The rate of disaster occurrence has increased greatly in the recent decades in both natural and man-made ones. There are more hurricanes and other natural disasters occurring now than a century ago. In addition, there is marked increase in the terrorist attacks on cities and civilians in both conventional weapons and in chemical and biological ones. The increase in the rate of disasters obliges medical society to pay more and more attention to the disaster response. There are attempts to make the subject of disaster as an independent specialty of medicine because it has unique focus in managing cases and it involves dealing with several issues other than direct medical treatment of patients.
Part of the book: Essentials of Accident and Emergency Medicine
During austere conditions when there is a large demand on healthcare services and the resources are limited for different reasons, there should be a special way of managing patients and victims in order to make the most benefit to the community. Trial of first come, first served will lead to losing most of the seriously injured patients because they will reach late if they reached a healthcare facility. In addition, day-to-day work protocols with full resources also are not the optimum to offer for the whole community during a major incident. Triage has been created and evolved in military medical services to face mass casualty with limited resources and then transferred to civilian life to deal with mass casualty incidents. Applying triage to patients created some interference with medical bioethics if those applied on individual bases, but if applied in the whole picture of state or country, we can understand its rations.
Part of the book: Emergency Medicine and Trauma
There is obvious increase in world population and in term of number of major incidents (MI) all over the world, there is a need for faster and wider responses. To achieve this aim and keep losses to the minimum, we need to optimize our methods and protocols of the response to decrease the losses, pain, and suffering of people and losses of infrastructures, belongings, and the country’s future. Primary health care (PHC) system, which is present in all residency gatherings in cities and towns, provides suitable potential for this improvement. This role has been formulated in 1978 in Alma-Ata meeting, which changes the scope of service of primary health care system to take responsibility of the community in addition to patients’ care. The involvement of the primary health care in response to major incidents shows good results, and there is a need to strengthen the major incidents’ response plan in the primary health care to provide better response and help to all populations especially the vulnerable ones.
Part of the book: Topics in Primary Care Medicine
Access to emergency services is essential for the health and well-being of people. The World Health Organization (WHO) made it a human right for everybody to have access to emergency care and it is an ethical obligation for governments to provide this service for the whole population. In recent years, the overcrowding in emergency departments has become a prominent issue that needs proper solutions. There have been several attempts resolving this ongoing issue. One of those is the patients’ distribution according to the severity level of their chief complaint, since more than half of the urgent cases are of low acuity and can be managed in less equipped facilities. Primary healthcare centers are perfectly suited to look after a significant proportion of cases for many reasons such as their scope of service, their wider geographical distribution, and are a more cost-effective resource for such cases than the use of higher acuity facilities. In Qatar, we have been implementing such model of patient distribution to release the burden on emergency departments since 1999. In this chapter we are proposing a full protocol to distribute emergency patients involving the ambulance service, primary healthcare centers, and emergency departments. Cooperation of all these services with the help of higher authorities and media is expected to show great improvements in patient care and better crowd control in emergency departments.
Part of the book: Healthcare Access