Medical Surge Capacity Workshop Summary (2010) / Chapter Skim
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Appendix G: Vulnerable Populations in Disasters: Health Effects and Needs
Appendix G: Vulnerable Populations in Disasters: Health Effects and Needs
Pages 133-142
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From page 133... ...
Surge capability, on the other hand, is measured in terms of the numbers of staff and resources truly available to provide the services for which these facilities and equipment are required. Estimates vary according to the type of hazard being encountered, such that as few as 50 percent of staff state they would report to work in large-scale bioevents, but in truth, no reliable estimates of local or national surge capability currently exist.
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From page 134... ...
Moreover, less than one-third of such hospitals may have reliable surge capacity in excess of 20 beds or access to 6 or more ventilators, while less than one-half may have access to pharmaceutical stockpiles.8
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From page 135... ...
Several general and specific strategies have been proposed not only for the population as a whole, but also for children and elders, in particular.19-24 For children, these involve recognition of the need for pediatric expertise in local disaster planning, age-linked strategies for pediatric
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From page 136... ...
This will only happen through concerted effort on the part of all public and private entities concerned with the health and well-being of the community as a whole -- including its corporate leaders, who depend on a healthy population for the continuity of businesses. While the approaches noted above provide useful information about what has succeeded in the recent past, it is interesting to cite the uncanny parallels between disaster planning efforts and time-tested injury prevention strategies first advocated by William Haddon, founding administrator of the National Highway Traffic Safety Administration, known universally within the public health sector as the Haddon Factor-Phase Matrix.25 This approach to injury prevention and control relies on identification of factors that impact on the host, agent, and environment, before, during, and after the traumatic event, and seeks to modify these factors through individually crafted strategies involving education, engineering, enforcement, and economics, to reduce the burden of preventable injury -- strategies such as widespread adoption and insistence on use of seat belts and shoulder harnesses that have substantially reduced the unacceptably high burden of highway traffic fatalities in the United States since this approach was first proposed in the early 1970s, and that are most successful when applied by comprehensive in
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From page 137... ...
activate local public health and healthcare systems to effectively manage intercurrent or recurrent injuries and illnesses using surviving or restored community-based resources. While it has become fashionable for many disaster experts to ask why it seems we are incapable of learning from the mistakes made in past disaster events, the answer lies in the very nature of the disaster event -- the word "disaster" itself being derived from the Latin words for "evil" and "star" -- for falling stars are seldom seen, and even when seen, vanish from view almost immediately.
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From page 138... ...
Without such a structured system, reliable information on the fate of special populations during disasters will continue to be hard to come by. One clear-cut example exists in the methods that have been used to estimate true case fatality rates in the adult population following Hurricane Katrina: review of death notices from local newspaper obituaries.27 However, due to the potential underreporting of such death notices among children, it has been difficult to adopt the same methodology for children.28 In the opinion of the author, therefore, only minimal datapoints, collected in real time as part of a nationwide disaster registry, are likely to solve the problem, and thus should become a key requirement of the Hospital Preparedness Program of the Office of the Assistant Secretary for Preparedness and Response of the Department of Health and Human Services.
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From page 139... ...
3. Health Resources and Services Administration.
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Disaster Med Public Health Prepared ness 2:S51–S57.
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From page 141... ...
2008. Surge Capacity Planning for Public Health Emergency Events: Examining the Dis tribution of Pediatric Resources in Relation to Pediatric Population Density in New York City.
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