Millin Michael G, Jenkins Jennifer L, Kirsch Thomas
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21209-3652, USA.
Prehosp Emerg Care. 2006 Oct-Dec;10(4):451-6. doi: 10.1080/10903120600884913.
Hurricane Katrina severely disrupted the health services in the U.S. Gulf Coast, necessitating an external health care response. The types and needs of patients following such an extensive event have not been well described. The objective of this study was to analyze the types of patients treated in two temporary clinics and to identify differences between them.
Two temporary sites were established: a disaster medical assistance team-based site in Mississippi and a volunteer-based site near New Orleans. Data were abstracted from patient charts for the two days of simultaneous operation: September 11 and 12, 2005. Each patient's age group, disposition, and primary discharge diagnosis was categorized and analyzed with descriptive and comparative statistics.
There were a total of 501 patient encounters. The most common presentation overall was for chronic health conditions such as medication refills (20.6%), immunizations (11.0%), obtaining community resources (6.0%). and management of acute exacerbation of chronic hypertension (4.6%). There were important differences; the Mississippi site treated more acute conditions than the Louisiana site, including lacerations (13.7% vs. 0%; p < 0.001), musculosketal injuries (9.4% vs. 2.6%; p < 0.001), and other nonspecified injuries (3.0% vs. 0.4%; p = 0.020).
With extensive damage to a health care system, these temporary clinics staffed by out-of-state volunteers provided needed health care. The most common health problems were related to chronic disease, primary health care, and routine emergency care, not to the direct impact of the hurricane. In addition to treating minor injuries, disaster planners should prepare to provide primary health care, administer vaccinations, and provide missing long-term medications.
卡特里娜飓风严重扰乱了美国墨西哥湾沿岸的医疗服务,因此需要外部医疗响应。此类大规模事件后患者的类型和需求尚未得到充分描述。本研究的目的是分析在两家临时诊所接受治疗的患者类型,并找出两者之间的差异。
设立了两个临时地点:一个位于密西西比州,以灾难医疗援助团队为基础;另一个位于新奥尔良附近,以志愿者为基础。从2005年9月11日和12日同步运营的两天内的患者病历中提取数据。对每位患者的年龄组、处置方式和主要出院诊断进行分类,并使用描述性和比较性统计方法进行分析。
总共接诊了501名患者。总体上最常见的情况是慢性健康问题,如药物续方(20.6%)、免疫接种(11.0%)、获取社区资源(6.0%)以及慢性高血压急性加重的管理(4.6%)。存在重要差异;密西西比州的诊所治疗的急性病症比路易斯安那州的诊所更多,包括撕裂伤(13.7%对0%;p<0.001)、肌肉骨骼损伤(9.4%对2.6%;p<0.001)以及其他未明确的损伤(3.0%对0.4%;p = 0.020)。
由于医疗系统遭受广泛破坏,这些由州外志愿者配备人员的临时诊所提供了所需的医疗服务。最常见的健康问题与慢性病、初级医疗保健和常规急诊护理有关,而非飓风的直接影响。除了治疗轻伤外,灾难规划者应准备好提供初级医疗保健、进行疫苗接种并提供缺失的长期药物。