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EUR-OPA Major Hazards Agreement: Open partial agreement on the prevention of, protection against and organisation of relief in major natural and technological disasters
Published in Jan de Boer, Marcel Dubouloz, Handbook of Disaster Medicine, 2020
Disaster medicine is a medical discipline that is based on emergency medicine and public health techniques, but also integrates non-medical and local requirements according to a strategy aimed at prevention and the limitation of the effects of a disaster on the health of the populations concerned, in particular through saving the greatest possible number of victims.
Introduction
Published in Emily Ying Yang Chan, Disaster Public Health and Older People, 2019
Disaster Public Health and Older People is a topic-specific reference textbook for professionals, students and fieldworkers who are interested in examining how health and well-being of the older population might be affected in the context of increasing frequency and intensity of disaster and humanitarian emergencies in the twenty-first century. Through the application of relevant public health theories and principles, readers will take a deep dive into exploring the public health impact and the health needs of older people at the forefront of disasters and crises. Insights in the challenges and opportunities to mitigate and reduce disaster risk and to mount up better response for older people will be examined. This book also aims at making lessons learnt from previous disasters available and comprehensible to students and practitioners of disaster medicine, disaster public health, humanitarian studies, gerontology and geriatrics, with a particular focus on low- and middle-income country settings.
Characteristics of EMS Fellowships in the United States
Published in Prehospital Emergency Care, 2023
Avram Flamm, Kyle Burch, Jeffrey Lubin, Francis Mencl
The ACGME requires that fellows log at least one experience in developing “a mass gathering medical plan and participation in its implementation” (10). The core content of EMS Medicine lists “allocation of scene resources” and “modified standard of care” under “practice-based learning” (8). Programs offer considerable variability of events listed in Table 2. It is unknown how these experiences compare and if any of these offerings are superior in providing training to future EMS physicians. It is also unknown to what extent they might influence a fellow’s program selection Few medical directors will provide care for gatherings in excess of 100,000 people, auto racing, college sporting events, or music concerts, and may therefore not view this as a priority. Likewise, while exposure and some knowledge of Disaster Medicine is desirable and therefore mandated, how these experiences compare or how many different agencies a fellow should interact with is uncertain. Almost every program’s fellows work with hospitals and EMS agencies in disaster planning. In many areas EMS is fire-based and almost half of the fellowships worked with fire departments. Even so, only a small number offered experiences and work with law enforcement or the federal government despite the fact that in larger disasters or civil disturbances they may interact with such agencies.
‘Other patients become a secondary priority:’ perceptions of Estonian frontline healthcare professionals on the influence of COVID-19 on health (in)equality and ethical decision-making
Published in Journal of Communication in Healthcare, 2022
Kadi Lubi, Kadri Simm, Kaja Lempu, Jay Zameska, Angela Eensalu-Lind
Procedural changes were seen as changes in triage and changed patient and/or symptom management, which also occasionally led to a delay in treatment. Several participants explained that ‘triage time slowed down’ because ‘evaluation of infection risk became a huge part of triaging. Triage became a potentially harmful activity for the staff.’ As these quotations indicate, several usual ways of acting in different kinds of procedures were changed due to the increase of perceived (and actual) risk. Therefore, practical aspects of triage also changed, and ‘triage was performed more by physicians rather than nurses.’ The latter is interesting from different perspectives. First, the symptoms of COVID-19 are relatively simple and should be detectable during triage by nurses; however, the lack and continuous change of information about COVID-19 probably forced this change in the usual roles. Second, physicians, as the highest-level healthcare professionals, took over the role of frontline workers. This method of operation is more characteristic of disaster medicine, in which there is a need for leadership and quick decision-making in multidisciplinary teams, which, among other things, improves the quality of emergency management [35]. The latter was needed in times that were emotionally intense and when there was insecurity in terms of lack of knowledge.
Between Usual and Crisis Phases of a Public Health Emergency: The Mediating Role of Contingency Measures
Published in The American Journal of Bioethics, 2021
David Alfandre, Virginia Ashby Sharpe, Cynthia Geppert, Mary Beth Foglia, Kenneth Berkowitz, Barbara Chanko, Toby Schonfeld
Much of the early and sustained attention of disaster medicine and public health preparedness has focused on planning for the crisis phase of a surge when, despite augmentation efforts, the demand for specific resources outstrips supply. However, the contingency phase has been neither sufficiently specified nor critically examined from an ethics perspective, even though health care organizations have been largely operating in the contingency phase since the COVID-19 pandemic began and many will remain in contingency status for months to come. In describing an ethical framework that addresses how to continue delivering high-quality patient care, delay scarcity of critical resources, reduce the risk of disease transmission, and limit staff and patient exposure to risk of harm, this paper aims to advance the ethical discourse and subsequent care practices during the contingency phase. The ethics framework presented here can be used by healthcare leaders to inform planning and implementation for ongoing COVID-19 contingency surge responses and in doing so, facilitate proactive ethics conversations about healthcare operations, which will ideally lead to ethically strong health care practices during extraordinary times.