Abstracts

CARING FOR VICTIMS OF NUCLEAR ANDRADIOLOGIC TERRORISM

A literature review is used to describe the clinical care ofpatients exposed to radiation. The authors describe emer-gency care, important considerations for handling poten-tially radioactive laboratory specimens, and clinical find-ings associated with exposure from blast zone and indirectblast zone areas. The signs and symptoms for each phaseof acute radiation syndrome are discussed. The authorsprovide an acute radiation syndrome treatment algorithmto help practitioners with the assessment, treatment, andisolation process. Adult, pediatric, and geriatric variationsare provided.

(Skorga P, Persell DJ, Arangie P, Gilbert-Palmer D, Win-ters R, Stokes EN, Young C. Caring for victims of nuclearand radiological terrorism. Nurse Practitioner 2003;28:24,26,32-34,37-38,41.)

IMPLICATIONS OF HOSPITAL EVACUATIONAFTER THE NORTHRIDGE, CALIFORNIA,EARTHQUAKE

A retrospective analysis was done of all acute carehospitals in Los Angeles County that reported having evac-uated patients after the Northridge earthquake in 1994.Investigators gave questionnaires to physicians, nurses,hospital administrators, and other staff who were on dutyat the time the hospitals were evacuated. Each hospital hada designated interview team, and each question was posedto 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 thehospitals evacuated immediately (by the end of the firstday), and 2 reported delayed evacuation (3 and 14 daysafter the earthquake). There were varying reasons for evac-uation. Of the 6 that evacuated immediately, 5 reported theevacuation resulted from extensive water damage and 3hospitals also had lost power. The 2 delayed evacuationhospitals were found to have significant structural damage,which was not immediately identified. Patients weremoved with available equipment, usually carried downstairs, and staff members were used to accompany patientswho were transferred to other facilities. The county’s emer-gency operations center was not used by all hospitals toassist with transfers.

The authors concluded that even moderate earthquakescan produce structural damage that will create a “hospital-

as-victim” scenario. The degree of structural damage maynot be immediately apparent, and the inspection processmay need revision. Water damage and loss of electricalpower posed significant problems for facilities. In a crisis,facilities used whatever staff, means, and vehicles availableand did not use the emergency operations center to man-age all transports. The authors make recommendations forfuture planning that include dealing with large increases inpatient volume (surge capacity) and developing backupsystems to provide acute care in alternative sites.

(Schultz CH, Koenig KL, Lewis RJ. Implications of hos-pital evacuation after the Northridge, California, Earth-quake. N Engl J Med 2003;348:1349-55.)

THE ROLE OF PASTORAL CRISISINTERVENTION IN DISASTERS, TERRORISM,VIOLENCE, AND OTHER COMMUNITY CRISES

The role for pastoral crisis intervention during a disasteror crisis event is presented. The author defines the type ofservice provided and distinguishes this form of psycho-logic service from counseling services and crisis interven-tion. Because a number of individuals may seek pastoralcounseling during a community-wide crisis, this model ofcare could be integrated into community mental healthresources. Pastoral crisis intervention differs from pastoralcounseling and may provide another resource during atime of high demand for services. The author acknowl-edges that pastoral crisis intervention may have a numberof potential problems if not used at the appropriate timeand place and with appropriate individuals.

(Everly GS. The role of pastoral crisis intervention indisasters, terrorism, violence, and other community crises.Int J Emerg Mental Health 2000;2:139-42.)

GENERIC EVALUATION METHODS FORDISASTER DRILLS IN DEVELOPING COUNTRIES

Disaster drills are considered to be an essential compo-nent to local disaster response training and planning. Theauthors note that drills can vary from small, tabletop exer-cises to large, multiagency regional activities; however,there generally are no accepted methods for evaluating themedical response during a simulated disaster.

A project was undertaken to create a standardizedmethod to evaluate the performance of medical providersand organizations in a simulated disaster. The goals of theproject were to develop a standardized method to supplydata that would provide insight into performance, creategeneric evaluation methods and instruments, and prospec-tively test the methods. The process used to identify datacollection needs, performance data, data collection instru-ments, and a system to collect data is described.

The investigators had the opportunity to pilot the pro-

Disaster Manage Response 2003;93-4.

Copyright � 2003 by the Emergency Nurses Association.

1540-2487/2003/$30.00 � 0

doi:10.1016/S1540-2487(03)00052-X

July-September 2003 Disaster Management & Response/Abstracts 93