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53 results in Koenig and Schultz's Disaster Medicine

Page 1 of 3

  • Preface

  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp xxiii-xxvi

  • Summary

    The specialty of disaster medicine has grown substantially since the terrorist attacks of 9/11 in the United States. In support of this growth, a number of disaster-related textbooks have been published. In some cases, however, these treatises have been authored by the 9/12'ers – people who suddenly gained interest and “expertise” in disasters once the topic became popular and U.S. federal funding flowed freely. As a result, much of the subject matter in these works was covered ineffectively. The challenge remained to create the definitive book written by nationally and internationally respected authors. We have considered editing such a book for the last dozen years; however, the timing never seemed right, and there was that ever-present thought that it would not be possible to “do it right” because we did not know exactly what “it” was.

    Complicating the situation is the absence of a standard definition of disaster, much less a uniform concept for an academic discipline of disaster medicine. The need to codify this emerging discipline and create such standards is becoming increasingly clear. For example, the president of the United States issued a Homeland Security Presidential Directive (HSPD) on October 18, 2007 entitled “Public Health and Medical Preparedness.” HSPD-21 “establishes a National Strategy for Public Health and Medical Preparedness, which builds upon principles set forth in Biodefense for the 21st Century (April 2004).”

  • 30 - Nuclear and Radiological Events

  • from SECTION A - CBRNE AND HAZMAT
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 477-510

  • Summary

    Mass exposure to radiation does not occur frequently but such events, when they do occur, present tremendous challenges to affected communities. With the concerns of recent years about nuclear or radiological terrorism, it would also appear that the risk of deliberate mass exposures to radiation has increased. Nuclear power plant accidents leading to the release of radioactive materials could cause widespread environmental contamination with a variety of radionuclides. This chapter summarizes the prompt and delayed effects of fission explosions in the range of energy yields expected from an improvised nuclear device. The acute radiation syndrome (ARS) encompasses a set of complex pathophysiological processes precipitated by exposure to high doses of radiation. The major determinant of clinical outcome following an acute radiation exposure is the dose received by the affected individual. Estimating this dose (in a process termed biodosimetry) thus becomes a critical part of clinical management of such individuals.

  • 1 - Disaster Research and Epidemiology

  • from PART I - CONCEPTUAL FRAMEWORK AND STRATEGIC OVERVIEW
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 3-20

  • Summary

    This chapter discusses research methods and findings in the context of the broader spectrum of processes involved in disasters. The discussion of the state of the art focuses on three aspects of disaster research: methodology, vulnerability, and estimates of morbidity and mortality. The study of disasters can occur in many different physical and temporal contexts. Disaster research, as with most other types of research, utilizes both qualitative and quantitative data. Surveys of individuals, healthcare providers, and healthcare organizations are heavily utilized in disaster epidemiology to obtain quantitative data about the health status of a population and possible associations between disaster exposure and health outcomes. The most commonly mentioned dimensions of vulnerability in disaster research are physical, economic, political, social, and psychological. The discussion of disaster morbidity and mortality describes how these estimates are derived, as well as the many factors that can influence their accuracy and introduce variability across studies.

  • 15 - Quarantine

  • from PART II - OPERATIONAL ISSUES
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 203-212

  • Summary

    Quarantine is an important tool in the armamentarium for protection of the public health from contagious infectious diseases. This chapter reviews the complexities of quarantine related to three separate but tightly linked perspectives: efficacy; legal authority; and ethical, as well as logistical, challenges in implementation. Quarantine has often been used interchangeably with isolation and civil commitment. In the United States, two model public health laws, the Model State Emergency Health Powers Act (MSEHPA) and the Turning Point Model State Public Health Act acknowledge that traditional public health powers such as surveillance, quarantine, and isolation are among the most outdated provisions in existing state laws The WHO addresses the legal issues of quarantine and outlines a collective defense strategy. It published legal guidance in the International Health Regulations 2005 (IHR-2005). The federal government also has the responsibility to assist states in the execution of their quarantine laws.

  • 10 - Legislative Authorities and Regulatory Issues

  • from PART II - OPERATIONAL ISSUES
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 151-164

  • Summary

    This chapter reviews disaster legal issues primarily from the perspective of a person or institution, who collectively provide medical care to patients in the midst of catastrophic disaster or other public health emergency. It summarizes the key changes in the legal environment under which disaster medicine is practiced. Most medical providers use well-developed procedures to assure that any exchange of patient information complies with law. In the U.S., states regulate the practice of medicine. Thus, providers must be licensed in the state in which they are providing medical care. Medicare in the U.S. also promulgates federal hospital emergency management plan accreditation requirements. The U.S. Emergency Medical Treatment and Labor Act (EMTALA) requires Medicare participating hospitals to provide any individual presenting for care on hospital grounds with medical screening, stabilizing services, and appropriate transfer to a higher level of care if indicated.

  • 8 - Special Needs Populations

  • from PART I - CONCEPTUAL FRAMEWORK AND STRATEGIC OVERVIEW
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 113-130

  • Summary

    In studying the impact of disasters, concern has developed regarding populations that demonstrate a greater vulnerability to injury, death, and/or property loss. This chapter reviews populations at risk and identifies the special needs that each might experience. Personnel with responsibilities for managing disasters reflect on how each population might be present in their practices or jurisdictions. The chapter examines a number of the populations considered vulnerable by generally following the emergence of that literature as it has unfolded over the past few decades. Both emergency managers and disaster researchers tend to group the practice and knowledge relating to disasters into a life cycle of emergency management. In the U.S., the National Governor's Association organized the phases into preparedness, response, recovery, and mitigation activities. The chapter addresses special needs concerns within each phase. It concludes with a consideration of practical strategies and includes recommendations for future research and a resource section.

  • 31 - Hazardous Material, Toxic, and Industrial Events

  • from SECTION A - CBRNE AND HAZMAT
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 511-526

  • Summary

    Hazardous material (HazMat) incidents are increasingly prevalent due to the continuing rapid growth and globalization of the chemical industry. Industrial accidents can be described by the initiating event, which can be one or more of the following: human error, environmental conditions, and container or equipment failure. To recognize a HazMat event, emergency medical services and fire department personnel responding to a motor vehicle collision or structure fire must have a high index of suspicion. Measures to mitigate, prevent, and manage toxic HazMat incidents are closely interconnected and can be similar in both execution and goals. When responding to an acute HazMat incident, the protocols and procedures that are planned during the preparation phase are followed and executed. A well-developed research agenda provides the evidence-based science to guide community risk management and enforcement of high safety standards in the chemical industry.

  • 12 - Triage

  • from PART II - OPERATIONAL ISSUES
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 174-183

  • Summary

    This chapter presents a description of the triage systems. These systems include Simple Triage and Rapid Treatment (START), Homebush Triage Standard, CareFlight Triage, Triage Sieve, the Sacco Triage Method, the CESIRA Protocol, MASS Triage, and Military/NATO Triage. The chapter provides a brief discussion of the Sort, Assess, Lifesaving measures, Treat/Transport (SALT) system. SALT begins with a global sorting of patients to prioritize them for individual assessment. The chapter discusses the secondary triage systems SAVE and Triage Sort, as well as the pediatric specific systems, JumpSTART and the Pediatric Triage Tape. There are two categories of outcomes that could be used in assessing how triage affects patient outcome: patient-based scoring systems and resource based systems. Specific attention to chemical, biological, and radiological/nuclear (CBRN) events is a critical component of state of the art triage systems and must be considered when choosing a triage methodology.

  • 7 - Disaster Mental and Behavioral Health

  • from PART I - CONCEPTUAL FRAMEWORK AND STRATEGIC OVERVIEW
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 103-112

  • Summary

    This chapter describes the range and timeline of typical reactions, approaches for screening, triage, and referral, preventing and managing psychological injuries, and integrated strategies to support disaster responders. Disasters and acts of terrorism produce a spectrum of common physiological, psychological, social, behavioral, emotional, cognitive, and spiritual reactions. An emerging incident management model for disaster mental and behavioral health is composed of three major components to enable a common operational picture for participating entities and jurisdictions. The components include community-based disaster systems of care, a common system for incident/event-specific rapid triage, and information technology for near-real-time data linkage. Psychological impact and resulting levels of psychiatric disorders may vary as a function of event characteristics, such as terrorism using weapons that can cause mass casualties and societal disruption. Using leadership, public messaging, and education greatly improves the mental and behavioral health of communities impacted by disasters and mass violence.

  • 18 - Transportation Disasters

  • from PART II - OPERATIONAL ISSUES
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 253-274

  • Summary

    In this chapter, the author uses the Haddon Matrix to describe the disasters affecting each mode of transportation and the British Major Incident Medical Management System (MIMMS) to illustrate how these events are managed. The chapter deals with air disasters, sea (ship and ferry) disasters, rail (train/railway) disasters, and motor vehicle (bus/coach) disasters. Airport rescue resources must adapt to local circumstances. Implementation of a well-developed communication plan after an aviation incident facilitates transmission of information to all participating agencies. "Load and go" principles have been used in takeoff and landing crashes because the transport times are often quite short. The large losses in sea disasters have often been related to warfare. An incident at sea often happens far from land and from emergency and rescue resources. The chapter focuses on the most probable type of traffic mass casualty event that rescue forces encounter, that is, a bus or coach crash.

  • 39 - Volcanoes

  • from SECTION B - ENVIRONMENTAL EVENTS
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 632-642

  • Summary

    This chapter describes the key elements of volcanic disaster planning for health sector workers. A simplified way to approach volcanoes and their hazards is to learn whether they are mainly explosive or effusive (a nonexplosive outpouring of fluid lava) in behavior. The main eruptive hazards can be divided into fall and flow processes. Pyroclastic flows and surges, lahars and debris flows, and lava flows can, for emergency planning purposes, be envisaged by thinking visually or intuitively, but their behavior belongs to the world of flow, or fluid dynamics, on which the understanding of the blood circulation, meteorology, and aeronautics is based. Although mitigation of human casualties by timely evacuation is the main goal in emergency management of volcanic threats, disaster planners must also be familiar with rescue and emergency treatment measures and prepare for unique conditions associated with volcanic eruptions.

  • 29 - Biological Events

  • from SECTION A - CBRNE AND HAZMAT
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 454-476

  • Summary

    Biological warfare has been a threat to humanity since ancient times and crude attempts at bioterrorism have been a growing concern for several decades. In June of 1999, U.S. public health experts met at CDC headquarters and used this rationale to develop a list of critical biological agents for health preparedness. Category A agents are those that, if released effectively, would be expected to have a high overall public health impact. Category B agents present a somewhat lesser requirement for preparedness, whereas category C agents require vigilance to guard against their future development as threat agents, but can be adequately managed within the framework of the existing public health infrastructure. To understand current biological warfare medical countermeasures research strategy and progress within the United States, it is useful to review weapons of mass destruction (WMD) medical countermeasure research programs led by Department of Defense, and the Department of Homeland Security.

  • 16 - Mass Dispensing of Antibiotics and Vaccines

  • from PART II - OPERATIONAL ISSUES
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 213-227

  • Summary

    The development of mass dispensing clinics and mass vaccination clinics should be incorporated into community disaster plans. Federal assistance in the event of a large-scale public health emergency requiring mass antibiotic prophylaxis or vaccination includes obtaining necessary medications from several sources. In the United States, the Strategic National Stockpile (SNS) is a federally managed supply of antibiotics, vaccines, antitoxins, antivirals, medical supplies, and equipment that is available to affected areas once local, state, or regional supplies are depleted or systems are overwhelmed. Points of dispensing (PODs) operation are the mechanisms available for dispensing medication or administering vaccines to large population after a catastrophic event. Medication-related adverse events may be seen in varying numbers in a mass dispensing or mass vaccination campaign. Each POD location should have the appropriate equipment such as forklifts or pallet jacks to move deliveries as well as sufficient equipment to provide cold chain storage as needed.

  • 37 - Winter Storms

  • from SECTION B - ENVIRONMENTAL EVENTS
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 586-608

  • Summary

    This chapter discusses the problems winter storms pose, and how they fit into the continuum from minor annoyance to major disaster. It explores what can be done to prepare for future events that threaten the welfare of those in their paths. Understanding the human impact of catastrophic events, so that society can be better prepared for future challenges, is the primary mission in the fields of emergency management and disaster medicine. Establishing an incident command structure, regardless of size, should bring together the resources officials need to determine the security and safety of affected areas, identify hazards to responders, and coordinate the support necessary to begin rescue and recovery efforts. Rapid assessments for identifying immediate challenges created by a winter storm and determining potential resources required to mount an effective response are necessary to avoid a dysfunctional approach.

  • 4 - International Perspectives on Disaster Management

  • from PART I - CONCEPTUAL FRAMEWORK AND STRATEGIC OVERVIEW
  • Edited by Kristi L. Koenig, University of California, Irvine, Carl H. Schultz, University of California, Irvine
  • Book:
    Koenig and Schultz's Disaster Medicine
    Published online:
    05 August 2011
    Print publication:
    30 September 2009, pp 51-61

  • Summary

    This chapter presents an international perspective that focuses on the evolution of the approach health specialists have used to reduce the health consequences linked to disasters. It highlights some of the main aspects of humanitarian disaster response training and disaster risk reduction. The chapter explores how disaster management has evolved to its present status. Both governmental and regional institutions have significantly improved their disaster management efforts over the last 30 years. The agency within the ministry of health is the designated entity for protecting health from the consequences of disasters. The rate at which disasters occur has a substantial impact on institutional development of these agencies. The humanitarian reform movement has generated the concept of dividing humanitarian assistance into several topic specific groups called clusters. Finally, the chapter explores avenues for future growth, and discusses examples of developments in emergency medicine education and research.

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