Abstract:
INTRODUCTION:The 2005 Gulf Coast hurricane season was one of the most costly and deadly in US history. Hurricane Rita stressed hospitals and led to multiple, simultaneous evacuations. This study systematically identified community factors associated with patient movement out of seven hospitals evacuated during Hurricane Rita. METHODS:This study represents the second of two systematic, observational, and retrospective investigations of seven acute care hospitals that reported off-site evacuations due to Hurricane Rita. Participants from each hospital included decision makers that comprised the Incident Management Team (IMT). Investigators applied a standardized interview process designed to assess evacuation factors related to external situational awareness of community activities during facility evacuation due to hurricanes. The measured outcomes were responses to 95 questions within six sections of the survey instrument. RESULTS:Investigators identified two factors that significantly impacted hospital IMT decision making: (1) incident characteristics affecting a facility's internal resources and challenges; and (2) incident characteristics affecting a facility's external evacuation activities. This article summarizes the latter and reports the following critical decision making points: (1) Emergency Operations Plans (EOP) were activated an average of 85 hours (3 days, 13 hours) prior to Hurricane Rita's landfall; (2) the decision to evacuate the hospital was made an average of 30 hours (1 day, 6 hours) from activation of the EOP; and (3) the implementation of the evacuation process took an average of 22 hours. Coordination of patient evacuations was most complicated by transportation deficits (the most significant of the 11 identified problem areas) and a lack of situational awareness of community response activities. All evacuation activities and subsequent evacuation times were negatively impacted by an overall lack of understanding on the part of hospital staff and the IMT regarding how to identify and coordinate with community resources. CONCLUSION:Hospital evacuation requires coordinated processes and resources, including situational awareness that reflects the condition of the community as a result of the incident. Successful hospital evacuation decision making is influenced by community-wide situational awareness and transportation deficits. Planning with the community to create realistic EOPs that accurately reflect available resources and protocols is critical to informing hospital decision making during a crisis. Knowledge of these factors could improve decision making and evacuation practices, potentially reducing evacuation times in future hurricanes.
journal_name
Prehosp Disaster Medjournal_title
Prehospital and disaster medicineauthors
Downey EL,Andress K,Schultz CHdoi
10.1017/S1049023X13000125subject
Has Abstractpub_date
2013-06-01 00:00:00pages
264-71issue
3eissn
1049-023Xissn
1945-1938pii
S1049023X13000125journal_volume
28pub_type
历史文章,杂志文章abstract:INTRODUCTION:Dialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear. PROBLEM:The impact of Hurricane Katrina on hospitalization ra...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12000945
更新日期:2012-08-01 00:00:00
abstract:INTRODUCTION:Morbidity and mortality due to acute but treatable conditions remain high in the developing world, as many significant barriers exist to providing emergency medical care. This study investigates these barriers in a rural region of Ethiopia. HYPOTHESIS:The limited capacity of frontline healthcare workers t...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00005240
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Heart failure poses a significant burden of disease, resulting in 2,658 Australian deaths in 2008, and listed as an associated cause of death in a further 14,466 cases. Common in the hospital setting, continuous positive airway pressure (CPAP) therapy is a non-invasive ventilation technique used to prevent a...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/S1049023X12001562
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:The disaster response environment in Haiti following the 2010 earthquake represented a complex healthcare challenge. This study was designed to identify challenges during the Haiti disaster response. METHODS:Qualitative and quantitative study of injured patients carried out six months after the January 2010...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12000088
更新日期:2011-12-01 00:00:00
abstract::Determining the most appropriate level of care for patients in the prehospital setting during medical emergencies is essential. A large body of literature suggests that, compared with Basic Life Support (BLS) care, Advanced Life Support (ALS) care is not associated with increased patient survival or decreased mortalit...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X17000292
更新日期:2017-08-01 00:00:00
abstract::In the early morning of 26 December 2003, Bam, an old city in southeastern Iran, was devastated by an earthquake measuring 6.6 on the Richter scale. Managing such situations always brings about many problems. In the case of the Bam Earthquake, two of the most serious problems were rescue operations and provision of ap...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00005355
更新日期:2007-11-01 00:00:00
abstract::This paper discusses the need for consistency in mass-gathering data collection and biomedical reporting. Mass gatherings occur frequently throughout the world, and having an understanding of the complexities of mass gatherings is important to inform health services about the possible required health resources. Factor...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12001288
更新日期:2012-12-01 00:00:00
abstract::The use of chemical warfare agents against civilians and unprotected troops in international conflicts or by terrorists against civilians is considered to be a real threat, particularly following the terrorist attacks on 11 September 2001 against the World Trade Center in New York and against the Pentagon in Washingto...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/s1049023x00001072
更新日期:2003-07-01 00:00:00
abstract::This special report was prepared as a white paper for the First World Health Organization (WHO) Consultation on Nursing and Midwifery Contributions in Emergencies held in Geneva on 22-24 November 2006. Pertinent issues related to research of nurses and midwives were identified based on prior international conferences....
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X11000124
更新日期:2011-04-01 00:00:00
abstract:INTRODUCTION:Millions of vulnerable, elderly individuals live in coastal areas susceptible to hurricanes and are at risk for adverse health outcomes. The purpose of this study was to determine the status of preparedness for and possible health consequences of a hurricane on a vulnerable, but experienced, elderly popula...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:To characterize the types of occupational exposures and injuries reported by emergency medical service (EMS) workers. METHODS:A blinded review of accidents/exposures among EMS workers employed by a Baltimore County fire department was conducted. Medical records for 1992 were reviewed. RESULTS:Two hundred a...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00041583
更新日期:1995-01-01 00:00:00
abstract::Introduction The concept of response time with minimal interval is intimately related to the practice of emergency medicine. The factors influencing this time interval are poorly understood. Problem In a process of improvement of response time, the impact of the patient's age on ambulance departure intervals was inves...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X16000947
更新日期:2016-12-01 00:00:00
abstract:INTRODUCTION:Out-of-hospital cardiac arrest (OHCA) is a lethal health problem that affects between 236,000 and 325,000 people in the United States each year. As resuscitation attempts are unsuccessful in 70-98% of OHCA cases, Emergency Medical Services (EMS) personnel often face the needs of bereaved family members. P...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12000167
更新日期:2012-02-01 00:00:00
abstract::This report is a summary of a study 1 conducted at the Royal Swedish Academy of War Sciences to evaluate collaboration during crisis management. The study includes relevant legal and regulatory dynamics, as well as conclusions and recommendations. Rules and regulations of international interest are presented in the Ap...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12000532
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To confirm the efficacy of prehospital administration of adenosine, using a 6 milligram (mg) initial dosing regimen, for the treatment of paroxysmal supraventricular tachycardia (PSVT). METHODS:Urban, suburban, rural emergency medical services (EMS) system in Clark County, Washington with advanced life suppo...
journal_title:Prehospital and disaster medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract:INTRODUCTION:Full-scale disaster drills are complex, expensive, and may involve hundreds or thousands of people. However, even when carefully planned, they often fail to manifest the details of medical care given to the casualties during the drill. OBJECTIVE:To assess the feasibility of integrating physicians among th...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract::Airway management is at the forefront for combat medics dealing with battlefield trauma. For military service members, compromised airways are the second leading cause of potentially survivable death on the battlefield, accounting for one in ten preventable combat deaths. Effective suction is a critical component of a...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20001065
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Triage at mass gatherings in Australia is commonly performed by staff members with first aid training. There have been no evaluations of the performance of first aid staff with respect to diagnostic accuracy or identification of presentations requiring ambulance transport to hospital. HYPOTHESIS:It was hy...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20000102
更新日期:2020-04-01 00:00:00
abstract:INTRODUCTION:Exposure to prolonged war stress is understudied. While there is debate regarding the empirical data of the dose-response model for posttraumatic stress disorder (PTSD), little is known about how weekly changes in external stress influences the level of PTSD symptoms. The purpose of this study was to measu...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00007640
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To study the effects of early, advanced prehospital life support on the survival rate of war casualties during the battle of Jalalabad, Afghanistan from 1989-1992. METHOD:The outcomes of simple trauma care administered from 1989-1990 were compared to the outcomes of advanced trauma care administered from 199...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:In the aftermath of Hurricane Katrina, widespread flooding devastated the New Orleans healthcare system. Prior studies of post-hurricane healthcare do not consistently offer evidence-based recommendations for re-establishing patient care post-disaster. The primary objective of this study is to examine associ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00005549
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Inadequately controlled chronic diseases may present a threat to life and well-being during the emergency response phase of disasters. Chronic disease exacerbations (CDE) account for one of the largest patient populations during disasters, and patients are at increased risk for adverse outcomes. OBJECTIVE:T...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/s1049023x00005835
更新日期:2008-03-01 00:00:00
abstract::This study compares the performance of two commercially available devices (Ambu TubeChek and SCOTI) in establishing endotracheal (ET) tube position (oesophageal vs. tracheal) in a mannequin and in miniature pigs. The Ambu TubeChek is a syringe-type, Oesophageal Detector Device (ODD) that fits to the endotracheal tube ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract::In October 2004, a World Association for Disaster and Emergency Medicine (WADEM) Seminar was convened in Brusselsby the Education Committee to discuss Disaster Education and Training. During this seminar, it became apparent that there was no single tool available to assess knowledge, skills, and resources within this ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00003629
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The current Fire/Emergency Medical Services (EMS) model throughout the United States involves emergency vehicles which respond from a primary location (ie, firehouse or municipal facility) to emergency calls. Quick response vehicles (QRVs) have been used in various Fire/EMS systems; however, their effectiven...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X15004732
更新日期:2015-08-01 00:00:00
abstract::The development of autocratic leaders in history reveals that many share severe character disorders that are consistently similar across borders and cultures. Diplomats and humanitarians negotiating for access to populations in-need and security of their programs, especially in health, must understand the limitations ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X18001280
更新日期:2019-01-15 00:00:00
abstract:INTRODUCTION:Few previous studies have been conducted on the prehospital management of hypotensive trauma patients in Stockholm County. The aim of this study was to describe the prehospital management of hypotensive trauma patients admitted to the largest trauma center in Sweden, and to assess whether prehospital traum...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00002582
更新日期:2005-07-01 00:00:00
abstract:UNLABELLED:Introduction To aid in preparation of military medic trainers for a possible new curriculum in teaching junctional tourniquet use, the investigators studied the time to control hemorrhage and blood volume lost in order to provide evidence for ease of use. Hypothesis Models of junctional tourniquet could perf...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X16000443
更新日期:2016-08-01 00:00:00
abstract:INTRODUCTION:The number of deaths due to trauma from road traffic accidents (RTAs), and from the use of firearms either for homicide or armed robbery, ethnic conflicts, and other events, such as flooding, explosions from petroleum products, and religious violence, is on the rise in Nigeria. This preliminary study is a ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00002454
更新日期:2005-05-01 00:00:00
abstract:INTRODUCTION:A case is presented in which a 43-year-old man suffering from a severe asthma attack, had ventilatory arrest during a hoisting procedure. Based on this experience, the influence of three hoisting techniques on lung function was tested. METHODS:The ventilatory capacity of 12 healthy volunteers was tested d...
journal_title:Prehospital and disaster medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-01-01 00:00:00