Evolving Need for Alternative Triage Management in Public Health Emergencies: A Hurricane Katrina Case Study

2008 ◽  
Vol 2 (S1) ◽  
pp. S40-S44 ◽  
Author(s):  
Kelly R. Klein ◽  
Paul E. Pepe ◽  
Frederick M. Burkle ◽  
Nanci E. Nagel ◽  
Raymond E. Swienton
Keyword(s):  
Public Health ◽  
Hurricane Katrina ◽  
Large Scale ◽  
The United States ◽  
Public Health Emergencies ◽  
Medical Needs ◽  
Decision Making Processes ◽  
Multiple Casualty Incidents ◽  
Mass Evacuation ◽  
Medical Planning

ABSTRACTIn many countries, traditional medical planning for disasters developed largely in response to battlefield and multiple casualty incidents, generally involving corporal injuries. The mass evacuation of a metropolitan population in the aftermath of Hurricane Katrina evolved into life-and-death triage scenarios involving thousands of patients with nontraumatic illnesses and special medical needs. Although unprecedented in the United States, triage management needs for this disaster were similar to other large-scale public health emergencies, both natural and human-generated, that occurred globally in the past half-century. The need for alternative triage-management processes similar to the methodologies of other global mass public health emergencies is illustrated through the experience of disaster medical assistance teams in the first 3 days following Katrina's landfall. The immediate establishment of disaster-specific, consensus-based, public health emergency–related triage protocols—developed with ethical and legal expertise and a renewed focus on multidimensional, multifactorial matrix decision-making processes—is strongly recommended. (Disaster Med Public Health Preparedness. 2008;2(Suppl 1):S40–S44)

State Intervention During Public Health Emergencies: Is the United States Prepared for an Ebola Outbreak?

2015 ◽  
Vol 12 (2) ◽  
Author(s):  
Marie-Helen Maras ◽  
Michelle D. Miranda
Keyword(s):  
Public Health ◽  
State Intervention ◽  
The United States ◽  
International Travel ◽  
American Government ◽  
Training And Education ◽  
Public Health Emergencies ◽  
The Us ◽  
Bioterrorism Agent ◽  
Legal Guidelines

AbstractIn the fall of 2014, the US was faced with the reality that a deadly, foreign virus had entered its borders. Ebola, a disease thought to be of little threat to the US yet classified as a major bioterrorism agent, became a reality for the American government and its citizens. The introduction of Ebola unveiled many deficiencies in the country’s health care system, international travel policies, and ability to control or restrict the movement of exposed individuals in order to protect the larger population. The need to review and establish legal guidelines and policies to deal with these deficiencies is paramount: the inherent lack of training and education; weaknesses in monitoring, maintenance, and treatment; and the lack of uniform guidelines to isolate international travelers have all demonstrated that the country may not be able to control a larger-scale threat in the future.

Current State of (Dis)Integration: Public Health and Fusion Centers

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Cody Minks ◽  
Anke Richter
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
Information Sharing ◽  
Homeland Security ◽  
Large Scale ◽  
Ad Hoc ◽  
Limiting Factor ◽  
Fusion Centers ◽  
Public Health Emergencies ◽  
Public Health Information

AbstractObjectiveResponding to large-scale public health emergencies relies heavily on planning and collaboration between law enforcement and public health officials. This study examines the current level of information sharing and integration between these domains by measuring the inclusion of public health in the law enforcement functions of fusion centers.MethodsSurvey of all fusion centers, with a 29.9% response rate.ResultsOnly one of the 23 responding fusion centers had true public health inclusion, a decrease from research conducted in 2007. Information sharing is primarily limited to information flowing out of the fusion center, with little public health information coming in. Most of the collaboration is done on a personal, informal, ad-hoc basis. There remains a large misunderstanding of roles, capabilities, and regulations by all parties (fusion centers and public health). The majority of the parties appear to be willing to work together, but there but there is no forward momentum to make these desires a reality. Funding and staffing issues seem to be the limiting factor for integration.ConclusionThese problems need to be urgently addressed to increase public health preparedness and enable a decisive and beneficial response to public health emergencies involving a homeland security response.

Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

2012 ◽  
Vol 27 (4) ◽  
pp. 325-329 ◽  
Author(s):  
David Howard ◽  
Rebecca Zhang ◽  
Yijian Huang ◽  
Nancy Kutner
Keyword(s):  
Hurricane Katrina ◽  
Large Scale ◽  
Service Use ◽  
Hospital Admissions ◽  
Gulf Coast ◽  
The United States ◽  
Time Varying ◽  
Dialysis Patients ◽  
Hospitalization Rates ◽  
The Impact

AbstractIntroductionDialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.ProblemThe impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.MethodsData from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.ResultsThe rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.ConclusionsHospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

Commissioned Corps Deployments & Family Resiliency

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Janice Arceneaux ◽  
James Dickens ◽  
Wanza Bacon
Keyword(s):  
Public Health ◽  
Health And Safety ◽  
United States Public Health ◽  
Disease Outbreaks ◽  
The United States ◽  
Humanitarian Assistance ◽  
Family Resiliency ◽  
Public Health Emergencies ◽  
National Public Health ◽  
The U.S

Established in 1889, the United States Public Health Service Commissioned Corps (Corps) is one of the seven uniformed services and is part of the U.S. Department of Health and Human Services. The Corps is committed to protecting, promoting and advancing the health and safety of the nation with a history that dates back over two centuries, beginning as the U.S. Marine Hospital Service. Today, the Corps responds and serves in many areas impacted by natural disasters, disease outbreaks, terrorist attacks and public health emergencies. Corps officers have deployed to provide assistance during national public health emergencies (e.g., hurricanes, bombings, flooding and wild fires); to combat the Ebola epidemic in West Africa; and to provide humanitarian assistance in Latin America and the Caribbean. Corps deployments impact not only service members but also their families. This article offers a brief overview of the Corps and discusses how deployments impact families. Family resiliency and future implications for research and practice will also be examined.

scholarly journals A Bibliometric Profile of Disaster Medicine Research from 2008 to 2017: A Scientometric Analysis

2018 ◽  
Vol 13 (02) ◽  
pp. 165-172
Author(s):  
Liang Zhou ◽  
Ping Zhang ◽  
Zhigang Zhang ◽  
Lidong Fan ◽  
Shuo Tang ◽  
...  
Keyword(s):  
Public Health ◽  
Hurricane Katrina ◽  
Disaster Preparedness ◽  
Analysis Data ◽  
The United States ◽  
Disaster Medicine ◽  
Scientometric Analysis ◽  
Public Health Preparedness ◽  
Medicine Research ◽  
Thomson Reuters

ABSTRACTThis study analyzed and assessed publication trends in articles on “disaster medicine,” using scientometric analysis. Data were obtained from the Web of Science Core Collection (WoSCC) of Thomson Reuters on March 27, 2017. A total of 564 publications on disaster medicine were identified. There was a mild increase in the number of articles on disaster medicine from 2008 (n=55) to 2016 (n=83). Disaster Medicine and Public Health Preparedness published the most articles, the majority of articles were published in the United States, and the leading institute was Tohoku University. F. Della Corte, M. D. Christian, and P. L. Ingrassia were the top authors on the topic, and the field of public health generated the most publications. Terms analysis indicated that emergency medicine, public health, disaster preparedness, natural disasters, medicine, and management were the research hotspots, whereas Hurricane Katrina, mechanical ventilation, occupational medicine, intensive care, and European journals represented the frontiers of disaster medicine research. Overall, our analysis revealed that disaster medicine studies are closely related to other medical fields and provides researchers and policy-makers in this area with new insight into the hotspots and dynamic directions. (Disaster Med Public Health Preparedness. 2019;13:165–172)

Biodefense and Emergency Use Authorization: Different Originations, Purposes, and Evolutionary Paths of Institutions in the United States and South Korea

2022 ◽  
Author(s):  
HyunJung Kim
Keyword(s):  
Public Health ◽  
United States ◽  
South Korea ◽  
Driving Forces ◽  
The United States ◽  
Lessons Learned ◽  
Post Exposure Prophylaxis ◽  
Meso Level ◽  
Public Health Emergencies ◽  
Level Analysis

Abstract Background: Historical institutionalism (HI) determines that institutions have been transformed by a pattern of punctuated evolution due to exogenous shocks. Although scholars frequently emphasize the role of agency - endogenous factors – when it comes to institutional changes, but the HI analytic narratives still remain in the meso-level analysis in the context of structure and agency. This article provides domestic and policy-level accounts of where biodefense institutions of the United States and South Korea come from, seeing through emergency-use-authorization (EUA) policy, and how the EUA policies have evolved by employing the policy-learning concepts through the Event-related Policy Change Model. Results: By employing the Birkland’s model, this article complements the limitation of the meso-level analysis in addressing that the 2001 Amerithrax and the 2015 Middle East Respiratory Syndrome (MERS) outbreak rooted originations and purposes of the biodefense respectively. Since the crisis, a new post-crisis agenda in society contributed to establishing new domestic coalition, which begin to act as endogenous driving forces that institutionalize new biodefense institutions and even reinforce them through path dependent way when the institutions evolved. Therefore, EUA policy cores (Post-Exposure Prophylaxis (PEP) in the United States and Non-Pharmaceutical Intervention (NPI) in South Korea keep strengthened during the policy revisions. Conclusions: The United States and South Korea have different originations and purposes of biodefense, which are institutions evolving through self-reinforce dependent way based on the lessons learned from past crises. In sum, under the homeland security biodefense institution, the US EUA focuses on the development of specialized, unlicensed PEP in response to public health emergencies; on the other hand, under the disease containment-centric biodefense institution, the Korean EUA is specialized to conduct NPI missions in response to public health emergencies.

scholarly journals Plague and Pregnancy: Why Special Considerations Are Needed

2020 ◽  
Vol 70 (Supplement_1) ◽  
pp. S27-S29
Author(s):  
Dana Meaney-Delman ◽  
Nadia L Oussayef ◽  
Margaret A Honein ◽  
Christina A Nelson
Keyword(s):  
Public Health ◽  
United States ◽  
At Risk ◽  
Pregnant Women ◽  
Yersinia Pestis ◽  
The United States ◽  
Highly Pathogenic ◽  
Pathogenic Organism ◽  
Public Health Emergencies ◽  
Life Threatening

Abstract Pregnant women are an important at-risk population to consider during public health emergencies. These women, like nonpregnant adults, may be faced with the risk of acquiring life-threatening infections during outbreaks or bioterrorism (BT) events and, in some cases, can experience increased severity of infection and higher morbidity compared with nonpregnant adults. Yersinia pestis, the bacterium that causes plague, is a highly pathogenic organism. There are 4 million births annually in the United States, and thus the unique needs of pregnant women and their infants should be considered in pre-event planning for a plague outbreak or BT event.

scholarly journals “Back to the Future”: Time for a Renaissance of Public Health Engineering

2019 ◽  
Vol 16 (3) ◽  
pp. 387
Author(s):  
Richard J. Gelting ◽  
Steven C. Chapra ◽  
Paul E. Nevin ◽  
David E. Harvey ◽  
David M. Gute
Keyword(s):  
Public Health ◽  
Native American ◽  
Alaska Native ◽  
Environmental Protection Agency ◽  
Large Scale ◽  
Public Health Practice ◽  
The United States ◽  
Modern World ◽  
Positive Health ◽  
The U.S

Public health has always been, and remains, an interdisciplinary field, and engineering was closely aligned with public health for many years. Indeed, the branch of engineering that has been known at various times as sanitary engineering, public health engineering, or environmental engineering was integral to the emergence of public health as a distinct discipline. However, in the United States (U.S.) during the 20th century, the academic preparation and practice of this branch of engineering became largely separated from public health. Various factors contributed to this separation, including an evolution in leadership roles within public health; increasing specialization within public health; and the emerging environmental movement, which led to the creation of the U.S. Environmental Protection Agency (EPA), with its emphasis on the natural environment. In this paper, we consider these factors in turn. We also present a case study example of public health engineering in current practice in the U.S. that has had large-scale positive health impacts through improving water and sanitation services in Native American and Alaska Native communities. We also consider briefly how to educate engineers to work in public health in the modern world, and the benefits and challenges associated with that process. We close by discussing the global implications of public health engineering and the need to re-integrate engineering into public health practice and strengthen the connection between the two fields.

scholarly journals The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ying Han ◽  
Wei Yan ◽  
Yongbo Zheng ◽  
Muhammad Zahid Khan ◽  
Kai Yuan ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Severe Pain ◽  
Large Scale ◽  
Social Economic ◽  
The United States ◽  
Therapeutic Strategies ◽  
Public Health Threat ◽  
Reduction Strategies ◽  
Overdose Deaths

Abstract Fentanyl is a powerful opioid anesthetic and analgesic, the use of which has caused an increasing public health threat in the United States and elsewhere. Fentanyl was initially approved and used for the treatment of moderate to severe pain, especially cancer pain. However, recent years have seen a growing concern that fentanyl and its analogs are widely synthesized in laboratories and adulterated with illicit supplies of heroin, cocaine, methamphetamine, and counterfeit pills, contributing to the exponential growth in the number of drug-related overdose deaths. This review summarizes the recent epidemic and evolution of illicit fentanyl use, its pharmacological mechanisms and side effects, and the potential clinical management and prevention of fentanyl-related overdoses. Because social, economic, and health problems that are related to the use of fentanyl and its analogs are growing, there is an urgent need to implement large-scale safe and effective harm reduction strategies to prevent fentanyl-related overdoses.

In Preparation or Response: Examining Health Care Coalitions Amid a Changing Economic and Political Landscape

2015 ◽  
Vol 9 (6) ◽  
pp. 698-703 ◽  
Author(s):  
Mark E. Dornauer
Keyword(s):  
Public Health ◽  
Health Care ◽  
Emergency Preparedness ◽  
Community Health Centers ◽  
Large Scale ◽  
Adverse Health Effects ◽  
Public Health Emergencies ◽  
Political Landscape ◽  
Department Of Health ◽  
Operations Capabilities

ABSTRACTThe Office of the Assistant Secretary for Preparedness and Response within the US Department of Health and Human Services leads the nation in preparing for, responding to, and recovering from the adverse health effects of public health emergencies, in part through formal collaborations between hospitals, health systems, community health centers, public health departments, and community organizations via health care coalitions (HCCs). HCCs endeavor to meet the medical surge demands inherent to disasters and to improve health outcomes before, during, and after public health emergencies. Nevertheless, significant changes in health economics and policy can impact the operations, capabilities, and scope of HCCs. Specifically, hospital consolidation and the Affordable Care Act (ACA) are altering the national health care landscape, as well as the emergency preparedness sector, and are challenging HCCs to adapt to large-scale, industry-wide transformations. This article examines HCCs in the context of the developments of hospital consolidation and the ACA in order to facilitate future discourse regarding the strategy and policy of HCCs amid a changing economic and political landscape. (Disaster Med Public Health Preparedness. 2015;9:698–703)

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