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1.
Air Med J ; 39(4): 251-256, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32690299

RESUMO

Recent coronavirus disease 2019 (COVID-19) events have presented challenges to health care systems worldwide. Air medical movement of individuals with potential infectious disease poses unique challenges and threats to crews and receiving personnel. The US Department of Health and Human Services air medical evacuation teams of the National Disaster Medical System directly supported 39 flights, moving over 2,000 individuals. Infection control precautions focused on source and engineering controls, personal protective equipment, safe work practices to limit contamination, and containment of the area of potential contamination. Source control to limit transmission distance was used by requiring all passengers to wear masks (surgical masks for persons under investigation and N95 for known positives). Engineering controls used plastic sheeting to segregate and treat patients who developed symptoms while airborne. Crews used Tyvek (Dupont Richmond, VA) suits with booties and a hood, a double layer of gloves, and either a powered air-purifying respirator or an N95 mask with a face shield. For those outside the 6-ft range, an N95 mask and gloves were worn. Safe work practices were used, which included mandatory aircraft surface decontamination, airflow exchanges, and designated lavatories. Although most patients transported were stable, to the best of our knowledge, this represents the largest repatriation of potentially contagious patients in history without infection of any transporting US Department of Health and Human Services air medical evacuation crews.


Assuntos
Medicina Aeroespacial , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Transporte de Pacientes/métodos , Betacoronavirus , China , Infecções por Coronavirus/terapia , Medicina de Desastres , Desinfecção , Equipamentos e Provisões , Governo Federal , Pessoal de Saúde , Humanos , Eliminação de Resíduos de Serviços de Saúde , Isolamento de Pacientes/métodos , Equipamento de Proteção Individual , Admissão e Escalonamento de Pessoal , Pneumonia Viral/terapia , Quarentena/métodos , Navios , Estados Unidos , United States Dept. of Health and Human Services
3.
Ann Emerg Med ; 76(2): 168-178, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32507491

RESUMO

The adverse influences of climate change are manifesting as health burdens relevant to clinical practice, affecting the very underpinnings of health and stressing the health care system. Emergency medicine is likely to bear a large burden, with its focus on urgent and emergency care, through its role as a safety-net provider for vulnerable populations and as a leader in disaster medicine. Clinically, climate change is affecting emergency medicine practice through the amplification of climate-related disease patterns and epidemiologic shifts for conditions diagnosed and treated in emergency departments (EDs), especially for vulnerable populations. In addition, climate-driven intensification of extreme weather is disrupting health care delivery in EDs and health care systems. Thus, there are significant opportunities for emergency medicine to lead the medical response to climate change through 7 key areas: clinical practice improvements, building resilient EDs and health care systems, adaptation and public health engagement, disaster preparedness, mitigation, research, and education. In the face of this growing health threat, systemwide preparation rooted in local leadership and responsiveness is necessary to efficiently and effectively care for our vulnerable communities.


Assuntos
Mudança Climática , Assistência à Saúde , Desastres , Medicina de Emergência , Saúde Pública , Populações Vulneráveis , Doenças Cardiovasculares , Doença Crônica , Medicina de Desastres , Serviço Hospitalar de Emergência , Transtornos de Estresse por Calor , Humanos , Transtornos Mentais , Doenças Respiratórias , Classe Social , Estados Unidos , Doenças Transmitidas por Vetores , Ferimentos e Lesões
4.
PLoS One ; 15(5): e0233831, 2020.
Artigo em Inglês | MEDLINE | ID: covidwho-436894

RESUMO

PURPOSES: During the outbreak of Coronavirus Disease 2019 (COVID-19) all over the world, the mental health conditions of health care workers are of great importance to ensure the efficiency of rescue operations. The current study examined the effect of social support on mental health of health care workers and its underlying mechanisms regarding the mediating role of resilience and moderating role of age during the epidemic. METHODS: Social Support Rating Scale (SSRS), Connor-Davidson Resilience scale (CD-RISC) and Symptom Checklist 90 (SCL-90) were administrated among 1472 health care workers from Jiangsu Province, China during the peak period of COVID-19 outbreak. Structural equation modeling (SEM) was used to examine the mediation effect of resilience on the relation between social support and mental health, whereas moderated mediation analysis was performed by Hayes PROCESS macro. RESULTS: The findings showed that resilience could partially mediate the effect of social support on mental health among health care workers. Age group moderated the indirect relationship between social support and mental health via resilience. Specifically, compared with younger health care workers, the association between resilience and mental health would be attenuated in the middle-aged workers. CONCLUSIONS: The results add knowledge to previous literature by uncovering the underlying mechanisms between social support and mental health. The present study has profound implications for mental health services for health care workers during the peak period of COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/psicologia , Pneumonia Viral/epidemiologia , China/epidemiologia , Medicina de Desastres , Humanos , Serviços de Saúde Mental , Pandemias , Escalas de Graduação Psiquiátrica , Resiliência Psicológica , Apoio Social
5.
Medicine (Baltimore) ; 99(20): e20230, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443354

RESUMO

Disaster medicine education in medical curricula is scarce and frequently nonexistent. It is reasonable to initiate educational approaches for physicians in this field at the medical school level. An understanding of disaster medicine and the health care system during massive casualty incidents has been recommended as an integral part of the medical curriculum in the United States and Germany.The goal of the reformed curriculum was to develop a longitudinal integrated disaster and military medicine education program extending from the first year to the sixth year based on previously separated clinical and military medicine topics. Emergency medicine physicians, military emergency medical technicians, and Tactical Combat Casualty Care instructors formed an interprofessional faculty group and designed a learning curriculum.A total of 230 medical students participated in the revised disaster preparedness curriculum. Satisfaction survey response rates were high (201/230, 87.4%). Most of the free-text comments on the program were highly appreciative. The students considered the number of teaching hours for the whole program to be adequate. The students showed significant improvements in knowledge and judgment regarding disaster medicine after the program.We found that medical students were highly interested, were appreciative of, and actively participated in this longitudinal integrated disaster and military medicine education program, but gaps existed between the students' scores and the educators' expectations. The educators believed that the students needed more disaster preparedness knowledge and skills.


Assuntos
Medicina de Desastres/educação , Medicina Militar/educação , Estudantes de Medicina/estatística & dados numéricos , Currículo , Medicina de Desastres/métodos , Educação de Graduação em Medicina/métodos , Educação de Graduação em Medicina/normas , Educação de Graduação em Medicina/tendências , Humanos , Medicina Militar/métodos , Projetos Piloto , Inquéritos e Questionários
6.
PLoS One ; 15(5): e0233831, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32470007

RESUMO

PURPOSES: During the outbreak of Coronavirus Disease 2019 (COVID-19) all over the world, the mental health conditions of health care workers are of great importance to ensure the efficiency of rescue operations. The current study examined the effect of social support on mental health of health care workers and its underlying mechanisms regarding the mediating role of resilience and moderating role of age during the epidemic. METHODS: Social Support Rating Scale (SSRS), Connor-Davidson Resilience scale (CD-RISC) and Symptom Checklist 90 (SCL-90) were administrated among 1472 health care workers from Jiangsu Province, China during the peak period of COVID-19 outbreak. Structural equation modeling (SEM) was used to examine the mediation effect of resilience on the relation between social support and mental health, whereas moderated mediation analysis was performed by Hayes PROCESS macro. RESULTS: The findings showed that resilience could partially mediate the effect of social support on mental health among health care workers. Age group moderated the indirect relationship between social support and mental health via resilience. Specifically, compared with younger health care workers, the association between resilience and mental health would be attenuated in the middle-aged workers. CONCLUSIONS: The results add knowledge to previous literature by uncovering the underlying mechanisms between social support and mental health. The present study has profound implications for mental health services for health care workers during the peak period of COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/psicologia , Pneumonia Viral/epidemiologia , China/epidemiologia , Medicina de Desastres , Humanos , Serviços de Saúde Mental , Pandemias , Escalas de Graduação Psiquiátrica , Resiliência Psicológica , Apoio Social
7.
Nurse Pract ; 45(2): 48-54, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31977622

RESUMO

This third installment of the Disaster Response Series focuses on the need for NPs to be familiar with the information communication technologies used in their geographic areas and be ready to use them when, not if, a disaster strikes.


Assuntos
Comunicação , Medicina de Desastres , Tecnologia da Informação , Profissionais de Enfermagem/psicologia , Humanos , Estados Unidos
9.
Nurse Educ Today ; 84: 104208, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31706206

RESUMO

BACKGROUND: Disaster nursing education is a necessity for nurses and students to improve their disaster relief competencies. Determining undergraduate student nurses' learning perceived needs for disaster nursing can help improve curricula construction. In China there is currently no valid instrument available for the evaluation of influencing factors. A disaster nursing course content system was developed using the Delphi method in 2011. However, this system was unformed and lacked psychometric evaluation. OBJECTIVES: To adapt the disaster nursing course content system into an instrument, to evaluate its psychometric properties, and to investigate undergraduate student nurses' learning perceived needs for disaster nursing. DESIGN, SETTINGS AND PARTICIPANTS: Two cross-sectional studies were conducted in public higher education institutions in China. In the first study, a total of 1714 undergraduate student nurses were recruited in May to October 2016; in the second study, 68 were recruited in May 2019. METHODS: The instrument was adapted through literature review, face validity and pilot testing in preliminary studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis, parallel analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability. RESULTS: The exploratory factor analysis and parallel analysis extracted a three-factor solution comprising 19 items that accounted for 71.69% of the total variance, including discipline introduction, skills and knowledge in disaster relief, and disaster management. The fit indices indicated a good fit. The internal consistency and test-retest reliability was good, as indicated by a Cronbach's alpha of 0.89 and an intraclass correlation coefficient of 0.87. CONCLUSION: The Learning Needs for Disaster Nursing questionnaire exhibited good psychometric properties, thereby proving itself a valuable instrument for evaluating learning perceived needs in undergraduate student nurses.


Assuntos
Medicina de Desastres/educação , Psicometria/normas , Estudantes de Enfermagem/psicologia , Adolescente , Adulto , Estudos Transversais , Bacharelado em Enfermagem/métodos , Feminino , Humanos , Masculino , Determinação de Necessidades de Cuidados de Saúde , Percepção , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários
10.
Prof Case Manag ; 25(1): 1-4, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31567751

RESUMO

The mass casualty statistics in the United States is numbing. Case managers must be prepared for potential disasters. This Editorial speaks to a case manager's personal experience and calls for others who have been through an experience with mass casualties, so all may better prepare: preparation is the antidote to panic.


Assuntos
Administração de Caso/organização & administração , Gerentes de Casos/psicologia , Defesa Civil/estatística & dados numéricos , Defesa Civil/normas , Medicina de Desastres/estatística & dados numéricos , Medicina de Desastres/normas , Incidentes com Feridos em Massa/estatística & dados numéricos , Humanos , Estados Unidos
11.
FP Essent ; 487: 2, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31799814
12.
FP Essent ; 487: 11-16, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31799815

RESUMO

Understanding common public health threats is critical in preparing for disasters and improving community resilience. Disasters can be natural (eg, earthquakes, landslides, floods, hurricanes, wildfires) or technological (ie, man-made) (eg, mass shootings, bioterrorism). Disasters caused by climate change constitute a combination of these two types-cases in which man-made actions have long-term consequences through natural disasters. After a disaster, immediate public health concerns include access to water and sanitation. Other concerns include safety and security, possible infectious disease outbreaks, mental health issues, and increased risk of human trafficking. Disease outbreaks often occur due to lack of potable water and disruption of sewage disposal systems. Mental stress and mental disorders, such as acute stress disorders and anxiety disorders, should be recognized and addressed. Chaos after disasters can overwhelm law enforcement, increasing the risk of violence and human trafficking for vulnerable populations. Disasters can have a devastating effect on health care infrastructure, increase the need for mortuary and morgue services, and increase demands on the health care system.


Assuntos
Tempestades Ciclônicas , Medicina de Desastres , Planejamento em Desastres , Desastres , Humanos , Saúde Pública
13.
FP Essent ; 487: 17-22, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31799816

RESUMO

The phases of emergency management are mitigation, preparedness, response, and recovery. Optimal disaster response requires knowledge and understanding of the US disaster response structure. In a disaster, the local government is the first to start a response. It initiates the incident command system, activates the local emergency management plan, sets up an emergency operations center (EOC), and activates mutual aid agreements as needed. Assistance from the state and federal governments may be requested. Hospitals respond using the hospital incident command system. The incident commander declares a hospital emergency, sets up an EOC, and uses the predisaster hazard vulnerability analysis tool to choose the incident action plan specific to the hazard. Principles of the crisis standard of care are used in disaster response when health care needs overwhelm available resources. Alert systems are critical to inform personnel and the public about weather conditions, evacuation orders, and closures of roads and health care facilities. Family physicians can play an important role during disaster response, including patient notification and immediate discharge or transfer of patients with less serious acute conditions from the hospital and emergency department to free beds.


Assuntos
Medicina de Desastres , Planejamento em Desastres , Serviço Hospitalar de Emergência , Humanos , Desastres Naturais , Saúde Pública
14.
FP Essent ; 487: 23-26, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31799817

RESUMO

Family physicians are well positioned to educate patients about creating their own disaster plans. Disaster preparedness education for individuals and families should include information about creation of Go Bags and personal and family emergency kits. Patients should be advised to include an updated printed or electronic list of their drugs and dosages in case of emergencies. To ensure disaster preparedness education is provided, physicians can offer printed materials or provide information on the office website. Patients who are part of vulnerable populations (eg, elderly patients, pregnant women, children, patients with disabilities) and patients with significant health issues need individualized disaster preparedness plans. During a disaster, patients receiving chemotherapy or facility-based dialysis should be prioritized for transport to facilities that can provide these services. Family physician offices should have disaster plans that are scalable to meet needs during any type of disaster. Planning should include alert systems for patients and staff, access to electronic health records, simulations and drills, mutual aid agreements with local organizations, and personal physician and staff needs during a disaster.


Assuntos
Pessoas com Deficiência , Medicina de Desastres , Planejamento em Desastres , Desastres , Idoso , Criança , Feminino , Humanos , Gravidez
15.
FP Essent ; 487: 27-33, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31799818

RESUMO

Volunteering during a disaster is helpful only if there is a need for assistance. Clinicians should not self-deploy to disaster areas. Disaster responders should understand the incident command system, know how to perform reverse triage, and be familiar with the three commonly used mass casualty triage algorithms. The medical supplies needed and types of injuries expected depend on the disaster type and severity. The safety of responders is a priority. As such, they may be required to receive appropriate vaccinations, take prophylactic antibiotics, use personal protective equipment, and take measures to minimize the risk of injury and manage stress. Law enforcement should ensure the safety of a disaster scene before responders enter the area. Patients with life-threatening injuries require immediate stabilization and evacuation to a health care facility. Trauma complications, vector-borne diseases, and mental disorders should be addressed the first day after a disaster and should be managed continuously.


Assuntos
Medicina de Desastres , Planejamento em Desastres , Serviços Médicos de Emergência , Incidentes com Feridos em Massa , Humanos , Triagem
16.
Nurse Pract ; 44(12): 42-48, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31764474

RESUMO

This second installment of the Disaster Response Series covers the nurse competencies for disaster response outlined by the International Council of Nurses and the World Health Organization and explores how NP disaster response competencies from the National Organization of Nurse Practitioner Faculties align with nurse competencies.


Assuntos
Competência Clínica , Medicina de Desastres , Profissionais de Enfermagem , Enfermeiras e Enfermeiros , Medicina de Desastres/educação , Humanos , Conselho Internacional de Enfermagem , Profissionais de Enfermagem/educação , Sociedades de Enfermagem , Estados Unidos , Organização Mundial da Saúde
17.
Curr Med Sci ; 39(5): 690-693, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612384

RESUMO

The occurrence of major emergencies often leads to environmental damage, property damage, health challenges and life threats. Despite the tremendous progress we have made in responding to the many challenges posed by disasters in recent years, there are still many shortcomings. As an emerging technology widely used in recent years, virtual reality (VR) technology is very suitable for many fields of disaster medicine, such as basic education, professional training, psychotherapy, etc. The purpose of this review article is to introduce the application of VR technology in the disaster medical field and prospect its trend in the future.


Assuntos
Medicina de Desastres/métodos , Medicina de Emergência/métodos , Conhecimentos, Atitudes e Prática em Saúde , Realidade Virtual , Medicina de Desastres/educação , Desastres , Medicina de Emergência/educação , Primeiros Socorros/métodos , Humanos , Imagens, Psicoterapia/métodos , Educação de Pacientes como Assunto/organização & administração
19.
Klin Lab Diagn ; 64(8): 459-462, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31479599

RESUMO

The use of point-of-care diagnostics can prevent a number of complications and leading to improved health outcomes for patients in critical condition. Research have shown that elongation of the preanalytic stage leading of errors of studies and changes the results of a number of laboratory parameters. The article presents the key problems associated with the elongation of the preanalytic stage and possible solutions to address the shortcomings of existing diagnostics.


Assuntos
Técnicas de Laboratório Clínico , Medicina de Desastres , Testes Imediatos , Fase Pré-Analítica , Cuidados Críticos , Humanos , Laboratórios
20.
Phys Med Rehabil Clin N Am ; 30(4): 723-747, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31563165

RESUMO

Rehabilitation plays a crucial role in natural disasters owing to the significant upsurge of survivors with complex and long-term disabling injuries. Rehabilitation professionals can minimize mortality, decrease disability, and improve clinical outcomes and participation. In disaster-prone countries, skilled rehabilitation workforce and services are either limited and/or comprehensive rehabilitation-inclusive disaster management plans are yet to be developed. The World Health Organization Emergency Medical Team initiative and guidelines provide structure and standardization to prepare, plan, and provide effective and coordinated care during disasters. Many challenges remain for implementation of these standards in disaster settings and integrating rehabilitation personnel.


Assuntos
Pessoas com Deficiência/reabilitação , Medicina de Desastres/normas , Planejamento em Desastres/normas , Desastres Naturais , Reabilitação/normas , Assistência à Saúde/organização & administração , Guias como Assunto/normas , Humanos , Organização Mundial da Saúde
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