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 Table of Contents    
LETTER TO EDITOR  
Year : 2012  |  Volume : 37  |  Issue : 4  |  Page : 265
 

Role of Primary Care Physicians in Mass Casualty Incidents


Department of Community Medicine, Maulana Azad Medical College, New Delhi, India

Date of Web Publication15-Nov-2012

Correspondence Address:
Neeti Rustagi
Department of Community Medicine, Maulana Azad Medical College, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-0218.103479

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How to cite this article:
Rustagi N, Kishore J. Role of Primary Care Physicians in Mass Casualty Incidents. Indian J Community Med 2012;37:265

How to cite this URL:
Rustagi N, Kishore J. Role of Primary Care Physicians in Mass Casualty Incidents. Indian J Community Med [serial online] 2012 [cited 2019 Aug 23];37:265. Available from: http://www.ijcm.org.in/text.asp?2012/37/4/265/103479


Sir,

India got worst affected because of emergencies in the last decade. Past experience in disaster response during Gujarat earthquake 2001 [1] and Tsunami 2004 [2] reflects that responding to increased demand of health personnel's and their effective deployment at incident site is an essential component in planning disaster response strategy. Depending on the nature of emergency, problems may arise in deploying forces from outside, especially in case of disruption of national transportation system or during floods etc. Following a mass-casualty event, the community and local government can be left "on their own" and may need to rely solely on local resources for at least one to two days and perhaps for as long as ten days. [3] Primary care physicians during these critical times may prove as an invaluable asset to perform triage and provide initial treatment to victims because of their breadth of knowledge and skills. This will even prevent emergency department overload of nearby hospitals resulting in better care of evacuees in critical state.

Further, studies indicate that most survivors of recent disasters (9/11 attack; [4] Istanabul bombings; [5] Hurricane Katrina [6] ) were either walking wounded with non-severe complaints (eye irritation and inhalational injuries) or were in need of prescription for essential medications especially to prevent exacerbations of chronic illnesses. Primary care physicians can act instrumental during these critical hours by extending care to majority of such patients who do not require hospitalization but need continuation of essential health care services. Besides, it has been reported that non-family physicians face discomfort in providing care for patients outside their speciality, adding to already prevailing chaos. [7],[8]

Education and training of primary physicians in disaster medicine are in their relative infancy in India. Under, Integrated Disease Surveillance project (IDSP) decentralized surveillance and rapid response mechanisms for impending outbreaks are being established. In wake of recent avian flu and swine flu epidemic, medical officers and field health workers were successfully trained for early detection of warning signals of disease and initiation of effective response. Understanding the pivotal role of primary physicians and upgrading their knowledge and skills to effectively utilize community resources during disrupted time will enable public health administrators in India to accomplish dual responsibility of responding to specific health threats and will ensure that essential health services are maintained for the affected communities during emergencies.

 
   References Top

1.Saxena R. Vulnerable health facilities: Casualty of disasters. Build disaster resilient health facilities. World Health Day Focus; 2009.  Back to cited text no. 1
    
2.Emergency Preparedness and Response. South - East Asia Earthquake and Tsunami. Country Information-India. Available from: http://www.searo.who.int/EN/Section1257/Section2263/Section2310/Section2311_12260.htm#links. [Last accessed on 2010 May 2].  Back to cited text no. 2
    
3.Rubinson L, Nuzzo JB, Talmor DS, O'Toole T, Kramer BR, Inglesby TV. Augmentation of hospital critical care capacity after bioterrorist attacks: Recommendations of the Working Group on Emergency Mass Critical Care. Crit Care Med 2005;33:2393-403.  Back to cited text no. 3
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4.Cushman JG, Pachter HL, Beaton HL. Two New York City hospitals' surgical response to the September 11, 2001, terrorist attack in New York City. J Trauma 2003;54:147-54; discussion 154-5.  Back to cited text no. 4
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5.Rodoplu U, Arnold JL, Yucel T, Tokyay R, Ersoy G, Cetiner S. Impact of the terrorist bombings of the Hong Kong Shanghai Bank Corporation headquarters and the British Consulate on two hospitals in Istanbul, Turkey, in November 2003. J Trauma 2005;59:195-201.  Back to cited text no. 5
    
6.Edwards TD, Young RA, Lowe AF. Caring for a surge of Hurricane Katrina evacuees in Primary Care Clinics. Ann Fam Med 2007;5:170-4.  Back to cited text no. 6
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7.Thomas DE, Gordon ST, Melton JA, Funes CM, Collinsworth HJ, Vicari RC. Pediatricians' experiences 80 miles up the river: Baton Rouge pediatricians' experiences meeting the health needs of evacuated children. Pediatrics 2006;117:S396-401.  Back to cited text no. 7
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8.Brown OW. Using international practice techniques in Texas: Hurricane Katrina experiences: Receiving patients in Longview, Texas, 350 miles from ground zero. Pediatrics 2006;117:S439- 41.  Back to cited text no. 8
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