanity even amidst utter inhumanity.

Objectives: In responding to a Chemical, Biological, Radiological, and Nuclear explosive (CBRNe) disaster, clinical leaders have important decision-making responsibilities which include implementing hospital disaster protocols or incident command systems, managing staffing, and allocating resources. Despite emergency care clinical leaders' integral role, there is minimal literature regarding the strategies they may use during CBRNe disasters. The aim of this study was to explore emergency care clinical leaders' strategies related to managing patients following a CBRNe disaster.

Methods: Focus groups across 5 tertiary hospitals and 1 rural hospital in Queensland, Australia. Thirty-six hospital clinical leaders from the 6 study sites crucial to hospital disaster response participated in 6 focus groups undertaken between February and May 2021 that explored strategies and decision making to optimize patient care following a CBRNe disaster.

Results: Analysis revealed the use of rehearsals, adopting new models of care, enacting current surge management processes, and applying organization lessons were facilitating strategies. Barriers to management were identified, including resource constraints and sites operating over capacity.

Conclusions: Enhanced education and training of clinical leaders, flexible models of care, and existing established processes and tested frameworks could strengthen a hospital's response when managing patients following a CBRNe disaster.

The injuries that occurred in earthquakes caused an accumulation in hospitals and the need for health services increased. The most needed human resource in the provision of health services in disasters is nurses. The aim of this study is to determine the scope of nursing services in earthquakes and to identify the service needs in hospitals during the February 6 earthquakes in Turkey. In this study, Delphi technique was used for needs analysis. The managers of health institutions in 11 provinces that experienced the earthquake were interviewed to determine how nursing services are carried out during earthquakes. As a result of this study, it was determined that there were inadequacies in triage, identification of earthquake victims, medical intervention and keeping records, identification of deceased earthquake victims, storage of personal belongings, communication with relatives of earthquake victims, and psychosocial support services in disasters such as earthquakes where many people were seriously injured. It has been observed that there is a need for disaster nurses and forensic nurses to work in these areas and it is thought that these 2 nursing fields should be taken into consideration in the planning of health professional resources in disasters.