Category: Disaster

The Disaster

Many parts of Springfield, New Jersey, are floodplains, so the area is often affected by floods. Floods occur during or after extreme rain events such as hurricanes and associated remnants, inland storm, and the like (Blaikie, Cannon, Davis, & Wisner, 2014). In their turn, extreme weathers are caused by climate change. Whereas, human activities can also lead to floods as the irresponsible use of lands can create the premises for the occurrence of floods. The natural disaster in question can have a significant negative impact on the community including casualties, the loss of property, damages to the infrastructure, and various health risks.

Floods are associated with such health issues as infectious diseases diarrheal diseases, wound infections, chemical hazards, injuries, animal and insect bites, and electrical hazards (Centers for Disease Control and Prevention [CDC], 2017). It is noteworthy that the major cause of deaths during floods is drowning, and it has been estimated that over 2,500 people drowned in floods between 1963 and 2012 (U.S. Global Change Research Program [USGCRP], 2016).

As far as infectious diseases are concerned, these health issues can lead to detrimental effects as they can result in epidemics. The infectious diseases associated with floods include tuberculosis, Hepatitis A/B/C, E. coli, cholera, salmonellosis, rotavirus diarrhea, typhoid fever, shigellosis (CDC, 2017). The development of these diseases usually occurs during a major disaster that causes substantial damage to the infrastructure (especially water supplies and disposal systems). It is also essential to make sure that corpses are handled properly as they may cause certain health hazards.

The Nursing Response

Springfield, New Jersey, does not have its own disaster mitigation plan so the disaster mitigation team and other stakeholders involved will follow the state’s hazard mitigation plan (State of New Jersey Office of Emergency Management, 2017). The county also has its hazards mitigation plan that can be used in the town. It is necessary to note that the plans do not include a specific section concerning the roles and responsibilities, as well as particular actions, of healthcare professionals. Each healthcare facility has their guidelines and emergency plans that are developed on the basis of the state and county plans mentioned above. During disaster events, the nursing staff of healthcare facilities is working in a more intensive mode.

As for the existing practices and guidelines, it is necessary to note that all states and many countries have their mitigation plans that are developed by a team of professionals involved in such spheres as the emergency department, city management, health care, law enforcement, and so on. Cowen and Moorhead (2014) name different roles nursing practitioners can perform during emergency events. For instance, emergency nurses are the most prepared nursing professionals who have the necessary knowledge and skills to respond to various types of emergency (Cowen & Moorhead, 2014). These professionals take part in the development and implementation of hazards mitigation plans. They also coordinate the work of other nurses during emergency events.

Clearly, all nursing practitioners contribute and should be prepared to contribute significantly when responding to an emergency. For instance, staff development measures undertaken at healthcare facilities enable nurses to respond effectively during a disaster (Stanhope & Lancaster, 2016). Nurses also receive certain training in medical schools as emergency response is a part of their curriculum.

However, it is also acknowledged that the level of preparedness is still insufficient, which can cause significant threats to public health (Veenema et al., 2017). At the same time, various recommendations are available online and through official channels as emergency departments collaborate with healthcare facilities to improve healthcare professionals’ preparedness. Healthcare facilities, as well as nursing practitioners, can use these guidelines to acquire skills and knowledge.

During emergency events, nurses administer various clinical procedures, provide psychological and emotional support to patients and their families, provide training and recommendations concerning people’s actions in different emergency events, collaborate with other healthcare professionals, and so on (Stanhope & Lancaster, 2016). Furthermore, vaccination is one of the most effective ways to prevent the spread of infectious diseases.

Nurses play an important role in the administration of vaccines and propagation of the benefits of this measure. It is necessary to note that the workload increases exponentially during disasters and certain periods after them, which may lead to burnout. Nurses often have to address various ethical issues, which also leads to nurses’ burnout, job dissatisfaction, and so on. These issues are often addressed in training courses, which increases nursing practitioners’ preparedness to emergency events.

It is also noteworthy that the mentioned plans and recommendations highlight some ways to assist the most vulnerable populations that include the elderly, children, ethnic minorities, people with limited resources access, and other groups. At that, Collins, Jimenez, and Grineski (2012) claim that these populations are still vulnerable and more attention should be paid when planning and implementing emergency plans. The major issues associated with the provision of care to these people are associated with access to resources and patients’ ability to make decisions.

The Community’s Preparedness

The brief analysis of the resources available in the community, as well as common practices and procedures used in other countries and states, shows that Springfield is not properly prepared to emergency events including the most common natural disaster in this area, floods. Although there are certain guidelines that reflect the major areas of concern when responding to natural disasters, these frameworks pay little attention to the roles and responsibilities of nurses. Springfield’s officials and the Department of Emergency should develop a detailed plan that could be used during emergency events.

The plan should include a description of communication channels among healthcare facilities and healthcare professionals, as well as major responsibilities of the staff. Nurses should also be aware of the resources available in the community. The developed plans, frameworks, and recommendations should be available online.

It is also critical to provide more extensive training to healthcare professionals and the community. Public nurses and emergency nurses will play central roles in this process. However, other nursing professionals should also take an active part in such activities. This will help nurses and people living in the community be better prepared to various emergency events. This kind of communication and collaboration is specifically critical with the vulnerable populations mentioned above. These groups and their families should know about available resources as well as major ways to behave during emergency events.

The development of different courses for the formal and on-the-job training is essential. These courses should address such areas as peculiarities of different emergency events, ways to respond to different situations, roles, and responsibilities of nurses and other healthcare professionals, ways to help the most vulnerable groups. These measures will make Springfield nurses well-prepared to floods and their aftermaths.

References

Centers for Disease Control and Prevention. (2017). Flood waters or standing waters. Web.

Collins, T., Jimenez, A., & Grineski, S. (2012). Hispanic health disparities after a flood disaster: Results of a population-based survey of individuals experiencing home site damage in El Paso (Texas, USA). Journal of Immigrant and Minority Health, 15(2), 415-426.

Cowen, P. S., & Moorhead, S. (2014). Current issues in nursing (8th ed.). St. Louis, MO: Elsevier Health Sciences.

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.

State of New Jersey Office of Emergency Management. (2017). 2014 New Jersey state hazard mitigation plan. Web.

U.S. Global Change Research Program. (2016). The impacts of climate change on human health in the United States: A scientific assessment. Web.

Veenema, T., Lavin, R., Griffin, A., Gable, A., Couig, M., & Dobalian, A. (2017). Call to action: The case for advancing disaster nursing education in the United States. Journal of Nursing Scholarship, 49(6), 688-696.

What advice would you give to local business owners to prepare for epidemics?

During epidemics of influenza, businesses often suffer as they lose revenues. Business owners have to address staffing issues as many employees especially those who are in close contact with customers can easily get infected (Stanhope & Lancaster, 2015). To address the issue, owners should try to be prepared for the seasonal epidemic. First, they should address a local healthcare facility that can provide the most recent and relevant information on the matter.

It is necessary to ask about the possible health risks, factors affecting the spread of the illness, available vaccines, as well as possible negative side effects associated with the use of this kind of medication (May, McCauley, Jeruzal, & Strong, 2015). Nursing professionals are likely to become the hospital’s representatives that will provide the data mentioned above. Business owners can address hospitals, local nursing organizations, public health nurses, and the like.

The second possible solution can be vaccination. Employees’ permission is essential. At that, the owner can ask a nurse from a local hospital to consult employees about the available vaccines. Rebmann, Elliott, Artman, VanNatta, and Wakefield (2015) note that nursing practitioners are mainly in favor of vaccination, so it is likely that the visiting nurse will try to encourage employees to be vaccinated. Finally, it is crucial to instruct employees regarding the most effective prevention measures with the focus on their hygiene.

Apart from a possible investment associated with the assistance of a nurse, the owner will have to pay for vaccines, as well as masks, and other items necessary to remain unaffected by the infection. The instructions mentioned above can also be used for the development of the business as owners can increase the number of goods or introduce products associated with the illness (certain fruit, tissues, scarfs, and so on).

Recommendations to hospital administration to keep their services available for the community

Nursing professionals are often prone to infections as they are in the closest contact with patients and their families. During epidemics of influenza, the burden on local healthcare facilities can increase significantly. In the given scenario, a quarter of the population needs healthcare services while 40% of the nursing staff is unavailable. One of the possible solutions is the use of telemedicine or, at least, some elements of this technological approach (Stanhope & Lancaster, 2015). Telenurses can assist many patients via telephone and the Internet. Patients can receive information regarding their symptoms, their treatment, necessary tests or results, and so on. As to the resources, technological issues will be minimal as hospitals have the necessary resources.

The major issue can be associated with staffing. Some training can be needed as there are some peculiarities of this kind of nursing practice. Telenurses employed at the hospital can train or instruct other nursing practitioners. Importantly, Bell, Dake, Price, Jordan, and Rega (2014) report that many nurses are ready to work from home, so it is possible to address the nursing professionals who are on sick leave to work from home for several hours per week or day. It is also vital to communicate with the community and explain the benefits of telemedicine.

At that, the hospital still needs nurses to make sure that patients receive all the necessary clinical procedures. Some administrative workers can complete some nursing tasks. To encourage healthcare professionals to cooperate actively, it is necessary to provide additional days to vacations, flexible schedules, and other perks. Monetary rewards can also be employed.

References

Bell, M., Dake, J., Price, J., Jordan, T., & Rega, P. (2014). A national survey of emergency nurses and avian influenza threat. Journal of Emergency Nursing, 40(3), 212-217.

May, T., McCauley, M. P., Jeruzal, J., & Strong, K. A. (2014). Catastrophic events versus infectious disease outbreak: Distinct challenges for emergency planning. Reason Papers, 37(1), 54-64.

Rebmann, T., Elliott, M., Artman, D., VanNatta, M., & Wakefield, M. (2015). Missouri K-12 school disaster and biological event preparedness and seasonal influenza vaccination among school nurses. American Journal of Infection Control, 43(10), 1028-1034.

Stanhope, M., & Lancaster, J. (2015). Public health nursing: Population-centered health care in the community. St. Louis, MO: Elsevier Health Sciences.

The Disaster

The community of the Bronx, NY, is susceptible to many human-made and natural disasters. One of the most notable issues that may lead to a population-level disaster is the occurrence of coastal storms. These natural disasters are defined by a combination of snow and rain, coastal flooding, and strong winds (NYC Health, n.d.). The region of the Bronx not the most vulnerable area of the city, but it is significantly affected by the storms’ effects nonetheless (NYC Health, 2016).

According to the report by the Centers of Disease Control and Prevention ([CDC], 2017a), the sea level rise and climate change lead to the increased rate of coastal storms affecting the U.S. During a coastal storm, communities of the Bronx and New York as a whole can encounter such problems as loss or damage of property, casualties, as well as infectious diseases and other health risks.

As it is stated above, coastal storms have many harmful effects. For example, strong winds may damage buildings, endanger people and animals, or disrupt the city’s infrastructure. Flooding is another significant concern which is followed by an increase in infectious diseases. In such hazardous situations, drowning becomes a prevalent cause of death among the affected residents (CDC, 2017a). Moreover, the water supply often becomes contaminated, exposing the citizens to dangerous pathogens. People may suffer from wounds, nose, throat, or ear infections, and gastrointestinal problems (diarrhea, E. coli).

Finally, there exist risks of electrocution, poisoning, and trauma due to falling debris or moving cars (CDC, 2017b). Individuals with disabilities and older people with mobility issues may be at risk of being trapped in their current location during a storm. It is vital to mention that people living in highly hazardous zones may experience exacerbations in mental illnesses linked to stress and anxiety.

The Nursing Response

As can be observed, a variety of precautionary measures have to be taken to minimize the effects of coastal storms. The Bronx, NY, does not have a plan for coastal storms that is unique to the area. All available links lead to the city’s preparations and the disaster mitigation initiatives suggested by the state (NYC Health, n.d.). It is crucial to point out that the role of the city’s services is mentioned briefly in these materials, while the majority of information is directed towards citizens. Moreover, the duties of medical professionals are not defined anywhere. This suggests that each healthcare establishment is expected to have a personal plan for dealing with coastal storms.

Nurses in such facilities need to follow a four-step approach to designing a disaster plan. Firstly, they should engage in prevention by collecting information about climate change and the preparedness of the region. Second, they should spread awareness of the storm’s outcomes and health risks, thus participating in community education (Veenema et al., 2016). Third, during a disaster, nurses should be prepared to work in an emergency mode which increases their burden. Finally, after the storm’s end, they should help the community to recover by providing medical assistance, wound treatment, and vaccination.

Emergency preparedness includes nursing training to increase the professionals’ effectiveness in responding to disasters. Before a storm occurs, nurses should work with community leaders, faith organizations, educational centers, healthcare organizations, and elsewhere to disseminate the information about disasters. They should encourage people to prepare – equip their houses with emergency kits, purchase insurance, and be aware of health risks.

People should be taught about preliminary signs of storms and weather changes (strong wind, rain, snow, low atmospheric pressure). During a storm, nurses should be ready to refocus their priorities towards people affected by the disaster and take on more responsibility by serving people with open wounds, infections, and other acute conditions. It is also vital for nurses to establish a communication channel with the residents.

The recommended plan for dealing with a coastal storm greatly relies on the preparedness of the community. For example, as the city’s emergency communication notifies the citizens, New Yorkers should know how these alert systems work. Upon receiving a message about an upcoming storm, people in the Bronx should act to minimize the damage. For example, they should hide objects that are placed outside their house.

People should also have emergency kits that they will use if the power is out, the water is contaminated, or some other services are unavailable. The residents need to be educated about the ways to safely evacuate their houses. They should know to which facilities they can go, what they should bring with them, and whom to contact in case of problems. This information should be provided to the community regularly with drills and community workshops.

The discussed above outcomes of coastal storms include various health ca problems that should be addressed by nurses. For example, vaccination is the best practice for dealing with increased infection rates due to flooding (Jones et al., 2016). Nurses should promote the use of vaccines in the community and administer them. Moreover, psychological support is also one of the nurses’ duties during and after the disaster. Many people experience PTSD, anxiety, stress, and depression, especially if they or their loved ones have been significantly affected by the disaster. Nurses should provide counseling, emotional support, and education to people to help cope with the existing concerns.

The Preparedness of the Community

For the community of the Bronx, the majority of public websites cover the preparedness of NYC in general. For example, NYC Health (n.d.) provides the public with information that explains what types of coastal storms exist and how they are treated by the city. It states that people should be ready to protect themselves from the flooding by acquiring an emergency kit, learning about evacuation zones, and purchasing insurance for their property.

Moreover, it notes that the TV and radio are used for emergency announcements, signifying that the city is prepared to establish communication channels. NYC has a specific program for notifying the community about the state of the disaster – Notify NYC.

The available resources fail to provide citizens with any particular information on medical care. Also, they do not mention any data about nursing responsibilities, although they mention some community work in the form of awareness workshops. According to Lumbroso, Suckall, Nicholls, and White (2017), the previous disasters have shown that NYC does not have a system that effectively prepares people for hurricanes and floods. The authors state that the disadvantaged communities are not educated by the government to handle such dangerous situations without substantial losses. Furthermore, the high rate of people living under the poverty line also exposes residents to the lack of medical assistance and preparedness for the disaster.

Summary

The danger of coastal floods is a high possibility for the residents of the Bronx, NYC. Thus, it is vital for nurses working in the region to develop a plan that provides knowledge and support to the citizens before, during, and after the disaster.

The plan for the Bronx should incorporate nursing activities mentioned above and provide more information about the resources available to communities. The websites for the public are filled with preventive suggestions, but the role of healthcare specialists is not defined. The limited access of impoverished populations to education is not recognized fully. Overall, the systems of NYC appear to follow the national rules, but they lack specific information and connection with healthcare organizations.

References

Centers for Disease Control and Prevention. (2017a). Coastal flooding, climate change, and your health: What you can do to prepare. Web.

Centers for Disease Control and Prevention. (2017b). Flood waters or standing waters. Web.

Jones, F. K., Ko, A. I., Becha, C., Joshua, C., Musto, J., Thomas, S.,… Nilles, E. J. (2016). Increased rotavirus prevalence in diarrheal outbreak precipitated by localized flooding, Solomon Islands, 2014. Emerging Infectious Diseases, 22(5), 875-879.

Lumbroso, D., Suckall, N., Nicholls, R., & White, K. (2017). Enhancing resilience to coastal flooding from severe storms in the USA: International lessons. Natural Hazards and Earth System Sciences, 17, 1357-1373.

NYC Health. (2016). NYC public health disasters. Web.

NYC Health. (n.d.). Coastal storms and hurricanes. Web.

Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, R. N., Couig, M. P.,… Larson, E. (2016). Nurses as leaders in disaster preparedness and response—A call to action. Journal of Nursing Scholarship, 48(2), 187-200.

Introduction

It should be noted that the earthquakes that occurred in Haiti and Nepal have affected not only the well-being of the population but also the environmental health of these areas. Consequences and effects were varied, and some of them were short-terms while many of them were long-term and required heavy investments from the side of the government and respective agencies. The purpose of this paper is to discuss the major environmental health concerns following these earthquakes and compare those with the possible consequences that could follow if the disaster outburst in the US.

Major Concerns

Such aspects as the quality of air and water, food safety, housing, and emergency preparedness are the main environmental health concerns that have arisen as a consequence of the earthquakes in 2010 and 2015. Despite the preventive measures employed in these countries, severe damage occurred to the infrastructure. Also, human health was affected extensively with both immediate and long-term consequences (Johnson & Lichtveld, 2017). As applied to the environment in these countries, roads were disrupted and, in some parts of the area, people could not be provided with the necessary amounts of food and drinking water.

Apart from that, electrical blackouts and shortages occurred in both countries due to electrical service being interrupted. These earthquakes completely destroyed or severely damaged the homes of many people (Johnson & Lichtveld, 2017). Houses that withstood the avalanche and the natural disaster faced numerous issues that could not be addressed immediately, which implied that many people had to abandon their homes and live in shelters. Some of the major problems included structural damage to the construction of houses and contamination with dirt, dust, and mud.

Extensive damage to houses and buildings resulted in deaths from physical trauma and head injuries. When buildings collapsed, many people were trapped inside, which lead to severe traumatization and preventable wounds. People, who were successfully evacuated to shelters, were exposed to other threats such as infectious diseases (Johnson & Lichtveld, 2017). Given the number of individuals residing in relief shelters, the danger of influenza epidemics became another health-related concern. Moreover, as a result of the two earthquakes, a lot of commodities and nutrition stored in warehouses started to rot, and the decomposing debris posed a threat of pest infestations.

Comparison

If an earthquake of a similar magnitude occurred in the United States, the environmental concerns would be somewhat different from those experienced in Nepal and Haiti. It is crucial to stress that the US invests heavily in preventive measures to minimize the effects of earthquakes and other natural disasters as much as possible. Buildings are constructed in such a way so that they can withstand earthquakes of different magnitudes (Johnson & Lichtveld, 2017).

Nevertheless, the consequences would be similar in so that many rural and urban territories (including industrial zones) may be severely damaged causing air and water pollution. The destruction of roads and railroads would result in disrupted relief efforts (Johnson & Lichtveld, 2017). In some parts of the US, it is quite possible that a local tsunami may outburst causing mold and mildew growth in houses and constructions. However, most importantly, the US is dependent on nuclear power. The destruction of nuclear plants will not only cause the loss of commercial reactors but also result in radiation releases that will pose a threat to environmental health and the well-being of the population.

Concluding Points

Thus, it can be concluded that the major environmental concerns connected with the earthquakes that happened in Nepal and Haiti are air and water quality, infectious disease prevention, healthy housing, and so on. If an earthquake of a similar magnitude occurred in the US, the effects on the environment would be a bit different. The housing would be affected less due to the construction techniques used; nevertheless, some of the greatest concerns would be air and water contamination and possible radiation releases.

Reference

Johnson, B. L., & Lichtveld, M. Y. (2017). Environmental policy and public health (2nd ed.). Boca Raton, FL: CRC Press.

Introduction

In light of the environmental situation on the planet each year, US citizens face more and more unavoidable casualties and natural disasters caused by climate change and the human factor. Although there are many policies and practices developed to help the community to prepare for the accidents, still a lot of work has to be done. The purpose of this paper is to assess community disaster preparedness and possible courses of action for public health nurses.

Overall Preparedness

During past decades, the general preparedness of the US public increased by several times. However, the researchers identified that the level of readiness depends on the welfare of the community. Access to resources such as freshwater, healthcare, power supply, and available food sources significantly increased the adaptive capacity of the communities. According to the research, those areas that initially had the financial and socio-economic support from the side of the government would fare better after natural disasters (Himes-Cornell et al., 2018). Therefore, improving general living conditions will automatically lead to improvements in disaster preparedness.

Other possible measures include cooperation between the government and community leaders. This collaboration may be beneficial in terms of raising the awareness of the population regarding the link between climate change and natural disasters (Beatty, Shimshack, & Volpe, 2019). Despite the governmental efforts, it is evident that better education on the matter would go a long way in the personal preparedness of the citizens. Climate change is a shared problem, so each individual can contribute to solving it.

Preparedness among Older Adults

It is necessary to discuss the preparedness for natural disasters as applied to the older adults sector separately. According to Nursing Outlook, when natural disasters outburst, older adults become particularly susceptible to various trauma, and the level of mortality is higher among senior adults as compared to middle-aged individuals (Spurlock et al., 2018). In addition, some senior residents use electronic devices that support their daily living. In the setting of a natural disaster, power outages are quite common, which leaves people (who depend on their life-supporting devices) vulnerable. Additional risks include interrupted health care, compromised mobility, and lack of physical training.

Role of Public Health Nurse

Another essential factor to be considered along with community disaster preparedness is the readiness of public health nurses. Community nurses are the largest healthcare staffing available during natural disasters. Therefore, a community nurse should demonstrate strong leadership and respond to problems at hand promptly (Himes-Cornell et al., 2018). Public health nurses should acknowledge their responsibility in terms of raising community disaster preparedness and participate in community education actively. Their profound expertise and valuable insights may be used for initiating new policies and public training programs.

As applied to such areas as Orange County, CA, as a result of natural disasters, diseases, which cause the majority of deaths, arise largely due to factors such as lack of clean drinking water. Due to the damage to the water supply, the underground water system, and sanitation infrastructure, many people may need safe drinking water and good sanitation. Public health nurses play a major role in preparing citizens for community disasters and an adequate response to those (Himes-Cornell et al., 2018). In particular, they need to instruct people to boil water for ten minutes before drinking it to make sure the water is clean. If electricity and gas cannot be used for these purposes, the nurse should educate community residents, what chemicals at their disposal may be used to sanitize water. Nurses should become active leaders in educating people in rescue shelters and the community in general on the procedures and resources available to them to make sure residents understand how they can get safe drinking water.

Conclusion

Summing up, due to climatic changes and socio-economic problems, the number of natural disasters is increasing each year. Nevertheless, the prognosis is not so frightful, as measures are taken to prepare the community for natural disasters. Better education and public awareness, as well as strong leadership on the part of community nurses, will help to explore the issue and deal with the outcomes more effectively.

References

Beatty, T. K. M., Shimshack, J. P., & Volpe, R. J. (2019). Disaster preparedness and disaster response: Evidence from sales of emergency supplies before and after hurricanes. Journal of the Association of Environmental and Resource Economists, 6(4), 633-668.

Himes-Cornell, A., Ormond, C., Hoelting, K., Ban, N. C., Zachary Koehn, J., Allison, E. H.,… Okey, T. A. (2018). Factors affecting disaster preparedness, response, and recovery using the community capitals framework. Coastal Management, 46(5), 335-358.

Spurlock, W. R., Rose, K., Veenema, T. G., Sinha, S. K., Gray-Miceli, D., Hitchman, S.,… Miller, E. T. (2019). American academy of nursing on policy position statement: Disaster preparedness for older adults. Nursing Outlook, 67(1), 118-121.

Introduction

This paper provides information on emergency training and its significance. It discusses the methods that may be implemented during its course and explains their benefits. The paper also presents the ways to avoid the adverse effects of training on personnel’s clinical duties, as well as addresses the financial aspects associated with it. It concludes that emergency training is crucial for an increase in hospitals’ incident preparedness and may improve medical professionals’ performance.

Emergency Training: Significance, Methods, and Impact

Emergency training is a crucial aspect of disaster preparedness as it allows health organizations to be able to respond to emergencies adequately (Skryabina, Reedy, Amlôt, Jaye, & Riley, 2017). It is necessary for the hospital’s staff to perform their duties quickly and effectively in the case of major incidents and disasters. To prevent adverse consequences from occurring, medical institutions can decide to implement educational programs for their staff. They may be provided by federal and local healthcare agencies, as well as professional educational organizations.

The most effective approach to training should combine several teaching methods to ensure that staff will receive comprehensive education and will be able to apply their knowledge to practice. A program should incorporate materials that are suitable for different learning styles of individuals; it may include verbal and visual information. Such an approach will ensure that all employees understand the significance and the context of training and approach it responsibly.

Moreover, it is reasonable to make training interactive rather than exclusively lecture-based as it will help staff to learn how to interact with each other during emergency cases. For example, the hospital team may work in groups to discuss emergency cases and the actions they should take to eliminate adverse consequences of them. Books may be used for training as well but only as one of the learning sources, as they can provide a solid theoretical background but do not allow for hands-on experience.

Emergency training may have a negative impact on staff’s clinical duties, as it is a time-consuming activity. To prevent adverse outcomes of the implementation of learning programs in the hospital, it may be useful to offer a computer-based training method as a primary teaching tool. Its primary benefit is that it can allow employees to study within their preferred schedule; they can do it from home or during their free time. The computer-based training is also significant for the educators as they can track the personnel’s progress in completing training modules.

It is necessary to address the financial impacts of providing the training and failing to do so. Many health institutions and other organizations see educational programs as expenses, not investments. However, in the context of emergency preparedness, the lack of training may cause steep financial losses. For example, in the case of a hurricane, an ineffective or a slow response to the incident may lead to preventable deaths. It means that the hospital may bear financial losses if their action was proven insufficient. Moreover, well-trained employees can improve the hospital’s financial situation, as they are less likely to make medical mistakes, eliminate the turnover rate, and improve patients’ satisfaction.

Conclusion

Emergency training is a key to a high level of disaster preparedness. It eliminates the number of preventable deaths and financial losses, as well as improves personnel’s clinical performance. To be effective, the training should utilize a comprehensive approach to teaching and be understandable and interactive, as well as have no effect on employees’ clinical duties. Financial costs of learning programs should be perceived as an investment, not an expense.

Reference

Skryabina, E., Reedy, G., Amlôt, R., Jaye, P., & Riley, P. (2017). What is the value of health emergency preparedness exercises? A scoping review study. International Journal of Disaster Risk Reduction, 21, 274-283.

Introduction

The force of a hurricane makes a devastating influence on the infrastructure of small island countries, leaving people without electricity, drinking water, and roads. Over the past ten years, the level of damage caused by floods and hurricanes amounted to more than $ 21 billion (Schwartz et al., 2018). The patterns of human health are also largely impacted by this natural disaster. It is possible to expect the onset of such infectious diseases as watery diarrhea, respiratory complications, and vector-borne diseases. In addition, the compromised critical facilities, including communications, hospitals, and gas, can deteriorate the state of people with chronic conditions. This report aims to shed light on the potential diseases that may appear as a result of the hurricane in order to provide feasible recommendations on their prevention.

Destroyed Infrastructure Threats

The hurricane that flooded the given island country largely affected buildings and facilities that provided services to the population. Considering that many buildings were flattered, it created the additional threat of their destruction due to cracks in the walls. Accordingly, people who were not evacuated and those who sought to be sheltered in them tend to be at a risk of injuries and death. McMichael (2015) claims that the surrounding standing water contaminated with sewage since this system is broken, which is likely to lead to tuberculosis, meningitis, cholera, et cetera. Since many people have to stay in camps or buildings without proper sanitation, it causes the endemic infections that are known to flourish after disasters. In other words, even one person having an infectious illness can contaminate others (McMichael, 2015). In this case, it should also be taken into account that the treatment plants are inoperable, which is associated with greater risks for the population walking in this contaminated water to have typhoid and hepatitis.

The collapse of communications, electricity, and gas deprived people of the ability to warm themselves, boil water for drinking, and call for help. This is associated with the threat of dehydration, chilblain, diarrhea, fever, and skin diseases (Saulnier, Ribacke, & von Schreeb, 2017). In addition, the fact that the roads were blocked without the opportunity to ensure vehicular traffic creates the difficulty with the transportation of injured persons and those who were locked in their houses. The water that submerged the roads and bridges degraded their integrity and left many people without the means of moving from the devastated area.

Impact on Infectious Diseases and Chronic Conditions

Water pollution is one of the key public health concerns since raw sewage spilled into the streets and buildings where the population should stay for a long time before the evacuation. The non-operational nature of treatment plants along with untreated sewage impacted the recreational water and reopened the most of shellfish water. A range of vector- and water-borne illnesses include such infectious risks as conjunctivitis, dermatitis, as well as throat and ear infections (“Flooding and communicable diseases fact sheet,” n.d.). The water becomes the mediator of diseases, while the mentioned conditions are not likely to turn to epidemics. Wound infections of people can contaminate those persons who also have injuries received in the course of the hurricane, before, or after it.

Leptospirosis, the bacterial infection transmitted via mucous membranes, can result from the direct or water contact with dead animals and humans. According to the World Health Organization (WHO), it is regarded as an acute infection characterized by intoxication with pronounced pain in the muscles, primary damage to the kidneys, liver, nervous and vascular systems, which is often accompanied by the development of hemorrhagic syndrome and / or jaundice (“Flooding and communicable diseases fact sheet,” n.d.). The source of the infection is sick and recovered wild and domestic animals that infect water and soil and form natural and mixed foci. Natural foci are due to the presence of infection among wild animals, which can also be found in the lakeside basins, marshy grass areas of forests, and in the standing water after disasters. Small rodents and insectivores are the key carriers of the infection along with cattle and pets.

Another direction in the onset of infectious diseases resulted from the identified hurricane refers to vector-borne issues. In particular, standing water can be the basis for breeding sites and the subsequent increase in the number of mosquitos that would spread the infections, such as malaria, dengue, and West Nile fever. With the receding of water, the outbreak of malaria may take only six-eight hours (Ahmed & Memish, 2017). Malaria and Zika virus are acute human infectious diseases caused by plasmodia and Aedes mosquitos accordingly, which are parasitic in the blood. The disease is characterized by febrile seizures, damage to the liver and spleen, anemia, and a relapsing course. The transferred disease does not leave a stable immunity even to the type of parasite that caused the disease, and the most serious complication is malarial coma, which is fatal without intensive specific therapy.

The risks caused by corps should also be taken into account as they present a significant threat: infections tend to survive for some time once their carriers are dead. For example, some bloodborne viruses such as human immunodeficiency viruses (HIV) can remain active up to six days after human death (Zorrilla, 2017). Gastrointestinal infections and tuberculosis are the two most common infections, which are typically transmitted via a fecal-oral route in the water. Tuberculosis agents may also be transferred when a person coughs or sneezes. People with weakened immune systems are much more likely to develop active tuberculosis. The likelihood of developing active tuberculosis is also high with HIV: in 2015, people with HIV accounted for 1.2 million (11 percent) of new cases of tuberculosis worldwide (Zorrilla, 2017). A lot of people who become infected do not show symptoms of the disease since the tuberculosis bacterium can live in the body in an inactive form. In most cases, the disease affects the lungs, and the symptoms comprise fever, persistent cough, chest pain, and dyspnea.

Considering the aggravating factors that are evident in case of the hurricane, the risk of malaria and other related infections raised drastically. Overcrowding, the inability to timely receive care services, and prolonged location outside lead to changes in human behavior (“Flooding and communicable diseases fact sheet,” n.d.). In this connection, anxiety, fatigue, shock, and other psychological factors are likely to set additional pressure on one’s health systems. In some places, people would have to wait for the dirt to dry completely to be able to move. This densely populated country would also experience an acute shortage of drinking water and rapid disease spread in the affected regions. A lack of food and water may affect not only the health of people, but also increase the risk of social conflicts over access to the scarce yet vital resources.

People trying to reach a hospital or other viral services, who had to walk into the water and by the obstructed roads, are more likely to meet roaming or dead animals. The latter present a higher risk of toxic waste contamination for persons walking around, which can occur by means of water and the contact with the skin, mouth ears, and nose. Among the most concerning infections, one may identify zoonosis that is a group of infections providing the potential to be transmitted from animals to humans. Blastomycosis, rabies, and intestinal Illness are the most widespread diseases that can be acquired during the aftermath of the hurricane since dead mammals leak feces, and spores can be inhaled by people.

Health care delivery insufficiency or the complete loss of the ability to provide services to the population is especially dangerous for people with chronic diseases. Cancers, respiratory problems, diabetes, and cardiovascular issues may be enumerated among those conditions that are associated with jeopardizing their care needs and leading to complications and deaths (Ryan et al., 2015). For people with the developing infection and having chronic obstructed pulmonary disease or asthma, dyspnea can be fatal if they have no drug intake opportunity. In their turn, persons with heart concerns are likely to develop a more acute response to long exposure to contaminated water and hydration insufficiency due to their deep vein thrombosis, coronary heart disease, et cetera (Ryan et al., 2015). Those with diabetes and / or cancer, being deprived of monitoring their condition and transportation means, are likely to encounter severe exacerbations and death. In addition, traumas and other chronic health problems may also become acute driven by the hurricane experience.

The social considerations regarding the hurricane consequences in terms of public health involve the decrease in the social functioning of the population. In particular, According to statistics provided by the United Nations, of all natural disasters, floods and hurricanes cause the highest levels of loss and damage to humanity (Schwartz et al., 2018). There are also social behaviors that affect the disaster chain, which demonstrates that risk awareness plays a rather important role. From the contextual stance, the response is a complex process, in which there are many social characteristics. For example, many members of society do not have the opportunity to change their residence to a safer area. People are not informed about risk and its potential impact on their health. They only plan their near future and do not present their capabilities in compatibility with disasters, rely on rapid aid from the government. Thus, post-traumatic stress disorder (PTSD) and depression tend to develop after natural disasters since people lose their typical way of life and turn out to be unready to recover.

Recommendations

In order to assist the population in recovering from the hurricane and reduce the inset of infectious disease, it is essential for the country to provide specific services. First of all, the local authorities should be focused on restoring clean water supplies (Ryan et al., 2015). Although this decision can save countless lives throughout the island, not all the population is likely to receive access to it. Therefore, in addition to the water supplied, new sewage treatment plants should be established as soon as possible. At least, temporary facilities should be constructed to avoid epidemics and allow people to address hydration needs. After a disaster of this magnitude, sanitary prevention is the most appropriate strategy: rehydration points where people can quickly have an oral rehydration solution to prevent serious dehydration can be organized (Ryan et al., 2015). In addition, nurses on duty who can promptly assist patients with suspected cholera or other serious diseases should be allocated in such centers.

In the long term, the structure of health effects from contagious diseases contains chronic diseases, mental disorders, and diseases associated with poverty, including malnutrition due to lack of water or healthy food. Therefore, Zorrilla (2017) stresses that increased attention to flood vulnerability and the hurricane impact on social development, economics, and health is necessary to overcome the health consequences of the population. An integrated approach to events and activities related to medical consequences during the elimination of the hurricane outcomes is a priority to combat them. The focus of institutions in terms of hygiene and anti-epidemic provision is a prerequisite for a quick solution to the onset and reduction of infectious diseases among the affected persons.

The preventative measures seem to be critical to conduct to prevent similar devastation in the future. The international organizations can be asked to provide technical equipment, logistical support, and planning assistance to the local authorities during vaccination campaigns. The evaluation of the food supply situation and the distribution of mosquito nets and hygiene kits in hard-to-reach settlements throughout the potential flood-hit region is another strategy (Zorrilla, 2017). Health care specialists should perform educational and advisory work to help people in realizing how the effects of hurricanes and other disasters can affect their physical and psychological states. In case of the suspected outbreak of an infectious disease, it is necessary to work with the population by explaining what the disease is and how to protect from it. It is possible to go to homes and tell the population about protection from cholera and malaria and where to get treatment in case of illness.

In addition, although it is regarded that insurance is one of the main tools of economic support for the suffered population, in developing countries, insurance costs are more inflated and difficult to access. In fact, disaster insurance has a high level of financial expenditure, and only national and transnational companies can be a source for insurance to compensate for the losses caused by significant natural disasters. In such countries, the government agencies can also take on such responsibilities, and there will be certain types of insurance support. In general, it can be stated that today, the assets of insurance companies to support the poor and rural communities are less accessible in developing countries.

Conclusion

To conclude, it should be emphasized that the country experienced an acute shortage of drinking water, timely medical services, and the potential onset of various infectious diseases. In particular, malaria, fever, cholera, and acute respiratory diseases were revealed as those that tend to spread rapidly. Professional monitoring of devastated areas, timely treatment, and responsible approach based on the preventative measures compose the key to successful recovery without the development of life-threatening complications. At the same time, the awareness of the population and the proactive approach of the government in responding to the hurricane consequences are likely to minimize the adverse impact of this natural disaster.

References

Ahmed, Q. A., & Memish, Z. A. (2017). The public health planners’ perfect storm: Hurricane Matthew and Zika virus. Travel Medicine and Infectious Disease, 15, 63-66.

Flooding and communicable diseases fact sheet. (n.d.). Web.

McMichael, A. J. (2015). Extreme weather events and infectious disease outbreaks. Virulence, 6(6), 543-547.

Ryan, B., Franklin, R. C., Burkle Jr, F. M., Aitken, P., Smith, E., Watt, K., & Leggat, P. (2015). Identifying and describing the impact of cyclone, storm and flood related disasters on treatment management, care and exacerbations of non-communicable diseases and the implications for public health. PLoS Currents, 28(7), 1-21.

Saulnier, D. D., Ribacke, K. B., & von Schreeb, J. (2017). No calm after the storm: A systematic review of human health following flood and storm disasters. Prehospital and Disaster Medicine, 32(5), 568-579.

Schwartz, R., Tuminello, S., Kerath, S., Rios, J., Lieberman-Cribbin, W., & Taioli, E. (2018). Preliminary assessment of hurricane Harvey exposures and mental health impact. International Journal of Environmental Research and Public Health, 15(5), 974-983.

Zorrilla, C. D. (2017). The view from Puerto Rico — Hurricane Maria and its aftermath. New England Journal of Medicine, 377(19), 1801-1803.

This paper studies trauma services available in Maryland and locally, in Silver Spring. It describes the structure and components of the system, presents the assistance offered at different levels of care, and indicates its strengths and weaknesses. The paper also estimates the degree of disaster preparedness of the local trauma system based on its capability to manage major incidents and studies the available sources of additional aid.

Trauma Services in Maryland

Maryland Institute for Emergency Medical Service Systems (n.d.) presents several local centers providing trauma services. The R. Adams Cowley Shock Trauma Center of the University of Maryland Medical System serves as a primary adult resource center. The Johns Hopkins Children’s Center (Baltimore City) is the center for pediatric trauma care. The Johns Hopkins Hospital also provides services for level I and level II trauma patients.

Level II trauma centers include Prince George’s Hospital Center (Cheverly), Sinai Hospital of Baltimore (Baltimore City), and Suburban Hospital (Bethesda). Meritus Medical Center (Hagerstown), Maryland Regional Medical Center (Cumberland), and Peninsula Regional Medical Center (Salisbury) provide level III trauma care. The closest centers available in my area are in Bethesda and Cheverly.

Structure and Components of the Trauma System

According to Soto, Zhang, Huang, and Feng (2018), the staff of Emergency Medical Services is the initial source of care for injured patients. After the assessment, the patients are referred to the hospital medical professionals that provide care according to the level of trauma. For example, in Maryland, institutions of all levels have resuscitation units, operating rooms, and intensive care units available at all times (Maryland Institute for Emergency Medical Service Systems, n.d.).

The assistance of trauma surgeons is offered at any time in levels I and II facilities and within 30 minutes of call for the patients requiring level III care, including on-call neurosurgeons in levels I and II. Anesthesiologists at all times are available in the level I and II care institutions but are shared with other services, and there are on-call professionals for level III traumas.

Strengths and Weaknesses of Trauma Care Systems

The research by Brown, Rosengart, Billiar, Peitzman, and Sperry (2016) states that Maryland has a relatively low injury fatality rate (up to 53 per 100,000 population). It means that the emergency medical services systems (EMSS) are effective in providing trauma care. The primary strength of EMSS in Maryland is that all medical professionals that are usually involved in trauma care are available either at all times or within 30 minutes of call. The main weakness of Maryland EMSS is that the state does not have maximized placement of trauma centers, which can be proven by the little number of available institutions (Brown et al., 2016). For example, people living in smaller cities have to be transferred to other locations to receive help, which may require 15 minutes to 2 hours.

Disaster Preparedness Estimation

In my opinion, the level of disaster preparedness of my local trauma system is moderate. For example, level III care is only provided in Hagerstown, Cumberland, and Salisbury; those medical centers are far from Silver Spring. The institutions in Bethesda and Cheverly only offer level II care; however, such assistance can be sufficient for the majority of injured people if an incident occurs. The closest available assets of additional aid are the George Washington University Hospital and other medical institutions in Washington, DC. I believe that in case of a disaster, local EMSS will require their assistance to avoid the lack of staff and care for patients.

Conclusion

The trauma services available in Maryland and Silver Spring are limited. The care is provided at all times or within 30 minutes of call, but only three institutions in the state offer assistance to level III patients. It means that in case of a major incident it may be reasonable to use the assets of Washington, DC to ensure that individuals have access to necessary treatment.

References

Brown, J. B., Rosengart, M. R., Billiar, T. R., Peitzman, A. B., & Sperry, J. L. (2016). Geographic distribution of trauma centers and injury related mortality in the United States. The Journal of Trauma and Acute Care Surgery, 80(1), 42–50.

Maryland Institute for Emergency Medical Service Systems (n.d.). Web.

Soto, J. M., Zhang, Y., Huang, J. H., & Feng, D. X. (2018). An overview of the American trauma system. Chinese Journal of Traumatology, 21(2), 77–79.

Introduction

In the bowels of our planet, continuous internal processes occur, as a result of which the face of the Earth changes. Most frequently, these changes are slow and gradual, and their effect is not noticed immediately. Detailed analyses reveal that some parts of the earth’s surface rise and even distances between continents do not remain constant. Sometimes, internal processes are stormy, and the terrible element of earthquakes turns whole cities into ruins and devastates entire areas (Chopra, 2017).

Maryland belongs to the U.S. states that are under the threat of an earthquake (Pulinets, Morozova, & Yudin, 2014). The greatest danger of such a natural disaster lies in its poor predictability and detrimental effect. However, the scientific achievements of recent years offer real opportunities not only to predict earthquakes but also to influence their progress. To arrange the successful emergency management in case of an earthquake, it is necessary to take into consideration the principles of incident management, public health issues, the problems of triaging victims, and the collaboration of agencies at different levels.

Fundamental Principles of Healthcare Incident Management

Emergencies demand immediate reaction to mitigate the outcomes. Fundamental principles of healthcare incident management involve the protection of people’s lives, the stabilization of the disaster spot, and the preservation of property. Comprehensive emergency management involves four stages: mitigation, preparedness, response, and recovery (Boatright-Royster & Brewster, 2016). An earthquake fits into this classification since its occurrence demands the fulfillment of all the mentioned principles and stages.

The principle of protecting the lives of citizens is the most important one since, in large earthquakes, people may find themselves in blockages. In conditions of prolonged soft tissue compression of individual body parts, lower or upper extremities, a severe lesion can develop, called the syndrome of prolonged squeezing of limbs or traumatic toxicosis (Haddow, Bullock, & Coppola, 2017). Such an occurrence is possible due to the absorption of toxic substances into the bloodstream, which are the products of the decomposition of proliferated soft tissues (Haddow et al., 2017).

Individuals affected by traumatic toxicosis complain of pain in the damaged part of the body, nausea, headache, and thirst. There usually are visible abrasions and dents on the injured part, repeating the outline of the protruding portions of the objects pressing. The possibility of these and other injuries justifies the necessity to employ the principle of protecting people’s lives.

The other two principles also bear much significance since they are aimed at arranging convenient living conditions for those who have suffered during an earthquake. To provide the stabilization of disaster area protect people’s property, the following programs have been introduced by the Centers for Disease Control and Prevention (CDC): planning and readiness assessment, surveillance and epidemiology capacity, education and training, health alert network, communication of health risks and dissemination of health information, and others (Boatright-Royster & Brewster, 2016).

The implementation of the fundamental principles of healthcare incident management involves the cooperation between various organizations and citizens. The outcomes of earthquakes allow considering this type of natural disaster eligible for this classification.

Triaging of Victims as a Challenge

Medical sorting is the method of distributing the victims to groups according to the need for similar therapeutic, preventive, and evacuation measures, depending on medical indications and the specific situation. The primary goal of triage is to ensure the timely delivery of medical care and rational evacuation to the affected (Waugh, 2015). This measure becomes particularly important in situations where the number of people requiring medical care exceeds the capacity of local health services. Medical assistance is considered timely only when it saves the life of the affected person and prevents the development of dangerous complications.

Medical sorting is a concrete, continuous, repetitive, and successive process of providing victims with all types of medical care. Triaging is carried out from the moment of rendering first medical aid on the site of the accident and in the pre-hospital period outside the zone of earthquake defeat, as well as when entering the national, regional and other medical institutions to receive full medical assistance and treatment until the outcome (Waugh, 2015).

Sorting the victims of an earthquake may be a challenging task since the number of affected individuals is great, and there may be a lack of competent healthcare specialists. Frequently, help is provided by the survivors whose injuries are not very serious, and these people may not have sufficient medical education. Another challenge is that the victims may have internal damages that are impossible to feel or notice at a glance.

In the hearth of the earthquake lesion, the simplest measures of medical sorting are performed in the place of the injury, in the interest of providing first aid. When the medical personnel arrives in the disaster area (ambulance brigades, disaster medicine teams), the sorting continues, and deepens (Waugh, 2015). The medical staff of any level of training and professional competence should first perform the selective sorting and identify the individuals most severely affected.

Then, it is essential to determine the predominant group of people that require medical care. These are children and individuals with external bleeding, asphyxia, or convulsions. Triaging of earthquake victims is a challenging task, but its appropriate fulfillment can mitigate the adverse outcomes to a considerable extent.

Injuries Most Likely to Occur

Since in the event of massive destruction of buildings, landslides, rockfalls, and landslides, various injuries may occur, medical aid for earthquakes is exceptionally diverse. The victims of an earthquake may have fractures, contusions, brain, and spinal cord injuries, dislocations, bruises, concussions, electric shock, and other damages. Earthquakes are considered to be the leading reason for mortality and morbidity associated with natural disasters (Clover, Jemec, & Redmond, 2014).

The most common damages after a quake are the injuries of the musculoskeletal system and soft tissues. The predominant injuries are those of limbs: 60% of all cases (Clover et al., 2014). Over 50% of people have fractures, 8-13% of which are open (Clover et al., 2014). Thus, the specialists most commonly needed by earthquake victims are surgeons.

Apart from tissue and musculoskeletal damage, survivors may also suffer from pneumonia or infectious diseases. Researchers studying the 2011 Great East Japan Earthquake remark that 43% of survivors had pneumonia, and 12% of people had skin and subcutaneous tissue infections (Aoyagi et al., 2013). Moreover, 20.5% of hospitalized individuals were positively tested for urinary pneumococcal antigen (Aoyagi et al., 2013). Since these diseases are related to climatic and weather factors of the earthquake spot, it is possible to conclude that survivors of a similar event in Maryland are also prone to such infections.

Another common injury that can be observed in earthquake victims is brain concussion. This condition is characterized by consciousness disorder, stunning, headaches of varying intensity, dizziness, or vomiting (Haddow et al., 2017). Frequently, the concussion is accompanied by focal symptoms: the violation of eye convergence, nystagmus, changes in pupillary reflexes, the deviation of the tongue from the midline, smoothness of the nasolabial fold, or the shift in tendon reflexes (weakening or strengthening) (Haddow et al., 2017). Characteristic features of a concussion include the change in body temperature, pallor or redness of the skin, increased sweating, and changes in heart rate or blood pressure. Thus, concussions complete the list of injuries most likely to occur after earthquakes, following musculoskeletal damages and infectious diseases.

Issues Affecting Vulnerable Populations

Although any person suffering from an earthquake may experience much physical pain or spiritual suffering, there are groups of individuals that are at specific risk. Such vulnerable populations include children, elderly citizens, disabled people, and pregnant women (Armaş, Toma-Danila, Ionescu, & Gavriş, 2017). Also, scholars identify individuals with low education as vulnerable in conditions of an earthquake (Armaş et al., 2017). The main problems affecting these populations’ likelihood to survive the outcomes of a natural disaster are concerned with their low emotional stability, poor physical abilities, and insufficient knowledge of how to behave.

Public Health Issues That May Ensue and Their Mitigation

Apart from immediate physical damages that earthquake victims undergo, there is a danger of public health issues developing as a result of the natural disaster. Due to the lack of proper hygienic conditions in the aftermath of an earthquake, there is a high risk of the spread of infectious diseases among the survivors. Such illnesses are commonly caused by various microorganisms such as viruses, fungi, or bacteria (Gamage, Kravolic, & Roselle, 2016). To mitigate this public health issue, it is crucial to provide the victims with drinking water and access to hygienic conditions as soon as possible.

Utilizing Interagency Cooperation and Local Collaboration

A highly significant issue that can improve the outcomes of an earthquake is the arrangement of collaboration between various organizations whose combined efforts can help the victims. The institution responsible for Maryland in case of an emergency is the National Naval Medical Center that is located in Bethesda, MD (Boatright-Royster & Brewster, 2016).

However, the efforts of only one agency cannot be enough, thus, Maryland relies not only on local but also on state organizations and programs, such as the National Disaster Medical System, the Office of Assistant Secretary for Preparedness and Response, the Food and Drug Administration, the Strategic National Stockpile, and others (Boatright-Royster & Brewster, 2016). The collaboration at all levels promotes prompt reaction to natural disasters and can save the lives of many people injured during an earthquake.

Considerations Unique to the Disaster

All-natural disasters have some things in common, such as a large number of victims or damages. However, when managing the outcomes of an earthquake, one should take into account some specific considerations. Probably the most crucial of such aspects is the possibility of earthquake-induced landslides (Carlton, Kaynia, & Farrokh, 2016). Disaster managers should not neglect this hazard since they can lead to the severe aftermath.

Conclusion

Earthquakes, which bring great harm to humankind, are the object of profound research and study. Maryland belongs to the states that are vulnerable to these natural disasters. The arrangement of the successful emergency management in case of an earthquake should involve the principles of incident management, public health issues, the problems of triaging victims, and the collaboration of agencies at different levels.

Thorough investigations of seismic zones are needed to predict earthquakes and inform people about the approaching disaster. Currently, scientists are doing everything possible to notify the state and citizens, which leads to building defensive structures and arranging safety methods. By taking into consideration the aspects discussed in the paper, it will be easier to mitigate the devastating outcomes of earthquakes.

References

Aoyagi, T., Yamada, M., Kunishima, H., Tokuda, K., Yano, H., Ishibashi, N., … Kaku, M. (2013). Characteristics of infectious diseases in hospitalized patients during the early phase after the 2011 Great East Japan Earthquake: Pneumonia as a significant reason for hospital care. Chest, 143(2), 349-356.

Armaş, I., Toma-Danila, D., Ionescu, R., & Gavriş, A. (2017). Vulnerability to earthquake hazard: Bucharest case study, Romania. International Journal of Disaster Risk Science, 8(2), 182-195.

Boatright-Royster, C., & Brewster, P. W. (2016). Public health and emergency management systems. In K. L. Koenig & C. H. Schultz (Eds.), Koenig and Schultz’s disaster medicine: Comprehensive principles and practices (2nd ed.) (pp. 165-182).

Carlton, B., Kaynia, A. M., & Farrokh, N. (2016). Some important considerations in analysis of earthquake-induced landslides. Geoenvironmental Disasters, 3(11).

Chopra, A. K. (2017). Dynamics of structures: Theory and applications to earthquake engineering (5th ed.). Essex, England: Pearson Education.

Clover, A. J. P., Jemec, B., & Redmond, A. D. (2014). The extent of soft tissue and musculoskeletal injuries after earthquakes; Describing a role for reconstructive surgeons in an emergency response. World Journal of Surgery, 38(10), 2543-2550.

Gamage, S. D., Kravolic, S. M., & Roselle, G. A. (2016). Emerging infectious diseases: Concepts in preparing for and responding to the next microbial threat. In K. L. Koenig & C. H. Schultz (Eds.), Koenig and Schultz’s disaster medicine: Comprehensive principles and practices (2nd ed.) (pp. 93-123).

Haddow, G. D., Bullock, J. A., & Coppola, D. P. (2017). Introduction to emergency management (6th ed.). Cambridge, MA: Butterworth-Heinemann.

Pulinets, S. A., Morozova, L. I., & Yudin, I. A. (2014). Synchronization of atmospheric indicators at the last stage of earthquake preparation cycle. Research in Geophysics, 4(1), 45-50.

Waugh, W. L. (2015). Living with hazards, dealing with disasters: An introduction to emergency management. New York, NY: Routledge.

Introduction

• Influenza pandemic lead to calamitous consequences
• Employees may contract influenza from residents
• Friends and relatives of the residents are also at risk
• Imperative to educate all parties
• Vaccination of all parties is fundamental

Learning outcomes

• Help understand the importance of receiving a flu shot
• Prevent social disruptions and economic consequences of the spread of flu
• Educators must understand the prevailing status and awareness of flu vaccination
• The study creates knowledge for all the parties by highlighting the reasons for and importance of vaccination

Background

• Vaccination is among the most proactive measures
• Recommended for individuals older than six years
• Reduces the percentage of individuals developing flu

Nursing Home Employees

• Employees in a nursing home environment are susceptible to contracting flu
• Option in the nursing home environment is left to the individual employees
• Vaccinating employees help save lives, mitigate social disruptions and economic consequences

Nursing Home Employees Cont’d

• Administrative staff have limited clinical information regarding influenza
• They consider themselves immune to flu
• The nursing home environment is contaminated with the influenza virus
• Imperative for the staff to be vaccinated
• Employees are highly exposed

Family and visitors

• Influenza is a communicable respiratory infection
• The flu pandemic in the public prevails when a fresh flu virus sub-type emerges
• No infection-specific vaccine is in existence when the flu emerges
• Individuals with poor health are more likely to contract flu
• Better nutrition and health care influence the consequent morbidity and mortality

Family and visitors Cont’d

• Individuals do not have to be in direct contact with the infected persons
• The environment is often contaminated with the flu virus
• Visitors and family to be vaccinated against flu
• Restrict the visits by friends and family to curtail the spread
• Should cooperate with health providers

Employee Preparedness

• Employees in nursing homes should be well prepared
• There is usually a short supply of vaccines
• Have elaborated acquisition and distribution channels
• Implement additional traditional prevention methods
• Use protective equipment in addition to vaccinations

Employee Preparedness Cont’d

• Have the ability to group residents
• Curtail social activities and rehabilitation events
• Facilitate the transfer of patients home or other nursing homes
• Communicate with family and friends as well as the media

Residents

• Different residents have different health needs
• Are exposed to the danger of being infected
• Paramount for the residents to be immunized against flu
• Chronic diseases are among the leading reason for taking flu vaccination
• There is perceived vulnerability to flu

References

Akan, H. (2010). Knowledge and attitudes of university students toward pandemic influenza: A cross-sectional study from Turkey. BMC Publ Health, 10(1), 412-413.

Bone, A. (2010). Population and risk group uptake of H1N1 influenza vaccine in mainland France 2009-2010: Results of a national vaccination campaign. Vaccine, 28(51), 8157-8161.

Cox, N., & Subbarao, K. (2011). Influenza. Lancet, 354(1), 1277-1282.

Hothersall, E. (2012). Factors associated with uptake of pandemic influenza vaccine among general practitioners and practice nurses in Shropshire, UK. Prim Care Respir Journal, 21(3), 302-307.

Iwasa, T., & Wada, K. (2013). Reasons for and against receiving influenza vaccination in a working-age population in Japan: A national crosssection study. BMC Public Health, 13(647), 1-7.

Jefferson, T. (2010). Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev, 7(1), 176-180.

Practices ACol. (2012). Recommended adult immunization schedule: United States. Ann Intern Med, 156(3), 211-217.

Crawford, N. (2011). Individual- and neighborhood-level characteristics associated with support of in-pharmacy vaccination among ESAPregistered pharmacies: Pharmacists’ role in reducing racial/ethnic disparities in influenza vaccinations in New York City. J Urban Health, 88(1), 176–185.

Liao, Q. (2011). Factors affecting intention to receive and self-reported receipt of 2009 pandemic (H1N1) vaccine in Hong Kong: A longitudinal study. PLoS One, 6(3),177-213.