martes, 3 de mayo de 2011

Desarrollo de un sistema de llamada del personal para los incidentes con víctimas masivas utilizando teléfono celular con mensajes de texto; Alivio y mitigación en desastres naturales; La preocupante falta de formación en desastres dentro de las escuelas de medicina latinoamericanas; Entrenamiento en medicina de desastres en medicina familiar: revisión de la evidencia


Desarrollo de un sistema de llamada del personal para los incidentes con víctimas masivas utilizando teléfono celular con mensajes de texto.
Development of a staff recall system for mass casualty incidents using cell phone text messaging.
Epstein RH, Ekbatani A, Kaplan J, Shechter R, Grunwald Z.
Department of Anesthesiology, Thomas Jefferson University Hospital, 111 S. 11th St., Suite 5480G, Philadelphia, PA 19107, USA.richard.epstein@jefferson.edu
Anesth Analg. 2010 Mar 1;110(3):871-8.
Abstract
BACKGROUND: After a mass casualty incident (MCI), rapid mobilization of hospital personnel is required because of an expected surge of victims. Risk assessment of our department's manual phone tree recall system revealed multiple weaknesses that would limit an effective response. Because cell phone use is widespread within the department, we developed and tested a staff recall system, based in our anesthesia information management system (AIMS), using Short Message Service (SMS) text messaging. METHODS: We sent test text messages to anesthesia staff members' cell phone numbers, determined the distance from their home to the hospital, and stored this information in our AIMS. Latency testing for the time from transmission of SMS test messages from the server to return of an e-mail reply was determined at 2 different times on 2 different dates, 1 of which was a busy holiday weekend, using volunteers within the department. Two unannounced simulated disaster recall drills were conducted, with text messages sent asking for the anticipated time to return to the hospital. A timeline of available staff on site was determined. Reasons for failure to respond to the disaster notification message were tabulated. RESULTS: Latency data were fit by a log-normal distribution with an average of 82 seconds from message transmission to e-mail reply. Replies to the simulated disaster alert were received from approximately 50% of staff, with 16 projecting that they would have been able to be back at the hospital within 30 minutes on both dates. There would have been 21 and 23 staff in-house at 30 minutes, and 32 and 37 staff in-house at 60 minutes on the first and second test date, respectively, including in-house staff. Of the nonresponders to the alert, 48% indicated that their cell phone was not with them or was turned off, whereas 22% missed the message. CONCLUSIONS: Our SMS staff recall system is likely to be able to rapidly mobilize sufficient numbers of anesthesia personnel in response to an MCI, but actual performance cannot be predicted with confidence. Using our AIMS as the source for contact information and from which to send messages was simple, inexpensive, and easy to implement. Updating contact information, periodic testing, and analysis of responses to simulated disaster alerts are essential for the effective functioning of such a system. However, maintenance of alternative methods of communication is recommended, because there may be more significant message transmission delays and failures during an actual MCI, and not all staff will receive the text message in a timely fashion.

http://www.anesthesia-analgesia.org/content/110/3/871.full.pdf+html  

Alivio y mitigación en desastres naturales
Natural Disaster Mitigation and Relief.
de Ville de Goyet C, Marti RZ, Osorio C.
In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, Jha P, Mills A, Musgrove P, editors. Disease Control Priorities in Developing Countries. 2nd edition. Washington (DC): World Bank; 2006. Chapter 61.
Excerpt
Sudden-onset natural and technological disasters impose a substantial health burden, either directly on the population or indirectly on the capacity of the health services to address primary health care needs. The relationship between communicable diseases and disasters merits special attention. This chapter does not address epidemics of emerging or reemerging diseases, chronic degradation of the environment, progressive climatic change, or health problems associated with famine and temporary settlements. In line with the definition of health adopted in the constitution of the World Health Organization (WHO), the chapter treats disasters as a health condition or risk, which, as any other "disease," should be the subject of epidemiological analysis, systematic control, and prevention, rather than merely as an emergency medicine or humanitarian matter. The chapter stresses the interdependency between long-term sustainable development and catastrophic events, leading to the conclusion that neither can be addressed in isolation.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group

La preocupante falta de formación en desastres dentro de las escuelas de medicina latinoamericanas
Luigi Accatino, Rodrigo A. Figueroa, Joaquín Montero, Matías González
Rev Panam Salud Publica. 2010 Aug;28(2):135-6. doi: 10.1590/S1020-49892010000800010  

De acuerdo al Centro de Investigación sobre la Epidemiología de los Desastres, entre 1974 y 2003 ocurrieron 6 367 desastres en el mundo, sin contar las epidemias. Estos desastres han dejado un saldo de más de 2 millones de muertos, 5 100 millones de afectados, 182 millones de personas sin hogar y daños en infraestructura valuados en US$ 1,38 billones (1).
http://www.scielosp.org/pdf/rpsp/v28n2/a10v28n2.pdf 
 

 Entrenamiento en medicina de desastres en medicina familiar: revisión de la evidencia
Disaster medicine training in family medicine: a review of the evidence.
Huntington MK, Gavagan TF.
Center for Family Medicine, University of South Dakota, Sioux Falls, SD, USA. mark.huntington@usd.edu
Fam Med. 2011 Jan;43(1):13-20.
Abstract
When disasters strike, local physicians are at the front lines of the response in their community. Curriculum guidelines have been developed to aid in preparation of family medicine residents to fulfill this role. Disaster responsiveness has recently been added to the Residency Review Committee Program Requirements in Community Medicine with little family medicine literature support. In this article, the evidence in support of disaster training in a variety of settings is reviewed. Published evidence of improved educational or patient-oriented outcomes as a result of disaster training in general, or of specific educational modalities, is weak. As disaster preparedness and disaster training continue to be implemented, the authors call for increased outcome-based research in disaster response training.
http://www.stfm.org/fmhub/fm2011/January/Mark13.pdf 
Atentamente
Anestesiología y Medicina del Dolor

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