Chief Complaints, Diagnoses, and Medications Prescribed Seven Weeks Post-Katrina in New Orleans

2008 ◽  
Vol 23 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Erica Howe ◽  
David Victor ◽  
Eboni G. Price
Keyword(s):  
Hurricane Katrina ◽  
New Orleans ◽  
Healthcare Delivery ◽  
Retrospective Chart Review ◽  
Central Business District ◽  
Patient Characteristics ◽  
Primary Objective ◽  
Urgent Care ◽  
Chief Complaints ◽  
Post Disaster

AbstractBackground:In the aftermath of Hurricane Katrina, widespread flooding devastated the New Orleans healthcare system. Prior studies of post-hurri-cane healthcare do not consistently offer evidence-based recommendations for re-establishing patient care post-disaster. The primary objective of this study is to examine associations between patient characteristics, chief com-plaints, final diagnoses, and medications prescribed at a post-Katrina clinic to better inform strategic planning for post-disaster healthcare delivery (e.g., charitable donations of medications and medical supplies).Methods:This study is a retrospective chart review of 465 patient visits from 02 September 2005 to 22 October 2005 at a post-Katrina clinic in New Orleans, Louisiana that was open for seven weeks, providing urgent care services in the central business district. Using logistic regression, the relationships between patient characteristics (date of visit, gender, age, evacuation status), type of chief complaint, final diagnosis, and type of medication prescribed was examined.Results:Of 465 patients, 49.2% were middle-aged, 62.4% were men, 35% were relief workers, and 33.3% were evacuees; 35% of visits occurred in week five. Of 580 chief complaints, 71% were illnesses, 21% were medication refill requests, and 8.5% were injuries. Among 410 illness complaints, 25% were ears, nose, and throat (ENT)/dental, 17% were dermatologic, and 11% were cardiovascular. Most requested classes of medication refills for chronic medical conditions (n = 121) were cardiovascular (52%) and endocrine (24%).Most illness-related diagnoses (n = 400) were ENT/dental (18.2%), dermatologic (14.8%), cardiovascular (10.2%), and pul-monary (10.2%). Thirty-six percent of these diagnoses were infectious. Among 667 medications prescribed, 21% were cardiac agents, 13% pulmonary, 13% neurologic/musculoskeletal/pain, 11% antibiotics, 10% endocrine, and 9.3% anti-allergy. The likelihood of certain chief complaints, diagnoses, and medica-tions prescribed varied with patient characteristics.Conclusions:Donations of certain classes of medications were more useful than others. Prevalence of select co-morbidities, the nature of patient involve-ment in recovery activities in the disaster area, and post-disaster health haz-ards may explain variations in chief complaints, diagnoses, and medications prescribed by patient characteristics.

Impact of Hurricane Katrina on healthcare delivery for New Orleans patients, 2005-2014

2018 ◽  
Vol 65 (12) ◽  
pp. e27406 ◽  
Author(s):  
Chittalsinh Raulji ◽  
Maria C. Velez ◽  
Pinki Prasad ◽  
Cierra Rousseau ◽  
Renee V. Gardner
Keyword(s):  
Hurricane Katrina ◽  
New Orleans ◽  
Healthcare Delivery

scholarly journals Differences in post-disaster mental health among Vietnamese and African Americans living in adjacent urban communities flooded by Katrina

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255303
Author(s):  
Mengxi Zhang ◽  
Mark VanLandingham ◽  
Yoon Soo Park ◽  
Philip Anglewicz ◽  
David M. Abramson
Keyword(s):  
Mental Health ◽  
African American ◽  
African Americans ◽  
Hurricane Katrina ◽  
New Orleans ◽  
Housing Stock ◽  
Short Form ◽  
Vietnamese Americans ◽  
Disaster Mental Health ◽  
Post Disaster

Some communities recover more quickly after a disaster than others. Some differentials in recovery are explained by variation in the level of disaster-related community damage and differences in pre-disaster community characteristics, e.g., the quality of housing stock. But distinct communities that are similar on the above characteristics may experience different recovery trajectories, and, if so, these different trajectories must be due to more subtle differences among them. Our principal objective is to assess short-term and long-term post-disaster mental health for Vietnamese and African Americans living in two adjacent communities in eastern New Orleans that were similarly flooded by Hurricane Katrina. We employ data from two population-based cohort studies that include a sample of African American adults (the Gulf Coast Child and Family Health [GCAFH study]) and a sample of Vietnamese American adults (Katrina Impacts on Vietnamese Americans [KATIVA NOLA study]) living in adjacent neighborhoods in eastern New Orleans who were assessed near the second and thirteenth anniversaries of the disaster. Using the 12-Item Short Form Survey (SF-12) as the basis of our outcome measure, we find in multivariate analysis a significant advantage in post-disaster mental health for Vietnamese Americans over their African American counterparts at the two-year mark, but that this advantage had disappeared by the thirteenth anniversary of the Katrina disaster.

Opioid Infusions in the Neonatal Intensive Care Unit

2010 ◽  
Vol 15 (2) ◽  
pp. 142-146
Author(s):  
Amanda Suarez ◽  
David C. Knoppert ◽  
David S. C. Lee ◽  
Donna Pletsch ◽  
Jamie A. Seabrook
Keyword(s):  
Pain Assessment ◽  
Neonatal Intensive Care ◽  
Assessment Tool ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Primary Objective ◽  
Procedural Pain ◽  
Opioid Use ◽  
Neonatal Pain ◽  
Scale Scores

ABSTRACT OBJECTIVES The primary objective of this study was to compare the use of opioid infusions to that proposed in guidelines published in an in-house medication handbook. Secondary objectives were to assess the documented use of a standardized neonatal pain assessment tool and to describe the supplemental use of opioids concurrent with an opioid infusion. METHODS A retrospective chart review was performed for all patients in the NICU who received opioid infusions between November 1, 2005, and November 30, 2006. Data collected included patient characteristics, opioid infusion dosing and duration, supplemental opioid use, and pain assessment documentation. RESULTS Of the110 neonates who received morphine or fentanyl during the study period, 65 patients met inclusion criteria. Reasons for starting an opioid infusion included nonsurgical sedation and/or analgesia (51%), postoperative pain (17%), and procedural pain (1%). No reason was documented for 31% of patients. Thirtyeight percent of neonates received a loading dose of opioid before initiation of the infusion. The median dose was 100 mcg/kg (IQR=48.2) for morphine and and 1 mcg/kg (IQR=0.8) for fentanyl. The mean ± SD starting rates of morphine and fentanyl infusions were 12.3 ± 4.7 mcg/kg/hr and 1.5 ± 1.7 mcg/kg/hr, respectively. Supplemental opioid doses were given to 46% of neonates during the infusion period. Supplemental doses were given for procedures (69%) and pain/agitation/sedation (26%). No reason was documented for 5% of patients. The Neonatal Pain, Agitation and Sedation Scale scores were only documented 9% of the time for each day that the patient received an opioid infusion. CONCLUSIONS Dosing of opioids generally was within the recommendations that are described in the in-house medication handbook. A substantial percentage of neonates received supplemental opioid doses while on opioid infusions, mostly for procedural pain management. Documentation of the reason for using opioid infusions and the assessment of neonatal pain was poor.

Persistence of Mental Health Needs among Children Affected by Hurricane Katrina in New Orleans

2011 ◽  
Vol 26 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Alina Olteanu ◽  
Ruth Arnberger ◽  
Roy Grant ◽  
Caroline Davis ◽  
David Abramson ◽  
...  
Keyword(s):  
Mental Health ◽  
Case Management ◽  
Hurricane Katrina ◽  
New Orleans ◽  
Health Needs ◽  
Mental Health Needs ◽  
Disaster Experience ◽  
Mental Health Patients ◽  
Pediatric Mental Health ◽  
Post Disaster

AbstractBackground: Hurricane Katrina made landfall in August 2005 and destroyed the infrastructure of New Orleans. Mass evacuation ensued. The immediate and long-lasting impact of these events on the mental health of children have been reported in survey research. This study was done to describe the nature of mental health need of children during the four years after Hurricane Katrina using clinical data from a comprehensive healthcare program. Medical and mental health services were delivered on mobile clinics that traveled to medically underserved communities on a regular schedule beginning immediately after the hurricane. Patients were self-selected residents of New Orleans. Most had incomes below the federal poverty level and were severely affected by the hurricane.Methods: Paper charts of pediatric mental health patients were reviewed for visits beginning with the establishment of the mental health program from 01 July 2007 through 30 June 2009 (n = 296). Demographics, referral sources, presenting problems, diagnoses, and qualitative data describing Katrina-related traumatic exposures were abstracted. Psychosocial data were abstracted from medical charts. Data were coded and processed for demographic, referral, and diagnostic trends.Results: Mental health service needs continued unabated throughout this period (two to nearly four years post-event). In 2008, 29% of pediatric primary care patients presented with mental health or developmental/learning problems, including the need for intensive case management. The typical presentation of pediatric mental health patients was a disruptive behavior disorder with an underlying mood or anxiety disorder. Qualitative descriptive data are presented to illustrate the traumatic post-disaster experience of many children. School referrals for mental health evaluation and services were overwhelmingly made for disruptive behavior disorders. Pediatric referrals were more nuanced, reflecting underlying mood and anxiety disorders. Histories indicated that many missed opportunities for earlier identification and intervention.Conclusions: Mental health and case management needs persisted four years after Hurricane Katrina and showed no signs of abating. Many children who received mental health services had shown signs of psychological distress prior to the hurricane, and no causal inferences are drawn between disaster experience and psychiatric disorders. Post-disaster mental health and case management services should remain available for years post-event. To ensure timely identification and intervention of child mental health needs, pediatricians and school officials may need additional training.

Screening Pediatric Patients in New-Onset Syncope (SPINS) Study

2019 ◽  
Vol 59 (2) ◽  
pp. 127-133
Author(s):  
Ayush Gupta ◽  
Margaret Menoch ◽  
Kelly Levasseur ◽  
Ismael E. Gonzalez
Keyword(s):  
Vasovagal Syncope ◽  
Retrospective Chart Review ◽  
Target Population ◽  
Primary Objective ◽  
First Episode ◽  
Cardiac Syncope ◽  
Chief Complaints ◽  
Screening Questions ◽  
New Onset

Objectives. The primary objective is to determine the frequency of history findings associated with cardiac syncope. Second, to determine the frequency of abnormal electrocardiograms (EKG) in patients presenting with typical vasovagal syncope. Methods. Retrospective chart review from January 2006 to April 2017 of children aged 5 to 18 years presenting to the emergency department with a chief complaint of syncope. Target population was all patients with first episode of syncope and a documented EKG. Excluded patients were those with head trauma, drug intoxication, current pregnancy, seizure, and any endocrine problem. Patients with cardiac causes of syncope were identified by an abnormal EKG or echocardiogram. Specific history findings (past cardiac history, chest pain, palpitations, syncope with exercise, absence of prodrome with syncope) were compared with those with and without cardiac etiology of syncope. The possibility of missing a patient with cardiac cause of syncope based on specific history findings was identified. Results. Of the total 4115 visits of patients with chief complaints of syncope, 2293 patients (55.7%) met the inclusion criteria. Nine patients (0.39%) were identified with cardiac etiology of syncope. The remaining were determined to be of vasovagal origin. All patients with cardiac etiology of syncope were found to have one positive specific history findings. A total of 1972 patients were identified with absence of specific history findings; no patient had a cardiac etiology of syncope. Conclusions. This study identifies screening questions to identify cardiac syncope. Implementing these standard questions could potentially decrease resource utilization and time for evaluation as well as guide follow-up.

Community organizing for post-disaster social development

2007 ◽  
Vol 50 (3) ◽  
pp. 321-333 ◽  
Author(s):  
Loretta Pyles
Keyword(s):  
Community Development ◽  
Social Development ◽  
Hurricane Katrina ◽  
New Orleans ◽  
Community Organizing ◽  
Disaster Recovery ◽  
Community Practice ◽  
Community Revitalization ◽  
Travail Social ◽  
Post Disaster

English Community revitalization is a neglected element in disaster recovery. The literature on disaster and community practice is reviewed and some community development and organizing endeavors in New Orleans after Hurricane Katrina are described. Social work's lack of emphasis on community organizing is a barrier to social development in post-disaster situations. French La revitalisation communautaire est un facteur né gligé dans la relè ve de catastrophe. L'auteur passe en revue la documentation sur les pratiques communautaires en situations de catastrophe et dé crit quelques initiatives de dé veloppement et d'organisation communautaires à la Nouvelle-Orlé ans aprè s le passage de l'ouragan Katerina. L'auteur conclut que le manque d'insistance du travail social sur l'organisation communautaire est un frein au dé veloppement social dans des situations post-catastrophe. Spanish Un elemento descuidado en el trabajo de recuperació n despué s de un desastre es la revitalizació n comunitaria. Hago una revisió n de lo publicado sobre desastres y práctica comunitaria, y describo algunos trabajos comunitarios de desarrollo y organizació n en Nueva Orleáns despué s del huracán Katrina. Concluyo que el no dar más importancia al trabajo comunitario es un impedimento al desarrollo social despué s de un desastre.

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