Post-Earthquake Injuries Treated at a Field Hospital ù Haiti, 2010

La "University of Miami Global Institute/Project Medishare" (UMGI/PM) a créé le premier hôpital de campagne à Port-au-Prince, en Haïti, après le séisme. Afin de caractériser les blessures et les interventions chirurgicales effectuées par l'UMGI/PM et d'évaluer les besoins spéciaux médicaux, chirurgicaux et de réadaptation, l'UMGI/PM et le "Centers for Disease Control and Prevention" (CDC) mènent une analyse rétrospective de tous les dossiers médicaux de malades disponibles pour la période du 13 janvier au 28 mai 2010. Le premier article de cette revue décrit les résultats de cette analyse et présente les données quantitatives obtenues.

An Analysis of Hospital Preparedness Capacity for Public Health Emergency in four Regions of China: Beijing, Shandong, Guangxi and Hainan

Background: Hospital preparedness is critical for the early detection and management of public health emergency (PHE). Understandig the current status of PHE preparedness is the first steep in planning to enhance hospitals capacities for emergency response. The objective of this study is to understand the current status of hospital PHE preparedness in China. Methods: Four hundred hospitals in four city and provinces of China were surveyed using a standardized questionnaire. Data related to hospital demographic data; PHE preparation; response to PHE in community; stockpiles of drugs and materials; detection and identification of PHE; procedures for medical treatment; laboratory diangnosis and management; staff training; and risk communication were collected and analyzed. Results: Valid responses were received from 318 (79.5%) of the 400 hospitals surveyed. Of the valid responses, 264 (85.2%) hospitals had emergency plans; 93.3% had command centres and personnel for PHE; 22.9% included community organisations during the training for PHE; 97.4% could transport needed medical staff to a PHE; 53.1% had evaluated stockpiles of drugs; 61.5% had evaluated their supply systems; 55.5% had developed surveillance systems; and 74.6% could monitor the abnormity (See appendix). Physicians in 80.2% of the analyzed hospitals reported up-to-date knowledge of their institutions PHE protocol. Of the 318 respondents, 97.4% followed strict laboratory regulations, however, only about 33.5% had protocols for suspected samples. Furthermore, only 59.0% could isolate and identify salmonella and staphylococcus and less than 5% could isolate and identify human H5NI avian flu and SARS. Staff training or drill programs were reported in 94.5% of the instituions; 50.3% periodically assessed the efficacy of staff training; 45% had experts to provide psychological counselling; 12.1% had provided training for their modical staff to assess PHE-related stress. All of the above capacities...

Emergency Response Planning in Hospitals, United States: 2003-2004

Objective: This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units. Methods: Information from the Bioterrorism and Mass Casualty Preparedness Suplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical shcool affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals. Results: About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources. (AU)

Hurricane Katrina´ s Impact on Tulane s Teaching Hospitals

On Monday, August 29, 2005 Hurricane Katrina passed east of New Orleans causing minimal damage to Tolane s Medical Center. Later that day, levees that protected the city failed and several feet of water entered the hospitals and school buildings. Emergency generators provided power for 36 hours before running out of fuel. Temperatures in the hospitals soared into the upper 90s and conditions were made intolerable by 100% humidity and backed-up sewage. For several days, faculty, residents nurses and hospitals personnel perfomed heroically, caring fo patients in appalling conditions, hand-ventilating critically ill patients in shifts. Approximately 200 patients, and 1500 additional personnel would be evacuated on Wednesday and Thursday from a makeshift heliport on Tulanes parking garage. Current disaster plans may be inadequate should facilities be inaccessible for months because of damage or contamination. Contingency plans also need to be made should outside disaster relief be markedly delayed as was the case with Katrina. (AU)