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The National Academies of Sciences, Engineering, and Medicine held a workshop on August 22â€"23, 2018, in Washington, DC, to explore medical and public health preparedness for a nuclear incident. The event brought together experts from government, nongovernmental organizations, academia, and the private sector to explore current assumptions behind the status of medical and public health preparedness for a nuclear incident, examine potential changes in these assumptions in light of increasing concerns about the use of nuclear warfare, and discuss challenges and opportunities for capacity building in the current threat environment. This publication summarizes the presentations and discussions from the workshop.
Today our emergency care system faces an epidemic of crowded emergency departments, patients boarding in hallways waiting to be admitted, and daily ambulance diversions. Hospital-Based Emergency Care addresses the difficulty of balancing the roles of hospital-based emergency and trauma care, not simply urgent and lifesaving care, but also safety net care for uninsured patients, public health surveillance, disaster preparation, and adjunct care in the face of increasing patient volume and limited resources. This new book considers the multiple aspects to the emergency care system in the United States by exploring its strengths, limitations, and future challenges. The wide range of issues covered includes: • The role and impact of the emergency department within the larger hospital and health care system. • Patient flow and information technology. • Workforce issues across multiple disciplines. • Patient safety and the quality and efficiency of emergency care services. • Basic, clinical, and health services research relevant to emergency care. • Special challenges of emergency care in rural settings. Hospital-Based Emergency Care is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency care providers, professional organizations, and policy makers looking to address the deficiencies in emergency care systems.
Meant to aid State & local emergency managers in their efforts to develop & maintain a viable all-hazard emergency operations plan. This guide clarifies the preparedness, response, & short-term recovery planning elements that warrant inclusion in emergency operations plans. It offers the best judgment & recommendations on how to deal with the entire planning process -- from forming a planning team to writing the plan. Specific topics of discussion include: preliminary considerations, the planning process, emergency operations plan format, basic plan content, functional annex content, hazard-unique planning, & linking Federal & State operations.
The March 11, 2011, Great East Japan Earthquake and tsunami sparked a humanitarian disaster in northeastern Japan. They were responsible for more than 15,900 deaths and 2,600 missing persons as well as physical infrastructure damages exceeding $200 billion. The earthquake and tsunami also initiated a severe nuclear accident at the Fukushima Daiichi Nuclear Power Station. Three of the six reactors at the plant sustained severe core damage and released hydrogen and radioactive materials. Explosion of the released hydrogen damaged three reactor buildings and impeded onsite emergency response efforts. The accident prompted widespread evacuations of local populations, large economic losses, and the eventual shutdown of all nuclear power plants in Japan. "Lessons Learned from the Fukushima Nuclear Accident for Improving Safety and Security of U.S. Nuclear Plants" is a study of the Fukushima Daiichi accident. This report examines the causes of the crisis, the performance of safety systems at the plant, and the responses of its operators following the earthquake and tsunami. The report then considers the lessons that can be learned and their implications for U.S. safety and storage of spent nuclear fuel and high-level waste, commercial nuclear reactor safety and security regulations, and design improvements. "Lessons Learned" makes recommendations to improve plant systems, resources, and operator training to enable effective ad hoc responses to severe accidents. This report's recommendations to incorporate modern risk concepts into safety regulations and improve the nuclear safety culture will help the industry prepare for events that could challenge the design of plant structures and lead to a loss of critical safety functions. In providing a broad-scope, high-level examination of the accident, "Lessons Learned" is meant to complement earlier evaluations by industry and regulators. This in-depth review will be an essential resource for the nuclear power industry, policy makers, and anyone interested in the state of U.S. preparedness and response in the face of crisis situations.
Annotation. Our nation faces the distinct possibility of a catastrophic terrorist attack using an improvised nuclear device (IND), according to international and U.S. intelligence. Detonation of an IND in a major U.S. city would result in tens of thousands to hundreds of thousands of victims and would overwhelm public health, emergency response, and health care systems, not to mention creating unprecedented social and economic challenges. While preparing for an IND may seem futile at first glance, thousands of lives can be saved by informed planning and decision making prior to and following an attack. In 2009, the Institute of Medicine published the proceedings of a workshop assessing the health and medical preparedness for responding to an IND detonation. Since that time, multiple federal and other publications have added layers of detail to this conceptual framework, resulting in a significant body of literature and guidance. However, there has been only limited planning effort at the local level as much of the federal guidance has not been translated into action for states, cities and counties. According to an informal survey of community preparedness by the National Association of City and County Health Officials (NACCHO), planning for a radiation incident ranked lowest in priority among other hazards by 2,800 local health departments. The focus of Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary is on key response requirements faced by public health and health care systems in response to an IND detonation, especially those planning needs of outlying state and local jurisdictions from the detonation site. The specific meeting objectives were as follows:- Understand the differences between types of radiation incidents and implications of an IND attack on outlying communities.-Highlight current planning efforts at the federal, state, and local level as well as challenges to the implementation of operational plans.-Examine gaps in planning efforts and possible challenges and solutions.-Identify considerations for public health reception centers: how public health and health care interface with functions and staffing and how radiological assessments and triage be handled.-Discuss the possibilities and benefits of integration of disaster transport systems.-Explore roles of regional health care coalitions in coordination of health care response.
This publication provides a practical resource for emergency planning, and fulfils, in part, functions assigned to the IAEA in the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency. If used effectively, it will help users to develop a capability to adequately respond to a nuclear or radiological emergency.
Disasters and Public Health: Planning and Response, Second Edition, examines the critical intersection between emergency management and public health. It provides a succinct overview of the actions that may be taken before, during, and after a major public health emergency or disaster to reduce morbidity and mortality. Five all-new chapters at the beginning of the book describe how policy and law drive program structures and strategies leading to the establishment and maintenance of preparedness capabilities. New topics covered in this edition include disaster behavioral health, which is often the most expensive and longest-term recovery challenge in a public health emergency, and community resilience, a valuable resource upon which most emergency programs and responses depend. The balance of the book provides an in-depth review of preparedness, response, and recovery challenges for 15 public health threats. These chapters also provide lessons learned from responses to each threat, giving users a well-rounded introduction to public health preparedness and response that is rooted in experience and practice. - Contains seven new chapters that cover law, vulnerable populations, behavioral health, community resilience, preparedness capabilities, emerging and re-emerging infectious diseases, and foodborne threats - Provides clinical updates by new MD co-author - Includes innovative preparedness approaches and lessons learned from current and historic public health and medical responses that enhance clarity and provide valuable examples to readers - Presents increased international content and case studies for a global perspective on public health
Disaster management is an increasingly important subject, as effective management of both natural and manmade disasters is essential to save lives and minimize casualties. This book discusses the best practice for vital elements of disaster medicine in both developed and developing countries, including planning and preparedness of hospitals, emergency medical services, communication and IT tools for medical disaster response and psychosocial issues. It also covers the use of state-of the-art training tools, with a full section on post-disaster relief, rehabilitation and recovery.