The Israeli Field Hospital in Haiti — Ethical Dilemmas in Early Disaster Response

Merin, Ofer; Ash, Nachman; Levy, Gad; Schwaber, Mitchell J.; Kreiss, Yitshak

doi:10.1056/nejmp1001693

Cited by 152 publications

(77 citation statements)

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“…After mass disasters, the number of casualties is overwhelming and health care possibilities are limited, necessitating triage with focus on patients in whom life-saving therapy is possible (9). In previous mass disasters, crush victims have been ignored because of lack of availability of dialysis (10). However, energetic fluid administration prevents crush syndrome.…”

Section: Introductionmentioning

confidence: 99%

Management of Crush Victims in Mass Disasters

Sever

Vanholder

2013

Clinical Journal of the American Society of Nephrology

156

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SummaryCrush syndrome is the second most common cause of death after earthquakes (the first most common is direct trauma). Many logistic problems with the treatment of patients with crush syndrome are due to chaotic disaster circumstances; consequently, medical and logistic recommendations on the treatment of crush victims are needed. In a joint initiative of the Renal Disaster Relief Task Force of the International Society of Nephrology and European Renal Best Practice, a work group of nephrologists, intensivists, surgeons, and logisticians with disaster experience or experts in guideline preparation collaborated to provide comprehensive information and recommendations on the management of crush casualties considering their occurrence with "epidemic" dimensions after mass disasters. The result is the monograph "Recommendations for the Management of Crush Victims in Mass Disasters", which may help provide effective health care to disaster victims with renal problems. This article discusses medical and logistic principles of the treatment of crush victims, both at the disaster field and on admission to hospitals, and guidance is described. The importance of early fluid administration even before extrication of the victims and avoidance of potassium-containing solutions during the treatment of crush victims is underlined. Also, the logistic problems in treating crush casualties are emphasized. The most important aspects of the recently published recommendations are highlighted.

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Section: Introductionmentioning

confidence: 99%

Management of Crush Victims in Mass Disasters

Sever

Vanholder

2013

Clinical Journal of the American Society of Nephrology

156

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“…16 Our findings may suggest that trauma-exposed hospital personnel need help processing the meaningful situation they have experienced. Toward this end, a brief debriefing by a colleague may be beneficial.…”

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confidence: 76%

Hospital Personnel Reactions to Haiti’s Earthquake

Ben–Ezra¹

2010

J. Clin. Psychiatry

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Haiti was struck by a magnitude 7.0 Mw earthquake.The results of the earthquake were severe, as about 230,000 people were killed and more than 300,000 were injured. 1 The Israeli aid delegation arrived in Haiti on January 15, 2010, and established an advanced field hospital. The aid delegation medical wing consisted of 40 physicians and 24 nurses. 2 During a 2-week period, they treated 1,110 patients, conducted 319 successful surgeries of various levels, and delivered 16 births. 3 The impact of large-scale natural disasters on hospital personnel is unknown. Most studies on hospital personnel have been conducted in the context of armed conflict, war, or terror. 4,5 Studies have shown that exposure to mutilated dead bodies of victims of violent death is a significant predictor of posttraumatic stress symptoms among rescue personnel. 6 Moreover, symptoms of posttraumatic stress disorder (PTSD) are also associated with functional decline among physicians. 7 The purpose of this preliminary study was to survey the reactions of hospital personnel to the sights in Haiti. On the basis of previous research, 5-7 we hypothesized that the hospital personnel who were in Haiti would report a higher level of posttraumatic stress symptoms, lower life satisfaction, lower perceived coping, and lower self-rated health in comparison to the matched group of hospital personnel who were not in Haiti.Method. The initial contact with the hospital personnel was made in Haiti; 75% (n = 48) gave their permission and consent to be interviewed after the aid mission to Haiti, while 25% (n = 16) refused without elaborating on their reasons. The initial contact with the remaining 75% (n = 48) was by phone, e-mail, and fax. Of

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“…In the case of the Haiti earthquake, the IDF Field Hospital deployed to Haiti within 3 days and treated a much greater proportion of earthquake victims than 1 CFH did. 11 The USNS Comfort, an American hospital ship, started receiving patients 7 days after the earthquake; many patients had severe trauma. 12 Our main surgical contribution was to treat neglected chronic conditions in an area where the medical infrastructure had been destroyed by the earthquake.…”

Section: Earthquake Responsementioning

confidence: 99%