Important Lessons for Planning Anesthesiologists' Critical Role in Disaster Response
Newswise — Anesthesiologists played a critical role as part of medical-surgical teams responding to this year's devastating earthquake in Haiti, reports the December issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).
Two teams provide an overview of their experiences in Haiti, highlighting important lessons for planning the anesthesiology response to future emergency situations with massive casualties. "Although challenging from many perspectives, the experience was emotionally enriching and recalls the fundamental reasons why we selected medicine and anesthesiology as a profession," according to an article by Dr. Mark J. Rice of University of Florida and colleagues.
Team Transforms a Rural Hospital into a Trauma CenterDr. Rice was part of a team traveling to the village of Milot—the location of Haiti's largest private hospital, which was not damaged by the earthquake. Arriving 12 days after the disaster, they found that the hospital was soon overwhelmed by a "massive influx" of casualties from other areas. To meet the pressing need for surgical care, four examining rooms were converted into operating rooms. In collaboration with local health care professionals, the team essentially expanded a small rural hospital into a makeshift trauma center
Lacking proper equipment and facilities to perform general anesthesia safely, they relied heavily on regional anesthesia techniques. The lack of a centralized gas supply posed special challenges, as oxygen and other gases had to be administered from individual tanks. Language barriers made it difficult to collect routine information from the patients—many of whom had never seen a doctor before.
Reviewing their experience, Dr. Rice and co-authors outline some important lessons for health care professionals responding to future disasters. Challenges include the need for increased staffing levels, including interpreters; anticipating the need for rapid communication between triage personnel and staff inside the hospital; increasing facilities and equipment to handle the large influx of patients; procuring supplies; and ensuring the safest possible transport of critically ill patients.
Careful Preparation Allows Penn Team to Mount Effective ResponseDr. Maureen McCunn and colleagues of University of Pennsylvania were part of a team invited to go to Haiti with a nongovernmental organization with experience working in Haiti. They traveled to the village of Cange, where the agency had a hospital, arriving 14 days after the earthquake.
The article details the structured and organized processes followed by the Penn team in preparing for their mission. Team members were selected from volunteers from the departments of anesthesiology, surgery, orthopedics, and nursing. The Penn team describes the development of equipment and medication lists, as well as a vaccination program for team members. The planning effort took advantage of guidelines published by the World Health Organization and other authorities, as well as information from contacts working in Haiti.
The team performed a total of 76 operations during their stay in Cange, along with other anesthetic procedures outside the operating room. "An organized system for international medical response to a natural disaster emergency can be accomplished safety and effectively by an academic anesthesiology department…within 6 to 12 days," McCunn and co-authors conclude. They note that this "may be the ideal timeframe to bridge the gap between emergency response and longer-term relief care."
"Earlier this year, our journal published reports from Chinese doctors responding to the 2008 earthquake in Sichuan province," comments Dr. Steven L. Shafer of Columbia University, Editor-in-Chief of Anesthesia & Analgesia. "The new reports from Haiti draw attention to the critical role played by anesthesiologists as responders to such catastrophic events, and once again underscore the need to prepare and practice disaster response strategies—not only abroad, but also here at home."
Read the full study in Anesthesia & Analgesia
About the IARS The International Anesthesia Research Society is a nonpolitical, not-for-profit medical society founded in 1922 to advance and support scientific research and education related to anesthesia, and to improve patient care through basic research. The IARS contributes nearly $1 million annually to fund anesthesia research; sponsors an annual forum for anesthesiology leaders to share information and ideas; maintains a worldwide membership of more 15,000 physicians, physician residents, and others with doctoral degrees, as well as health professionals in anesthesia-related practice; sponsors the SAFEKIDS initiative; and publishes the journal Anesthesia & Analgesia. Additional information about the society and the journal may be found at www.iars.org www.iars.org and www.anesthesia-analgesia.org .
About Anesthesia & Analgesia Anesthesia & Analgesia was founded in 1922 and was issued bi-monthly until 1980, when it became a monthly publication. A&A is the leading journal for anesthesia clinicians and researchers and includes more than 500 articles annually in all areas related to anesthesia and analgesia, such as cardiovascular anesthesiology, patient safety, anesthetic pharmacology, and pain management. The journal is published on behalf of the IARS by Lippincott Williams & Wilkins (LWW) , a division of Wolters Kluwer Health .