Manmade Disasters

Abstract

A disaster that produces a multitude of patients may severely stress a community's health-care system, from the EMS system to the hospitals. Physicians involved in such an event must realize that they will have to change their normal mode of delivering care, having to make decisions with less than the normal amount of information, and doing the most good for the most salvageable patients. Some understanding of and appreciation for the unique problems that face emergency personnel in the field are important for physicians who do not normally interact with fire and EMS personnel, because it will allow them to realize that they are not alone in the chaos of a disaster. Many manmade disasters produce patients with medical or surgical problems with which one is familiar, the only difference being the sheer number of patients. Other manmade disasters, however, most notably those involving hazardous materials and radioactive materials, are capable of producing patients who not only have unfamiliar medical problems but also have problems about which little information is readily available in the medical literature. Hospital physicians can do much to prepare themselves for these eventualities. Discussion and planning should be done among separate staffs (ICU, operating suite, emergency department), as well as among staff of the various disciplines so they can interact more effectively when a disaster occurs. Local disaster planners should receive input from hospital staffs so hospital capabilities are known and the field operation can mesh well with the hospital's operation.

Ineffective responses to unlikely outbreaks: Hypothesis building in newly‐emerging infectious disease outbreaks

“…Instead, relevant information was dispersed across an uncoordinated, diffuse network of actors, mostly through splaying chains of dyadic communications. The result of this was a "variable disjunction of information," in which no individual or group had access to all of the available information but, instead, had to draw on incomplete and often poorly relayed packages of information (Turner, 1978). The limited access to raw epidemiological data and the lack of knowledge of the origin of data being circulated impaired actors' abilities to assess the veracity of the monkey-borne outbreak hypothesis and inhibited their ability to formulate new hypotheses.…”

Prehospital Transport Time and Mode of Transportation in Zenica, Bosnia

“…3 Previous studies in disaster medicine often have focused on civilian casualties resulting from a natural or episodic, manmade disaster. 4 - 5 Military aggression against civilian populations may be expected to have an even greater impact on a country's health-care system than even very large natural disasters, because of the protracted, recurrent, and migratory nature of the event.…”