Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-23T11:37:33.408Z Has data issue: false hasContentIssue false

Management of Diabetic Surgical Patients in a Deployed Field Hospital: A Model for Acute Non-Communicable Disease Care in Disaster

Published online by Cambridge University Press:  27 July 2017

Kathleen M. McDermott
Affiliation:
National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia
Ruth M. Hardstaff
Affiliation:
Division of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia
Sophie Alpen
Affiliation:
National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia
David J. Read
Affiliation:
National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia Division of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia
Nicholas R. Coatsworth*
Affiliation:
National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia
*
Correspondence: Nick Coatsworth, MBBS, MIntPH, FRACP National Critical Care and Trauma Response Centre Royal Darwin Hospital, Rocklands Drive Tiwi Northern Territory 0810, Australia E-mail: [email protected]

Abstract

Sudden onset disasters (SODs) have affected over 1.5 billion of the world’s population in the past decade. During the same time, developing nations have faced a sustained increase in the burden of non-communicable disease (NCD) with extra pressure placed on health systems. The combined increase in SODs and the NCD epidemic facing the world’s most disaster-prone nations will present new challenges to emergency medical teams (EMTs) during disaster response. This report details the experience as an EMT during the Typhoon Haiyan disaster of 2013, with particular reference to the challenges of diabetic management in a surgical field hospital. The incidence of diabetes in this surgical cohort exceeded that of the population by a factor of four. The steps to prepare for and treat diabetes in the field provide a useful model for the management of NCD in the deployed field hospital environment after a disaster.

McDermottKM, HardstaffRM, AlpenS, ReadDJ, CoatsworthNR. Management of Diabetic Surgical Patients in a Deployed Field Hospital: A Model for Acute Non-Communicable Disease Care in Disaster. Prehosp Disaster Med. 2017;32(6):657–661.

Type
Special Reports
Copyright
© World Association for Disaster and Emergency Medicine 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Conflicts of interest: none

References

1. United Nations International Strategy for Disaster Reduction (UNISDR). The Sendai Framework for Disaster Risk Reduction 2015-2030. http://www.unisdr.org/we/coordinate/sendai-framework. Accessed January 10, 2016.Google Scholar
2. World Risk Report. 2014. Bündnis Entwicklung Hilft (Alliance Development Works) and United Nations University – Institute for Environment and Human Security (UNU-EHS). http://i.unu.edu/media/ehs.unu.edu/news/4070/11895.pdf. Accessed February 23, 2016.Google Scholar
3. World Health Organization. Global status report on non-communicable diseases. 2014. http://www.who.int/nmh/publications/ncd-status-report-2014/en/. Accessed January 15, 2016.Google Scholar
4. Brolin, K, Howajri, O, von Schreeb, J. Foreign medical teams in the Philippines after Typhoon Haiyan 2013 – who were they, when did they arrive, and what did they do? PLoS Curr. 2015;7.Google Scholar
5. Gerdin, M, Wladis, A, von Schreeb, J. Foreign field hospitals after the 2010 Haiti Earthquake: how good were we? Emerg Med J. 2013;30(1):e8.CrossRefGoogle Scholar
6. von Schreeb, , Riddez, L, Samnegard, H, Rosling, H. Foreign field hospitals in the recent sudden-onset disasters in Iran, Haiti, Indonesia, and Pakistan. Prehosp Disaster Med. 2008;23(2):144-151.Google Scholar
7. Fonesca, VA, Smith, H, Kuhadiya, N, et al. Impact of natural disaster on diabetes: exacerbation of disparities and long-term consequences. Diabetes Care. 2009;32(9):1632-1638.Google Scholar
8. Read, D, Holian, A, Moller, C, Poutawera, V. Surgical workload of a foreign medical team after Typhoon Haiyan. ANZ J Surg. 2015;86(5):361-365.CrossRefGoogle ScholarPubMed
9. Norton, I, von Schreeb, J, Aitkin, P, et al. Classification and Minimum Standards for Foreign Medical Teams in Sudden Onset Disasters. Geneva, Switzerland: World Health Organization; 2013; http://www.who.int/entity/hac/global_health_cluster/fmt_guidleines_september2013.pdf?ua=1. Accessed November 06, 2015.Google Scholar
10. Chakungal, S, Nickerson, J, Knowiton, L, et al. Best practice guidelines on surgical response in disasters and humanitarian emergencies: report of the 2011 Humanitarian Action Summit Working Group on surgical issues within the humanitarian space. Prehosp Disaster Med. 2011;26(6):1-7.Google Scholar
11. Burkle, FM Jr, Nickerson, JW, von Schreeb, J, et al. Emergency surgery data and documentation reporting forms for sudden onset disasters, humanitarian crises, natural disasters, and existing burden of surgical disease. Prehosp Disaster Med. 2012;27(6):577-582.Google Scholar
12. Centre for Research on the Epidemiology of Disasters (CRED). http://www.cred.be/. Accessed January 5, 2016.Google Scholar
13. Philippines Statistical Authority Census Data. http://nsch.gov.ph/ru8. Accessed January 1, 2016.Google Scholar
14. Coatsworth, N. The Australian medical response to Typhoon Haiyan. Med J Aust. 2014;201(11):632-634.CrossRefGoogle ScholarPubMed
15. Quinn, RH, Wedmore, I, Johnson, E, et al. Wilderness Medical Society practice guidelines for basic wound management in the austere environment. Wilderness Environ Med. 2014;25(3):295-310.Google Scholar
16. Ramachandran, A, Snelhalatha, S, Shetty, A, Nanditha, A. Trends in prevalence of diabetes in Asian countries. World J Diabetes. 2012;3(36):110-117.Google ScholarPubMed
17. International Diabetes Federation. IDF Diabetes Atlas. 2015. http://www.diabetesatlas.org/. Accessed January 15, 2016.Google Scholar
18. Guha‐Sapir, D, Van Panhuis, WG, Lagoutte, J. Short communication: patterns of chronic and acute diseases after natural disasters–a study from the International Committee of the Red Cross field hospital in Banda Aceh after the 2004 Indian Ocean tsunami. Trop Med Int Health. 2012;12(11):1338-1341.CrossRefGoogle Scholar
19. Noji, EK, Toole, MJ. The historical development of public health responses to disasters. Disasters. 1997;21(4):366-376.Google Scholar
20. Shultz, JM, Russell, J, Espinel, Z. Epidemiology of tropical cyclones: the dynamics of disaster, disease, and development. Epidemiol Rev. 2005;27(1):21-35.Google ScholarPubMed
21. Cefalu, W, Smith, S, Blonde, L, Fonesca, V. The Hurricane Katrina aftermath and its impact on Diabetes Care. Diabetes Care. 2006;29(1):158-160.Google Scholar
22. World Health Organization. WHO Model List of Essential Medicines. 19th Edition. Geneva, Switzerland: WHO; April 2015. Amended August 2015. http://www.who.int/selection_medicines/committees/expert/20/EML_2015_FINAL_amended_AUG2015.pdf?ua=1. Accessed February 10, 2016.Google Scholar
23. Tsourdi, E, Barthel, A, Rietzsch, H, Reichel, A, Bornstein, SR. Current aspects in the pathophysiology and treatment of chronic wounds in diabetes mellitus. BioMed Res Int. 2013;2013:385641.Google Scholar
24. Yendamuri, S, Fulda, GJ, Tinkoff, GH. Admission hyperglycemia as a prognostic indicator in trauma. J Trauma. 2003;55(1):33-38.Google Scholar
25. Miller, AC, Arquilla, B. Chronic diseases and natural hazards: impact of disasters on diabetic, renal, and cardiac patients. Prehosp Disaster Med. 2008;23(2):185-194.Google Scholar
26. Rodbard, H, Blonde, L, Braithwaite, S, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract. 2007;13(Suppl 1):1-68.Google Scholar
27. Higuchi, M. Access to diabetes care and medicines in the Philippines. Asia-Pac J Public Health. 2010;22(3 suppl):96S-102S.Google Scholar
28. Martinez, RE, Quintana, R, Go, JJ, et al. Surveillance for and issues relating to noncommunicable diseases post-Haiyan in Region 8. Western Pac Surveill Response J. 2015;6(Suppl 1):21-24.CrossRefGoogle ScholarPubMed