Fire disaster following LPG tanker explosion at Chala in Kannur (Kerala,India): August 27, 2012

A fire disaster following LPG tanker explosion occurred at Chala bypass, Kannur, Kerala, India on August 27, 2012. The three chambered tanker with total 16 tonnes (162.57 quintal) LPG collided with a road divider and exploded thrice. A total of 41 people became victims during first blast; out of which 20 died in various hospitals. Five people remained inside the house after first blast and escaped unhurt from the zone of accident before second blast. All the victims were transferred to various hospitals; of these, six were transferred to the burns unit of the Kasturba Hospital, Manipal (320 km from Chala). Five (5/6) were transferred within 1–5 days at our burns unit suffered 31–72% total body surface area (TBSA) burn, none had external injuries. One (1/6) was transferred on 20th day as a follow up case of 15% TBSA burn with 4% residual raw area and diabetes mellitus. Except one, all were managed conservatively using Limited access dressings (LAD; Negative Pressure Wound Therapy). One of the patient wound bed prepared under LAD and on 41 post burn day underwent split skin grafting under LAD. Out of the six patients admitted at the burns unit, two (2/6) admitted patients expired (one due to inhalation injury and another due to sepsis with multiple organ failure). One survivor (1/4) developed sepsis related liver dysfunction with hepatomegaly but recovered well. The total hospital stay of survivors at the burns unit varied from 8 to 60 days (mean hospital stay 36.5 days). All the victims who developed psychological symptoms were treated by psychiatrists and counselled before discharge. Three of survivors developed psychological symptoms. Two of them (2/3) developed mixed anxiety-depression disorder (ICD 10 code F41.8) and one of these two showed grief reaction too (ICD 10 code F43.23). One victim (1/3) developed non-organic insomnia (ICD 10 code F51.0) and responded to counselling. The article describes the incident, mechanism of the incident, injuries sustained, author, explanations on pattern of burn and suggestions in relation to future safety measures.     

巴基斯坦洪灾国际医疗救援中疾病分类存在的问题和对策

【目的】探讨巴基斯坦洪灾后期医疗救援中疾病分类存在的问题和解决方法。【方法】回顾性分析2010年9月15日-10月3日在巴基斯坦特达市实施医疗救援期间,洪灾后期疾病谱的变化规律,探讨洪灾后期疾病分类中存在问题和对策。【结果】洪灾后期疾病谱以当地常见病、多发病为主,不同于灾害早期和中期。目前缺乏适合灾害后期的疾病分类方法。我们设计了这种灾害疾病的系统分类方法,该方法按照人体解剖系统录入疾病信息,普遍适用于灾害后期的疾病特点,易于救援现场记录疾病信息和后期疾病数据的统计分析。【结论】灾害疾病的系统分类方法可兼顾平时疾病和灾害疾病的发病特点,是一种适用于灾害医疗救援的疾病分类方法。     

灾害护理相关知识技能掌握、培训现状及学习需求调查分析

目的了解临床一线护理人员对灾害护理基本知识和技能掌握情况、培训现状及学习需求,探讨提高我国灾害护理整体水平的对策。方法采取在护理学术会议发放问卷和在部分医院各病区随机发放问卷的方式,对河南省22所三级甲等、二级甲等和一级医院涉及22个专业共104名护士进行“灾害护理相关知识技能掌握、培训现状及学习需求”的问卷调查。结果被调查的104人中有10人（9．6％）在5．12汶川地震前对灾害护理有所了解;29人（27．9％）通过教科书了解灾害护理;测试中不及格人数达72人（69．2％）,平均成绩52．94分;82人（78．8％）未经过灾害护理相关知识、技能培训;103人（99．0％）认为护士有必要进行灾害护理相关知识、技能培训。结论护理人员对灾害护理认识不足,灾害护理相关知识技能掌握欠缺,灾害护理教育缺失,护理人员对灾害相关知识技能学习需求迫切。     

汶川特大地震后双流县临时安置点灾区受灾群众心理卫生状况调查

[目的]了解地震后灾区群众的心理卫生状况,为开展其他危机事件及突发公共事件心理援助工作提供依据。[方法]2008年5月16~30日,对双流县黄龙溪临时安置点内128名来自地震灾区的群众开展心理卫生状况调查。[结果]调查128人,心理卫生状况良好的占36.72%,有轻度心理问题的占33.69%,有中度心理问题的占24.22%,有严重心理问题的占5.47%。存在心理问题者所占比例,男性为55.74%,女性为70.15%(P0.05);4~18岁、19~30岁、31~60岁、61~84岁的分别为53.33%、45.45%、73.85%、54.55%(P0.05),其中31~60岁高于其他年龄人群(52.38%)(P0.05);有亲属丧失者为90.53%,无亲属丧失者为54.17%(P0.01)。[结论]地震后灾区群众多数存在心理问题,青壮年和有亲属丧失者尤为严重。     

Disaster preparedness in healthcare professionals amid COVID-19 and beyond: A systematic review of randomized controlled trials

BackgroundDisasters like COVID-19 are oftentimes inevitable, which makes disaster preparedness indispensable to global health and social stability. However, there is a dearth of understanding of how well healthcare professionals, who often have to work at the epicenter of disasters as they evolve, are trained to be sufficiently prepared for these crises. To this end, this study aims to examine the characteristics and effectiveness of existing interventions that aim to improve healthcare professionals’ disaster preparedness.MethodsWe searched RCTs that aim to improve healthcare professionals’ disaster preparedness in databases including PubMed, PsycINFO, CINAHL and Scopus. Results were screened against the eligibility criteria. The review was registered with PROSPERO (CRD42020192517) and conducted following the PRISMA guidelines.ResultsA total of 7382 articles were screened for eligibility, among which, 27 RCTs, incorporating 35,145, met the inclusion criteria. Review results show that most of the eligible RCTs were conducted in high-income countries. Only two RCTs were developed in disaster contexts that share similarities with COVID-19. Most of the interventions did not address critical disaster coping abilities, such as how can healthcare professionals protect or improve their personal or the general public’s mental health amid pandemics. Furthermore, almost half of the disaster preparedness RCTs failed to generate statistically significant outcomes.ConclusionsAlbeit inevitable, disasters are preventable. Our study results underscore the imperative of designing and developing effective and comprehensive interventions that could boost healthcare professionals’ disaster preparedness, so that these frontline workers can better protect personal and public health amid global crises like COVID-19.     

Preparing for a burn disaster in Brazil: Geospatial modelling to inform a coordinated response

IntroductionTo optimize the early care of burned patients, protocols were developed that guide pre-hospital care and the need to transfer to a specialized burn treatment unit. Burn disasters are an important public health concern in developed and developing nations. Among the early steps in disaster preparedness is the understanding of geographic locations and capacity of burn care facilities. We aimed to map and classify medical facilities that provide burn care in Brazil and to undertake a location-allocation analysis to identify which could be targeted to increase capacity.MethodsA review of burn hospitalizations was conducted using Brazilian Ministry of Health data. Capacity was defined by number of burn patients admitted each year and bed type. Spatial population data per one-square kilometer were obtained from World Pop as a raster dataset. A road network dataset using Open Street Map data was created to conduct the drive time analysis. Location/allocation analysis was conducted to identify the proportion of Brazil’s population living within 2- and 6-hours’ drive time of a burn care capable hospital, stratified by the level of hospital capacity. Hospitals were ranked according to number of additional people served.ResultsWe found 26.471 burn admissions. Of these, 3.508(13,2 %) were ICU admissions. A total of 735(2,7 %) hospital deaths occurred under the selected burn codes. In all, 1.273 facilities admitted burn patients, and 263(20,7 %) reported ICU admissions of burn patients. Seventeen hospitals were classified as maximum capacity facilities. Additional 23 hospitals were identified as potential targets for capacity building. Most maximum capacity hospitals are clustered in the Southeast of Brazil. Currently, 40.8 % of the Brazilian population live within 2 h of a maximum capacity facility. A large part of the population lives farther than 6 h away from a maximum capacity hospital. Most of the potential targets for capacity building are located near the coast of Brazil.DiscussionWe mapped and classified facilities that provide public burn care in Brazil. We identified public facilities that could be targeted to increase capacity to improve access for patients in the event of a burn disaster. Mapping, planning, and coordinating response is key for optimal outcomes in Mass Casualties Incidents. Cataloging and understanding local resources is a crucial first step in disaster management. Inequality in profiles can determine specific regional needs. Specialized burn centers are rare in regions other than the southeast. Health equity should be considered when planning disaster preparedness initiatives. Location-allocation modelling may assist in universal and equitable burn care service offerings.ConclusionThis study proposes an initial step in the classification and mapping of available burn treatment centers and population coverage in Brazil.     

手术室护理人员灾害应急能力培训大纲的构建及效果评价

【摘要】目的 构建手术室护理人员灾害应急能力培训大纲，提高手术室护理人员的灾害应急能力。方法 我院手术室组建灾害应急培训专项小组，结合对国家紧急医学救援队（四川队）在玉树地震、芦山地震及尼泊尔地震中所开展的救护内容、救治伤员的伤情及实施手术的类型进行分析，初步拟定手术室护理人员灾害应急能力培训大纲框架，经过两轮德尔菲专家咨询并结合咨询结果确定培训大纲的项目、内容、方式与学时，最终确立了手术室护理人员灾害应急能力培训大纲。结果 以手术室护理人员灾害应急需具备的知识、技能、能力、特质为框架，构建的培训大纲涵盖8个培训项目共 27项具体内容，确定了相应的培训学时和授课方式,并将此大纲运用于实践培训中，培训效果显著。 结论 基于灾害救援实践经验之上所构建的培训大纲，专家积极系数和权威程度较高，咨询结果可靠，为规范手术室护理人员灾害应急能力培训提供了科学依据。