讲义参考医学丛书oxford american handbook of disaster medicine

1、Oxford American Handbook ofDisaster MedicineAbout the Oxford American Handbooks in MedicineThe Oxford American Handbooks are pocket clinical books, providing practical guidance in quick reference, note form. Titles cover major medical specialties or cross-specialty topics and are aimed at s, residen

2、ts, internists, family physi- cians, and practicing physicians within specic disciplines.Their reputation is built on including the best clinical information, com- plemented by hints, tips, and advice from the authors. Each one is carefully reviewed by senior subject experts, residents, and s to ens

3、ure that con- tent reects the reality of day-to-day medical practice.Key series features Written in short chunks, each topic is covered in a concise format to enableers to nd information quickly. They are also perfect for test preparation and gaining a quick overview of a subject without scanning th

4、rough unnecessary pages. Content is evidence based and complemented by the expertise and judgment of experienced authors. The Handbooks provide a humanistic approach to medicinethey are more than just treatment by numbers. A “friend in your pocket,” the Handbooks offer honest, reliable guidance abou

5、t the difculties of practicing medicine and provide coverage of both the practice and art of medicine. For quick reference, useful “everyday” information is included on the inside covers.Published and ForthcoOxford American Handbook of Clinical MedicineOxford American Handbook of AnesthesiologyOxfor

6、d American Handbook of CardiologyOxford American Handbook of Clinical DentistryOxford American Handbook ofOxford American HandbooksOxford American Handbook of Nephrology and HypertensionOxford American Handbook of NeurologyOxford American Handbook of Obstetrics and Gynecology Oxford American Handboo

7、k ofOncologyOxford American Handbook ofClinical DiagnosisOphthalmologyOxford American Handbook of OtolaryngologyOxford American Handbook of PediatricsOxford American Handbook of Physical Medicine andabilitationOxford American Handbook of PsychiatryOxford American Handbook of Pulmonary MedicineOxford

8、 American Handbook of Reproductive MedicineOxford American Handbook of RheumatologyOxford American Handbook of Sports MedicineOxford American Handbook of SurgeryOxford American Handbook of UrologyOxford American Handbook of Clinical Examination and Practical SkillsOxford American Handbook of Clinica

9、l PharmacyOxford American Handbook of Critical CareOxford American Handbook of Disaster MedicineOxford American Handbook of Endocrinology and DiabetesOxford American Handbook of Emergency MedicineOxford American Handbook of Gastroenterology and HepatologyOxford American Handbook of Geriatric Medicin

10、eOxford American Handbook of Hospice and Palliative MedicineOxford American Handbook of Infectious DiseasesOxford American Handbook ofDisaster MedicineEdited byRobert A. Partridge, MD, MPH, FACEPDepartment of Emergency Medicine, Emerson HospitalConcord, Massachusetts andDepartment of Emergency Medic

11、ine, Rhode Island HospitalAdjunsociate Professor of Emergency MedicineWarren Alpert Medical School of Brown UniversityProvidence, Rhode IslandLawrence Proano, MD, DTMH, FACEPDepartment of Emergency Medicine, Rhode Island HospitalClinical Associate Professor of Emergency MedicineWarren Alpert Medical

12、 School of Brown UniversityProvidence, Rhode IslandDavid Marcozzi, MD, MHS-CL, FACEPOfce of the Assistant Secretary of Preparedness and ResponseDepartment of Health and Human ServicesWashington, DCWithAlexander G. Garza, MD, MPHDirector of Military Programs, Department of Emergency MedicineWashingto

13、n Hospital Center Georgetown University School ofMedicine Washington, DCIra Nemeth, MD, FACEPAssistant Professor and Director of EMS and Disaster MedicineSection of Emergency Medicine, Department of MedicineBaylor College of Medicine Houston, TexasKathryn Brinseld, MDDepartment of Homeland Security

14、Washington, DC andAssociate Professor of Emergency Medicine, Boston UniversityAssociate Medical Director, Boston EMSBoston, MassachusettsEric S. Weinstein, MDAttending Physician, Carolinas Hospital SystemEmergency Department Florence, South Carolina13Oxford University Press, Inc. publishes works tha

15、t further Oxford Universitys objective of excellencein research, scholarship and education.Oxford New YorkAuckland Cape Town Dar es SalaamKarachiKuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei TorontoWith ofces inArgentina Austria Brazil Chile Czech Republic France Greece

16、 Guatemala Hungary Italy Japan Poland PortugalSingapore South Korea Switzerland Thailand Turkey Ukraine VietnamCopyright © 2012 by Oxford University Press, Inc.Published by Oxford University Press Inc.198 Madison Avenue, New York, New York 10016Oxford is a registered trademark of Oxford Univers

17、ity PressNo part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise,without the prior permission of Oxford University Press.Materials appearing in this book prepared by United

18、 States government employees were not prepared in the individuals ofcial capacity asU.S. government employees. Therefore, any views expressed therein do not represent the views of the United States government and such individuals participation in the Work is not meant to serve as an ofcial endorseme

19、nt by the United States government. Dr. Kathryn Brinseld was not an employee of the US government while serving as co-editor of this book.Library of Congress Cataloging in Publication DataOxford American handbook of disaster medicine / edited by Robert A. Partridge. et al.p. ; cm. (Oxford American h

20、andbooks in medicine) Handbook of disaster medicineIncludes bibliographical references and index. ISBN 9780195379068I. Partridge, Robert A. II. Title: Handbook of disaster medicine. III. Series: Oxford American handbooks.DNLM: 1. Disaster PlanningHandbooks. 2. Disaster MedicineHandbooks. WA 39 363.3

21、48dc23201103972410 9 8 7 6 5 4 3 2 1Printedon acid-paperThis material is not intended to be, and should not be considered, a sub- stitute for medical or other professional advice. Treatment for the con- ditions described in this material is highly dependent on the individual circumstances. Although

22、this material is designed to offer accurate infor- mation with respect to the subject matter covered and to be current as of the time it was written, research and knowledge about medical and health issues is constantly evolving, and dose schedules for medications are beingrevised continually, with n

23、ew side effects recognized anded forregularly.ers must, therefore, always check the product informa-tion and clinical procedures with the most up-to-date published prod- uct information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulation. Oxford U

24、niversity Press and the authors make no representations or warr es to ers, express or implied, about the accuracy or completeness of this material, including without limitation that they make no representation or warran- ties about the accuracy or efcacy of the drug dosages mentioned in the material

25、. The authors and the publishers do not accept, and expressly disclaim, any responsibility for any liability, loss, or risk that may be claimed or incurred as a consequence of the use and/or application of any of the contents of this material.This page intentionally left blankDedicated to my parents

26、, Raymond and Alison, and my beloved wife and children, Karen, Rachel, Sarah, and Alexander. You have all given me endless support, encouragement, and love.Robert PartridgeThis book is dedicated to the mentors who have been role ms in myprofessional career, and to all those who selessly respond to h

27、elp otherswhen disaster strikes.Lawrence ProanoTo those who have helped me along the waymy wife, my parents, my brother and sister, Dr. Robert Kadlec, Dr. Kevin Yeskey, Mrs. Heidi Avery, Mr. Richard Reed, Dr. Kathleen Clem, Dr. Michael Hocker, Dr. Selim Suner, and all my colleagues and friendsI dedi

28、cate this text to your love,mentorship, and unwavering support.David MarcozziThis page intentionally left blankixForewordWith the incidence of natural and intentional disastersand the number of people affected by such eventson the increase, the importance of disasters as a public-health problem has

29、captured the attention of the world. This situation represents an unprecedented challenge to the medi- cal and public-health commu . Ten years have now passed since the catastrophic events of September 11, 2001. Since then, periodic reviews of the medical and public-health impact of disasters have a

30、ppeared in a number of publications, with updates on the “state of the art” of disaster science. As a result, a considerable body of knowledge and experience related to the adverse health effects of disasters is now accumulating that requires regular updating so that we can apply the lessons learned

31、 during one disaster to the management of the next. These historical lessons will not be implemented, however, unless they are supported by adequate preparedness planning, coordination, communications, logistics, nel management, and training of physicians and other health-care providers.By blending

32、the comp ensiveness of a weighty full-length text with the convenience of a eld guide, the Oxford American Handbook of Disaster Medicine skilfully addresses these challenges and more. With years of experience, editors Robert Partridge and Lawrence Proano, along with a distinguished list of co-author

33、s, give the er ample technical descrip- tions of each kind of disaster, pertinent summaries of previous disasters, and copious information useful for health-care providers in the eld, the classroom, or the ward. Unique chapters address topics such as the politi- cal and ethical issues in disaster re

34、sponse; urban versus rural approaches; effective media relations; interfaces between disaster medicine and mili- tary, operational, and wilderness medicine; and the evolving priorities of the Department of Homeland Security (example, the NRP and an NIMS). In view of recent catastrophic events and ne

35、wly recognized threats, spe- cic elements such as tsunamis and pandemic inuenza that are usually included as part of other chapters (for example, earthquakes and com- municable diseases) are now covered in their own chapters. Deserving of special attention are crosscutting chapters in the handbook t

36、hat integrate information across hazards, such as communications, lessons learned, exercises and drills, and disaster informatics.In addition, while always emphasizing the use of proven and evidence- based medical methods and practices, Drs. Partridge and Proano challenge health professionals with q

37、uestions that must still be answered for them to respond effectively in emergency situations. Approached from a real- world perspective, designed and written by clinical and public-health pro- viders with disaster experience, this handbook provides realistic, hands-on experiences that challenge the

38、er to apply information provided in every chapter. The inclusion of “key messages” and “essential concepts” that introduce each chapter, plus practical information such as protocols, clinical tools, and unique case studies, has resulted in the creation of a major resource that will serve as a timely

39、 and comp ensive text forx FOREWORDhealth providers. It will be an important resource in the education of hos- pital, commu, state, and national health and emergency managers, aswell as medicals and residents who will assume mass emergencypreparedness responsibilities soon, if not immediately after

40、graduation.All disasters are unique because each affected commuhas differ-ent social, economic, cultural, and baseline health conditions. The Oxford American Handbook of Disaster Medicine will serve as the most up-to-dateeld manual and course textbook available not only for medical profes- sionals r

41、esponsible for preparing their hospitals to respond effectively to disasters, pandemics, and other public health crises, but also for emer- gency managers and other decision makers charged with ensuring that disasters are well managed.Eric K. Noji, MD Washington, DCxiPrefaceDisasters happenanywhere,

42、 anytime, and frequently. In the United States, in response to numerous recent man- and natural catastro- phes, disaster preparation efforts have become widesp . Over time, they have also become more complex and broader in scope.Added layers of complexity make it more difcult to stay on top of best

43、practices, but it is essential to do so. The public expects a rapid, well-coordinated and effective response when disaster strikes. The media will cover the disaster and the response with extensive and analysis. After a disaster, recovery and mitigation of future disasters are critical ele- ments of

44、 the disaster cycle that will be an ongoing challenge for disaster planners and providers.Preparation for disasters has occurred at the federal, state, and regional levels, with active involvement of health professionals, law enforcement, rescue and recovery nel, and relief organizations, as well as

45、 ordi- nary citizens. However, even with the most careful preparation and plan- ning, a disaster will overwhelm all standard resources. Responders have an opportu to save lives, limit damage and maintain public condence by doing their jobs well. To manage a disaster effectively, health practitioners

46、 must be y to think on the y, make rapid and unfamiliar decisions and know where to obtain key knowledge and resources.This handbook is intended to be one such resource. It can be pulled out of a pocket, off a desktop, or out of the glove compartment of a rescue vehicle, to provide immediate, access

47、ible information on a wide range of topics. By covering critical areas of disaster preparation, planning, and response for the types of disasters that are most likely to occur in the United States and around the world, this book gives health-care respond- ers a rst-line tool for ensuring their own p

48、reparedness. It is designed to assist involved health practitioners on any aspect of disaster management at any point along the disaster timeline.Although this handbook is thorough, it is not compensive.ersare encouraged to consult other texts, peer-reviewed literature, web sites and suggested ings

49、at the end of each chapter for additional informa- tion and . It is our hope that this handbook will be an essential part of a larger library of information to help health practitioners limit the impact of disasters through effective preparation and response.Robert Partridge Lawrence ProanoThis page

50、 intentionally left blankxiiiAcknowledgmentsThe authors are grateful for the efforts of many people who worked very hard to make this book possible. Foremost, we would like to thank all of our co-authors. The depth and quality of this book are a testament to their dedication and interest in the stud

51、y of disaster medicine.Thanks also go out to our co-editors, David Marcozzi, Alex Garza, Kathy Brinseld, Ira Nemeth, and Eric Weinstein, whose vision guided the development of this project.In addition, we are indebted to the team at Oxford University Press, particularly Andrea Seils and Staci Hou, w

52、ho have worked diligently to bring this book to fruition.Finally, we would like to acknowledge disaster responders everywhere, whom we all rely on but often dont have the opportu to thank. Their work has not only informed and inspired us but also left us better pre- pared to respond to the next disa

53、ster.Robert Partridge Lawrence ProanoThis page intentionally left blankxvContentsContributors xxiPart 1: Introduction123The disaster cycle: an overview4567Part 2: General ConceptsComponents of Disaster Response8910111213141516Hospital Components of Disaster Response1718Hospital administration disast

54、er response131Hospitalllary services disaster response141Local-level disaster response53State-level disaster response62Federal disaster response69Military disaster response74Emergency management in disasters85Emergency medical services92Public health in disasters103International disaster response112

55、Complex humanitarian emergencies118of disaster phases20Mitigation phase of disasters25Preparedness phase of disaster33Response phase of disaster39Recovery phase of disasters43Denition of a disaster3All-hazards approach10xvi CONTENTS1920Hospital medical staff disaster response146Hospital nursing disa

56、ster response 152Part 3: Pre-disaster ConsiderationsDisaster length: an overview212223242526 163Short-term events 170Long-term events 174Extended events 179Hazard vulnerability analysis 182Drills and evaluation 191Part 4: Fundamental Principles of Disaster ManagementCommunications27282930313233343536373839 201Decontamination 211Evacuation 227Force health238251Incidentd