From the Introduction:"Look around," the drill sergeant said. "In a few years, or even a few months, several of you will be dead. Some of you will be severely wounded or so badly mutilated that your own mother can't stand the sight of you. And for the real unlucky ones, you will come home so emotionally disfigured that you wish you had died over there." It was Week 7 of Basic Training . . . 18 years old and I was preparing myself to die. They say the Army makes a man out of you - but for 18-year-old SPC Michael Anthony, that fabled rite of passage proved a very dark journey. After soliciting his parents’ approval to enlist at only 17, Anthony began his journey with an unshakeable faith in the military born of his family's long tradition of service. But when thrust into a medical unit of misfits as lost as he was, SPC Anthony not only witnessed the unspeakable horror of war—but the undeniable misconduct of the military—firsthand. Everything he ever believed in dissolved, forcing Anthony to rethink his loyalties, and ultimately risk his career—and his freedom—to challenge the military he had so firmly believed in. This searing memoir chronicles the iconic experiences that changed one young soldier forever. A seasoned veteran before the age of twenty-one, he faced the truth about the war - and himself - in this shocking and unprecedented eyewitness account.
Problems contacting emergency services and delayed assistance are not unusual when incidents occur in rural areas, and the consequences can be devastating, particularly with mass casualty incidents. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop to examine the current capabilities of emergency response systems and the future opportunities to improve mass casualty response in rural communities.
Mass Fatality and Casualty Incidents: A Field Guide presents in checklist form the recommended responses to events that result in mass fatalities, such as the Oklahoma City bombing, the crash of a jet airliner, or the attack on the World Trade Center. All cities in the United States will have to have a mass fatality disaster plan in effect by the end of 1999. Mr. Jensen is a leading authority in this area and provides training for police, fire and hospital personnel (including EMTs and social workers), local, state, federal and international emergency planners and responders. This book details actions that are part of a mass fatality incident response. Specifically, they are the actions that begin once life and property preservation ceases and continues through to the release of the deceased. Thus, primary focus is on search, recovery, medicolegal investigation, personal effects operations, family assistance operations, and media operations. Ancillary steps include logistics support, security, responder protection, attitudes and coping with mass death.
Jane's Mass Casualty Handbook: Hospital is designed for physicians, nurses and other hospital-based personnel responding to mass casualty incidents, particularly chemical, biological, radiological, nuclear or explosive incidents. The Handbook provides focused guidance in developing emergency management capabilities, including an effective and robust Emergency Operations Plan (EOP). The procedures and policies recommended are practical, cost-effective, sustainable and applicable for all hazards and day-to-day operations. Background information, general guidelines and system requirements allow each healthcare facility to make use of the material according to their specific needs, while building on existing standards and procedures such as HEICS and JCAHO. The Handbook also provides principles and checklists aimed at enhancing preparedness, whilst adhering to a 'system approach' by offering helpful hints to encourage management, doctors and other hospital staff to work together.
This book provides a systemic approach to acute trauma care in line with the ABCDE paradigm and up-to-date information on assessing and managing major trauma from the pre-hospital to the rehabilitation phase. The book's early sections are dedicated to identifying and managing pathology caused by massive haemorrhage, airway, breathing, circulation or neurological trauma and examining the current evidence base relating to their management. The book then builds from fundamental skills to advanced interventions so that each level of responder can identify and implement aspects of clinical practice that will be of benefit to them at their stage. This approach also explains advanced interventions that may be executed subsequently, explaining how each phase of care sits together. This has a further benefit of producing seamless care for patients by practitioners of different levels using this book as a reference point. Later sections deal with specifics of in-hospital trauma care by speciality, including the explanation of decision making processes by specialities, use of diagnostic and interventional radiology, rehabilitation and psychological aspects of trauma care. The Textbook of Acute Trauma Care also focuses on non-clinical issues relevant to trauma such as training and logistics of retrieval and repatriation, aviation considerations in HEMS, legal and forensic evidence considerations and ethical issues dealing with trauma patients. In addition, the book contains chapters from international experts on cognitive and human factors relating to healthcare and suggests strategies for training and minimising errors. This book is an essential resource for all grades of practitioner, from first responders to Consultant/Attending Physician level providers.
This book is the first to address specifically the mechanisms and treatment of orthopedic injuries due to natural disasters and other mass casualty events. Casualty management is discussed in a range of contexts, from earthquakes and tsunamis to terror attacks and combat situations. Organizational aspects are addressed, general treatment principles are documented, and the management of a variety of orthopedic injuries is described with the aid of numerous illustrations. The book will serve as an invaluable source of practical knowledge for a broad spectrum of medical and other staff, including emergency personnel, orthopedic and trauma surgeons, general practitioners, medical students, and professionals working for the military, government bodies, and NGOs.
During natural disasters, disease pandemics, terrorist attacks, and other public health emergencies, the health system must be prepared to accommodate a surge in the number of individuals seeking medical help. For the health community, a primary concern is how to provide care to individuals during such high demand, when the health system's resources are exhausted and there are more patients than the system can accommodate. The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop June 10-11, 2009, to assess the capability of and tools available to federal, state, and local governments to respond to a medical surge. In addition, participants discussed strategies for the public and private sectors to improve preparedness for such a surge. The workshop brought together leaders in the medical and public health preparedness fields, including policy makers from federal agencies and state and local public health departments; providers from the health care community; and health care and hospital administrators. This document summarizes the workshop.
Mass Casualty events may occur as a result of natural or human-caused disasters or after an act of terrorism. The planning and response to disasters and catastrophes needs to take into consideration the distinction between progressive and sudden events. Insidious or slowly progressive disasters produce a large number of victims but over a prolonged time period, with different peaks in the severity of patients presenting to the hospital. For example, radiation events will produce a large number of victims who will present days, weeks, months, or years after exposure, depending on the dose of radiation received. The spread of a biological agent or a pandemic will produce an extremely high number of victims who will present to hospitals during days to weeks after the initial event, depending on the agent and progression of symptoms. On the other hand, in a sudden disaster, there is an abrupt surge of victims resulting from an event such as an explosion or a chemical release. After the sarin gas attack in a Tokyo subway in 1995, a total of 5500 victims were injured and required medical attention at local hospitals immediately after the attack. The car bomb that exploded near the American Embassy in Nairobi, Kenya, killed 213 people and simultaneously produced 4044 injured patients, many requiring medical care at local hospitals. The Madrid train bombing in March 2004 produced more than 2000 injured victims in minutes, overwhelming the city’s healthcare facilities. More than 500 injured patients were treated at local hospital after the mass shooting in Las Vegas. Finally, earthquakes may produce a large number of victims in areas in which the medical facilities are partially or completely destroyed. Sudden events bring an immediate operational challenge to community healthcare systems, many of which are already operating at or above capacity. The pre-hospital as well as hospital planning and response to sudden mass casualty incidents (SMCI’s) is extremely challenging and requires a standard and protocol driven approach. Many textbooks have been published on Disaster Medicine; although they may serve as an excellent reference, they do not provide a rapid, practical approach for management of SMCI’s. The first edition of “Mass Casualty Incidents: The Nuts and Bolts of Preparedness and Response for Acute Disasters” dealt exclusively with sudden mass casualty incidents. The second edition will expand its focus and include planning and response for insidious and protracted disasters as well. This new book is designed to provide a practical and operational approach to planning, response and medical management of sudden as well as slow progressive events. The target audience of the second edition will be health care professionals and institutions, as well as allied organizations, which respond to disasters and mass casualty incidents. Parts I and II are essentially the first edition of the book and consist of planning of personnel, logistic support, transport of patients and equipment and response algorithms. These 2 parts will be revised and updated and include lessons learned from major mass shootings that occurred recently in the United States and other parts of the world Part III will describe the planning process for progressive disasters and include response algorithms and checklists. Part IV will handle humanitarian and mental health problems commonly encountered in disaster areas. Part V will deal with team work and communication both critical topics when handling catastrophes and mass casualty incidents. This new book will be a comprehensive tool for healthcare professionals and managers and should perform demonstrably better in sales and downloads. It will be of value at the pre-hospital as well as the hospital level, to plan and respond to the majority of catastrophes and mass casualty incidents.
The two-volume Emergency Medical Services: Clinical Practice and Systems Oversight delivers a thorough foundation upon which to succeed as an EMS medical director and prepare for the NAEMSP National EMS Medical Directors Course and Practicum. Focusing on EMS in the 'real world', the book offers specific management tools that will be useful in the reader's own local EMS system and provides contextual understanding of how EMS functions within the broader emergency care system at a state, local, and national level. The two volumes offer the core knowledge trainees will need to successfully complete their training and begin their career as EMS physicians, regardless of the EMS systems in use in their areas. A companion website rounds out the book's offerings with audio and video clips of EMS best practice in action. Readers will also benefit from the inclusion of: A thorough introduction to the history of EMS An exploration of EMS airway management, including procedures and challenges, as well as how to manage ventilation, oxygenation, and breathing in patients, including cases of respiratory distress Practical discussions of medical problems, including the challenges posed by the undifferentiated patient, altered mental status, cardiac arrest and dysrhythmias, seizures, stroke, and allergic reactions An examination of EMS systems, structure, and leadership
