Table Of Content

Oxford American Handbook of Disaster Medicine About the Oxford American Handbooks in Medicine The Oxford American Handbooks are pocket clinical books, providing practical guidance in quick reference, note form. Titles cover major medical specialties or cross-specialty topics and are aimed at students, residents, internists, family physicians, and practicing physicians within specifi c disciplines. Their reputation is built on including the best clinical information, complemented by hints, tips, and advice from the authors. Each one is carefully reviewed by senior subject experts, residents, and students to ensure that content refl ects the reality of day-to-day medical practice. Key series features • Written in short chunks, each topic is covered in a concise format to enable readers to fi nd information quickly. They are also perfect for test preparation and gaining a quick overview of a subject without scanning through unnecessary pages. • Content is evidence based and complemented by the expertise and judgment of experienced authors. • The Handbooks provide a humanistic approach to medicine—they are more than just treatment by numbers. • A “friend in your pocket,” the Handbooks offer honest, reliable guidance about the diffi culties of practicing medicine and provide coverage of both the practice and art of medicine. • For quick reference, useful “everyday” information is included on the inside covers. Published and Forthcoming Oxford American Handbooks Oxford American Handbook of Oxford American Handbook of Clinical Medicine Nephrology and Hypertension Oxford American Handbook of Oxford American Handbook of Anesthesiology Neurology Oxford American Handbook of Oxford American Handbook of Cardiology Obstetrics and Gynecology Oxford American Handbook of Oxford American Handbook of Clinical Dentistry Oncology Oxford American Handbook of Oxford American Handbook of Clinical Diagnosis Ophthalmology Oxford American Handbook of Clinical Oxford American Handbook of Examination and Practical Skills Otolaryngology Oxford American Handbook of Oxford American Handbook of Clinical Pharmacy Pediatrics Oxford American Handbook of Oxford American Handbook of Critical Care Physical Medicine and Rehabilitation Oxford American Handbook of Oxford American Handbook of Disaster Medicine Psychiatry Oxford American Handbook of Oxford American Handbook of Endocrinology and Diabetes Pulmonary Medicine Oxford American Handbook of Oxford American Handbook of Emergency Medicine Reproductive Medicine Oxford American Handbook of Oxford American Handbook of Gastroenterology and Hepatology Rheumatology Oxford American Handbook of Oxford American Handbook of Geriatric Medicine Sports Medicine Oxford American Handbook of Oxford American Handbook of Hospice and Palliative Medicine Surgery Oxford American Handbook of Oxford American Handbook of Infectious Diseases Urology Oxford American Handbook of Disaster Medicine Edited by Robert A. Partridge, MD, With MPH, FACEP Alexander G. Garza, MD, MPH Department of Emergency Director of Military Programs, Medicine, Emerson Hospital Department of Emergency Concord, Massachusetts and Medicine Department of Emergency Washington Hospital Center Medicine, Rhode Island Georgetown University School of Hospital Medicine Adjunct Associate Professor of Washington, DC Emergency Medicine Warren Alpert Medical School of Ira Nemeth, MD, FACEP Brown University Assistant Professor and Director Providence, Rhode Island of EMS and Disaster Medicine Section of Emergency Medicine, Lawrence Proano, MD, Department of Medicine DTMH, FACEP Baylor College of Medicine Department of Emergency Houston, Texas CliMniecadli cAinseso, Rcihaoted eP rIoslfaensdso Hr osf pital Kathryn Brinsfi eld, MD Emergency Medicine Department of Homeland Security Warren Alpert Medical School of Washington, DC and Brown University Associate Professor of Emergency Providence, Rhode Island Medicine, Boston University Associate Medical Director, David Marcozzi, MD, Boston EMS MHS-CL, FACEP Boston, Massachusetts Offi ce of the Assistant Secretary Eric S. Weinstein, MD of Preparedness and Response Department of Health and Human Attending Physician, Carolinas Services Hospital System Washington, DC Emergency Department Florence, South Carolina 1 3 Oxford University Press, Inc. publishes works that further Oxford University’s objective of excellence in research, scholarship and education. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offi ces in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Copyright © 2012 by Oxford University Press, Inc. Published by Oxford University Press Inc. 198 Madison Avenue, New York, New York 10016 www.oup.com Oxford is a registered trademark of Oxford University Press All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press. Materials appearing in this book prepared by United States government employees were not prepared in the individuals’ offi cial capacity as U.S. government employees. Therefore, any views expressed therein do not represent the views of the United States government and such individuals’ participation in the Work is not meant to serve as an offi cial endorsement by the United States government. Dr. Kathryn Brinsfi eld was not an employee of the US government while serving as co-editor of this book. Library of Congress Cataloging in Publication Data Oxford American handbook of disaster medicine / edited by Robert A. Partridge ... [et al.]. p. ; cm. — (Oxford American handbooks in medicine) Handbook of disaster medicine Includes bibliographical references and index. ISBN 978–0–19–537906–8 I. Partridge, Robert A. II. Title: Handbook of disaster medicine. III. Series: Oxford American handbooks. [DNLM: 1. Disaster Planning—Handbooks. 2. Disaster Medicine—Handbooks. WA 39] 363.348—dc23 2011039724 10 9 8 7 6 5 4 3 2 1 Printed in China on acid-free paper This material is not intended to be, and should not be considered, a sub- stitute for medical or other professional advice. Treatment for the con- ditions described in this material is highly dependent on the individual circumstances. Although this material is designed to offer accurate information with respect to the subject matter covered and to be current as of the time it was written, research and knowledge about medical and health issues is constantly evolving, and dose schedules for medications are being revised continually, with new side effects recognized and accounted for regularly. Readers must, therefore, always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulation. Oxford University Press and the authors make no representations or warranties to readers, express or implied, about the accuracy or completeness of this material, including without limitation that they make no representation or warranties about the accuracy or effi cacy of the drug dosages mentioned in the material. The authors and the publishers do not accept, and expressly disclaim, any responsibility for any liability, loss, or risk that may be claimed or incurred as a consequence of the use and/or application of any of the contents of this material. This page intentionally left blank Dedicated to my parents, Raymond and Alison, and my beloved wife and children, Karen, Rachel, Sarah, and Alexander. You have all given me endless support, encouragement, and love. Robert Partridge This book is dedicated to the mentors who have been role models in my professional career, and to all those who selfl essly respond to help others when disaster strikes. Lawrence Proano To those who have helped me along the way—my wife, my parents, my brother and sister, Dr. Robert Kadlec, Dr. Kevin Yeskey, Mrs. Heidi Avery, Mr. Richard Reed, Dr. Kathleen Clem, Dr. Michael Hocker, Dr. Selim Suner, and all my colleagues and friends—I dedicate this text to your love, mentorship, and unwavering support. Thank you. David Marcozzi This page intentionally left blank ix Foreword With the incidence of natural and intentional disasters–and the number of people affected by such events–on the increase, the importance of disasters as a public-health problem has captured the attention of the world. This situation represents an unprecedented challenge to the medical and public-health community. Ten years have now passed since the catastrophic events of September 11, 2001. Since then, periodic reviews of the medical and public-health impact of disasters have appeared in a number of publications, with updates on the “state of the art” of disaster science. As a result, a considerable body of knowledge and experience related to the adverse health effects of disasters is now accumulating that requires regular updating so that we can apply the lessons learned during one disaster to the management of the next. These historical lessons will not be implemented, however, unless they are supported by adequate preparedness planning, coordination, communications, logistics, personnel management, and training of physicians and other health-care providers. By blending the comprehensiveness of a weighty full-length text with the convenience of a fi eld guide, the Oxford American Handbook of Disaster Medicine skilfully addresses these challenges and more. With years of experience, editors Robert Partridge and Lawrence Proano, along with a distinguished list of co-authors, give the reader ample technical descrip- tions of each kind of disaster, pertinent summaries of previous disasters, and copious information useful for health-care providers in the fi eld, the classroom, or the ward. Unique chapters address topics such as the politi- cal and ethical issues in disaster response; urban versus rural approaches; effective media relations; interfaces between disaster medicine and military, operational, and wilderness medicine; and the evolving priorities of the Department of Homeland Security (example, the NRP and an NIMS). In view of recent catastrophic events and newly recognized threats, specifi c elements such as tsunamis and pandemic infl uenza that are usually included as part of other chapters (for example, earthquakes and com- municable diseases) are now covered in their own chapters. Deserving of special attention are crosscutting chapters in the handbook that integrate information across hazards, such as communications, lessons learned, exercises and drills, and disaster informatics. In addition, while always emphasizing the use of proven and evidence- based medical methods and practices, Drs. Partridge and Proano challenge health professionals with questions that must still be answered for them to respond effectively in emergency situations. Approached from a real- world perspective, designed and written by clinical and public-health providers with disaster experience, this handbook provides realistic, hands-on experiences that challenge the reader to apply information provided in every chapter. The inclusion of “key messages” and “essential concepts” that introduce each chapter, plus practical information such as protocols, clinical tools, and unique case studies, has resulted in the creation of a major resource that will serve as a timely and comprehensive text for