American Journal of Disaster Medicine

BACKGROUND: Terrorist attacks and natural disasters such as Hurricanes Katrina and Harvey have increased focus on disaster preparedness planning. Despite the attention on planning, many studies have found that hospitals in the United States are underprepared to manage extended disasters appropriately and the surge in patient volume it might bring. AIM: This study aims to profile and examine the availability of hospital capacity specifically related to COVID-19 patients, such as emergency department (ED) beds, intensive care unit (ICU) beds, temporary space setup, and ventilators...

BACKGROUND: Recent news has shown the strain on hospital emergency departments (EDs) and emergency medical services agencies due to the surge of COVID-19; however, compared to all emergency medical service transports, is it true that the United States is seeing an increase in the frequency of diversions? In this quantitative research report, data were collected and analyzed from a national prehospital emergency medical services information system, which allowed for a comparison of the frequency of diverted ambulances, transport times, and final patient acuity of patients arriving by diverted ambulances before and during the COVID-19 pandemic...

INTRODUCTION: Fear of COVID-19 may differ for individuals with compromised health and those with unhealthy behaviors, placing them at greater risk. Based on previous analysis of academic medical center faculty and staff, the authors predicted that workers who were smokers/previous smokers would express the greater fear of COVID-19 relative to nonsmokers. METHODS: The present study used the Fear of COVID-19 Scale to assess fear among nonsmokers (n = 1,489) and smokers/previous smokers (n = 272) from a larger population of academic medical center members (N = 1,761)...

OBJECTIVE: Targeting of healthcare infrastructures in Ukraine has served as a tactical warfare strategy. The goal of the Global Surgical and Medical Support Group (GSMSG) is to provide sustainable, high quality medical and surgical care in war zones. INTERVENTIONS: GSMSG deployed United States (US) Special Operations veterans and highly specialized licensed medical experts. Training of Ukrainian civilians was implemented. RESULTS: Over 20,000 Ukrainians trained and over 100 major surgeries performed with assistance of world experts...

Chile is one of the most seismically active nations in the world. Due to the frequency of earthquakes, the Chilean government has invested heavily in several earthquake mitigation strategies and is able to boast impressively low numbers of deaths after relatively strong earthquakes. These include earthquake-centered building codes, which help prevent collapses, early detection technologies, early warning systems, public awareness campaigns, and unified command of responding agencies. Disaster risk management is a field in need of more evidence-based recommendations, and taking cues from successful programs such as these is vital to decrease global deaths...

OBJECTIVE: Noncommunicable diseases (NCDs) are of increasing prevalence in low- and middle-income countries (LMICs), affected by disasters. Humanitarian actors are increasingly confronted with how to effectively manage NCDs, yet primary focus on this topic is lacking. We conducted a systematic review on the effects of disasters on NCDs in LMICs. Key interventions were identified, and their effects on populations in disaster settings were reviewed. DESIGN: We electronically searched Medline, PubMed, Global Health, and Social Science Citation Index...

OBJECTIVE: The objective of this study was to assess the training and readiness levels of Collegiate Emergency Medical Service (EMS) providers to respond to mass casualty incidents (MCIs). METHODS: An anonymous cross-sectional survey of Collegiate EMS providers was performed. PARTICIPANTS: Participants were US-based EMS providers affiliated with the National Collegiate Emergency Medical Services Foundation. OUTCOME MEASURES: The main outcome measures were levels of EMS experience and MCI training, subjective readiness levels for responding to various MCI scenarios, and analyzing the effect of the COVID-19 pandemic on MCI response capabilities...

BACKGROUND: Shooting events in hospitals are increasing in frequency, with the emergency department (ED) being the most common site of such events. EDs must be prepared for shooting events, but current practices surrounding active shooter preparation are unknown. OBJECTIVE: To determine what active shooter training emergency medicine physicians are receiving. METHODS: A survey was developed to assess current practices around active shooter preparation in EDs...

OBJECTIVE: To study the pattern of ophthalmic emergencies after Hurricane Harvey (HH). DESIGN: A retrospective chart review. SETTING: University of Texas Medical Branch (UTMB) in Galveston, Texas. PARTICIPANTS: Patients who presented to UTMB emergency room (ER) during the month before (47 patients) and the month after (39 patients) HH landfall and were seen by the ophthalmology service. MAIN OUTCOME MEASURES: Ocular injuries before and after hurricane landfall were classified by duration of symptoms (acute, subacute, and chronic), type of injury (hurricane related, traumatic, and infectious), region of injury (corneal/anterior segment, glaucoma, vitreoretinal, orbital-oculoplastic, and neuro-ophthalmologic), and level of involvement of injury (limited to eye, a manifestation of systemic disease, and associated with other bodily injuries)...

BACKGROUND: In France, in 2015, prehospital emergency doctors were faced with civilian casualties in hemorrhagic shock resulting from terrorist attacks with automatic rifle fire and explosive weapons. The present study aimed to evaluate the impact of these attacks on the advanced life support (ALS) team's practices and equipment and on physician training in the prehospital management of traumatic hemorrhagic shock. METHODS: This before-and-after multicenter study evaluated professional practices based on a questionnaire sent to emergency department heads and medical practitioners in 370 ALS teams in metropolitan France...

The coronavirus disease 2019 (COVID-19) pandemic has required healthcare systems to adapt, innovate, and collaborate to protect public health through treatment, testing, and vaccination initiatives related to the virus. As the pandemic evolved, lessons learned early on through testing and treatment were applied to vaccination efforts. Hartford HealthCare (HHC) is one of the largest healthcare systems in New England and took an integral role in vaccinating patients throughout the region, thus providing one of the largest vaccination campaigns in Connecticut...

OBJECTIVE: To review the current standards being followed for diagnostic radiology at low-resource settings. DESIGN: A systematic review was conducted. SETTING: Low-resource field hospitals were reviewed. PATIENTS AND PARTICIPANTS: All patients who were diagnosed using imaging in field hospitals were included in this review. INTERVENTIONS: Only standard care diagnostic imaging was reviewed. RESULTS: Scanty evidence on the standard quality control for mobile health unit (MHU) in low-resource settings is observed...

BACKGROUND: The use and storage of chemical weapons in war was banned. However, chemical weapons continue to be used in wars. Therefore, in this study, we tried to identify the chemical agents used by defining the characteristics of chemical attacks. METHOD: We designed our study using the international dataset that can be accessed from www.start.umd.edu/gtd/. Chemical attacks between 1970 and 2020 were recorded in terms of decade, type of attack, success, suicidal purpose, property damage, number of deaths and injuries, and agents used...

Major disasters often displace populations, requiring coordinated response efforts from governmental and voluntary organizations to support and assist an influx of evacuees. Despite the frequency and significance of this occurrence, this aspect of disaster management has received limited scholarly attention, with research predominantly focusing on response and recovery at the impacted disaster sites. This study investigates disaster management and support offered to Puerto Rican evacuees arriving in Central Florida after Hurricane Maria...

OBJECTIVES: This study aims to provide metadesign indications for the improvement of healthcare facilities, emphasizing the role of spatial design in the management of epidemic health emergencies. STUDY DESIGN: A parallel mixed-method study including literature reviews, survey creation, and survey distribution was performed. METHODS: Data were collected between August and October 2020 capturing information related to the first wave of the COVID-19 pandemic, utilizing a review of existing literature, a comparison of existing hospital planning guidelines and assessment tools, and distribution of a survey to analyze design changes within selected Italian hospitals...

PURPOSE: The purpose of the research discussed in this paper is to better understand the negative health outcomes resulting from Hurricane Katrina and the disaster response that followed. This understanding can inform future disaster response. DESIGN: We conducted 10 in-depth interviews with individuals who lived in New Orleans at the time of Hurricane Katrina. We conducted thematic analysis on the interview content and identified patterns across all 10 interviews...

The emergence of the COVID-19 pandemic has put health systems under enormous pressure, pushing for health systems' resilience. Malawi, mostly rural with hard-to-reach areas, had their first case in April 2020, amidst political turmoil. So far, much has been documented on how health systems contained the COVID-19 pandemic. This paper describes the role of community health system structures in ensuring health systems' resilience during the COVID-19 pandemic in rural Malawi. To highlight the role of community health structures in the Malawian health system, we developed and applied a framework on health systems' resilience through the community health system structures in a rural district in Malawi...

OBJECTIVES: This information paper will describe the current research and recommendations for improving healthcare worker's (HCW) mental health. Individual and organizational goals will be outlined with items broken up into the time frames of predisaster, during a disaster, and post-disaster. METHODS: A team of subject matter experts reviewed the current literature utilizing a search of PubMed, Google Scholar, relevant article reference lists, and subject matter interviews...

OBJECTIVE: To review the literature on the effects seen after disaster on those with poor social determinants of health (SDOH) and individual social needs. DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians (ACEP) formed a work group to study healthcare disparities seen in disaster. This group was composed of six physicians on the committee, all of whom have extensive background in disaster medicine and the chair of the committee...

OBJECTIVE: This simulation exercise was conducted to test the functionality of the hospital incident command system, triage, treatment areas, and external coordination and communication. DESIGN: This was an observational study. Coordination, logistic, technical design, staging, and evaluation of the exercise were planned for the exercise. The exercise was conducted in six hospitals. Observations were recorded, and a validated checklist was used to score. SETTING: This was a semisurprise exercise in the hospital setup...