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PubMedDate not supplied

[Medical supervision in rescue work--systematics and personal studies].

All institutions of the organised public medical emergency services are functions of public health welfare and risk defence, hence they are subjects to the public health department in a supervisory capacity. Legal definitions and standards are the pertaining framework. Systematic and qualified improvements of areal plans, organization and realization, material and personal equipment, and hygienic standards in the public medical emergency service are Supervisory tasks that have to be tackled by public health departments. Planning requires random tests and local spatial analysis. This may be performed by the public health department itself or by external institutions. Therefore, organized public medical emergency service is part of (communal) health reports.

Emergency Medical Services↗
PubMed1997

The aftermath of an industrial disaster.

An explosion in a Danish supertanker under construction in 1994 caused the death of six workers and injured 15. Six months later 270 workers took part in this study, which analyses the relationships between objective stressors, the workers' own feelings and the reactions of their families after the explosion together with training, attitude to the workplace, general out-look, and received crisis help. Traumatisation, coping style and crisis support was assessed via the Impact of Event Scale (IES), the Coping Styles Questionnaire (CSQ) and the Crisis Support Scale (CSS). Emotionally, workers and their families were strongly affected by the explosion. The IES-score was 17.6 and the invasion score 9.1. The degree of traumatisation was higher in the group who had an 'audience position' than in the group who was directly hit by the explosion. Training in rescue work did not protect against adverse effects. Rescue work had a strong impact on the involved. Social support was a significant factor, that seems to buffer negative effects. High level of social integration, effective leadership in the situation, and professional crisis intervention characterised the disaster situation. All the same, 41 per cent of the workers reached the caseness criteria by Horowitz (IES > or = 19).

Accidents, Occupational↗
PubMed1994

Occupational meanings and coping practices of rescue workers in an earthquake disaster.

On 17 October 1989, an earthquake measuring 7.1 on the Richter scale struck the San Francisco Bay Area, causing the collapse of .76 miles of a double-decker roadway (known as the Cypress Street Viaduct), resulting in the death of 42 people. A study examined the effects of rescue work at 6 and 20 months after the event, among 42 people including: military pararescuers, firefighters, transportation workers, and coroner-investigators. The researcher explored the rescuers' motivations, actions, coping strategies, interactions, and understanding of their responses to the event, as well as the practical wisdom each acquired. This article focuses on the 6-month data, and reports the specific work meanings and practices that shaped forms of involvement, issues of stress, and sources of coping that influenced the experience of rescue work in this disaster.

Adaptation, Psychological↗
PubMed1997

[Experiences of treatment of mass burn casualties].

A fire in Karamay, Xinjiang on December 8, 1994, took a toll of 323 deaths at the site of the disaster, including 208 children, 75 teenagers and 40 adults. 135 burn patients were admitted to the hospital (including 41 children, 62 teenagers, and 32 adults). They were classified as extremely serious 9, serious 35, moderate 64 and mild 27. Among them 77 patients were complicated by inhalation injury, and tracheostomy was performed for moderate serious cases within 24 hours. Escharectomy and skin-grafting were done for III degree burn wound of hands, and early wound infection was effectively controled. Because of efficient organization, the rescue work and treatment were successful.

Adolescent↗
PubMed1990

[Aviation support of measures for rendering medical care to the victims of natural disasters, accidents and catastrophes].

The unpredictable character of natural calamities and technological accidents makes some specific demands on the organization and planning of the wide range complex of social measures to abolish their awful and tragic consequences. Analysing and summarizing the reviews and reports of international congresses on the emergency and catastrophic medicine and their own experience, the authors accentuate attention on the advantages and capabilities of aerial transport in delivering of medical personnel, all necessary equipment to the zones of mass sanitary losses and its really essential role in rapid aeromedical evacuation of injured. The authors scrutinize in details the structural scheme of organization of patient's search-and-rescue work and suggest, that main principles of planning and management of search-and-rescue operations in aviation could be applied in a decision of problems, which arise in medical assistance to the victims of the natural disasters and accidents.

Accidents↗
PubMed1986

The Bhopal tragedy--what has Swedish disaster medicine planning learned from it?

On December 3, 1984, a leak of methylisocyanate (MIC) from a chemical plant in Bhopal, India, affected 150,000 to 200,000 people. More than 10,000 people were severely injured and approximately 2,500 died. In this article a survey of symptoms, treatment, and rescue work is given. On the basis of this, we discuss ways to help reduce the effects of a major release of an irritant gas. People living in the vicinity of potential health hazards need information on how to behave in case of accidents. Rescue workers and medical personnel must be trained to operate under "toxic conditions." There must be planning for treatment of thousands of patients at the same time, a circumstance that will often require temporary "satellite hospitals" to be opened. As symptoms and injuries are of the same kind, even if the magnitude and the effect may differ, treatment can, in many ways, be standardized. Therefore members of the health care team, irrespective of their daily different specialty fields, can work with the most urgent missions.

Accidents, Occupational↗
PubMed1996

Voluntary and professional disaster-workers: similarities and differences in reactions.

Forty-three rescuers responding to a bus crash that killed 12 children and 4 adults and injured many more answered questionnaires at 1 and 13 months following the crash. This study compared the responses of the voluntary and professional helpers, using the Impact of Event Scale (IES) and the General Health Questionnaire (GHQ). For all helpers taken together, the decline in IES-intrusion and IES-total scores was significant from 1 to 13 months. The voluntary helpers reported significantly more intrusion and avoidance on the IES at 1 month than professional helpers, and for avoidance the voluntary helpers still evidenced a significantly higher score than professional helpers at 13 months. The GHQ scores at 13 months reflected that the long-term negative impact of the event was low.

Accidents, Traffic↗
PubMed1996

Immediate application of hyperbaric oxygen therapy using a newly devised transportable chamber.

A transportable hyperbaric chamber called the Gamow bag has been reported as an effective means of treating high-altitude illness. The pressure limit of the original bag is set at 2 psi because of the fragility of the fabric. However, improvement of the hardware to make the bag capable of withstanding higher pressures has made it possible to perform standard hyperbaric oxygen therapy with the newly devised portable chamber, the Chamberlite 15. In this study, the safety of the new bag was examined using healthy human volunteers, and the bag was shown to be usable in clinical emergency cases, such as CO intoxication and decompression sickness. The effectiveness of emergency hyperbaric oxygen therapy was also examined using the CO intoxication model of the rat. It was suggested that hyperbaric therapy was especially beneficial if applied during the first 30 minutes of rescue work. It was concluded that the transportable chamber was a promising emergency tool for CO intoxication.

Animals↗
PubMed1992

Psychological responses of rescue workers: fire fighters and trauma.

The psychological responses of two groups of fire fighters were examined following the performance of rescue work. Four types of responses were reported: identification with the victims, feelings of helplessness and guilt, fear of the unknown, and physiological reactions. Stress was found to be mediated by availability of social support, type of leadership, level of training, and use of rituals. Implications of these findings for preventive intervention measures are discussed.

Accidents, Aviation↗
PubMed1989

The stress upon rescuers involved in an oil rig disaster. "Alexander L. Kielland" 1980.

Nine months post-disaster, 134 rescuers involved in an off-shore oil rig disaster were investigated by using a structured self report questionnaire to chart their experience of coping with disaster impact stressors and their mental and physical health 9 months after the disaster. Of the 134 rescuers, 24 were categorized as professional rescuers, 101 as non-professionals and 9 could not be classified. Of the 212 victims, all oil rig workers, 89 (42%) were rescued. Seventy-six percent of the rescuers reported they had been exposed to danger during the rescue operation, and 62% found the experience to be the worst ever. Eighty to ninety percent felt they had coped fairly well with the task, and severely disturbed coping was reported to be below 10% for decision-making, ability to judge risk, capacity to function as leader, and finally ability to cooperate and act efficiently. For the non-professionals, severe disturbance in ability to plan before acting was reported by 10% and moderate disturbance was reported by 38%. The frequency of emotional stress reactions during the rescue work can be assessed from the fact that 64% to 52% reported discouragement, restlessness, uncertainty, anxiety and irritation. The stressors inherent in this type of disaster seem to satisfy the DSM III stressor criterion for post-traumatic stress disorder. Nine months after the disaster 24% reported their mental health to be poor due to the disaster impact, and only the most experienced rescuers had a low health risk compared to the others.

Adaptation, Psychological↗
PubMed1989

Fire fighters: a study of stress and coping.

Fifty-eight non-professional fire fighters, 91% of all firefighters from different industries who participated in a hotel fire rescue operation, were investigated by means of a structured self-report questionnaire about their stress experience during and after the rescue action. Together with 57 professional fire fighters, they participated in rescuing hotel guests confined for as much as three hours in a 12 storeyed hotel building on fire. Fourteen persons (11%) died, 114 guests survived. Forty-seven percent of the non-professional fire fighters reported that the disaster experience was the worst they had ever experienced. Even so, 80% thought that they had coped with the job well to fairly well and for as many as 66% the rescue action represented something positive to them in retrospect. Ten percent claimed that stress reactions disturbed them in executing effective rescue work. Fifty-eight percent maintained that more preparation and training could have improved their effort. Fire fighters with previous practical experience seemed to "digest" the disaster experience more easily than inexperienced fire fighters as measured by the Impact of Event Scale. High level of competence and opportunity for debriefing as well as disaster characteristics are discussed as factors explaining the favourable coping with extreme stress.

Adaptation, Psychological↗
PubMedDate not supplied

Medical outreach after hurricane Marilyn.

INTRODUCTION: Many geographical areas are subject to devastating disasters that leave the citizens not only without homes, but also without their local medical systems. Now medical-aid stations consisting of personnel, supplies, and equipment quickly can be deployed when needed to such areas under the aegis of the National Disaster Medical System (NDMS). Such teams can provide emergent medical care as well as daily medical care. However, these aid stations are of no help for the home-bound or nursing home patients too infirm to reach them. Thus, these citizens only can obtain medical care if medical teams make planned outreach excursions to reach them. OBJECTIVE: To describe a planned outreach program that was implemented for such patients on St. Thomas Island after it was devastated by Hurricane Marilyn in 1995. RESULTS: Over a five-day period, the outreach team provided medical care for 67 patients ranging in age from 11 days to 90 years. Play and art therapy was provided for non-injured children. The most common needs in the elderly were anti-hypertensive medications and insulin-loaded syringes. CONCLUSIONS: For outreach efforts of this nature, membership of the team should include a registered nurse, a paramedic, a respiratory therapist, a public health specialist, and a local authority familiar both with the area and its inhabitants. A physician does not need to be assigned to the team, but should be available by radio.

Adolescent↗