Disaster Medicine and Public Health Preparedness最新文献

Objective: The aim of this study was to determine the health problems of individuals who survived the 2023 Kahramanmaraş earthquake according to the Omaha System.

Methods: This descriptive cross-sectional study was conducted in Adıyaman, Türkiye, and included 297 earthquake survivors. Data were collected using the Problem Classification Scheme of the Omaha System.

Results: The majority of individuals who survived the earthquake were women and had at least one chronic disease. Of the 42 problems listed in the Omaha Problem Classification Scheme, 38 were identified. Most of the identified problems were actual and individual-level issues. Income, Sanitation, Residence, Living/workplace safety, Communication with community resources, Communicable/infectious condition, and Nutrition problems were identified in all earthquake survivors.

Conclusions: The Omaha System provides nurses with pertinent data to organize health services and prioritize interventions in the post-disaster period. The problems identified highlight the urgent need to improve health and living conditions in temporary shelters.

Objective: This study examined the relationship between food safety, food access, and nutritional status among earthquake victims in Kahramanmaraş and Hatay, Türkiye.

Methods: This descriptive, cross-sectional study was conducted face-to-face with 209 earthquake victims in 2023.

Results: The median age was 42 years, and 52.6% were female. Among women, the perception of unhealthy food, inadequate mass feeding services, and dissatisfaction with meals increased the risk of food safety concerns. In men, those with an associate degree or higher were 20.7 times more likely to perceive food safety as inadequate, while the perception of unhealthy food raised this risk by 12.4 times. Lack of access to sufficient drinking water increased the risk of food inaccessibility by 2.6 times among women. In men, employment and dissatisfaction with meals increased this risk by 2.7 and 2.8 times, respectively. Both genders exhibited inadequate intake of water, energy, protein, polyunsaturated fats, fiber, folate, potassium, calcium, magnesium, iron, zinc, and several vitamins (P <0.05), while phosphorus and sodium levels were elevated (P <0.01).

Conclusions: Food safety and access issues were critical among earthquake victims, significantly impacting nutritional status. Findings emphasize the need for improved emergency food aid and distribution systems to mitigate post-disaster nutritional risks.

Background: On September 17, 2024, a coordinated detonation of approximately 5,000 pager devices in Lebanon produced a large mass-casualty incident. Devices contained pentaerythritol tetranitrate (PETN). We report 5 pediatric patients transferred to a tertiary referral center for management of complex multisystem injuries.

Methods: We performed a brief report of 5 children (<12 years) referred to Baqiyatallah Hospital, Tehran. Demographics, injury pattern, surgical interventions, and short-term outcomes (up to 3 months) were abstracted from medical records. All patients received multidisciplinary care (ophthalmology, plastic surgery, orthopedics, otolaryngology, pediatrics, infectious disease).

Results: Mean age was 9.2 years (range 5-11). All 5 children sustained ocular, facial, and hand injuries. Three eyes were auto-eviscerated, and 4 children underwent partial hand amputations. Multiple operative procedures were required per patient (ocular surgery, facial reconstruction, orthopedic fixation). Early outcomes were poor for vision and hand function in the majority; reconstructive planning and prosthetic rehabilitation were anticipated for longer-term care.

Conclusion: Close-range exposure to small PETN-containing devices produced a distinctive pediatric injury pattern dominated by severe ocular and upper-extremity trauma. These findings emphasize the need for pediatric-focused acute care algorithms and sustained rehabilitation resources after blast incidents.

Objective: In March 2019, flooding of the Missouri River and its tributaries destroyed infrastructure and farmland and affected communities, including those in the state of Nebraska. The objective of this study was to assess emergency preparedness and satisfaction with flood response, recovery, and relief efforts 5 years following the 2019 floods in rural eastern Nebraska.

Methods: Using stratified simple random sampling, this study surveyed 13 Nebraska communities to assess emergency preparedness and satisfaction with flood response, recovery, and relief efforts 5 years following the 2019 Missouri River Flood. Descriptive statistics are reported.

Results: Households impacted by the 2019 Nebraska flood reported worsening physical and mental health symptoms and identified major gaps in communication, long-term mental health support, and infrastructure resilience. Self-reported preparedness improved post-flood. Inadequate early warnings and poor information dissemination eroded trust.

Conclusions: There are persistent mental and physical health impacts resulting from exposure to the 2019 Missouri River floods that can impact communities' ability to respond and recover from subsequent hazards. Evaluating the impacts of previous disasters is a critical component of increasing community resiliency and local public health and emergency preparedness capacity to serve these populations.

Medical shelters are frequently utilized after major disasters to care for displaced individuals with severe mobility limitations and chronic medical conditions that may be inadequately addressed in general population sheltering. A retrospective chart review was conducted on 680 patients served in state-operated Medical Needs Shelters (MNS) in Louisiana following three major hurricanes from 2020 to 2021. The authors aimed to produce a descriptive analysis of the degree and variety of medical complexity of patients within the shelters to guide future shelter planning. Data illustrate demographic characteristics, clinical attributes, and outcomes among shelter patients. Patients were found to have numerous medical comorbidities, often with serious concomitant neuropsychiatric, cardiovascular, and pulmonary conditions. The shelter population was highly dependent on nursing staff for medication management and activities of daily living. They also had high utilization of respiratory therapies, hemodialysis, and wound care. Clinically significant events (e.g., falls, mental status changes, vital sign abnormalities), often resulting in transport to local hospitals, occurred in approximately 20% of all patient stays. Limitations of the study include suspected underreporting of disease prevalence and the study's retrospective approach. Public health planners should consider the clinical needs of this population when designing strategic and tactical approaches to mass care for medically vulnerable individuals. Future research might examine which factors place individuals at higher risk for decompensation within a medical shelter.

Introduction: Operational Canines are highly trained and valuable animals that support emergency and disaster response efforts, such as Search and Rescue, scene security, and recovery operations. While working, Operational Canines often encounter dangerous operational and environmental situations.

Discussion: To maintain their health and operational readiness, it is critical that Operational Canines receive regular wellness care before entering the field and emergency treatment when necessary in the field.

Limitations: Nevertheless, the most common first responders to Operational Canine field emergencies-Canine Handlers, Law Enforcement Officers, and Emergency Medical Service personnel-often have limited species-specific medical training, and there are no nationally standardized training programs.

Conclusion: This article proposes a nationally standardized program to train first responders, specifically Canine Handlers, Law Enforcement Officers, and Emergency Medical Service personnel on Operational Canine wellness management and emergency medical care at a level tailored to participants' knowledge and skill sets. Finally, this article discusses recent legal trends relating to OpK9 emergency medical care, which highlight the pressing need for a nationally standardized training program.

Objective: This study aims to elucidate the ethical dilemmas faced by pre-hospital emergency medical service personnel during disaster triage, with a specific focus on the Kahramanmaraş Earthquakes, and to document their experiences.

Materials and methods: This phenomenological study employed semi-structured interviews with 29 pre-hospital emergency medical service workers who served during the first 72 hours of the Kahramanmaraş Earthquakes to gather qualitative data. Purposeful sampling was used for face-to-face interviews, and MAXQDA20 was utilized for content analysis.

Results: The main themes encompassed problems related to disaster management organization, environmental factors, and individual factors. Environmental factors, such as coordination deficiencies at the scene, jurisdictional confusion, security concerns, and seasonal conditions, as well as personal factors including education and experience, were pivotal in the occurrence of ethical dilemmas in disaster triage.

Conclusion: Pre-hospital emergency medical services personnel affected by the disaster faced more ethical dilemmas. The presence of many affected children had a profound emotional impact on participants, leading to more frequent ethical dilemmas, particularly in the application of black code protocols.

Objective: This research explores the legal and jurisdictional frameworks governing the deployment of Australian WHO-classified Emergency Medical Teams (EMTs) in Asia-Pacific disaster responses, focusing on how these factors influence authorization, timeliness, scope of practice, and legal risks.

Methods: A scoping review was conducted using thematic document analysis, comparative legal analysis, and case studies anchored in specific jurisdictions. Sixty-one publicly available sources were reviewed, including legal instruments, national disaster laws, bilateral agreements, and reports from recent EMT missions.

Results: EMTs face fragmented legal environments. Host-country sovereignty primarily determines authorization, but the mechanisms for expedited licensure, customs clearance, and legal protection are often lacking. WHO classification provides no overarching legal standing during international deployments. Other barriers include immigration rules, drug regulations, and inconsistent data protection laws. Case studies highlight gaps in bilateral agreements and inconsistent credential recognition.

Conclusions: Despite improved technical standards, legal uncertainty hampers EMT effectiveness, including legal risk exposure. Countries should establish bilateral frameworks, regional licensing systems, embedded legal support, and standardized data governance. These steps are critical for ensuring timely, safe, and lawful EMT operations during international disasters.

Objective: To prevent power lines from igniting wildfires, utility companies in California are authorized to conduct Public Safety Power Shutoffs (PSPS), de-energizing, or shutting off power to equipment during periods of high wildfire risk. This study assessed the association between PSPS and emergency department visits.

Methods: The study quantified the extent to which counties in California experienced PSPS each day between September 15 and November 30, 2019. Linear mixed models were used to estimate the rate of emergency department encounters per 100,000 county residents based on quartiles of PSPS exposure, compared to no PSPS exposure at the county-day level. Analyses examined all emergency department encounters as well as age- and diagnosis-specific visits.

Results: There was an increase of 15 emergency department visits per 100,000 persons aged 65 years and older on days with the highest levels of PSPS exposure compared to days without PSPS. The highest level of PSPS exposure was associated with increased rates of emergency department visits for respiratory, cardiovascular, injury, and mental or behavioral diagnoses.

Conclusions: Despite advanced notification, PSPS events are associated with negative health consequences. Older adults are particularly vulnerable to the unintended adverse health effects of PSPS and should be prioritized in mitigation efforts.