Palliative Care Training for Work in an Austere Environment after a Natural Disaster
DOI:
https://doi.org/10.17140/PMHCOJ-4-128Keywords:
Disaster response, Palliative care training, Triage, Expectant, managementAbstract
Healthcare professionals who work in the disaster field confront many challenges to the care of victims of natural disasters. Disaster responders face destroyed physical infrastructures, scarce supplies, and a limited trained peer group. During a mass casualty event, healthcare responders will encounter disaster victims who are triaged to the “expectant” category of care because either their injuries are not survivable or the resources needed to care for them surpass what is available. Responders have not been traditionally trained to administer palliative care in a disaster setting. This commentary examines the challenges that responders face in caring for dying patients in the field and advocates for basic palliative care training prior to deploying to a disaster.References
Learning J, Guha-Sapir D. Natural disasters, armed conflict, and public health. N Engl J Med. 2013; 369: 1836-1842. doi: 10.1056/ NEJMra1109877
Sasser SM, Hunt RC, Faul M, et al. Centers for isease Control and Prevention (CDC). Guidelines for field triage of injured pa-tients. Recommendations of the National Expert Panel on Field Triage, 2011. MMWR Recommendations & Reports. 2012; 61(RR-1): 1-20.
Matusow H, Benoit E, Elliott L, Dunlap E, Rosenblum A. Challenges to opioid treatment programs after hurricane sandy: Patient and Provider Perspectives on Preparation, Im-pact, and Recovery. Subst Use Misuse. 2018; 53(2): 206-219. doi: 10.1080/10826084.2016.1267225
Goodman A, Black L. The Challenge of allocating scarce medi-cal resources during a disaster in a low-income country: A case study from the 2010 Haitian earthquake. Palliat Med Hosp Care Open J. 2015; 1(1): 24-29. doi: 10.17140/PMHCOJ-1-105
King BT, Peterson WC. The care of thermally injured patients in operational, austere, and mass casualty situations. Wilderness Envi-ron Med. 2017; 28(2S): S103-S108. doi: 10.1016/j.wem.2017.03.011
Ho MLL, Lim JZM, Tan MZW, et al. Humanitarian Assistance and Disaster Relief mission by a tripartite medical team led by the Singapore Armed Forces after the 2015 Nepal earthquake. Singa-pore Med J. 2016; 57(8): 426-431. doi: 10.11622/smedj.2016132
Ozaki A, Tsubokura M, Leppold C, et al. The importance of family caregiving to achieving palliative care at home: a case report of end-of-life breast cancer in an area struck by the 2011 Fuku-shima nuclear crisis: A case report. Medicine, 2017; 96(46); e8721. doi: 10.1097/MD.0000000000008721
Harris C, McCarthy K, Liu EL, et al. Expanding understanding of response roles: an examination of immediate and first respond-ers in the United States. Int J Environ Res Public Health. 2018; 15(3): 534. doi: 10.3390/ijerph15030534
Morris AM, Ricci KA, Griffin AR, Heslin KC, Dobalian A. Per-sonal and professional challenges confronted by hospital staff fol-lowing Hurricane Sandy: A qualitative assessment of management perspectives. BMC Emergency Medicine. 2016; 16: 18. doi: 10.1186/ s12873-016-0082-5
Reissman DB, Howard J. Responder safety and health: Prepar-ing for future disasters. Mt Sinai J Med. 2008; 75(2): 135-141. doi: 10.1002/msj.20024
Luft BJ, Schechter C, Kotov R, et al. Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers. Psychological Medicine. 2012; 42(5): 1069-1079. doi: 10.1017/S003329171100256X
Kranke D, Weiss EL, Heslin KC, Dobalian A. “We are disas-ter response experts”: A qualitative study on the mental health impact of volunteering in disaster settings among combat vet-erans. Social Work in Public Health. 2017; 32(8): 500-509. doi: doi: 10.1080/19371918.2017.1365033
Hunt MR. Establishing moral bearings: Ethics and expatriate health care professionals in humanitarian work. Disasters. 2011; 35(3): 606-622. doi: 10.1111/j.1467-7717.2011.01232.x
Goodman A. From Boston to Nepal: How to treat suffer-ing without resources. Humanitarian Health Ethics. 2017. Web site. https://humanitarianhealthethics.net/2017/05/04/from-boston-to-nepal-how-to-treat-suffering-without-medical-resources/. Ac-13 Goodman A, et al cessed April 15, 2018.
Suwanabol PA, Reichstein AC, Suzer-Gurtekin ZT, et al. Surgeons’ perceived barriers to palliative and end-of-life care: A mixed methods study of a surgical society. J Palliat Med. 2018; doi: 10.1089/jpm.2017.0470. [Epub ahead of print]
World Health Organization (WHO), (2017). Essential medi-cines in emergencies. Web site. http://www.who.int/hac/tech-guidance/pht/essentialmed/en/. Accessed April 15, 2018.
Hunt MR, Schwartz L, Sinding C, Elit L. The ethics of engaged presence: A framework for health professionals in humanitarian assistance and development work. Dev World Bioeth. 2014; 14(1): 47-55. doi: 10.1111/dewb.12013
Marom T, Segal D, Erlich T, Tsumi E, Merin O, Lin G. Ethical and clinical dilemmas in patients with head and neck tumors visit-ing a field hospital in the Philippines. Am J Disaster Med. 2014; 9(3): 211-219. doi: 10.5055/ajdm.2014.0172
Lakin JR, Koritsanszky LA, Cunningham R, et al. A systematic intervention to improve serious illness communication in primary care. Health Aff (Millwood). 2017; 36(7): 1258-1264. doi: 10.1377/ hlthaff.2017.0219
Smith MB, Macieira TGR, Bumbach MD, et al. The use of sim-ulation to teach nursing students and clinicians palliative care and end-of-life communication: A systematic review. Am J Hosp Palliat Care. 2018: 1049909118761386. doi: 10.1177/1049909118761386. [Epub ahead of print] Commentary | Volume 4 | Number 1|
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