Focus On Disaster Medicine And Preparedness

Guest: Narayan Nair, MD Host: Maurice Pickard, MD Guest: Robert J. Tosatto, RPh, MPH, MBA Organized in 2002, this nationwide network of local, volunteer medical and public health professionals contribute their expertise throughout the year as well as in times of community need. Corps Directors - Captain Robert Tosatto and Dr. Narayan Nair, describe how the program is working.

Guest: Mark Smith, MD Host: Larry Kaskel, MD Dr. Mark Smith, professor and chair of emergency medicine at Georgetown University School of Medicine, and chief of emergency medicine at Washington Hospital Center in Washington, DC, explains to host Dr. Larry Kaskel the positive impact of disaster preparedness guidelines on the day-to-day function of an emergency department. Dr. Smith outlines how the physical facility design and communication system of ER One, the federally-funded project to construct the national prototype for next-generation emergency care, where Dr. Smith is the director, will protect patients from hospital-acquired infections, reduce hospital errors and create an overall safer work environment for care providers.

Guest: Mark Smith, MD Host: Larry Kaskel, MD Intended to be built at the Washington Hospital Center in our nation's capital, ER One is projected to serve as the national prototype for emergency department design, to maximize our risk management capabilities in all scenarios, including large-scale terrorist threats and natural disasters. Host Dr. Larry Kaskel welcomes Dr. Mark Smith, director of ER One and professor and chair of emergency medicine at Georgetown University School of Medicine, to describe key design recommendations for an all-risk ready emergency care facility, which features single-patient care rooms that are negatively pressurized to prevent the spread of infection, with self-decontaminating surfaces, and modular equipment solutions.

Guest: Ralph Shealy, MD Host: John Armstrong, MD No matter where we live and work, we know that disasters will happen in our community. We don’t necessarily know when and in what form, but in the view of Dr. Ralph Shealy, co-director of the Disaster Preparedness and Response Training Network for the South Carolina Area Health Education Consortium, and an internationally recognized expert in disaster medicine, the eventual certainty of these tragedies makes disaster medicine ‘one of the costs of doing business for society.’ In this conversation with host Dr. John Armstrong, Dr. Shealy implores us to remember that when disaster strikes, there is no guarantee that help is coming from Washington and other government resources. With this in mind, how do we keep ourselves prepared and ready to respond when an emergent calamity strikes in our community?

Guest: Ralph Shealy, MD Host: John Armstrong, MD We may one day find ourselves in a disaster scenario that far outstrips our normal capabilities of emergency response. In this circumstance, we may well find ourselves without imaging capabilities or lab results, while also lacking the possibility of consultation or referral. So how can we, as healthcare providers, persevere to create the best possible outcome? Dr. Ralph Shealy, co-director of the Disaster Preparedness and Response Training Network for the South Carolina Area Health Education Consortium, and an internationally recognized expert in disaster medicine, encourages us to get back to the basics of ‘doctoring.' Dr. John Armstrong hosts.

Guest: Ralph Shealy, MD Host: John Armstrong, MD There are many avenues for participation by healthcare professionals in disaster preparedness and larger-scale emergency response, but in a sense, many of us are unsure exactly where our areas of expertise would allow us to make a contribution in preparation for, and in response to, a disaster. Should we just accept that disaster will happen, and begin our preparations from there? If not, how and why should we facilitate broader preparations? Dr. Ralph Shealy, co-director of the Disaster Preparedness and Response Training Network for the South Carolina Area Health Education Consortium, and an internationally recognized expert in disaster medicine, presents a series of interesting considerations about our individual roles in disaster scenarios during this conversation with host Dr. John Armstrong.

Guest: James J. James, MD, DrPH, MHA Host: Bill Rutenberg, MD Where can a physician get disaster life support training, and what does it entail? Joining host Dr. Bill Rutenberg for a lively discussion of this novel concept is Dr. James James. A retired brigadier general, Dr. James is the director of the American Medical Association Center for Public Health Preparedness and Disaster Response. He is also the editor in chief of the journal Disaster Medicine and Public Health Preparedness. You'll learn about a unique series of courses currently available to train physicians and medical personnel how to function as effective healthcare providers and team leaders during times of disaster.

Guest: James J. James, MD, DrPH, MHA Host: Bill Rutenberg, MD The spread of communicable diseases is prevalent following disasters. Joining host Dr. Bill Rutenberg for a conversation of new recommendations for vaccine preparedness to protect disaster survivors is Dr. James James. Dr. James is the director of the American Medical Association Center for Public Health Preparedness and Disaster Response and editor-in-chief of the journal Disaster Medicine and Public Health Preparedness. 

Guest: Dave Gruber Host: Susan Dolan, RN, JD How are states addressing preparatory needs for a pandemic influenza outbreak? How does a state's preparedness dovetail with other state and federal efforts? Dave Gruber, senior assistant commissioner for the division of health infrastructure preparedness and emergency response for the state of New Jersey, evaluates key preparedness indicators to measure progress in your state. More specifically, Mr. Gruber looks at state-level movement toward anti-viral stockpiling, in collaboration with national preparedness organizations. Susan Dolan hosts.

Guest: Dave Gruber Host: Susan Dolan, RN, JD It's been almost a century since the outbreak of Spanish flu in 1918, arguably our most significant struggle with pandemic influenza. Dave Gruber, senior assistant commissioner for the division of health infrastructure preparedness and emergency response for the state of New Jersey, briefly chronicles the breadth of our 20th century pandemic encounters, and examines how these events apply to our evolving understanding of the public health consequences. Very simply, what defines a case of pandemic influenza? Mr. Gruber also updates us on the details of a potential vaccine for prospective Avian flu scenarios. Susan Dolan hosts.

Guest: Philip Smith, MD Host: Mark Nolan Hill, MD Guest: Lona Mody, MBBS A major disaster scenario in the United States would likely overwhelm acute care hospitals. Nursing homes present one alternative location for providing care. In the case of a pandemic influenza outbreak, are these care facilities prepared to handle an overflow of patients? From an ethical standpoint, are they obliged to extend their services to the population at large? Dr. Philip Smith, professor and chief of infectious diseases at the University of Nebraska School of Medicine, and Dr. Lona Mody, assistant professor of internal medicine in the division of geriatric medicine at the University of Michigan Medical School, also examine the need for nursing homes to maintain open lines of local and regional communication with other facilities and public health officials. Dr. Mark Nolan Hill hosts.

Guest: Philip Smith, MD Host: Mark Nolan Hill, MD Guest: Lona Mody, MBBS Providing healthcare in an influenza pandemic would likely bring an all-hands-on-deck approach. The staff at nursing homes and other care facilities would be enlisted to supply treatment to their own residents, likely in addition to outside patients requiring immediate assistance. How can nursing home institutions train their care providers for the specific demands of a pandemic flu scenario? What would be the special needs of nursing home residents during this time? For a closer look at these questions and more, host Dr. Mark Nolan Hill welcomes Dr. Philip Smith, professor and chief of infectious diseases at the University of Nebraska School of Medicine, and Dr. Lona Mody, assistant professor of internal medicine in the division of geriatric medicine at the University of Michigan Medical School.

Guest: Mauricio Lynn, MD Host: Shira Johnson, MD Blast injuries present a special set of medical issues. Dr. Mauricio Lynn, director of the Trauma Resuscitation Unit at Ryder Trauma Center at Jackson Memorial Hospital in Miami, discusses the science and medicine behind current strategies for blast injury treatment. From this perspective, Dr. Lynn shares nearly 20 years of military experience in the Israeli Defense Forces Medical Corps with host Dr. Shira Johnson.

Guest: Mauricio Lynn, MD Host: Shira Johnson, MD The threat of explosive device attacks is an everyday reality in Isreal. Dr. Mauricio Lynn, associate professor of surgery at the University of Miami Miller School of Medicine and director of the Trauma Resuscitation Unit at the Ryder Trauma Center at Jackson Memorial Hospital in Miami, served in the Israeli Defenses Forces for 18 years. He talks with host Dr. Shira Johnson about our preparedness for an explosive device attack on US soil. What have we learned from the experiences of Israelis and others?

Guest: Edward Pombier Host: Shira Johnson, MD Dr. Shira Johnson explores with Ed Pombier, director of the University of Miami Radiation Control Center at Jackson Memorial Hospital, the reality and the impact of a possible radiologic attack. Several years after September 11th, what do you really know about the aftermath of a dirty bomb? 

Guest: Richard Weisman, PharmD Host: Shira Johnson, MD On March 20, 1995, a group of terrorists launched a chemical attack on the Tokyo Metro, one of the world's busiest commuter transport systems, at the peak of the morning rush hour. The chemical weapon was sarin nerve gas. What do we know about this weapon, its devastating impacts on the body, and how to treat its victims? Dr. Richard Weisman, research associate professor of pediatrics at the University of Miami Miller School of Medicine and coordinator of their Weapons of Mass Destruction Response Program, reviews the critical facts about nerve gas and our current clinical understandings.

Guest: Richard Weisman, PharmD Host: Shira Johnson, MD How would the survivors present after a nerve gas attack and what do you need to know to treat them? Dr. Richard Weisman, research associate professor of pediatrics at the University of Miami Miller School of Medicine and coordinator or the Weapons of Mass Destruction Response Program at the University of Miami Jackson Memorial Medical Center discusses the clinical picture of exposure to nerve gas. Dr. Shira Johnson is the host in this infomative session to teach you about the short and long term clinical effects and practical implications.

Guest: Maureen F. Orr, MS Host: Larry Kaskel, MD Should health professionals be concerned about secondary contamination? How often does it occur and what are the signs that should prompt you to take extra precautions? Maureen Orr, an epidemiologist at the Centers for Disease Control's Agency for Toxic Substances and Disease Registry, talks with host Dr. Larry Kaskel about her published report, "Secondary Contamination of Medical Personnel, Equipment, and Facilities Resulting From Hazardous Materials Events, 2003-2006."

Guest: Derek Robinson, MD Host: Maurice Pickard, MD Emergency room visits nationwide are on the rise, even as the total number of emergency rooms is falling. Add this to the fact that, according to the Center for Disease Control and Prevention's recent publication, National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary, only 15.9 million out of 119 million visits to the emergency room in 2006 were urgent or emergent, and we see just how taxed our emergency rooms are. Dr. Derek Robinson, of the American College of Emergency Physicians, explores solutions to this expensive and inefficient way to provide care. Dr. Maurie Pickard hosts.

Guest: James W. Jones, PsyD, PhD, ThD Host: Leslie P. Lundt, MD Religious terrorism has become commonplace in our lifetime.  What causes a person to kill innocent strangers in the name of religion?  Our guest Dr. James Jones is uniquely qualified to address this question. Dr. Jones, a professor of religion and adjunct professor of clinical psychology at Rutgers University is an authority on comparative religion and a clinical psychologist. Host Dr. Leslie Lundt welcomes Dr. Jones to discuss how we can help patients struggling with these issues.