Coping with the Challenges of Early Disaster Response: 24 Years of Field Hospital Experience After Earthquakes

2013 ◽  
Vol 7 (5) ◽  
pp. 491-498 ◽  
Author(s):  
Elhanan Bar-On ◽  
Avi Abargel ◽  
Kobi Peleg ◽  
Yitshak Kreiss
Keyword(s):  
Disaster Response ◽  
Structured Interviews ◽  
Field Hospital ◽  
Patient Profile ◽  
Hospitalization Rates ◽  
Self Sufficiency ◽  
Number Of Patients ◽  
Wide Variability ◽  
Medical Teams ◽  
Israel Defense Forces

AbstractObjectiveTo propose strategies and recommendations for future planning and deployment of field hospitals after earthquakes by comparing the experience of 4 field hospitals deployed by The Israel Defense Forces (IDF) Medical Corps in Armenia, Turkey, India and Haiti.MethodsQuantitative data regarding the earthquakes were collected from published sources; data regarding hospital activity were collected from IDF records; and qualitative information was obtained from structured interviews with key figures involved in the missions.ResultsThe hospitals started operating between 89 and 262 hours after the earthquakes. Their sizes ranged from 25 to 72 beds, and their personnel numbered between 34 and 100. The number of patients treated varied from 1111 to 2400. The proportion of earthquake-related diagnoses ranged from 28% to 67% (P < .001), with hospitalization rates between 3% and 66% (P < .001) and surgical rates from 1% to 24% (P < .001).ConclusionsIn spite of characteristic scenarios and injury patterns after earthquakes, patient caseload and treatment requirements varied widely. The variables affecting the patient profile most significantly were time until deployment, total number of injured, availability of adjacent medical facilities, and possibility of evacuation from the disaster area. When deploying a field hospital in the early phase after an earthquake, a wide variability in patient caseload should be anticipated. Customization is difficult due to the paucity of information. Therefore, early deployment necessitates full logistic self-sufficiency and operational versatility. Also, collaboration with local and international medical teams can greatly enhance treatment capabilities. (Disaster Med Public Health Preparedness. 2013;0:1–8)

Implementing the Sphere Project’s standards for patient’s healthcare rights in the disaster zone: The experience of the Israeli field hospital in post-quake Nepal

2021 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Deganit Kobliner-Friedman, RN, MPH ◽  
Ofer Merin, MD ◽  
Eran Mashiach, MD ◽  
Reuven Kedar, MD ◽  
Shai Schul, MHA ◽  
...  
Keyword(s):  
Disaster Response ◽  
Sexual Exploitation ◽  
World Health ◽  
Field Hospital ◽  
Medical Teams ◽  
Health Organization ◽  
The Individual ◽  
The Right ◽  
Israel Defense Forces ◽  
Privacy And Confidentiality

Emergency medical teams (EMTs) encounter chaos upon arriving at the scene of a disaster. Rescue efforts are utilitarian and focus on providing the technical aspects of medical care in order to save the most lives at the expense of the individual. This often neglects the basic healthcare rights of the patient. The Sphere Project was initiated to develop universal humanitarian standards for disaster response.The increase in the number of EMTs led the World Health Organization (WHO) to organize standards for disaster response. In 2016, the WHO certified the Israel Defense Forces Field Hospital (IDF-FH) as the first to be awarded the highest level of accreditation (EMT-3). This paper presents the IDF-FH’s efforts to protect the patient’s healthcare rights in a disaster zone based on the Sphere Principles.These core Sphere Principles include the right to professional medical treatment; the right to dignity, privacy, and confidentiality; the right for information in an understandable language; the right to informed consent; the obligation to maintain private medical records; the obligation to adhere to universal ethical standards, to respect culture and custom and to care for vulnerable populations; the right to protection from sexual exploitation and violence; and the right to continued treatment.

Management of Diabetic Surgical Patients in a Deployed Field Hospital: A Model for Acute Non-Communicable Disease Care in Disaster

2017 ◽  
Vol 32 (6) ◽  
pp. 657-661 ◽  
Author(s):  
Kathleen M. McDermott ◽  
Ruth M. Hardstaff ◽  
Sophie Alpen ◽  
David J. Read ◽  
Nicholas R. Coatsworth
Keyword(s):  
Disaster Response ◽  
Communicable Disease ◽  
Sudden Onset ◽  
Hospital Environment ◽  
Surgical Patients ◽  
Publication Type ◽  
Field Hospital ◽  
Surgical Field ◽  
Medical Teams ◽  
Non Communicable Disease

AbstractSudden onset disasters (SODs) have affected over 1.5 billion of the world’s population in the past decade. During the same time, developing nations have faced a sustained increase in the burden of non-communicable disease (NCD) with extra pressure placed on health systems. The combined increase in SODs and the NCD epidemic facing the world’s most disaster-prone nations will present new challenges to emergency medical teams (EMTs) during disaster response. This report details the experience as an EMT during the Typhoon Haiyan disaster of 2013, with particular reference to the challenges of diabetic management in a surgical field hospital. The incidence of diabetes in this surgical cohort exceeded that of the population by a factor of four. The steps to prepare for and treat diabetes in the field provide a useful model for the management of NCD in the deployed field hospital environment after a disaster.McDermottKM, HardstaffRM, AlpenS, ReadDJ, CoatsworthNR. Management of diabetic surgical patients in a deployed field hospital: a model for acute non-communicable disease care in disaster. Prehosp Disaster Med. 2017;32(6):657–661.

Hard times call for creative solutions: Medical improvisations at the Israel Defense Forces field hospital in Haiti

2010 ◽  
Vol 5 (3) ◽  
pp. 188-192 ◽  
Author(s):  
Guy Lin, MD ◽  
Haim Lavon, MD ◽  
Reuven Gelfond, RN, BA ◽  
Avi Abargel, MD, MHA ◽  
Ofer Merin, MD
Keyword(s):  
Disaster Medicine ◽  
Limited Resources ◽  
Field Hospital ◽  
Creative Solutions ◽  
Hard Times ◽  
Medical Teams ◽  
Earthquake Zone ◽  
Israel Defense Forces ◽  
Self Production ◽  
Complex Wounds

Mass disaster medicine is characterized by the need to manage limited resources that are far inadequate to meet the population’s demands. Under these hectic conditions, lack of specific medical equipment is expected and requires improvisation using available items.We describe the innovative use of medical improvisations at the Israel Defense Forces field hospital, working in the earthquake zone, Port-au-Prince, Haiti, on January 2010.Creative solutions were found to several problems in a variety of medical fields: blood transfusion, debridement and coverage of complex wounds, self-production of orthopedic hardware, surgical exposure, and managing maxillofacial injuries.We hope that the methods described will help to inspire medical teams working in disaster regions.

Sexuality and Intimacy Needs Within a Hospitalized Palliative Care Population: Results From a Qualitative Study

2021 ◽  
pp. 104990912110369
Author(s):  
Anne Kelemen ◽  
Clara Van Gerven ◽  
Katherine Mullins ◽  
Hunter Groninger
Keyword(s):  
Palliative Care ◽  
Family Relationships ◽  
Comparative Method ◽  
Future Research ◽  
Spiritual Needs ◽  
Structured Interviews ◽  
Course Of Illness ◽  
Serious Illness ◽  
Medical Teams ◽  
The Impact

Background: Palliative care (PC) clinicians are well trained to address physical, psychosocial and spiritual needs of patients who have a serious illness. However, one area that is often overlooked is intimacy and sexuality. Objective: To explore patient concerns regarding intimacy as it relates to illness, family reactions, physician conversations, and coping strategies and challenges. Methods: Eligible subjects (at least 18 years old, capacitated, receiving PC consultation at the lead author’s institution) participated in semi-structured interviews between November and December 2017. Transcripts were open-coded and analyzed using Dedoose 3.5.35 software. A constant comparative method was used to identify patterns in the data. Results: 21 interviews were analyzed and several themes emerged. Participants described the effect of physical and mental/emotional changes on their relationships. Family relationships, romantic relationships, and sexuality were prominent in patients’ experiences of intimacy and how it changed as the illness progressed. Relationships were often noted to strengthen during the course of illness, while sexual activity was frequently reported to be negatively impacted. Patients consistently reported little provider communication on the impact of illness on intimacy beyond instructions about what sexual activities they could or could not engage in. Conclusion: This study underlines the significant impact of serious, progressive illness on relationships, sexuality, and physical and emotional intimacy. It highlights that these topics continue to be priorities for patients with serious illness, and that medical teams frequently fail to address them at all. Future research should further explore these issues across diverse patient populations.

High Success Rate of Prehospital and En Route Cricothyroidotomy Performed in the Israel Defense Forces: 20 Years of Experience

2021 ◽  
pp. 1-6
Author(s):  
Eran Beit Ner ◽  
Avishai M. Tsur ◽  
Roy Nadler ◽  
Elon Glassberg ◽  
Avi Benov ◽  
...  
Keyword(s):  
Success Rate ◽  
Body Part ◽  
Salvage Procedure ◽  
Care Providers ◽  
Success Rates ◽  
Exact Test ◽  
Medical Teams ◽  
Israel Defense Forces ◽  
Different Levels ◽  
Overall Mortality

Abstract Introduction: Securing the airway is a crucial stage of trauma care. Cricothyroidotomy (CRIC) is often addressed as a salvage procedure in complicated cases or following a failed endotracheal intubation (ETI). Nevertheless, it is a very important skill in prehospital settings, such as on the battlefield. Hypothesis/Problem: This study aimed to review the Israel Defense Forces (IDF) experience with CRIC over the past two decades. Methods: The IDF Trauma Registry (IDF-TR) holds data on all trauma casualties (civilian and military) cared for by military medical teams since 1997. Data of all casualties treated by IDF from 1998 through 2018 were extracted and analyzed to identify all patients who underwent CRIC procedures. Variables describing the incident scenario, patient’s characteristics, injury pattern, treatment, and outcome were extracted. The success rate of the procedure was described, and selected variables were further analyzed and compared using the Fisher’s-exact test to identify their effect on the success and failure rates. Odds Ratio (OR) was further calculated for the effect of different body part involvement on success and for the mortality after failed ETI. Results: One hundred fifty-three casualties on which a CRIC attempt was made were identified from the IDF-TR records. The overall success rate of CRIC was reported at 88%. In patients who underwent one or two attempts, the success rate was 86%. No difference was found across providers (physician versus paramedic). The CRIC success rates for casualties with and without head trauma were 80% and 92%, respectively (P = .06). Overall mortality was 33%. Conclusions: This study shows that CRIC is of merit in airway management as it has shown to have consistently high success rates throughout different levels of training, injuries, and previous attempts with ETI. Care providers should be encouraged to retain and develop this skill as part of their tool box.

Post-Preparedness Medical Disaster Response in Costa Rica

1994 ◽  
Vol 9 (2) ◽  
pp. 96-106 ◽  
Author(s):  
Richard A. Bissell ◽  
Ernesto Pretto ◽  
Derek C. Angus ◽  
Bern Shen ◽  
Victor Ruíz ◽  
...  
Keyword(s):  
Costa Rica ◽  
Rural Area ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Structured Interviews ◽  
Urban Populations ◽  
Radio Communications ◽  
Roles And Responsibilities ◽  
Epidemiologic Data

AbstractIntroduction:The 1991 earthquake in the Limón area of Costa Rica presented the opportunity to examine the effectiveness of a decade of disaster preparedness.Hypothesis:Costa Rica's concentrated work in disaster preparedness would result in significantly better management of the disaster response than was evident in earlier disasters in Guatemala and Nicaragua, where disaster preparedness largely was absent.Methods:Structured interviews with disaster responders in and outside of government, and with victims and victims' neighbors. Clinical and epidemiologic data were collected through provider agencies and the coroner's office.Results:Medical aspects of the disaster response were effective and well-managed through a network of clinic-based radio communications. Nonmedical aspects showed confusion resulting from: 1) poor government understanding of the roles and responsibilities of the central disaster coordinating agency; and 2) poor extension of disaster preparedness activities to the rural area that was affected by the earthquake.Conclusion:To be effective, disaster preparedness activities need to include all levels of government and rural, as well as urban, populations.

scholarly journals Disaster response and recovery in two informal settlements: A local government perspective

2011 ◽  
Vol 8 (3) ◽  
pp. 606-621 ◽  
Author(s):  
Bethuel Sibongiseni Ngcamu ◽  
Malcolm Alan Henworth Wallis
Keyword(s):  
Urban Areas ◽  
Disaster Response ◽  
Building Materials ◽  
Informal Settlements ◽  
Structured Interviews ◽  
Government Officials ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Response And Recovery ◽  
The Impact

Informal settlements in urban areas have long been afflicted by disasters and exposed to exploitation by politicians, shacklords, academics, journalists, non-governmental organizations (NGOs), tavern owners and government officials. This problem is caused to some degree by limited land for expansion which has resulted in the creation of highly densified and unplanned, irregular settlements using poor, combustible building materials. The purpose of the article is to investigate whether eThekwini Municipality’s strategies are sufficient to respond to and recover from the impact of disasters. The research was undertaken at the Foreman and Kennedy Road informal settlements located in Clare Estate, under Ward 25, in Durban within eThekwini Municipality in KwaZulu-Natal (refer to Annexure 1). These areas are very important politically as they are densily populated and highly contested between political parties and local resistant’s organizations such as Abahlali baseMjondolo. Questionnaires were self-administered to a sample size of 220 of which 140 respondents completed the questionnaires, thereby generating a response rate of 63.6%. Semi-structured interviews were also conducted with municipal officials. The findings indicate that 44.3% of the victims of disasters received assistance from NGOs and regard civil society as playing an important role after disasters compared to 7.1% of the responding municipal officials.

scholarly journals O turismo étnico como ferramenta para o etnodesenvolvimento da aldeia Tabaçu Reko Ypy, Itanhaém-Peruíbe (SP)

2016 ◽  
Vol 9 (3) ◽  
Author(s):  
Cássia Aparecida Praeiro Mateus ◽  
Andrea Rabinovici
Keyword(s):  
Social Behavior ◽  
Mining Activities ◽  
Structured Interviews ◽  
Ethnic Tourism ◽  
The Gaze ◽  
The People ◽  
Self Sufficiency ◽  
Supporting Tool ◽  
Environmental Balance ◽  
The Village

A presente pesquisa acompanhou as vivências turísticas ocorridas entre indígenas da etnia Ñandeva ao longo dos anos de 2013 a 2015 na aldeia Tabaçu Reko Ypy. Analisou as possíveis consequências e os impactos ao etnodesenvolvimento exercido pelo turismo étnico. Esta comunidade desenvolve e pratica esta atividade como uma ferramenta de apoio à geração de renda alternativa na busca de melhores condições de vida em prol da recuperação do seu território gravemente degradado pela atividade de mineração. Afora isso visa obter um auto sustento que colabore com o resgate das suas tradições. Por se tratar de uma aldeia recentemente formada, nenhuma literatura específica sobre este povo foi encontrada. Basicamente todos os registros e informações sobre a sua política, comportamento social e cultural foram obtidas através de entrevistas semiestruturadas, participação em vivências e doação de registros realizada pelos próprios indígenas. Através deste estudo pôde-se notar consequências diversas advindas do turismo étnico e refletir sobre possíveis futuros impactos. Conclui-se que, através das ações exercidas pelo povo Ñandeva, a possibilidade em se fazer uso de novas ferramentas e diretrizes servirão de apoio para o alcance de um etnodesenvolvimento autônomo sob o olhar de um modelo de turismo inclusivo capaz de gerar renda, que respeite a cultura local e que também busque promover o equilíbrio ambiental. Ethnic tourism as a tool for ethnodevelopment of the village Tabaçu Reko Ypy, Itanhaém-Peruíbe (SP, Brazil) ABSTRACT This research has followed the tourist experiences that occurred among indigenous ethnic Ñandeva over the period from 2013 to 2015 as well as analyzing the possible consequences and impacts on the ethnodevelopment carried out by the ethnic tourism. The village develops and performs this activity as a supporting tool for generating alternative income with the purpose of improving their living conditions and recovering their territory, which was seriously degraded by mining activities. Furthermore, the community aims to reach self-sufficiency so that they will be able to recover their traditions. I should make it clear that, due to the fact that I have dealt with a recently formed village, no specific literature about its people has been found. Basically, all the documents and information about their politics, social behavior and culture have been obtained through semi-structured interviews, participation in field experiences and documents provided by the indigenous people themselves. This study noted several consequences arising from ethnic tourism and reflect on possible future impacts. It is concluded that, through the actions carried out by the people, Ñandeva make use of new tools and guidelines will serve as a support to the achievement of an ethno-development as under the gaze of a inclusive tourism model capable of generating income, that respects local culture and which also seek to promote the environmental balance. KEYWORDS: Ethnodevelopment; Ethnic tourism; Ethnicity Ñandeva.

Managing Humanitarian Aid

2019 ◽  
Vol 2 (2) ◽  
pp. 17-34
Author(s):  
Ame Khin May-Kyawt
Keyword(s):  
Disaster Response ◽  
Cultural Context ◽  
Research Question ◽  
Humanitarian Aid ◽  
Culturally Appropriate ◽  
Structured Interviews ◽  
Case Study Analysis ◽  
Context Sensitive ◽  
Government Organizations

This article contributes to an overall understanding of the challenges faced by humanitarian aid international non-government organizations (INGOs) in specific culturally context-sensitive regions of Myanmar. This research is based on a review of literature, relevant case study analysis, and on ten semi-structured interviews with the humanitarian activists of the Myanmar Diaspora in Canada. The author investigates the following research question: To what extent does “cultural context” play a crucial role in managing humanitarian aid during disaster response operations in a given affected area, and how does it consequently link to the challenges of humanitarian aid INGOs in Myanmar? Based on the findings, a culturally appropriate framework will be introduced for the efficacy of humanitarian aid INGOs when implementing disaster response operations in Myanmar.

scholarly journals P138: Using electronic health record data to assess emergency medicine trainees independent and interdependent performance: a qualitative perspective on measuring what matters

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S106-S106
Author(s):  
L. Shepherd ◽  
S. Sebok-Syer ◽  
L. Lingard ◽  
A. McConnell ◽  
R. Sedran ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Electronic Health Record ◽  
Performance Indicators ◽  
Clinical Performance ◽  
Turnaround Time ◽  
Health Record ◽  
Structured Interviews ◽  
Electronic Health Record Data ◽  
Number Of Patients ◽  
Electronic Health

Introduction: Competency-based medical education (CBME) affirms that trainees will receive timely assessments and effective feedback about their clinical performance, which has inevitably raised concerns about assessment burden. Therefore, we need ways of generating assessments that do not rely exclusively on faculty-produced reports. The main object of this research is to investigate how data already collected in the electronic health record (EHR) might be meaningfully and appropriately used for assessing emergency medicine (EM) trainees independent and interdependent clinical performance. This study represents the first step in exploring what EHR data might be utilized to monitor and assess trainees clinical performance Methods: Following constructivist grounded theory, individual semi-structured interviews were conducted with 10 EM faculty and 11 EM trainees, across all postgraduate years, to identify EHR performance indicators that represent EM trainees independent and interdependent clinical actions and decisions. Participants were presented with a list of performance indicators and asked to comment on how valuable each would be in assessing trainee performance. Data analysis employed constant comparative inductive methods and occured throughout data collection. Results: Participants created, refined, and eliminated performance indicators. Our main result is a catalogue of clinical performance indicators, described by our participants, as reflecting independent and/or interdependent EM trainee performance that are believed to be captured within the EHR. Such independent indicators include: number of patients seen (according to CTAS levels), turnaround time between when a patient is signed up for and first orders are made, number of narcotics prescribed. Meanwhile, interdependent indicators include, but are not limited to, length of stay, bounce-back rates, ordering practices, and time to fluids. Conclusion: Our findings document a process for developing EM trainee report cards that incorporate the perspectives of clinical faculty and trainees. Our work has important implications for distinguishing between independent and interdependent clinical performance indicators.

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