scholarly journals Using a joint triage model for multi-hospital response to a mass casualty incident in New York city

2009 ◽  
Vol 2 (2) ◽  
pp. 114 ◽  
Author(s):  
Bonnie Arquilla ◽  
Lorenzo Paladino ◽  
Charlotte Reich ◽  
Ethan Brandler ◽  
Michael Lucchesi ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Hospital Response

Utilizing a Pediatric Disaster Coalition Model to Increase Pediatric Critical Care Surge Capacity in New York City

2017 ◽  
Vol 11 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Michael Frogel ◽  
Avram Flamm ◽  
Mayer Sagy ◽  
Katharine Uraneck ◽  
Edward Conway ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critical Care ◽  
York City ◽  
Emergency Preparedness ◽  
Mass Casualty ◽  
Surge Capacity ◽  
Pediatric Critical Care ◽  
Mass Casualty Event ◽  
Care Surgery

AbstractA mass casualty event can result in an overwhelming number of critically injured pediatric victims that exceeds the available capacity of pediatric critical care (PCC) units, both locally and regionally. To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) was established. The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from 18 of 25 major NYC PCC-capable hospitals. A PCC surge committee created recommendations for making additional PCC beds available with an emphasis on space, staff, stuff (equipment), and systems. The PDC assisted 15 hospitals in creating PCC surge plans by utilizing template plans and site visits. These plans created an additional 153 potential PCC surge beds. Seven hospitals tested their plans through drills. The purpose of this article was to demonstrate the need for planning for disasters involving children and to provide a stepwise, replicable model for establishing a PDC, with one of its primary goals focused on facilitating PCC surge planning. The process we describe for developing a PDC can be replicated to communities of any size, setting, or location. We offer our model as an example for other cities. (Disaster Med Public Health Preparedness. 2017;11:473–478)

scholarly journals The New York City Pediatric Disaster Coalition: A Regional Model for Pediatric Mass-Casualty Planning

2010 ◽  
Vol 25 (S1) ◽  
pp. S51-S51
Author(s):  
Michael Frogel ◽  
Katherine Uraneck ◽  
Arthur Cooper ◽  
Mayer Sagy ◽  
Michael Tunik ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Mass Casualty ◽  
Regional Model

A Modified Simple Triage and Rapid Treatment Algorithm from the New York City (USA) Fire Department

2015 ◽  
Vol 30 (2) ◽  
pp. 199-204 ◽  
Author(s):  
Faizan H. Arshad ◽  
Alan Williams ◽  
Glenn Asaeda ◽  
Douglas Isaacs ◽  
Bradley Kaufman ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Group Performance ◽  
Treatment Algorithm ◽  
Fire Department ◽  
Mass Casualty ◽  
Publication Type ◽  
Percent Correct ◽  
Rapid Treatment

AbstractIntroductionThe objective of this study was to determine if modification of the Simple Triage and Rapid Treatment (START) system by the addition of an Orange category, intermediate between the most critically injured (Red) and the non-critical, non-ambulatory injured (Yellow), would reduce over- and under-triage rates in a simulated mass-casualty incident (MCI) exercise.MethodsA computer-simulation exercise of identical presentations of an MCI scenario involving a 2-train collision, with 28 case scenarios, was provided for triaging to two groups: the Fire Department of the City of New York (FDNY; n = 1,347) using modified START, and the Emergency Medical Services (EMS) providers from the Eagles 2012 EMS conference (Lafayette, Louisiana USA; n = 110) using unmodified START. Percent correct by triage category was calculated for each group. Performance was then compared between the two EMS groups on the five cases where Orange was the correct answer under the modified START system.ResultsOverall, FDNY-EMS providers correctly triaged 91.2% of cases using FDNY-START whereas non-FDNY-Eagles providers correctly triaged 87.1% of cases using unmodified START. In analysis of the five Orange cases (chest pain or dyspnea without obvious trauma), FDNY-EMS performed significantly better using FDNY-START, correctly triaging 86.3% of cases (over-triage 1.5%; under-triage 12.2%), whereas the non-FDNY-Eagles group using unmodified START correctly triaged 81.5% of cases (over-triage 17.3%; under-triage 1.3%), a difference of 4.9% (95% CI, 1.5-8.2).ConclusionsThe FDNY-START system may allow providers to prioritize casualties using an intermediate category (Orange) more properly aligned to meet patient needs, and as such, may reduce the rates of over-triage compared with START. The FDNY-START system decreases the variability in patient sorting while maintaining high field utility without needing computer assistance or extensive retraining. Comparison of triage algorithms at actual MCIs is needed; however, initial feedback is promising, suggesting that FDNY-START can improve triage with minimal additional training and cost.ArshadFH, WilliamsA, AsaedaG, IsaacsD, KaufmanB, Ben-EliD, GonzalezD, FreeseJP, HillgardnerJ, WeakleyJ, HallCB, WebberMP, PrezantDJ. A modified Simple Triage and Rapid Treatment algorithm from the New York City (USA) Fire Department. Prehosp Disaster Med. 2015;30(2):1-6.

Traumatic Brain Injuries after Mass-Casualty Incidents: Lessons from the 11 September 2001 World Trade Center Attacks

2007 ◽  
Vol 22 (3) ◽  
pp. 157-164 ◽  
Author(s):  
Wesley Rutland-Brown ◽  
Jean A. Langlois ◽  
Leze Nicaj ◽  
Robert G. Thomas ◽  
Susan A. Wilt ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
World Trade ◽  
Brain Injuries ◽  
World Trade Center ◽  
Traumatic Brain Injuries ◽  
Mass Casualty ◽  
Trade Center ◽  
Wtc Attacks

AbstractIntroduction:The 11 September 2001 terrorist attacks on the World Trade Center (WTC) resulted in thousands of deaths and injuries. Research on previous bombings and explosions has shown that head injuries, including traumatic brain injuries (TBIs), are among the most common injuries.Objective:The objective of this study was to identify diagnosed and undiagnosed (undetected) TBIs among persons hospitalized in New York City following the 11 September 2001 WTC attacks.Methods:The medical records of persons admitted to 36 hospitals in New York City with injuries or illnesses related to the WTC attacks were abstracted for signs and symptoms of TBIs. Diagnosed TBIs were identified using the International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes. Undiagnosed TBIs were identified by an adjudication team of TBI experts that reviewed the abstracted medical record information. Persons with an undiagnosed TBI were contacted and informed of the diagnosis of potential undetected injury.Results:A total of 282 records were abstracted. Fourteen cases of diagnosed TBIs and 21 cases of undiagnosed TBIs were identified for a total of 35 TBI cases (12% of all of the abstracted records). The leading cause of TBI was being hit by falling debris (22 cases). One-third of the TBIs (13 cases) occurred among rescue workers.More than three years after the event, four out of six persons (66.67%) with an undiagnosed TBI who were contacted reported they currently were experiencing symptoms consistent with a TBI.Conclusions:Not all of the TBIs among hospitalized survivors of the WTC attacks were diagnosed at the time of acute injury care. Some persons with undiagnosed TBIs reported problems that may have resulted from these TBIs three years after the event. For hospitalized survivors of mass-casualty incidents, additional in-hospital, clinical surveys could help improve pre-discharge TBI diagnosis and provide the opportunity to link patients to appropriate outpatient services. The use and adequacy of head protection for rescue workers deserves re-evaluation.

scholarly journals (P1-78) Utilizing New York City Pediatric Disaster Coalition Site Visits to Create Hospital Pediatric Critical Care Surge Plans

2011 ◽  
Vol 26 (S1) ◽  
pp. s124-s124
Author(s):  
A. Flamm ◽  
G. Foltin ◽  
K. Uraneck ◽  
A. Cooper ◽  
B.M. Greenwald ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critical Care ◽  
York City ◽  
Emergency Preparedness ◽  
Capacity Planning ◽  
Mass Casualty ◽  
Federal Grant ◽  
Surge Capacity ◽  
Pediatric Critical Care

PurposeThe New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has supported a federal grant establishing a Pediatric Disaster Coalition (PDC) comprised of pediatric critical care (PCC) and emergency preparedness consultants from major city hospitals and health agencies. One of the PDC's goals was to develop recommendation for hospital-based PCC surge plans.MethodsMembers of the PDC convened bi-weekly and among other projects, developed guidelines for creating PCC surge capacity plans. The PDC members, acting as consultants, conducted scheduled visits to hospitals in NYC and actively assisted in drafting PCC surge plans as annexes to existing hospital disaster plans. The support ranged from facilitating meetings to providing draft language and content, based on each institutions request.ResultsNew York City has 25 hospitals with PCC services with a total of 244 beds. Five major hospitals have completed plans, thereby adding 92 PCC beds to surge capacity. Thirteen additional hospitals are in the process of developing a plan. The PDC consultants participated in meetings at 11 of the planning hospitals, and drafted language for 10 institutions. The PDC continues to reach out to all hospitals with the goal of initiating plans at all 25 PCC hospitals.ConclusionsProviding surge guidelines and the utilization of on-site PDC consultants was a successful model for the development and implementation of citywide PCC surge capacity planning. Visiting hospitals and actively assisting them in creating their plans was an effective, efficient and well received, method to create increased PCC surge capacity. By first planning with major hospitals, a significant increase of surge beds (92 or 38%) was created, from a minimal number of hospitals. Once hospitals complete plans, it is anticipated that there will be the addition of at least 200 PCC surge beds that can be incorporated in to regional city-wide response to pediatric mass-casualty incident.

scholarly journals (A47) Pediatric Mass-Casualty Triage: The New York City Approach

2011 ◽  
Vol 26 (S1) ◽  
pp. s16-s16
Author(s):  
A. Cooper ◽  
D. Gonzalez ◽  
M. Frogel ◽  
A. Flamm ◽  
D. Prezant ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critically Ill ◽  
York City ◽  
Emergency Preparedness ◽  
Early Recognition ◽  
Trauma Surgery ◽  
Mass Casualty ◽  
Infants And Children ◽  
Mass Casualty Event

IntroductionA Mass-Casualty Event (MCE) involving pediatric victims could overwhelm existing pediatric resources. Therefore, early recognition of critically ill infants and children is essential for proper distribution among pediatric capable hospitals. However, emergency medical services (EMS) personnel have limited experience with pediatric assessments, and less with pediatric mass-casualty triage (MCT). To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) in collaboration with the Fire Department (FDNY) and Office of Emergency Management, made simple alterations to the START-based NYC-MCT Algorithm that can be rapidly and accurately applied by EMS personnel in the field with minimal additional education and preparation, obviating the requirement for extensive and expensive retraining.MethodsThe PDC includes experts in pediatric emergency preparedness, emergency medicine, critical care, and trauma surgery in NYC, as well as DOHMH, FDNY-OMA, and OEM. Its Triage Subcommittee determined the minimum essential pediatric alterations to the Algorithm, which then was tested by FDNY-EMS.ResultsAfter focused literature review and multiple draft revisions aimed to maximize pediatric benefit yet minimize unnecessary complexity, the Algorithm was modified to ensure that: (1) five rescue breaths will be provided to infants or children prior to being categorized as Dead or Expectant; (2) infants under 12 months old will be categorized as Critical and receive priority transport, and (3) children initially categorized as Delayed or Minor will be uptriaged to a new Urgent (Orange) category to receive such care in a rapid manner. To date, > 3,000 FDNY personnel have been trained in its use, and tested its accuracy using tabletop scenarios. Mean accuracy is 80–90%.ConclusionsThe model is an effective, multidisciplinary approach to planning. Minimum alterations to the Algorithm were adopted by the regional EMS system. The Modified Algorithm improves identification of critically ill infants and children. This approach could be adopted by other large urban centers.

An Important Armenian MS. with Greek Miniatures

1942 ◽  
Vol 74 (3-4) ◽  
pp. 155-162
Author(s):  
H. Kurdian
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Christian Iconography

In 1941 while in New York City I was fortunate enough to purchase an Armenian MS. which I believe will be of interest to students of Eastern Christian iconography.

Hospitals: N.Y. Appellate Court Denies Move to Privatize Public Hospital

1999 ◽  
Vol 27 (2) ◽  
pp. 202-203
Author(s):  
Robert Chatham
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Public Health System ◽  
Municipal Hospital ◽  
The Public ◽  
Public Benefit ◽  
For Profit ◽  
Benefit Corporation ◽  
The City

The Court of Appeals of New York held, in Council of the City of New York u. Giuliani, slip op. 02634, 1999 WL 179257 (N.Y. Mar. 30, 1999), that New York City may not privatize a public city hospital without state statutory authorization. The court found invalid a sublease of a municipal hospital operated by a public benefit corporation to a private, for-profit entity. The court reasoned that the controlling statute prescribed the operation of a municipal hospital as a government function that must be fulfilled by the public benefit corporation as long as it exists, and nothing short of legislative action could put an end to the corporation's existence.In 1969, the New York State legislature enacted the Health and Hospitals Corporation Act (HHCA), establishing the New York City Health and Hospitals Corporation (HHC) as an attempt to improve the New York City public health system. Thirty years later, on a renewed perception that the public health system was once again lacking, the city administration approved a sublease of Coney Island Hospital from HHC to PHS New York, Inc. (PHS), a private, for-profit entity.

Cultural Competence Needed to Distinguish Disorder from Difference: Beyond Kumbaya

2015 ◽  
Vol 22 (2) ◽  
pp. 64-76 ◽  
Author(s):  
Catherine J. Crowley ◽  
Kristin Guest ◽  
Kenay Sudler
Keyword(s):  
New York ◽  
New York City ◽  
Public Schools ◽  
Cultural Competence ◽  
York City ◽  
Cultural Sensitivity ◽  
Graduate Program ◽  
Language Disorder ◽  
New York State ◽  
Deep Understanding

What does it mean to have true cultural competence as an speech-language pathologist (SLP)? In some areas of practice it may be enough to develop a perspective that values the expectations and identity of our clients and see them as partners in the therapeutic process. But when clinicians are asked to distinguish a language difference from a language disorder, cultural sensitivity is not enough. Rather, in these cases, cultural competence requires knowledge and skills in gathering data about a student's cultural and linguistic background and analyzing the student's language samples from that perspective. This article describes one American Speech-Language-Hearing Association (ASHA)-accredited graduate program in speech-language pathology and its approach to putting students on the path to becoming culturally competent SLPs, including challenges faced along the way. At Teachers College, Columbia University (TC) the program infuses knowledge of bilingualism and multiculturalism throughout the curriculum and offers bilingual students the opportunity to receive New York State certification as bilingual clinicians. Graduate students must demonstrate a deep understanding of the grammar of Standard American English and other varieties of English particularly those spoken in and around New York City. Two recent graduates of this graduate program contribute their perspectives on continuing to develop cultural competence while working with diverse students in New York City public schools.

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