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Evolving Need for Alternative Triage Management in Public Health Emergencies: A Hurricane Katrina Case Study

Published online by Cambridge University Press:  08 April 2013

Kelly R. Klein ,
Paul E. Pepe ,
Frederick M. Burkle Jr ,
Nanci E. Nagel  and
Raymond E. Swienton
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Abstract

In many countries, traditional medical planning for disasters developed largely in response to battlefield and multiple casualty incidents, generally involving corporal injuries. The mass evacuation of a metropolitan population in the aftermath of Hurricane Katrina evolved into life-and-death triage scenarios involving thousands of patients with nontraumatic illnesses and special medical needs. Although unprecedented in the United States, triage management needs for this disaster were similar to other large-scale public health emergencies, both natural and human-generated, that occurred globally in the past half-century. The need for alternative triage-management processes similar to the methodologies of other global mass public health emergencies is illustrated through the experience of disaster medical assistance teams in the first 3 days following Katrina's landfall. The immediate establishment of disaster-specific, consensus-based, public health emergency–related triage protocols—developed with ethical and legal expertise and a renewed focus on multidimensional, multifactorial matrix decision-making processes—is strongly recommended. (Disaster Med Public Health Preparedness. 2008;2(Suppl 1):S40–S44)

Keywords

homeland securitymass casualtiestriagesurge capacitypublic health emergencies
Type
Special Focus
Information
Disaster Medicine and Public Health Preparedness , Volume 2 , Issue S1 , September 2008 , pp. S40 - S44
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2008

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References

REFERENCES

1. World Health Organization Web site. http://www.wpro.who.int/internet/files/pub/297/part1_1.6.pdf. Accessed December 11, 2006.Google Scholar
2.Noji, EK, Kelen, GD. Disaster preparedness. Tintinalli J, Kelen G, Stapczynski J, eds. Emergency Medicine: A Comprehensive Guide. 6th ed. New York: McGraw-Hill; 2004: 27–35.Google Scholar
3.Burkle, FM Jr, Rupp, G.Hurricane Katrina: disasters keep us honest. [commentary]. Monday Developments. 2005;23 175.Google Scholar
4. Burkle FM. Complex public health emergencies. In: Koenig KL, Schultz CH, eds. Disaster Medicine. Cambridge, UK: Cambridge University Press. In press.Google Scholar
5. Federal Aviation Administration briefing. FAA Web site. faa.gov/news/disaster_response/katrina/operation_aircare. Accessed October 24, 2006.Google Scholar
6. Basic Disaster Life Support (BDLS). American Medical Association Web site. 2003. http://www.ama-assn.org/ama/pub/category/12618.html. Accessed June 23, 2008.Google Scholar
7.Burkle, FM Jr. Mass casualty management of a large scale bioterrorist event: an epidemiological approach that shapes triage decision. Emerg Med Clin North Am. 2002;20:409–436.CrossRefGoogle Scholar
8.Croddy, E, Ackerman, G. Biological and chemical terrorism: a unique threat.Veenema TG. Disaster Nursing and Emergency Preparedness for Chemical, Biological, and Radiological Terrorism and Other Hazards. New York: Springer; 2003: 300–329.Google Scholar
9.Rinnert, KJ, Wigginton, JG, Pepe, PE. Catastrophic anachronisms: the past, present, and future of emergency medicine. In: Vincent JL, ed. The 2006 Update in Intensive Care and Emergency Medicine. Berlin: Springer-Verlag; 2006: 761–772.Google Scholar
10.Burkle, FM. Triage.Burkle FM, Sanner PH Wolcott BW, eds. Disaster Medicine: Application for the Immediate Management and Triage of Civilian and Military Disaster Victims. New Hyde Park, NY: Medical Examination Publishing; 1984: 45–80.Google Scholar
11.Burkle, FM, Newland, C, Orebaugh, S, Blood, CG.Emergency medicine in the Persian Gulf War—part 2: triage methodology and lessons learned. Ann Emerg Med. 1994;23:748–754.Google Scholar
12.Burkle, FM.Population-based triage management in response to surge-capacity requirements during a large-scale bioevent disaster. Acad Emerg Med. 2006;11:1118–1129.Google Scholar
13.Stephens, KU, Grew, D, Chin, K, et alExcess mortality in the aftermath of Hurricane Katrina: a preliminary report. Disaster Med Public Health Preparedness. 2007;1:15–20.Google Scholar
14.Cheng, MH.Health and housing after the Indian Ocean tsunami. Lancet. 2007;9579:2066–2068.CrossRefGoogle Scholar
15. Kix P. Give us your huddled masses. D Magazine Web site. 2005. http://www.dmagazine.com/ME2/Audiences/dirmod.asp?sid=5C1933F1D01C4247A724BAB13C6E670B&nm=test&type=MultiPublishing&mod=PublishingTitles&mid=7155F7796F354F21B1183937D847D6DF&AudId=29CB3DCAC7E94A08B642EC371FE6E70B&tier=4&id=F7701F4E0886457EA1A6FAD08295A0E3. Accessed June 23, 2008.Google Scholar
16.North, CS, King, RV, Polatin, P, et alPsychiatric illness among transported hurricane evacuees: acute phase findings in a large receiving shelter site. Psychiatr Ann. 2008;38:104–113.Google Scholar
17.Drabek, TE. Sociology, disasters, and emergency management: history, contributions, and future agenda. In: McEntire DA, eds. Disciplines, Disasters, and Emergency Management: The Convergence and Divergence of Concepts, Issues, and Trends From the Research Literature. Springfield, IL: Charles C Thomas; 2007:61–74.Google Scholar