Society for Disaster Medicine and Public Health: 2016 Annual Meeting Proceedings Part 1

In July 2016, the Society for Disaster Medicine and Public Health held their  Annual Meeting. Dr. Luis Rios presents his educational pearls from that meeting in this series of blog posts. Stay tuned for Part 2!

Society for Disaster Medicine and Public Health: 2016 Annual Meeting Day 1

Kellerman (Chair EM/OM @ UHSUS):

• Participation in the “STOP the hemorrhage” Program civilian with ACS/COT.
• Glaring disconnect between funding and threat needs: 2/3 for bioterrorism, 10% for natural disasters and ~4% for terrorism: mass shootings in 2011 lead short fall in preparedness currently.
• Supporting a proactive regional, national and international interaction pre-emptively with coordination in a seam-less, scalable strategy across borders.
• Increased focus in Mass Shootings on medic response with tactical team’s response, quick focused treat & triage and logistical tagged victim back up.

Peleg (Israeli National Center for Trauma and Emergency Medicine Research; TAU):

• Finer differences between Open and Closed Space blast events (Israel, London, Paris):
• Bus explosion inside vs. Bus explosion outside of door vs. semi-open = at building entrance vs. open space are 4 different paradigms.

1. Closed space: highest mortality and highest ICU use.
2. Inside bus: highest lethal blast injury and high ICU use.
3. Open space: lowest burn.
4. Outside bus: lowest penetrating injury, surgery and ICU use.

This model is better predictor of OR, ICU, hospital utilization and mortality rate.

• Differences between Interpersonal and Terrorist Stabbings:

1. Terrorist stabbings have 3 x SSI, scene MR and in-hospital MR than interpersonal stabbings.
2. Terror trajectory is most often overhead to maximize injury and lethality vs. interpersonal which is underhand; coincides with abdomen only injury with interpersonal vs. multi-anatomic areas with terror.
3. 3 x higher >3 diagnoses with terror than interpersonal type.

• Difference between Terrorist (civilian) and Wartime (military active duty) hospital resources as opposed to pure wartime:

1. Terror/Civilian carry 3 x higher civilian than soldiers.
2. War/Civilian carry 7% vs. soldier 3%
3. Wartime and terrorist event in civilian carry > body regions involved, > LOS, ICU and utilization than soldiers ~ same in wartime as in terror events.

Major difference is PPE (Kevlar) and tactical behavior skills.

Diehl (Center for Global Health Engagement-National Global Health Security Initiatives)

• Pushing force protection and readiness scalable to a global scale.
• Evolving into Infectious Disease is destabilizing health stress: partnering with other National Public Health systems, Prevention Programs and Social Media.
• Extending to Military’s Line Commands overseas under Health Initiatives at Divisional levels.
• Course offerings electronic and traditional at USUHS.
• Available partnering research with GHE in DOD: helps answer some congressional value questions i.e., the tactical to service leverage.

Koch: epidemic of epidemics: Wars and commerce are microbe’s best friend. Technology is not the answer, addressing the foibles and vulnerabilities IS at this point.

Cordero: Zika lessons learned so far (Named after the Ugandan Zika Forrest where it was discovered in 1947:

• Start preparing for the next one, nature always fit into a niche.
• Coordinate response vertically.
• Central and South America, Caribbean, New Guinea
• Appropriate threat communication to “movers & shakers” as well as public.
• Threat communication: condoms even in monogamy.
• No current detection test in the US.
• ??? Purity of Zika-Micro/Anencephaly, Association is 10 x less in epidemics of Puerto Rico and Colombia than in Brazil.

Koenig (Disaster Global Health-UC):

• 3 I school: identify, Isolate and inform approach to infection at risk in Triage.
• Quarantine: is for sick people; Isolation: FOCUS on when infectious period starts for the disease in question.
• Nursing is a better choice of infrastructure to disinformation on transmission, etc..

Callaway (Team Rubicon and Carolinas OM/DM Fellowship):

• Ex-Military – Civilian connection using GPS technology = NGO on steroids.
• Encourage business sponsors in the technology.
• Leverage UNC’s academic partnering with private sector resources on task specific basis.
• Quick reaction force similar to DMAT’s dual hat operations.
• Refugee camps in Greece widened to PH similar to our DMAT’s mission in Waco, Texas for Hurricane Rita.