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The Quarterly 2011

 

Below are a series of journal articles that have been recently published addressing the area of health service management in the wake of disasters. A link to the publicly accessible article is provided, along with a brief summary of the findings of the study.


National health and hospital network for Australia's future: Implications for emergency medicine
FitzGerald G & Ashby R. Published in Emergency Medicine Australasia (2010) 22, 384–390
http://onlinelibrary.wiley.com/doi/10.1111/j.1742-6723.2010.01329.x/full

The realignment of health responsibilities resulting from the agreement reached between the Australian Federal and State and Territory governments (apart from Western Australia) in April 2010 are considered the most fundamental since the introduction of Medicare in 1983. This article provides a contextual background for the proposals (both Health System and Emergency Medicine contexts) and an overview of the proposals from a Health System perspective examines the potential impact of the proposals on Emergency Medicine and provides a framework for further discussion. The authors conclude that the proposals have significant potential to improve the quality of care within Emergency Departments, but will need careful design, based on proper analysis of the available evidence and a structured approach to research and development.


Disaster medicine reporting: The need for new guidelines and the CONFIDE statement
Bradt D, Aitken P. Published in Emergency Medicine Australasia (2010) 22, 483–487
http://onlinelibrary.wiley.com/doi/10.1111/j.1742-6723.2010.01342.x/full

This editorial for the December 2010 issue of Emergency Medicine Australasia discusses the drivers for and implications of new guidelines for writing disaster case reports to be published in Emergency Medicine Australasia. The article includes a table of the top 10 MEDLINE-indexed, peer-reviewed, event-specific journals publishing articles relating to disaster management discusses the challenges of identifying good quality evidence in the literature and briefly describes the types of disaster case reporting most frequently published. They conclude that a systematic approach to writing case reports is of benefit, and outline the key components of the CONFIDE guidelines (CONsensus guidelines on reports of Field Interventions in Disasters and Emergencies). Guidelines for authors wishing to submit case reports to the journal are also summarised.


Flood fatalities in contemporary Australia (1997–2008)
FitzGerald G, Du W, Jamal A, et al. Published in Emergency Medicine Australasia (2010) 22, 180–186
http://onlinelibrary.wiley.com/doi/10.1111/j.1742-6723.2010.01284.x/full

This article analyses a database of flood fatalities in Australia over a recent 10-year period. The authors concluded that the majority of flood-related deaths were preventable, with over 90% of deaths caused by attempts to ford flooded waterways or inappropriate or high-risk behaviour during the floods. Demographics by year, month, State, age, and gender are presented, together with circumstances of death.


Preparedness for short-term isolation among Queensland residents: Implications for pandemic and disaster planning
Aitken P, Leggat P, Brown L, et al. Published in Emergency Medicine Australasia (2010) 22, 135-441
http://onlinelibrary.wiley.com/doi/10.1111/j.1742-6723.2010.01319.x/full

It is likely that during a natural disaster or disease pandemic, households could face short-term isolation and possible interruption of utility services and, as a consequence, the potential for lack of food supplies and potable water during this period. As part of the Queensland Social Survey 2009, households were asked two questions relating to preparedness for 3 days of isolation. This article presents results of the survey, and found that while most respondents (>90%) would have enough food to last for 3 days, only half (53%) would have enough food and potable water for 3 days without utility services. Results are further analysed by various demographic variables, including age, geographic area, education levels and occupation.


Mass catastrophe and disaster psychiatry
Raphael B, Ma H. Published in Mol Psychiatry (2011) 16(3), 247-51
no link available

This paper discusses the vital role of disaster psychiatry in the evolving structures for preparedness and response in the fields of disaster management. The authors address the role of science and experience in addressing the tragedies of mass catastrophe, the need for systems and the challenges of integrating mental health contributions into the practical requirements for survival, aid, emergency management and ultimately recovery. The human face of disaster and the understanding of human strengths and resilience alongside the protection of, and care for, those suffering profound trauma and grief are central issues.


Taking seriously the "what then?" question: an ethical framework for the responsible management of medical disasters
McCullough LB. Published in J Clin Ethics (2010) 21(4), 321-7.
http://clinicalethics.com/single_article/wlc4wlutriA.html

When healthcare resources become overwhelmed in medical disasters, the question remains: "What then?" or more precisely, "What should we do when we run out of resources?" In a mass casualty event, resources are quickly exhausted. This article provides an ethical framework for the responsible management of medical disasters in which the "What then?" question must be asked. The framework begins with a critique of existing guidance from professional associations of physicians and then argues for an alternative approach.


Need for continual education about disaster medicine for health professionals in China-a pilot study
Huang B, Li J, Li Y, Zhang W, Pan F, Miao S. Published in BMC Public Health (2011) 11, 89.
http://www.biomedcentral.com/1471-2458/11/89

Traditionally the medical education curriculum in China has not incorporated Disaster Medicine training, despite the country’s need. The authors assess the need for continual education regarding disaster management for health professionals in China by surveying 324 health professionals, who participated in the response to the Wenchuan earthquake medical relief and public health assessment in October, 2008. 67.3% of the participants received informal disaster medicine training, and only a few (12.7%) participated in disaster drills. Most of the participants wanted to get continual education about disaster medicine training (89.8%), but prefer on-line training course for the flexibility of time scheduling and travel through China. It was concluded that the need for continual disaster medicine training is high; health professionals should be equipped with knowledge and skills for disaster management.


Crisis communication during an air pollution event
Hayward, A. Published in Australian Journal of Emergency Management (2010) 25(1), 42 – 46.
http://www.ema.gov.au/www/emaweb/rwpattach.nsf/VAP/ (8AB0BDE05570AAD0EF9C283AA8F533E3) ~Hayward,+Peters, +van+Bockxmeer,+Seow, +McKitrick+&+Canyon.pdf/$file/Hayward,+Peters,+van+Bockxmeer,+Seow,+McKitrick+&+Canyon.pdf

During an emergency air pollution crisis, two options exist for potentially exposed residents: shelter-in-place or evacuate. The effectiveness of public health communication in guiding this decision is thus critical. The author conducted a survey collecting data on the 2004 Bayswater Scrap Metal Fire relating to perception of risk, type of communication authorities, method of communication, nature of advice, decision in response to advice, most trusted advice provider, and likelihood of behavioural change.


Effective training of mine rescue personnel: a case study
Ingham, V. Published in Australian Journal of Emergency Management (2010) 25 (1), 58-63.
http://www.ema.gov.au/www/emaweb/rwpattach.nsf/VAP/ (8AB0BDE05570AAD0EF9C283AA8F533E3) ~Ingham +&+Ingham.pdf/$file/Ingham+&+Ingham.pdf

A model is presented for the effective training of Mine Rescue personnel. Organising effective training sessions for a Mine Rescue team presents unique problems generated by fly in/fly out rosters and the transitory nature of personnel on a mine site. The selection strategies and criteria for Mine Rescue team members, the structure of training sessions and the overall benefits to the workplace and specific benefits to individuals will be discussed in relation to the current practice of the Mine Rescue Team at Golden Grove, Western Australia. The transferability and application of skills learned in training will be demonstrated with an actual incident within the mine’s environs.


Evacuation responsiveness by government organisations (ERGO): a preparedness toolkit for Europe
Kailiponi, P. Published in IAEM Bulletin (2010) 27 (1), 17-18.
http://www.astoncrisis.com/crisiscms/Evacuation-Responsiveness-by-Government-Organisations

Governments across Europe are preparing to evacuate their public in response to major catastrophic incidents. However, because the need for mass evacuation is rare, there are few examples of good practice from which to learn. Thus, evacuation preparedness may need to rely on officials' personal experience as well as assessments of how operational targets can be met given different resource configurations and evacuation policies.



Dr Susan Keam
AFRACMA


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