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The role of pastoral crisis intervention in disasters, terrorism, violence, and other community crises
Abstracts CARING FOR VICTIMS OF NUCLEAR AND RADIOLOGIC TERRORISM A literature review is used to describe the clinical care of patients exposed to radiation. The authors describe emergency care, important considerations for handling potentially radioactive laboratory specimens, and clinical findings associated with exposure from blast zone and indirect blast zone areas. The signs and symptoms for each phase of acute radiation syndrome are discussed. The authors provide an acute radiation syndrome treatment algorithm to help practitioners with the assessment, treatment, and isolation process. Adult, pediatric, and geriatric variations are provided. (Skorga P, Persell DJ, Arangie P, Gilbert-Palmer D, Winters R, Stokes EN, Young C. Caring for victims of nuclear and radiological terrorism. Nurse Practitioner 2003;28: 24,26,32-34,37-38,41.)
IMPLICATIONS OF HOSPITAL EVACUATION AFTER THE NORTHRIDGE, CALIFORNIA, EARTHQUAKE A retrospective analysis was done of all acute care hospitals in Los Angeles County that reported having evacuated patients after the Northridge earthquake in 1994. Investigators gave questionnaires to physicians, nurses, hospital administrators, and other staff who were on duty at the time the hospitals were evacuated. Each hospital had a designated interview team, and each question was posed to an entire group of staff. Out of the 91 acute care hospitals in the county, 8 (9%) reported they had evacuated at least 1 inpatient. Six of the hospitals evacuated immediately (by the end of the first day), and 2 reported delayed evacuation (3 and 14 days after the earthquake). There were varying reasons for evacuation. Of the 6 that evacuated immediately, 5 reported the evacuation resulted from extensive water damage and 3 hospitals also had lost power. The 2 delayed evacuation hospitals were found to have significant structural damage, which was not immediately identified. Patients were moved with available equipment, usually carried down stairs, and staff members were used to accompany patients who were transferred to other facilities. The county’s emergency operations center was not used by all hospitals to assist with transfers. The authors concluded that even moderate earthquakes can produce structural damage that will create a “hospitalDisaster Manage Response 2003;93-4. Copyright 䊚 2003 by the Emergency Nurses Association. 1540-2487/2003/$30.00 ⫹ 0 doi:10.1016/S1540-2487(03)00052-X
July-September 2003
as-victim” scenario. The degree of structural damage may not be immediately apparent, and the inspection process may need revision. Water damage and loss of electrical power posed significant problems for facilities. In a crisis, facilities used whatever staff, means, and vehicles available and did not use the emergency operations center to manage all transports. The authors make recommendations for future planning that include dealing with large increases in patient volume (surge capacity) and developing backup systems to provide acute care in alternative sites. (Schultz CH, Koenig KL, Lewis RJ. Implications of hospital evacuation after the Northridge, California, Earthquake. N Engl J Med 2003;348:1349-55.)
THE ROLE OF PASTORAL CRISIS INTERVENTION IN DISASTERS, TERRORISM, VIOLENCE, AND OTHER COMMUNITY CRISES The role for pastoral crisis intervention during a disaster or crisis event is presented. The author defines the type of service provided and distinguishes this form of psychologic service from counseling services and crisis intervention. Because a number of individuals may seek pastoral counseling during a community-wide crisis, this model of care could be integrated into community mental health resources. Pastoral crisis intervention differs from pastoral counseling and may provide another resource during a time of high demand for services. The author acknowledges that pastoral crisis intervention may have a number of potential problems if not used at the appropriate time and place and with appropriate individuals. (Everly GS. The role of pastoral crisis intervention in disasters, terrorism, violence, and other community crises. Int J Emerg Mental Health 2000;2:139-42.)
GENERIC EVALUATION METHODS FOR DISASTER DRILLS IN DEVELOPING COUNTRIES Disaster drills are considered to be an essential component to local disaster response training and planning. The authors note that drills can vary from small, tabletop exercises to large, multiagency regional activities; however, there generally are no accepted methods for evaluating the medical response during a simulated disaster. A project was undertaken to create a standardized method to evaluate the performance of medical providers and organizations in a simulated disaster. The goals of the project were to develop a standardized method to supply data that would provide insight into performance, create generic evaluation methods and instruments, and prospectively test the methods. The process used to identify data collection needs, performance data, data collection instruments, and a system to collect data is described. The investigators had the opportunity to pilot the proDisaster Management & Response/Abstracts 93
IMPLICATIONS OF HOSPITAL EVACUATION AFTER THE NORTHRIDGE, CALIFORNIA, EARTHQUAKE A retrospective analysis was done of all acute care hospitals in Los Angeles County that reported having evacuated patients after the Northridge earthquake in 1994. Investigators gave questionnaires to physicians, nurses, hospital administrators, and other staff who were on duty at the time the hospitals were evacuated. Each hospital had a designated interview team, and each question was posed to an entire group of staff. Out of the 91 acute care hospitals in the county, 8 (9%) reported they had evacuated at least 1 inpatient. Six of the hospitals evacuated immediately (by the end of the first day), and 2 reported delayed evacuation (3 and 14 days after the earthquake). There were varying reasons for evacuation. Of the 6 that evacuated immediately, 5 reported the evacuation resulted from extensive water damage and 3 hospitals also had lost power. The 2 delayed evacuation hospitals were found to have significant structural damage, which was not immediately identified. Patients were moved with available equipment, usually carried down stairs, and staff members were used to accompany patients who were transferred to other facilities. The county’s emergency operations center was not used by all hospitals to assist with transfers. The authors concluded that even moderate earthquakes can produce structural damage that will create a “hospitalDisaster Manage Response 2003;93-4. Copyright 䊚 2003 by the Emergency Nurses Association. 1540-2487/2003/$30.00 ⫹ 0 doi:10.1016/S1540-2487(03)00052-X
July-September 2003
as-victim” scenario. The degree of structural damage may not be immediately apparent, and the inspection process may need revision. Water damage and loss of electrical power posed significant problems for facilities. In a crisis, facilities used whatever staff, means, and vehicles available and did not use the emergency operations center to manage all transports. The authors make recommendations for future planning that include dealing with large increases in patient volume (surge capacity) and developing backup systems to provide acute care in alternative sites. (Schultz CH, Koenig KL, Lewis RJ. Implications of hospital evacuation after the Northridge, California, Earthquake. N Engl J Med 2003;348:1349-55.)
THE ROLE OF PASTORAL CRISIS INTERVENTION IN DISASTERS, TERRORISM, VIOLENCE, AND OTHER COMMUNITY CRISES The role for pastoral crisis intervention during a disaster or crisis event is presented. The author defines the type of service provided and distinguishes this form of psychologic service from counseling services and crisis intervention. Because a number of individuals may seek pastoral counseling during a community-wide crisis, this model of care could be integrated into community mental health resources. Pastoral crisis intervention differs from pastoral counseling and may provide another resource during a time of high demand for services. The author acknowledges that pastoral crisis intervention may have a number of potential problems if not used at the appropriate time and place and with appropriate individuals. (Everly GS. The role of pastoral crisis intervention in disasters, terrorism, violence, and other community crises. Int J Emerg Mental Health 2000;2:139-42.)
GENERIC EVALUATION METHODS FOR DISASTER DRILLS IN DEVELOPING COUNTRIES Disaster drills are considered to be an essential component to local disaster response training and planning. The authors note that drills can vary from small, tabletop exercises to large, multiagency regional activities; however, there generally are no accepted methods for evaluating the medical response during a simulated disaster. A project was undertaken to create a standardized method to evaluate the performance of medical providers and organizations in a simulated disaster. The goals of the project were to develop a standardized method to supply data that would provide insight into performance, create generic evaluation methods and instruments, and prospectively test the methods. The process used to identify data collection needs, performance data, data collection instruments, and a system to collect data is described. The investigators had the opportunity to pilot the proDisaster Management & Response/Abstracts 93