BOOK
Ciottone's Disaster Medicine E-Book
Gregory R. Ciottone | Paul D Biddinger | Robert G. Darling | Saleh Fares | Mark E Keim | Michael S Molloy | Selim Suner
(2015)
Additional Information
Book Details
Abstract
The most comprehensive resource of its kind, Ciottone’s Disaster Medicine, 2nd Edition, thoroughly covers isolated domestic events as well as global disasters and humanitarian crises. Dr. Gregory Ciottone and more than 200 worldwide authorities share their knowledge and expertise on the preparation, assessment, and management of both natural and man-made disasters, including terrorist attacks and the threat of biological warfare. Part 1 offers an A-to-Z resource for every aspect of disaster medicine and management, while Part 2 features an exhaustive compilation of every conceivable disaster event, organized to facilitate quick reference in a real-time setting.
- Quickly grasp key concepts, including identification of risks, organizational preparedness, equipment planning, disaster education and training, and more advanced concepts such as disaster risk reduction, tactical EMS, hazard vulnerability analysis, impact of disaster on children, and more.
- Understand the chemical and biologic weapons known to exist today, as well as how to best manage possible future events and scenarios for which there is no precedent.
- Consult this title on your favorite e-reader.
- Be prepared for man-made disasters with new sections that include Topics Unique to Terrorist Events and High-Threat Disaster Response and Operational Medicine (covering tactical and military medicine).
- Get a concise overview of lessons learned by the responders to recent disasters such as the earthquake in Haiti, Hurricane Sandy, the 2014 Ebola outbreak, and active shooter events like Sandy Hook, CT and Aurora, CO.
- Learn about the latest technologies such as the use of social media in disaster response and mobile disaster applications.
- Ensure that everyone on your team is up-to-date with timely topics, thanks to new chapters on disaster nursing, crisis leadership, medical simulation in disaster preparedness, disaster and climate change, and the role of non-governmental agencies (NGOs) in disaster response – a critical topic for those responding to humanitarian needs overseas.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Inside Front Cover | ES2 | ||
| Ciottone's Disaster Medicine | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Acknowledgments | vii | ||
| Associate Editors | ix | ||
| Section Editors | xi | ||
| Contributors | xiii | ||
| Foreword | xxv | ||
| Preface | xxvii | ||
| Contents | xxix | ||
| Part I: Overview of Disaster Management | 1 | ||
| Chapter 1: Introduction to Disaster Medicine | 2 | ||
| The disaster cycle | 2 | ||
| Natural and human-made disasters | 2 | ||
| Defining disaster | 3 | ||
| Disaster medicine | 4 | ||
| References | 4 | ||
| Section One: Introduction | 6 | ||
| Chapter 2: Public Health and Disasters | 6 | ||
| Introduction to public health | 6 | ||
| Definition, Scope, and Achievements of Public Health | 6 | ||
| Public Health System and Infrastructure | 6 | ||
| Public Health Essential Services | 7 | ||
| Public health consequences of disasters | 7 | ||
| Direct Effect on the Health of Population | 7 | ||
| Direct Effect on the Health Care System | 8 | ||
| Indirect Effect on the Health of the Population | 8 | ||
| Indirect Effect on the Health Care System | 8 | ||
| Public health and the disaster-management cycle | 8 | ||
| Prevention and Mitigation | 9 | ||
| Preparedness | 9 | ||
| Response | 10 | ||
| Recovery | 10 | ||
| Public health in national disaster frameworks: the case of the united states | 10 | ||
| National Prevention Framework | 10 | ||
| National Mitigation Framework | 11 | ||
| National Response Framework | 11 | ||
| National Disaster Recovery Framework | 11 | ||
| Conclusion | 11 | ||
| References | 11 | ||
| EMS internationally | 14 | ||
| Current practice | 16 | ||
| Pitfalls | 18 | ||
| References | 18 | ||
| Chapter 4: Role of Emergency Medicine in Disaster Management | 20 | ||
| Historical perspective | 20 | ||
| Current practice | 22 | ||
| Role of Emergency Medicine Specialists | 22 | ||
| Role of the ED in a Disaster | 22 | ||
| Organization of the Emergency Department during a Disaster | 23 | ||
| Initiate Procedures for Clearing Emergency Department Care Space for Incoming Patients | 24 | ||
| Set Up a Decontamination Area | 24 | ||
| Establishing Zones and Health Care Teams | 24 | ||
| Assess Functionality of Emergency Department Tracking Systems for the Impending Disaster | 24 | ||
| Alert and Organize Registration for the Incoming Victims | 24 | ||
| Organize Specialty Services in the Emergency Department | 24 | ||
| Management of Volunteer Providers | 24 | ||
| When the Number of Victims Begins to Wind Down | 24 | ||
| Emergency Medicine Preparedness and Training for Disasters | 25 | ||
| Conclusion | 25 | ||
| Pitfalls | 25 | ||
| References | 25 | ||
| Chapter 5: Disaster Nursing | 27 | ||
| Historical perspective | 27 | ||
| Current practice | 27 | ||
| Education and Principles of Disaster Nursing | 27 | ||
| Nursing Within the Disaster Cycle | 28 | ||
| Mitigation | 28 | ||
| Preparedness | 28 | ||
| Response | 28 | ||
| Recovery | 29 | ||
| Nursing roles within disaster response | 29 | ||
| Pitfalls | 29 | ||
| Conclusion | 29 | ||
| References | 30 | ||
| Chapter 6: Role of Hospitals in a Disaster | 31 | ||
| Historical perspective | 31 | ||
| Current practice | 32 | ||
| Public Expectation of Hospital Function | 32 | ||
| Elements of comprehensive hospital preparedness for disasters | 32 | ||
| Hospital Vulnerability | 32 | ||
| Structural Elements | 32 | ||
| Nonstructural Elements | 32 | ||
| Administrative and Organizational Elements | 32 | ||
| Hospital Safety Index | 33 | ||
| Hazard Vulnerability Analysis | 33 | ||
| Hospital Incidence Command System | 33 | ||
| Surge Capacity | 34 | ||
| Hospital Evacuation | 35 | ||
| Hospital Readiness for Hazardous Materials Emergencies | 35 | ||
| Education and Training | 36 | ||
| Assessment of Hospital Preparedness for Disasters | 36 | ||
| Pitfalls | 36 | ||
| Summary | 37 | ||
| References | 37 | ||
| Chapter 7: Complex Emergencies | 40 | ||
| Characterization of complex emergencies | 40 | ||
| Mass Population Displacement | 40 | ||
| Food Insecurity | 41 | ||
| Sexual Violence | 41 | ||
| Historical perspective | 41 | ||
| Current practice | 42 | ||
| Humanitarian Response | 42 | ||
| Evolution of Civilian Medical Needs in Complex Emergencies | 42 | ||
| Public Health Priorities | 43 | ||
| Public Health Indicators | 43 | ||
| Communicable Diseases | 43 | ||
| Diarrhea | 43 | ||
| Measles | 43 | ||
| Malaria | 43 | ||
| Respiratory Illnesses | 44 | ||
| Meningitis | 44 | ||
| Noncommunicable Diseases | 44 | ||
| Mental Health | 44 | ||
| Reproductive Health | 44 | ||
| Sector-Specific Responses | 44 | ||
| Nutrition | 44 | ||
| Shelter | 44 | ||
| Water and Sanitation | 45 | ||
| Pitfalls | 45 | ||
| Summary | 45 | ||
| References | 45 | ||
| Chapter 8: Disaster and Climate Change | 47 | ||
| Introduction | 47 | ||
| Historical perspective | 47 | ||
| Current practice | 48 | ||
| Preparedness and Prevention | 48 | ||
| Response and Recovery | 50 | ||
| Pitfalls | 51 | ||
| Summary | 51 | ||
| References | 51 | ||
| Chapter 9: Children and Disaster | 53 | ||
| Historical perspective | 53 | ||
| Current practice | 54 | ||
| Water, Sanitation, and Hygiene | 54 | ||
| Food Security and Nutrition | 55 | ||
| Shelter, Settlement, and Nonfood Items | 56 | ||
| Health Action | 56 | ||
| Psychological Support | 57 | ||
| Pitfalls | 58 | ||
| References | 58 | ||
| Chapter 10: Psychological Impact of Disaster on Displaced Populations and Refugees of Multiple Traumas | 60 | ||
| Postmigration and adjustment of traumatized refugees in host nations | 60 | ||
| Level of exposure to violence and human disaster versus vulnerabilities of displacement | 61 | ||
| Disaster and mental health triage of refugees and suggested therapeutic approaches | 61 | ||
| Unaccompanied children, women, and displaced refugee families | 62 | ||
| National and international policies on asylum seekers, displaced populations, and refugees of multiple trauma | 63 | ||
| Concluding remarks on a refugee being in an unfamiliar, unknown host surrounding | 64 | ||
| References | 64 | ||
| Chapter 11: Ethical Issues in Disaster Medicine | 67 | ||
| Historical perspective | 67 | ||
| Current practice | 67 | ||
| Section1. Prevention, Mitigation, and Planning | 67 | ||
| Section2. Altered Standards of Care | 67 | ||
| Section3. Informed Consent | 68 | ||
| Section4. Triage | 68 | ||
| Triage Methods | 68 | ||
| Fundamental Goals Behind Triage | 69 | ||
| Disability Weights, Age Weights, and Discrimination | 69 | ||
| Response Worker Prioritization | 70 | ||
| Nondisaster Needs | 70 | ||
| Repeat Triage | 70 | ||
| Section5. Disparities | 71 | ||
| Section6. Quarantine | 71 | ||
| Section7. Surveillence | 71 | ||
| Section8. Research | 71 | ||
| Section9. Rescuers Rights | 71 | ||
| Section10. Transparency and Communication | 72 | ||
| Section11. Political Involvement | 72 | ||
| Section12. Recovery | 72 | ||
| Conclusion | 72 | ||
| Pitfalls | 72 | ||
| Acknowledgment | 73 | ||
| References | 73 | ||
| Chapter 12: Issues of Liability in Emergency Response | 75 | ||
| Historical perspective | 75 | ||
| History of Emergency Response Management | 75 | ||
| Basic Concepts of Law | 76 | ||
| Current practice | 76 | ||
| Basis of Law | 76 | ||
| The Judicial System | 77 | ||
| Courts | 77 | ||
| Venue | 77 | ||
| Case Law | 77 | ||
| Standard of Care | 77 | ||
| The Role of the Jury | 78 | ||
| The Role of the Trial Judge | 78 | ||
| The Attachment of Liability | 78 | ||
| Immunities | 79 | ||
| Good Samaritan Laws | 79 | ||
| Federal Tort Claims Act | 79 | ||
| Volunteer Protection Act | 79 | ||
| The Emergency Management Assistance Compact | 79 | ||
| The Uniform Emergency Volunteer Health Practitioners Act | 79 | ||
| The Model State Emergency Health Powers Act | 80 | ||
| Patient rights | 80 | ||
| Nondiscriminatory response | 80 | ||
| Regulatory violations | 80 | ||
| Summary | 81 | ||
| Pitfalls | 81 | ||
| References | 81 | ||
| Section Two: Domestic and International Resources | 82 | ||
| Chapter 13: Disaster Response in the United States | 82 | ||
| Historical perspective | 82 | ||
| The Early Years: 1776 to 1945 | 82 | ||
| Civil Defense Era: 1945 to 1974 | 82 | ||
| Coordinating State and Federal Response: 1974 to 2001 | 82 | ||
| New Millennium, New Threats: Post-2001 | 83 | ||
| Current concepts of disaster response | 83 | ||
| Local Level Emergency Management | 83 | ||
| State-Level Emergency Management | 83 | ||
| Federal-Level Emergency Management | 84 | ||
| Department of Homeland Security | 84 | ||
| National Incident Management System | 85 | ||
| Summary | 85 | ||
| References | 85 | ||
| Chapter 14: Disaster Response in Europe | 86 | ||
| Historical perspective | 86 | ||
| From Ancient Times to the Middle Ages | 86 | ||
| Modern Era | 86 | ||
| Contemporary era and current practice | 87 | ||
| Local Level Emergency Management | 87 | ||
| Regional Level Emergency Management | 88 | ||
| National Level Emergency Management | 88 | ||
| International Level Emergency Management (European Union) | 88 | ||
| References | 88 | ||
| Chapter 15: Local Disaster Response | 90 | ||
| Local governance | 90 | ||
| Supporting organizations and capabilities | 91 | ||
| Local resources | 91 | ||
| Local response concepts of operations | 92 | ||
| Community Warning | 92 | ||
| Response Scene Operations | 92 | ||
| Receiving Facility Considerations | 93 | ||
| Public Welfare Issues | 93 | ||
| Issues in local response | 93 | ||
| Summary | 94 | ||
| References | 94 | ||
| Chapter 16: State Disaster Response | 95 | ||
| State and local emergency management organization | 95 | ||
| State departments of health and health functions | 96 | ||
| Specific public health and medical programs | 96 | ||
| Emergency functions | 97 | ||
| Summary | 97 | ||
| References | 97 | ||
| Chapter 17: Selected Federal Disaster Response Agencies and Capabilities | 98 | ||
| Principal federal agencies | 98 | ||
| Department of Homeland Security | 98 | ||
| Homeland Security Grants Program | 98 | ||
| Department of Health and Human Services | 98 | ||
| National Disaster Medical System | 98 | ||
| Strategic National Stockpile | 99 | ||
| The Office of the Assistant Secretary for Preparedness and Response | 99 | ||
| Agency for Healthcare Research and Quality | 100 | ||
| Centers for Disease Control and Prevention | 100 | ||
| Food and Drug Administration | 100 | ||
| Health Resources and Services Administration | 100 | ||
| Indian Health Service | 101 | ||
| National Institutes of Health | 101 | ||
| Substance Abuse and Mental Health Services Administration | 101 | ||
| Commissioned Corps of the U.S. Public Health Service | 101 | ||
| Department of Veterans Affairs | 101 | ||
| Department of Defense | 102 | ||
| American Red Cross | 102 | ||
| Issues in federal response to disasters | 103 | ||
| Summary | 103 | ||
| References | 103 | ||
| Chapter 18: Global Disaster Response | 105 | ||
| Historical perspective | 105 | ||
| Current practice | 107 | ||
| Pitfalls | 108 | ||
| References | 109 | ||
| Chapter 19: Nongovernmental Organizations in Disaster Medicine | 111 | ||
| Historical perspective | 111 | ||
| Current practice | 113 | ||
| Nongovernmental Organizations and Volunteers | 114 | ||
| When Disasters Occur | 114 | ||
| After and in Between Disasters | 115 | ||
| Challenges | 115 | ||
| Coordination | 116 | ||
| Collaboration in the United States | 116 | ||
| Future perspective | 117 | ||
| Conclusion | 118 | ||
| References | 118 | ||
| Suggested Readings | 119 | ||
| Chapter 20: Disaster and Emergency Management Programs | 120 | ||
| What Is Disaster and Emergency Management? | 120 | ||
| The Emergency Management Cycle | 120 | ||
| Why Do We Need Disaster and Emergency Management Programs? | 120 | ||
| Historical perspective | 120 | ||
| History of Disaster and Emergency Management Programs | 120 | ||
| Current practice | 121 | ||
| Federal Programs | 121 | ||
| Community Emergency Response Team | 121 | ||
| Voluntary Organizations Active in Disaster | 121 | ||
| National Preparedness System | 121 | ||
| Medical Reserve Corps | 121 | ||
| National Disaster Medical System | 121 | ||
| Federal Education Programs | 121 | ||
| State Emergency Management | 122 | ||
| Local Emergency Management | 122 | ||
| Nongovernment Organizations | 122 | ||
| Community and Faith-Based Organizations | 122 | ||
| University Programs | 122 | ||
| Private Sector Programs | 122 | ||
| Hospitals | 122 | ||
| Businesses | 122 | ||
| Pitfalls | 123 | ||
| Communication | 123 | ||
| Resilience | 123 | ||
| Accountability | 123 | ||
| Funding | 123 | ||
| Lack of Private Sector Ties | 123 | ||
| References | 123 | ||
| Section Three: Pre-Event Topics | 125 | ||
| Chapter 21: Emergency Department Design | 125 | ||
| Historical perspective | 125 | ||
| Recommendations of Project ER One | 126 | ||
| Scalability | 126 | ||
| Alternate Care Sites | 126 | ||
| Capability | 126 | ||
| Threat Mitigation | 126 | ||
| Current practice | 126 | ||
| Scalability, Surge, and Treatment Capacity | 126 | ||
| Security | 127 | ||
| Information | 127 | ||
| Isolation and Decontamination | 128 | ||
| Pitfalls | 129 | ||
| Conclusion | 129 | ||
| References | 129 | ||
| Chapter 22: Community Hazard Vulnerability Assessment | 131 | ||
| Historical perspective | 131 | ||
| Current practice | 132 | ||
| cHVA Team Membership6 | 132 | ||
| Development of Community Profile | 132 | ||
| Hazard Identification | 133 | ||
| Hazard Profiling (Probability, Vulnerability, and Consequences) | 133 | ||
| Probability Assessment | 133 | ||
| Consequences | 134 | ||
| Vulnerability Assessment | 134 | ||
| Summary | 134 | ||
| Pitfalls | 134 | ||
| Management of Low-Probability, High-Consequence Events | 134 | ||
| Conclusion | 135 | ||
| References | 135 | ||
| Chapter 23: Health Care Facility Hazard and Vulnerability Analysis | 136 | ||
| Historical perspective | 136 | ||
| Current practice | 136 | ||
| Pitfalls | 141 | ||
| Conclusion | 141 | ||
| References | 142 | ||
| Chapter 24: Public Information Management | 143 | ||
| Media history | 143 | ||
| Media and disasters | 144 | ||
| Current practices | 144 | ||
| Medical/Emergency Medical Services/Fire Models | 145 | ||
| Effect of Media Reports | 146 | ||
| Media Communication | 146 | ||
| Detroit Free Press Example | 146 | ||
| Lessons from Recent Disasters | 146 | ||
| Tokyo Sarin Attack, 1995 | 146 | ||
| Oklahoma City Bombing, 1995 | 146 | ||
| Haiti Earthquake, 2010 | 146 | ||
| Pitfalls of managing public information | 146 | ||
| Failing to Bring in Experts | 146 | ||
| Using Complex Language or Jargon | 147 | ||
| Arguing, Fighting, or Losing Your Temper | 147 | ||
| Predicting | 147 | ||
| Answering a Question That You Are Not Qualified to Answer | 147 | ||
| Failing to Show Empathy | 147 | ||
| Lying, Clouding the Truth, or Covering Up | 147 | ||
| Not Responding Quickly | 147 | ||
| Not Responding at All | 147 | ||
| Failing to Practice Emergency Communications | 147 | ||
| Conclusion | 147 | ||
| References | 147 | ||
| Suggested Reading | 148 | ||
| Chapter 25: Informatics and Telecommunications in Disaster | 149 | ||
| Historical perspective1 | 149 | ||
| Current practice | 150 | ||
| Computer Devices | 150 | ||
| The Laptop | 150 | ||
| The Tablet PC | 150 | ||
| The Smartphone | 151 | ||
| Local Area Network/Wide Area Network/Wireless Network | 152 | ||
| Communications Devices | 152 | ||
| Geographical Positioning System | 152 | ||
| Cellular Devices | 152 | ||
| Satellite Phone Systems | 152 | ||
| Mobile Communications Vehicles | 153 | ||
| Radio Systems | 153 | ||
| Specialized Informatics Systems and Decision Support Tools | 154 | ||
| Humanitarian Information Systems | 154 | ||
| Surveillance and Bioterrorism Detection Systems | 154 | ||
| Summary | 154 | ||
| References | 155 | ||
| Suggested Readings | 155 | ||
| Chapter 26: Medical Simulation in Disaster Preparedness | 156 | ||
| Historical perspective | 156 | ||
| Educational theory in simulation | 156 | ||
| Types of simulators | 157 | ||
| Use of simulation in disaster preparedness | 158 | ||
| The future simulation in disaster planning | 158 | ||
| References | 159 | ||
| Chapter 27: Disaster Mitigation | 160 | ||
| Hyogo framework for action | 160 | ||
| Engaging the Whole Community | 160 | ||
| Introduction of mitigation in the united states | 160 | ||
| Goals and concepts of mitigation | 161 | ||
| Recent historical perspective | 161 | ||
| Current practice | 162 | ||
| New hampshire critical care and supplemental oxygen program (NHCCSOP) | 164 | ||
| Common pitfalls | 164 | ||
| Conclusion | 165 | ||
| References | 165 | ||
| Suggested Readings | 166 | ||
| Chapter 28: Disaster Risk Management | 167 | ||
| Overview of disaster risk management | 167 | ||
| Ethical Considerations | 167 | ||
| Ventilator Allocation | 167 | ||
| Critical Care Admission Thresholds | 168 | ||
| Triage of Pharmaceuticals and Medical Countermeasures | 168 | ||
| Elective Procedures and Outpatient Units | 168 | ||
| Legal Considerations | 168 | ||
| Altered Standards of Care | 168 | ||
| Triage Protocols | 169 | ||
| Modified Scopes of Practice | 170 | ||
| Physician Assistants | 170 | ||
| Advanced Practice Nurses | 170 | ||
| Advanced Prehospital Providers (Paramedics) | 171 | ||
| Health Profession Students | 171 | ||
| Credentialing of Volunteer Health Care Providers | 171 | ||
| Waiver of State and Federal Health Care Laws and Regulations | 172 | ||
| Health Insurance Portability and Accountability Act | 172 | ||
| Emergency Medical Treatment and Active Labor Act | 172 | ||
| Medical Licensing | 172 | ||
| Operational Considerations | 173 | ||
| Reducing Nonessential Hospital Operations | 173 | ||
| Closing Outpatient Services | 173 | ||
| Cancellation of Elective Procedures | 173 | ||
| Surge Capacity and Capability | 173 | ||
| Emergency Department Surge Capacity | 173 | ||
| Medical/Surgical Beds and Step-Down | 174 | ||
| Critical Care Surge Capability | 174 | ||
| Transforming Nonpatient Care Areas into Subacute Holding Areas | 174 | ||
| Mobile Solutions, Tents, etc | 174 | ||
| Supply Chain Issues | 174 | ||
| Medical Equipment and Supplies | 174 | ||
| Linen | 174 | ||
| Pharmaceuticals and Medical Countermeasures | 175 | ||
| Food Services | 175 | ||
| Alternative Care Sites | 175 | ||
| Summary | 176 | ||
| References | 176 | ||
| Chapter 29: Vaccines | 178 | ||
| Historical background | 178 | ||
| Immunity | 178 | ||
| Vaccines | 179 | ||
| Vaccine Storage | 179 | ||
| Current practice | 179 | ||
| Potential Bioterrorism Agents | 179 | ||
| Category A | 179 | ||
| Anthrax (Bacillus anthracis) | 179 | ||
| Botulism (Clostridium botulinum) | 180 | ||
| Smallpox (Variola major) | 180 | ||
| Plague (Yersinia pestis) | 181 | ||
| Tularemia (Francisella tularensis) | 181 | ||
| Hemorrhagic fever viruses | 181 | ||
| Category B | 181 | ||
| Food safety threats (e.g., Salmonella species, Chapter 134; Escherichia coli O157:H7, Chapter 139; Shigella, Chapter 133) | 181 | ||
| Water safety threats (e.g., Vibrio cholerae, Chapter 132) | 182 | ||
| Vaccinations for displaced persons | 182 | ||
| Influenza | 182 | ||
| Pitfalls | 182 | ||
| References | 183 | ||
| Chapter 30: Occupational Medicine | 185 | ||
| References | 190 | ||
| Chapter 31: Worker Health and Safety in Disaster Response | 192 | ||
| Planning and training | 192 | ||
| Management of workers involved in disaster response | 192 | ||
| Occupations involved in disaster response | 193 | ||
| First Responders | 193 | ||
| Firefighters | 194 | ||
| Police | 196 | ||
| Emergency Medical Services Personnel | 196 | ||
| Secondary Responders and Skilled Support Personnel | 197 | ||
| References | 197 | ||
| Chapter 32: Disaster Preparedness | 200 | ||
| Definition | 200 | ||
| Disaster Terminology | 200 | ||
| Disaster Risk Management | 200 | ||
| Preparedness | 200 | ||
| Historical perspective | 200 | ||
| Current practice | 202 | ||
| The Approach to Disaster Preparedness | 202 | ||
| Health Objectives of Disaster Preparedness | 202 | ||
| Key Elements of Disaster Preparedness | 202 | ||
| A Capability-Based Approach for Disaster Preparedness Programs | 203 | ||
| Capability and Capacity | 204 | ||
| Process for Development of Disaster Preparedness Programs | 204 | ||
| Risk Assessment | 206 | ||
| Emergency Operations Plan | 207 | ||
| Principles of Effective Emergency Operations Planning | 207 | ||
| Operational-Level Planning | 208 | ||
| Objective-Based Planning | 208 | ||
| Capability-Based Planning | 208 | ||
| Consensus-Based Planning | 208 | ||
| Compliance with Local, National, and International Strategies | 208 | ||
| Plan Elements | 208 | ||
| Planning Method | 209 | ||
| Gap Analysis | 209 | ||
| Implementation of Preparedness Programs | 210 | ||
| Managing the Process of Disaster Preparedness | 211 | ||
| Monitoring and Evaluation | 211 | ||
| Disaster preparedness pitfalls | 211 | ||
| Pitfalls of Disaster Management in General | 211 | ||
| Preparedness as a Short-Term Activity Instead Long-Term Sustainable Versus Programs | 212 | ||
| Lack of Valid Assumptions and Knowledge Regarding the Disaster Phenomenon | 212 | ||
| Over-Reliance upon External Assistance, Mobile Field Hospitals, and Specialized Surgical Teams | 212 | ||
| Misuse of Disaster Exercises | 212 | ||
| Problems in Disaster Planning | 212 | ||
| Over-Emphasis on Mass Casualty Care in Health Sector Disaster Plans | 212 | ||
| Poor Planning for Management of Human Resources | 212 | ||
| Quality Management as Applied to Disaster Preparedness | 212 | ||
| The future of disaster preparedness | 213 | ||
| References | 213 | ||
| Suggested Readings | 214 | ||
| Chapter 33: Policy Issues in Disaster Preparedness and Response | 215 | ||
| The ethical view for the scientist | 215 | ||
| Evacuation orders: ``you may want to heed this advice for your own good´´ | 216 | ||
| An outbreak and the emergency medical treatment and labor act: patient care ensured | 216 | ||
| Smallpox vaccinations: think before you act | 217 | ||
| Legislating public health | 218 | ||
| Communication Policy in the Age of Social Media | 219 | ||
| The direction from here | 220 | ||
| References | 220 | ||
| Chapter 34: Mutual Aid | 222 | ||
| The mutual aid concept | 222 | ||
| Response, Recovery, and Regional Capacity Building | 222 | ||
| Conceptual Planning Concerns | 222 | ||
| Historical perspective | 224 | ||
| Current practice | 224 | ||
| Local Community Assets | 224 | ||
| Local Emergency Planning Committees | 224 | ||
| U.S. Citizen Corps | 224 | ||
| Other Government Agencies | 225 | ||
| Voluntary Organizations and Volunteers | 225 | ||
| Local Emergency Management Plans and Mutual Aid | 225 | ||
| Hospitals | 226 | ||
| Command Structure | 227 | ||
| State Assets | 227 | ||
| National Guard | 227 | ||
| State Emergency Response Commission | 228 | ||
| Emergency Management Assistance Compact | 228 | ||
| Model Intrastate Mutual Aid Legislation | 228 | ||
| Private Sector Resources | 228 | ||
| Federal Assets | 228 | ||
| The Disaster Declaration Process and Federal Disaster Assistance | 228 | ||
| Operational pitfalls | 230 | ||
| Too Many Contracts | 230 | ||
| Two-Hat Syndrome | 230 | ||
| Complicated Wire Diagram-Who Is in Charge? | 230 | ||
| Summary | 230 | ||
| References | 230 | ||
| Chapter 35: Patient Surge | 233 | ||
| Historical perspective | 233 | ||
| Current practice | 234 | ||
| Surge ``Capability´´ Versus Surge ``Capacity´´ | 234 | ||
| Developing useful indicators and triggers | 235 | ||
| The Components of Surge | 236 | ||
| Staffing Strategies | 236 | ||
| Supply Strategies | 236 | ||
| Strategies for Expanding Space | 237 | ||
| Systems | 237 | ||
| Strategies to Manage Demand | 238 | ||
| Pitfalls | 238 | ||
| Conclusion | 239 | ||
| References | 239 | ||
| Section Four: Event-Response Topics | 241 | ||
| Chapter 36: Accidental versus Intentional Event | 241 | ||
| Historical persepctive | 241 | ||
| Current practice | 242 | ||
| Epidemiological Clues | 242 | ||
| Unusual Variations in Disease Outbreaks | 243 | ||
| Unusual Characteristics of Disease or Agents | 243 | ||
| Other Species Signals | 243 | ||
| Radiological and Chemical Agents | 243 | ||
| Pitfalls | 244 | ||
| References | 244 | ||
| Chapter 37: Crisis Leadership in Public Health Emergencies | 246 | ||
| Historical perspective | 246 | ||
| Current practice | 246 | ||
| Aircrew Captains | 246 | ||
| Military In Extremis Leaders | 246 | ||
| First Responder Incident Commanders | 247 | ||
| Nuclear Power Plant Emergency Team Leaders | 247 | ||
| Underground Mine Fire Survivors | 247 | ||
| Common attributes of crisis leaders | 247 | ||
| Crisis Leadership in Public Health Emergencies | 247 | ||
| Pitfalls and soulutions | 247 | ||
| Acknowledgment | 249 | ||
| References | 249 | ||
| Chapter 38: The Incident Command System | 251 | ||
| Historical perspective | 251 | ||
| Current practice | 251 | ||
| Command Function | 252 | ||
| General Staff Operations | 253 | ||
| General Staff Planning | 253 | ||
| General Staff Logistics | 253 | ||
| General Staff Finance and Administration | 253 | ||
| Pitfalls | 254 | ||
| References | 254 | ||
| Chapter 39: Scene Safety and Situational Awareness in Disaster Response | 255 | ||
| Historical perspective | 255 | ||
| Current practice | 255 | ||
| Large Geographic Scale and Unfamiliar Surroundings | 256 | ||
| Falling or Flying Debris | 256 | ||
| Secondary Collapse of Damaged Buildings | 256 | ||
| Exposure to Hazardous Materials | 256 | ||
| Excessive Noise from Machinery and Equipment | 257 | ||
| Adverse Weather | 257 | ||
| Inadequate Personal Protective Equipment | 257 | ||
| Debris Fields Causing Fall or Trip Hazards | 257 | ||
| Convergent Volunteers | 258 | ||
| Secondary Explosive Devices Planted by Terrorists | 258 | ||
| Fatigue, Lack of Sleep, and Inadequate Food and Hydration | 258 | ||
| Scene safety at the disaster site | 258 | ||
| Crew Resource Management for Safety | 259 | ||
| Response to Disasters | 260 | ||
| Scene Size-Up | 260 | ||
| Lookouts, Communications, Escape Routes, and Safety Zones | 260 | ||
| Pitfalls | 261 | ||
| References | 261 | ||
| Chapter 40: Needs Assessment | 263 | ||
| Historical perspective | 263 | ||
| Current practice | 263 | ||
| Purpose | 263 | ||
| Preparedness | 264 | ||
| Planning | 264 | ||
| Conducting the Assessment | 265 | ||
| Sentinel Surveillance | 265 | ||
| Surveys by Specialist Teams (Sampling Methods) | 265 | ||
| Detailed Critical Sector Assessments by Specialists | 265 | ||
| New Innovations | 266 | ||
| Analyzing and Presenting Data | 266 | ||
| Pitfalls | 267 | ||
| References | 267 | ||
| Chapter 41: Operations and Logistics | 269 | ||
| Historical perspective | 269 | ||
| Current practice | 270 | ||
| Operations | 270 | ||
| Logistics | 271 | ||
| Pitfalls | 273 | ||
| Conclusion | 273 | ||
| References | 273 | ||
| Chapter 42: Disaster Communications | 275 | ||
| Historical perspective | 275 | ||
| Current practice | 276 | ||
| Pitfalls | 278 | ||
| Summary | 278 | ||
| References | 278 | ||
| Chapter 43: Mobile Disaster Applications | 280 | ||
| Form factors | 280 | ||
| Thin versus thick client | 280 | ||
| Patient identification | 281 | ||
| Patient tracking | 281 | ||
| Cell service and internet disruption | 281 | ||
| Resource management | 282 | ||
| Pitfalls | 282 | ||
| Summary | 282 | ||
| Suggested Readings | 282 | ||
| Chapter 44: The Role of Social Media in Disasters | 283 | ||
| Historical perspective | 283 | ||
| Current practice | 283 | ||
| Pitfalls | 284 | ||
| References | 284 | ||
| Chapter 45: Volunteers and Donations | 285 | ||
| Drug donations | 285 | ||
| Historical perspective: drug dontations | 286 | ||
| Current practice: drug donations | 287 | ||
| Blood donations | 289 | ||
| Disaster volunteerism | 289 | ||
| Historical perspective: volunteerism | 290 | ||
| Current practice: volunteerism | 291 | ||
| References | 291 | ||
| Chapter 46: Personal Protective Equipment | 294 | ||
| Historical perspective | 294 | ||
| Current practice | 295 | ||
| Hazard Vulnerability Analysis | 295 | ||
| Defining the Agency and the Facility Role | 295 | ||
| Risks to Providers | 296 | ||
| Chemical Protective Equipment | 296 | ||
| Atmosphere-Supplying Respirators | 297 | ||
| Air-Purifying Respirators | 297 | ||
| Chemical Protective Equipment | 298 | ||
| Biological Protective Equipment | 298 | ||
| Regulations and Training | 299 | ||
| Pitfalls and ongoing challenges | 299 | ||
| References | 300 | ||
| Chapter 47: Role of Bystanders in Disasters | 302 | ||
| Historical perspective | 302 | ||
| Current practice | 303 | ||
| Pitfalls | 304 | ||
| References | 306 | ||
| Chapter 48: Surveillance | 308 | ||
| Historical perspective | 308 | ||
| Current practice | 308 | ||
| Data Collection | 309 | ||
| Analysis, Interpretation, and Dissemination | 310 | ||
| Pitfalls | 310 | ||
| References | 311 | ||
| Chapter 49: Geographic Information Systems in Crises | 312 | ||
| Historical perspective | 313 | ||
| Aerial Photography, Satellite Imaging, and Remote Sensing | 313 | ||
| Expanding Agency: Crowd-Sourcing, Participatory Mapping, and Collective Intelligence | 313 | ||
| Hazard Modeling, Operations Research, and Geographic Information System for Decision Support | 313 | ||
| Current practice | 314 | ||
| Pitfalls | 315 | ||
| References | 316 | ||
| Chapter 50: Management of Mass Fatalities | 317 | ||
| Historical Perspective | 317 | ||
| Current Practice | 318 | ||
| Pitfalls | 321 | ||
| References | 323 | ||
| Chapter 51: Disaster Management of Animals | 324 | ||
| Historical perspective | 324 | ||
| Current practice | 325 | ||
| Pitfalls | 327 | ||
| References | 328 | ||
| Section Five: Mechanical Operations in Disasters | 329 | ||
| Chapter 52: Urban Search and Rescue | 329 | ||
| Historical perspective | 329 | ||
| Current practice | 329 | ||
| Urban Search and Rescue Task Force Composition and Deployment | 329 | ||
| Search and Rescue Operations | 330 | ||
| Confined Space Medicine | 331 | ||
| Crush Injury and Crush Syndrome | 332 | ||
| Pitfalls | 332 | ||
| References | 332 | ||
| Chapter 53: Medical Care in Remote Areas | 334 | ||
| Historical perspective | 334 | ||
| Current practice | 334 | ||
| Pitfalls | 336 | ||
| References | 336 | ||
| Suggested Readings | 336 | ||
| Chapter 54: Triage | 337 | ||
| Historical perspective | 337 | ||
| Current practice | 338 | ||
| What Triage Classification Will Be Used? | 338 | ||
| Will a Formal Triage Scoring System Be Used? | 339 | ||
| What On-Site/Hospital Documentation Will Be Used? | 340 | ||
| Who Will Be the Triage Officer(s)? | 340 | ||
| Who Will Collect Vital Signs for the Triage Officer(s)? | 340 | ||
| Physically, Where Will Casualties from Each Triage Category Be Cared for (and Who Will Staff Each Area)? | 340 | ||
| What Overtriage and Undertriage Rates Are Acceptable, and What Level of Casualty Gets ``Black-Tagged´´? | 340 | ||
| Assuming 10 Patients in 20 Minutes per Triage Officer,21 Are There Enough Officers? Are There Enough Other Personnel to Kee... | 341 | ||
| Are Resources Being Used Appropriately, Including On-Site Medical Interventions, Evacuation Resources, and Hospital-Based R... | 341 | ||
| After Casualties Initial Triage, Who Reevaluates the Patient, and How Often? After Each Reassessment, Has the Triage Plan B... | 342 | ||
| Focus: Training/Planning Specific Issues | 342 | ||
| Pitfalls | 342 | ||
| References | 342 | ||
| Chapter 55: Patient-Tracking Systems in Disasters | 344 | ||
| Historical perspective | 344 | ||
| Current practice | 345 | ||
| Manual Systems: Paper Tags, Cards, and Charts | 345 | ||
| Electronic Systems: Bar Codes or RFID and Wi-Fi Networks | 347 | ||
| General Considerations | 347 | ||
| The future | 348 | ||
| Pitfalls | 348 | ||
| References | 349 | ||
| Chapter 56: Infectious Disease in a Disaster Zone | 351 | ||
| Historical perspective | 351 | ||
| Current practice | 352 | ||
| Pitfalls | 354 | ||
| References | 354 | ||
| Chapter 57: Pharmaceuticals and Medical Equipment in Disasters | 356 | ||
| Historical perspective | 357 | ||
| Current practice | 357 | ||
| Terrorism | 357 | ||
| Natural Disasters | 358 | ||
| Management of Pharmaceutical Donations | 358 | ||
| Pitfalls | 359 | ||
| Summary | 359 | ||
| References | 359 | ||
| Suggested Readings | 360 | ||
| Section Six: Post-Event Topics | xxx | ||
| Chapter 58: Displaced Populations | 361 | ||
| Refugees | 361 | ||
| Internally displaced persons | 361 | ||
| Priorities for a displaced population | 361 | ||
| Initial evaluation | 362 | ||
| Measles and tuberculosis | 362 | ||
| Water | 362 | ||
| Sanitation and hygiene | 362 | ||
| Food and nutrition | 363 | ||
| Shelter | 363 | ||
| Medical care | 363 | ||
| References | 364 | ||
| Chapter 59: Rehabilitation and Reconstruction | 365 | ||
| Historical perspective | 365 | ||
| Current practice | 366 | ||
| Pitfalls | 367 | ||
| References | 368 | ||
| Chapter 60: Disaster Education and Research | 369 | ||
| Historical perspective | 369 | ||
| Definitions | 369 | ||
| Current practice | 369 | ||
| Education | 369 | ||
| Simulation Training | 370 | ||
| Civilian and Commercial High-Fidelity Simulation Applications in Disaster and Weapons of Mass Destruction Education | 371 | ||
| Future Directions in Simulation | 371 | ||
| Categories of research | 372 | ||
| After-Action Report and Case Studies | 372 | ||
| Epidemiology | 372 | ||
| Discussion of Planning, Training, and Mitigation Techniques | 372 | ||
| Trials of Specific Techniques or Equipment | 372 | ||
| Organizational and Analytical Schemes | 372 | ||
| Randomized Controlled Trials | 372 | ||
| Summary | 373 | ||
| References | 373 | ||
| Chapter 61: Practical Applications of Disaster Epidemiology | 375 | ||
| Historical perspective | 375 | ||
| Current practice | 375 | ||
| Vulnerability Analyses | 376 | ||
| Rapid Needs Assessments | 376 | ||
| Surveys | 377 | ||
| Qualitative Assessments | 378 | ||
| Pitfalls | 378 | ||
| References | 378 | ||
| Chapter 62: Measures of Effectiveness in Disaster Management | 380 | ||
| Historical perspective | 380 | ||
| Current practice | 380 | ||
| Pitfalls | 381 | ||
| References | 381 | ||
| Section Seven: Topics Unique to Terrorist Events and High-Threat Disaster Response | 382 | ||
| Chapter 63: Lessons Learned as a Result of Terrorist Attacks | 382 | ||
| Historical perspective | 382 | ||
| The Development of Current U.S. Emergency Management Policy | 382 | ||
| The Development of Incident Management Systems | 383 | ||
| The Development of Disaster Risk-Reduction Strategies | 383 | ||
| Recent Terrorist Events That Have Influenced U.S. Policy | 383 | ||
| Current practice and ``lessons learned´´ | 383 | ||
| Pitfalls | 383 | ||
| The Public Health and Health Care Sector Is Quite Diverse and Collaboration Has Been Difficult as a Result | 383 | ||
| The Process of Developing Coordination among Federal Agencies | 392 | ||
| Occupational Health and Safety Are Critical to Effective Disaster Response | 392 | ||
| Interoperability and Robust Methods of Communication Are Difficult to Maintain | 392 | ||
| Disaster Policy and Plans Are Difficult to Integrate | 392 | ||
| The Ongoing Need to Improve Chemical, Radiological, and Nuclear Capabilities | 393 | ||
| Significant Challenges Associated with Protecting Agriculture from a Terrorist Attack | 393 | ||
| Conclusion | 393 | ||
| References | 393 | ||
| Chapter 64: The Psychology of Terrorism | 395 | ||
| Historical perspective | 395 | ||
| Developmental perspectives | 396 | ||
| Pitfalls | 398 | ||
| Community perspectives | 399 | ||
| Learning theory perspectives | 400 | ||
| Conclusion | 400 | ||
| References | 401 | ||
| Suggested Readings | 402 | ||
| Chapter 65: Thinking Outside the Box | 403 | ||
| Information, Integration, Interoperability, and Interdependency | 403 | ||
| Transform the Public Sector | 404 | ||
| Engaging the Private Sector | 405 | ||
| Engaging the People in Communities | 405 | ||
| Beyond Resilience | 405 | ||
| Conclusion | 405 | ||
| References | 406 | ||
| Chapter 66: Integrated Response to Terrorist Attacks | 407 | ||
| Historical perspective | 407 | ||
| Federal | 407 | ||
| Fire service | 408 | ||
| Development and History of Response | 408 | ||
| Part II: Management of Specific Event Types | 565 | ||
| Section Nine: Natural Disasters | 566 | ||
| Chapter 93: Introduction to Natural Disasters | 566 | ||
| Historical perspective | 566 | ||
| Current practice | 566 | ||
| Pitfalls | 567 | ||
| References | 568 | ||
| Chapter 94: Hurricanes, Cyclones, and Typhoons | 569 | ||
| Description of event | 569 | ||
| Pre-Incident actions | 569 | ||
| During the Storm | 569 | ||
| Post-Incident actions | 570 | ||
| Medical treatment of casualties | 570 | ||
| Unique considerations | 570 | ||
| Pitfalls | 570 | ||
| References | 571 | ||
| Chapter 95: Earthquake | 572 | ||
| Description of event | 572 | ||
| Pre-Incident actions | 572 | ||
| Post-Incident actions | 572 | ||
| Medical Treatment of Casualties | 573 | ||
| Unique considerations | 573 | ||
| Pitfalls | 574 | ||
| References | 574 | ||
| Chapter 96: Tornado | 575 | ||
| Description of event | 575 | ||
| Pre-Incident actions | 576 | ||
| Communication | 576 | ||
| Command and Control | 576 | ||
| Warning Systems | 577 | ||
| Injury Prevention | 577 | ||
| Focused Education | 577 | ||
| Sheltering Guidelines | 577 | ||
| Health Care Provider Training | 577 | ||
| Emergency Medical Response | 577 | ||
| Traffic Control at Hospitals | 577 | ||
| Post-Incident actions | 577 | ||
| Search and Rescue | 577 | ||
| Emergency Medical Service Triage | 578 | ||
| Hospital Triage | 578 | ||
| Secondary Response | 578 | ||
| Medical treatment of casualties | 578 | ||
| Unique considerations | 578 | ||
| Pitfalls | 578 | ||
| References | 579 | ||
| Chapter 97: Flood | 580 | ||
| Description of event | 580 | ||
| Pre-Incident actions | 580 | ||
| Post-Incident actions | 580 | ||
| Medical treatment of casualties | 581 | ||
| Unique considerations | 581 | ||
| Pitfalls | 581 | ||
| References | 581 | ||
| Chapter 98: Tsunami | 583 | ||
| Description of event | 583 | ||
| Pre-incident actions | 583 | ||
| Tsunami Mitigation and Planning | 583 | ||
| Post-incident actions | 584 | ||
| Medical treatment of casualties | 584 | ||
| Wound Management | 584 | ||
| Other Health Problems | 585 | ||
| Acute Illnesses and Exacerbation of Chronic Illnesses | 585 | ||
| Mortuary Operations | 585 | ||
| Psychosocial Problems | 585 | ||
| Unique considerations | 586 | ||
| Pitfalls | 586 | ||
| Summary | 587 | ||
| References | 587 | ||
| Chapter 99: Heat Wave | 589 | ||
| Description of event | 589 | ||
| Pre-Incident actions | 589 | ||
| Post-Incident actions | 589 | ||
| Medical treatment of casualties | 590 | ||
| Unique considerations | 590 | ||
| Pitfalls | 591 | ||
| References | 591 | ||
| Chapter 100: Winter Storm | 592 | ||
| Description of event | 592 | ||
| Pre-Incident action | 592 | ||
| Post-Incident action | 594 | ||
| Medical treatment of casualties | 594 | ||
| Unique considerations | 596 | ||
| Pitfalls | 596 | ||
| References | 596 | ||
| Chapter 101: Volcanic Eruption | 598 | ||
| Description of event | 598 | ||
| Pre-incident actions | 599 | ||
| Post-incident actions | 602 | ||
| Medical treatment of casualties | 602 | ||
| Unique considerations | 602 | ||
| Pitfalls | 602 | ||
| Reference | 602 | ||
| Chapter 102: Famine | 604 | ||
| Description of event | 604 | ||
| Pre-Incident actions | 605 | ||
| Post-Incident actions | 605 | ||
| Medical treatment of casualties | 605 | ||
| Unique considerations | 606 | ||
| Pitfalls | 606 | ||
| References | 606 | ||
| Chapter 103: Landslides | 607 | ||
| Description of event | 607 | ||
| Type of Events | 607 | ||
| Historical Events | 607 | ||
| Scope of impact | 607 | ||
| Common Health Impacts | 607 | ||
| Unusual Health Impacts | 608 | ||
| Pre-Incident actions | 608 | ||
| Post-Incident actions | 609 | ||
| Medical treatment of casualties | 610 | ||
| Unique considerations and pitfalls | 610 | ||
| References | 610 | ||
| Chapter 104: Avalanche | 612 | ||
| Description of event | 612 | ||
| Pre-Incident actions | 612 | ||
| Post-Incident actions | 612 | ||
| Medical treatment of casualties | 612 | ||
| Unique considerations | 613 | ||
| Pitfalls | 613 | ||
| References | 613 | ||
| Suggested Readings | 614 | ||
| Section Ten: Nuclear/Radiation Events | 615 | ||
| Chapter 105: Introduction to Nuclear and Radiological Disasters | 615 | ||
| Radiation physics | 615 | ||
| Biological Effects | 616 | ||
| Nuclear or Radiological Scenarios | 616 | ||
| Historical perspective | 617 | ||
| Current practice | 618 | ||
| Pitfalls | 619 | ||
| References | 619 | ||
| Chapter 106: Nuclear Detonation | 621 | ||
| Description of event | 621 | ||
| Pre-Incident actions | 621 | ||
| Post-Incident actions | 621 | ||
| Medical treatment of casualties | 622 | ||
| Blast Injury | 622 | ||
| Burn Injury | 623 | ||
| Acute Radiation Injury | 623 | ||
| Acute Radiation Syndrome | 623 | ||
| Delayed Radiation Effects (2 to 4 Weeks after Event) | 623 | ||
| Risk of Malignancy | 623 | ||
| Psychological Injury | 624 | ||
| Unique considerations | 624 | ||
| Pitfalls | 624 | ||
| References | 624 | ||
| Chapter 107: Radiation Accident-Isolated Exposure | 625 | ||
| Description of event | 625 | ||
| Pre-Incident actions | 625 | ||
| Post-Incident actions | 626 | ||
| Medical treatment of casualties | 626 | ||
| Localized Exposure | 626 | ||
| Whole-Body or Large Partial-Body Exposure | 627 | ||
| Physical Examination | 627 | ||
| Laboratory Studies | 627 | ||
| Treatment | 627 | ||
| Unique considerations | 627 | ||
| Pitfalls | 628 | ||
| References | 628 | ||
| Chapter 108: Radiation Accident-Dispersed Exposure | 630 | ||
| Description of event | 630 | ||
| Pre-Incident actions | 630 | ||
| Post-Incident actions | 631 | ||
| Medical treatment of casualties | 632 | ||
| Localized External Contamination | 633 | ||
| Internal Contamination | 633 | ||
| Reducing Uptake | 633 | ||
| Blocking Agents | 633 | ||
| Mobilizing Agents | 633 | ||
| Chelation | 633 | ||
| Unique considerations | 633 | ||
| Pitfalls | 634 | ||
| References | 634 | ||
| Chapter 109: Nuclear Power Plant Meltdown | 635 | ||
| Description of event | 635 | ||
| Pre-incident actions | 635 | ||
| Post-incident actions | 636 | ||
| Medical treatment of casualties | 636 | ||
| Unique considerations | 637 | ||
| Pitfalls | 637 | ||
| References | 637 | ||
| Suggested Readings | 638 | ||
| Chapter 110: Introduction to Chemical Disasters | 639 | ||
| Historical perspective | 639 | ||
| Current practice | 641 | ||
| Pitfalls | 642 | ||
| Index | 985 | ||
| Inside Back Cover | ES3 |