Excluded but not forgotten: Veterinary emergency care during emergencies and disasters.

BACKGROUND: Disasters or crises impact humans, pets, and service animals alike. Current preparation at the federal, state, and local level focuses on preserving human life. Hospitals, shelters, and other human care facilities generally make few to no provisions for companion care nor service animal care as part of their disaster management plan. Aban-doned animals have infectious disease, safety and psychologic impact on owners, rescue workers, and those involved in reclamation efforts. Animals working as first responder partners may be injured or exposed to biohazards and require care. DATA SOURCES: English language literature available via PubMed as well as lay press publications on emergency care, veterinary care, disaster management, disasters, biohazards, infection, zoonosis, bond-centered care, prepared-ness, bioethics, and public health. No year restrictions were set. CONCLUSIONS: Human clinician skills share important overlaps with veterinary clinician skills; similar overlaps occur in medical and surgical emergency care. These commonalities offer the potential to craft-specific and disaster or crisis-deployable skills to care for humans, pets (dogs and cats), service animals (dogs and miniature horses) and first-responder partners (dogs) as part of national disaster healthcare preparedness. Such a platform could leverage the skills and resources of the existing US trauma system to underpin such a program.

Assessing the efficacy of rescue equipment in lifeguard resuscitation efforts for drowning.

PURPOSE: The whole drowning process usually occurs within seconds to a few minutes. An early rescue may stop and/or prevent most medical complications. Fins, rescue tube, and rescue board (RB) are the equipment most frequently used by lifeguards. Our objective was to compare, in a water rescue quasiexperimental trial, these different pieces of rescue equipment to define the safest and with the lower rescue time as well as to assess their effects on the lifeguards' physiological state and cardiopulmonary resuscitation (CPR) performance. METHOD: A controlled trial was conducted to study the time effect of 4 different rescue techniques and assess CPR quality, along with the physiological effects of each rescue technique (blood lactate and subjective Borg's scale effort perception) on 35 lifeguards. RESULTS: Among the final sample subjects (n = 23), a total of 92 rescues were completed. Total water rescue time was longer without equipment (NE). The total rescue time was significantly lower using RB (P < .001). Similar good quality of CPR before and after water rescue was observed in all trials (P > .05), although correct ventilations represented less than 50% of total in all trials. Blood lactate increased after all rescues. The subjective effort Borg's scale showed significantly less effort using RB vs without equipment, fins, and fins and rescue tube. CONCLUSION: The use of propelling and/or floating equipment saves precious time with repercussions in the reduction of drowning mortality and morbidity. The RB offers a significant advantage. Lifeguards need more CPR training, especially considering the importance of efficient ventilations for drowning victims.

Management of acute traumatic stress in nuclear and radiological emergencies.

In order to effectively respond to and minimize the psychological impact following disasters, such as radio-nuclear ones, it is essential to understand the mechanisms involved in such conditions and how to prevent and treat the psychological impacts, including those related to acute traumatic stress and its consequences across life span. Radio-nuclear emergencies may cause psychological traumatic stress, with its potentially significant consequences in mental health, with both short and long-term effects, which extend beyond the individuals directly affected. Ionizing radiation cannot be perceived by human senses and most people are unaware of the magnitude of its effects, which could result in feelings of helplessness and vulnerability. Those situations with a high degree of uncertainty, regarding potential future health effects, are more psychologically traumatic than others. The present century has witnessed a steady increase in the number of publications concerning the mental health impact of traumatic events, showing the need of increasing the study of traumatic stress and its impact on mental health. A prompt, planned and effective response to manage disaster-induced acute traumatic stress may prevent the evolutionary reactions of traumatic stress into disorders or even chronic stress diseases that can appear after a nuclear or radiological emergency.

Learning from recovery after Hurricane Mitch.

This paper reviews how Nicaragua has recovered from Hurricane Mitch of October 1998. In particular, it examines how the assumptions and claims that were made during initial recovery planning have proven relevant in light of subsequent development. One must consider the response to Hurricane Mitch from the perspective of the broader trends that have driven recovery, including household, community and government initiatives and the wider economic context. Recovery efforts have not 'transformed' Nicaragua. In fact, market upheavals and livelihood changes in rural areas have had a more profound impact on poverty profiles than recovery programmes. Social protection programmes have been piloted, but patron-client ties and relations with aid providers are still more reliable sources of support in a time of crisis. Risk reduction has become more deeply integrated into the rural development discourse than was the case before the disaster, but risk reduction initiatives continue to place undue emphasis on hazard response rather than addressing vulnerability.

Asistencia prehospitalaria del traumatizado grave / Prehospitalary assistance of the acute trauma

La asistencia pre-hospitalaria del traumatizado se remonta a la época de los griegos y romanos. Ha sido durante los grandes conflictos bélicos que se han mejorado el tratamiento y el transporte de las víctimas del trauma. En nuestros días el trauma es la principal causa de mortalidad en jóvenes y demanda enormes costos en asistencia y rehabilitación. El rescate de las víctimas que sobreviven al trauma requiere: respuesta rápida, entrenamiento, materiales adecuados y sentido común. El asegurar la vía aérea y lograr una buena ventilación, junto con estabilizar la columna para no causar daño secundario, y el rápido traslado a un centro hospitalario adecuado son las claves de la sobrevida de estos pacientes. Se requieren programas de educación a gran escala para abatir las cifras de mortalidad actuales. (AU)

Asistencia prehospitalaria del traumatizado grave / Prehospitalary assistance of the acute trauma

La asistencia pre-hospitalaria del traumatizado se remonta a la época de los griegos y romanos. Ha sido durante los grandes conflictos bélicos que se han mejorado el tratamiento y el transporte de las víctimas del trauma. En nuestros días el trauma es la principal causa de mortalidad en jóvenes y demanda enormes costos en asistencia y rehabilitación. El rescate de las víctimas que sobreviven al trauma requiere: respuesta rápida, entrenamiento, materiales adecuados y sentido común. El asegurar la vía aérea y lograr una buena ventilación, junto con estabilizar la columna para no causar daño secundario, y el rápido traslado a un centro hospitalario adecuado son las claves de la sobrevida de estos pacientes. Se requieren programas de educación a gran escala para abatir las cifras de mortalidad actuales.