Disaster medicine training in family medicine: A review of the evidence

Center for Family Medicine, University of South Dakota, Sioux Falls, SD, USA.
Family medicine (Impact Factor: 1.17). 01/2011; 43(1):13-20.
Source: PubMed


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.

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Available from: Thomas F Gavagan, Jun 11, 2014
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    • "The impact of natural disasters to public health has been growing (Keim 2011). There are educational efforts being implemented in emergency medicine and family medicine to develop capacity in disaster medicine (Franc-Law et al. 2010; Huntington and Gavagan 2011). However, the current level of knowledge of disaster medicine among medical students and health professionals is not sufficient (Su et al. 2013). "
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    ABSTRACT: As the impacts of natural disasters have grown more severe, the importance of education for disaster medicine gains greater recognition. We launched a project to establish an international educational program for disaster medicine. In the present study, we surveyed medical personnel and medical/public health students in the Philippines (n = 45) and Indonesia (n = 67) for their awareness of the international frameworks related to disaster medicine: the Human Security (securing individual life and health), the Sphere Project (international humanitarian response), and the Hyogo Framework for Action 2005-2015 (international strategy for disaster reduction). In both countries, more than 50% responders were aware of human security, but only 2 to 12% were aware of the latter two. The survey also contained questions about the preferred subjects in prospective educational program, and risk perception on disaster and disaster-related infections. In the Philippines, significant disasters were geophysical (31.0%), hydrological (33.3%), or meteorological (24.8%), whereas in Indonesia, geophysical (63.0%) and hydrological (25.3%) were significant. Moreover, in the Philippines, leptospirosis (27.1%), dengue (18.6%), diarrhea (15.3%), and cholera (10.2%) were recognized common disaster-related infections. In Indonesia, diarrhea (22.0%) and respiratory infection (20.3%) are major disaster-related infections. Water-related infections were the major ones in both countries, but the profiles of risk perception were different (Pearson's chi-square test, p = 1.469e-05). The responders tended to overestimate the risk of low probability and high consequence such as geophysical disaster. These results are helpful for the development of a postgraduate course for disaster medicine in Asia Pacific countries.
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    • "These chemicals disperse a crowd that could be protesting or rioting, or to clear a building. They can also be used for chemical warfare defense training (Huntington and Gavagan, 2011), although their use in warfare itself is a violation of Article I.5 of the Chemical Weapons Convention (CWC). Article II.9 of the CWC specifically authorizes their use for civilian law enforcement. "
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    ABSTRACT: Riot control agents are highly potent sensory irritants of relatively low toxicity that produce dose and time-dependent acute site-specific toxicity. These compounds have been referred to as transient incapacitating agents or as lacrimators, and in common parlance they are known as "tear gases". These compounds interact pharmacologically with sensory nerve receptors associated with mucosal surfaces and the skin at the site of contamination, resulting in localized discomfort or pain with associated reflexes. This biological response, e.g. ocular irritation, results in pain in the eye and excess reflex lacrimation and blepharospasm. Riot control agents have both civil and military applications and have been classified as either military chemicals or chemical warfare agents. Non-lethal or less lethal weapons have become increasingly popular for law enforcement use when confronting dangerous, combative individuals in the field, include riot control agents. Many incapacitating agents were developed during the Cold War. Oleoresin capsicum (OC) spray, an extracted resin from Capsicum pepper plants, was first developed in the 1970s as an alternative to CS (2-chlorobenzylidene malononitrile) and CN (chloroacetophenone) agents. Most recently, a synthetic form of capsaicin, PAVA (pelargonic acid vanillylamide), gained popularity as a defensive aerosol in the early 1990s. Chemical, pharmacological, and toxicological properties of PAVA are discussed in this paper.
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