Legal Preparedness for Hurricane Sandy: Authority to Order Hospital Evacuation or Shelter-in-Place in the Mid-Atlantic Region.

Hospitals were once thought to be places of refuge during catastrophic hurricanes, but recent disasters such as Hurricanes Katrina and Sandy have demonstrated that some hospitals are unable to ensure the safety of patients and staff and the continuity of medical care at key times. The government has a duty to safeguard public health and a responsibility to ensure that appropriate protective action is taken when disasters threaten or impair the ability of hospitals to sustain essential services. The law can enable the government to fulfill this duty by providing necessary authority to order preventive or reactive responses--such as ordering evacuation of or sheltering-in-place in hospitals--when safety is imperiled. We systematically identified and analyzed state emergency preparedness laws that could have affected evacuation of and sheltering-in-place in hospitals in order to characterize the public health legal preparedness of 4 states (Delaware, Maryland, New Jersey, and New York) in the mid-Atlantic region during Hurricane Sandy in 2012. At that time, none of these 4 states had enacted statutes or regulations explicitly granting the government the authority to order hospitals to shelter-in-place. Whereas all 4 states had enacted laws explicitly enabling the government to order evacuation, the nature of this authority and the individuals empowered to execute it varied. We present empirical analyses intended to enhance public health legal preparedness and ensure these states and others are better able to respond to future natural disasters, which are predicted to be more severe and frequent as a result of climate change, as well as other hazards. States can further improve their readiness for catastrophic disasters by ensuring explicit statutory authority to order evacuation and to order sheltering-in-place, particularly of hospitals, where it does not currently exist.

[Medical service for sports events]. / Medizinische Versorgung bei Sportanlässen.

The medical service for sports events is for physicians and other healthcare professionals a particular challenge, depending on type and size of the event. Planning criteria exist but only in general terms and are often inadequate, so the preparation should based principally on experience. In addition to a good cooperation with the other partners of the emergency medical services, specific accidents and clinical pictures, as well as legal implications have to observed.

Le service médical des événements sportifs est un challenge spécial pour les médecins et le personnel paramédical, selon le type et la dimension de cette manifestation. Les principes de planification existent seulement en termes généraux et sont souvent insuffisiants de sorte qu'il faut les baser sur l'expérience. En plus d'une bonne coopération avec les autres partenaires du service médical d'urgence, les accidents et pathologies spécifiques et leur conséquences légales doivent être prises en compte.

World Trade Center Health Program; addition of certain types of cancer to the list of WTC-related health conditions. Final rule.

Title I of the James Zadroga 9/11 Health and Compensation Act of 2010 amended the Public Health Service Act (PHS Act) to establish the World Trade Center (WTC) Health Program. The WTC Health Program, which is administered by the Director of the National Institute for Occupational Safety and Health (NIOSH), within the Centers for Disease Control and Prevention (CDC), provides medical monitoring and treatment to eligible firefighters and related personnel, law enforcement officers, and rescue, recovery, and cleanup workers who responded to the September 11, 2001, terrorist attacks in New York City, at the Pentagon, and in Shanksville, Pennsylvania, and to eligible survivors of the New York City attacks. In accordance with WTC Health Program regulations, which establish procedures for adding a new condition to the list of covered health conditions, this final rule adds to the List of WTC-Related Health Conditions the types of cancer proposed for inclusion by the notice of proposed rulemaking.

The rescue of Jewish physicians in the independent state of Croatia (NDH), 1941-1945.

Despite the murder of three-fourths of Croatia's Jews, Croatian doctors, representatives of the Ministry of Health, and other government figures saved 142 Jewish physicians by mobilizing them for a mission to alleviate endemic syphilis in Bosnia. Twenty-seven others were recruited into the Home Guard. Along with members of their families, these Jews were granted "Aryan rights." In 1942 some began defecting to the partisans; others followed after the capitulation of Italy in 1943. Many died in battle, succumbed to typhus, or were murdered by the Nazis, the Croatian fascist Ustae, or the Serbian nationalist etniks. But the story recounted below shows how much better they fared than the Jewish population generally: sixty-two percent survived, thanks to courageous efforts by Croatian civilians and officials. Their rescue demonstrates both that popular attitudes influenced events in Yugoslavia, and that common stereotypes of Croatia during the war should be reconsidered.

Cutting through the red tape: update of NAHC's efforts to ease regulatory constraints during emergencies.

The terrorist attacks on New York City and Washington, DC, on September 11, 2001, the hurricanes that struck the Gulf States in 2005, along with preparations for an impending influenza pandemic have dramatically underscored the vital role of all aspects of the health care delivery system, including home care, in addressing emergency situations.

Material de rescate en espeleo-socorro (II) / No disponible

Antes de iniciar cualquier rescate, y en particular un rescate de espeleología, hay que cerciorarse de que el material con el que se va a trabajar cumple unas normas mínimas de seguridad. En este sentido, el presente artículo hace referencia de manera somera a la normativa vigente en esta materia. Además, establece varias clasificaciones de los materiales utilizando como criterio la distribución por equipos, la fase de alerta del Decálogo Prehospitalario (1) y el propio material en sí de trabajo. En el siguiente punto se identifican y describen algunos de los elementos que integran el equipo de protección individual (EPI) (arnés, mosquetón y cuerda). Desde mi punto de vista, considero necesario enfatizar la importancia de conocer algunas de las características de estos dispositivos, ya que constituyen la herramienta básica de movilidad y seguridad que debe saber manejar cualquier profesional que trabaje en un grupo de rescate sanitario. Sin olvidar que se trata de un equipo médico, se indica, en líneas generales, el material de urgencia que se porteará al interior de la cavidad natural. Por último, se describen detalladamente el mantenimiento que requieren los elementos de seguridad, textil y/o metálico, del EPI (AU)

Before any kind of rescue, and particulary a speleological rescue, all the equipment must be checked. This equipment has to fulfil minimum security conditions. This article makes a slight reference to the legislation in force in this field. Furthermore, it establishes different material classifications according to the equipment distribution, the pre-hospital Decalogue’s alert phase (1) and the material used itself. Next, the article identifies and describes some of the main elements in an individual protection equipment (harness, snap ring and ropes). From my personal point of view, I believe it important to stress the importance of knowing some of the features of these devices. They are the basic safety and mobility equipment any professional working on a health-care rescue team should know. Without forgetting it is a medical team, the article describes in general terms the emergency material the team should carry into the cavern. Finally, it describes in detail the maintenance all this EPI security elements (metallic or textile) require (AU)

A comparative study of laws, rules, codes and other influences on nursing homes' disaster preparedness in the Gulf Coast states.

In 2005, Hurricanes Katrina and Rita devastated several Gulf Coast states and caused many deaths. The hurricane- related deaths of 70 nursing home residents--34 believed drowned in St. Rita's Nursing Home in Louisiana and 36 from 12 other nursing homes--highlighted problems associated with poorly developed and executed disaster plans, uninformed evacuation decision-making, and generally inadequate response by providers and first responders (DHHS, 2006; Hyer, Brown, Berman, & Polivka-West, 2006). Such loss of human life perhaps could have been prevented and certainly lessened if, prior to the hurricanes, policies, regulations, and laws had been enacted, executable disaster guidelines been available, vendor contracts been honored, and sufficient planning taken place. This article discusses applicable federal and state laws and regulations that govern disaster preparedness with a particular focus on nursing homes. It highlights gaps in these laws and makes suggestions regarding future disaster planning.

A brief primer on Good Samaritan law for health care professionals.

The Good Samaritan law is not found on the statute books, but has been a concept that courts have applied as public policy. However, this has recently changed in all the states and territories in Australia with the codification of Good Samaritan law. This paper is a timely reminder for health practitioners of the doctrine of the Good Samaritan, as well as the relative legal uncertainty of rescue at common law.

Tsunami disaster victim identification in Sri Lanka: legal aspects.

Natural hazards amounting to disasters have almost become an endemic phenomenon during past decades throughout the globe, particularly affecting less resourced countries. The capabilities of the affected nations are stretched to the maximum in most of the disasters, thereby exposing deficiencies at various levels of the disaster mitigation mechanisms. A key factor identified through the human experience of all previous disaster scenarios is the requisite of effective and integrated local, national and regional disaster management mechanisms. The national and regional legal framework in this context can supplement disaster management enormously by drafting and implementing practical legislation which can be activated in disaster situations to co-ordinate the relief missions and minimize the damage. Thus, the existing legal systems and legislation at national and regional levels should be modified accordingly to yield proper disaster management policies. However, many less resourced countries are still lacking functional disaster management mechanisms in local legislation and are consequently highly vulnerable to heavy casualties in disasters. Sri Lanka is a typical example of a state which had an ineffective disaster management mechanism, not strengthened by legislation, when the Asian tsunami struck the country in December 2004, despite having frequently been affected by natural and man-made hazards during the past three decades. The net effect was total disarray in disaster victim identification, leading to drastic and irreparable consequences.

When terror is routine: how Israeli nurses cope with multi-casualty terror.

The wave of terror that has befallen the Israeli civilian population over the past two years, striking deep into the heart of towns and cities all over the country, presents a unique challenge for the health care system in general and nursing in particular. This article has a two-fold purpose: (a) to describe discussions that took place with four focus groups consisting of emergency room nurses who had recently cared for victims of terror, and (b) to delineate recommendations for policy enhancement based upon these discussions. Qualitative analysis of the data collected from focus group discussions revealed four stages of personal and professional involvement, each one eliciting a specific response from the nurses: call up to report for duty, waiting for casualties to arrive, caring for the victims, and closure of the event. Nurses identified numerous hardships and great anxiety along with a strong sense of professional fulfillment. Recommendations for policy include: incorporating stress management and debriefing skills in post-basic ER training, designing workshops and drills in trauma care for non-ER nurses who float into the ER in the wake of a multi-casualty act of terror, and developing leadership seminars for head nurses in the ER departments.

Australian surf life-saving and the "forgotten members".

The history and mythology of Australia's surf life-saving movement portray the surf life-saver as an inter and postwar national symbol, an image of manhood often regarded as the successor to that of the bushman and the digger. According to this viewpoint, women had no place on the beaches, being supportive fundraisers and social organisers. In fact, almost from surf life-saving's commencement in 1906, many women refused to be confined to these roles; they participated in their own competitions, were proficient in rescue techniques and were proud to belong to the movement, thus contradicting the widely shared belief that their active involvement began only in 1980 when they were granted full membership.