Table Of ContentOxford American Handbook of
Disaster Medicine
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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
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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
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stitute for medical or other professional advice. Treatment for the con-
ditions described in this material is highly dependent on the individual
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mation with respect to the subject matter covered and to be current as of
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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
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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 medi-
cal 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 mili-
tary, 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, spe-
cifi 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 pro-
viders 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
