Improving Medical Diagnosis During Disasters

Rapid medical testing and diagnosis during disasters such as Hurricane Katrina and the tsunami of 2004 could improve triage, according to new research.

Researchers from the University of California Davis School of Medicine (UC Davis, USA) and Chulalongkorn University (Bangkok, Thailand) surveyed medical staff and administrators in 14 health care facilities administered by the Thai government and in 22 Louisiana (USA) hospitals. In Thailand, interviewees were asked to list needs and describe how they could have been better prepared. In the United States, researchers asked personnel about hospital size, number of staff, laboratory services, point-of-care testing (POCT) availability, critical care testing, cardiac biomarkers, and disaster responses. They also identified the influence of environmental conditions such as temperature, humidity, and electricity.

In Thailand, community hospital staff listed numerous needs, including whole-blood analyzers, POCT for cardiac biomarkers, oxygen-saturation monitoring, and infectious disease tests. Regional health systems need mobile resources, uninterruptible wireless communications, shared responsibility, mutual preparedness, and improved rapid, sustainable care for mainland and island emergencies.

The researchers found that after the Katrina hurricane in the United States, hospitals, evacuation sites, and local agencies were not prepared fully to assist quickly with POCT, which is used primarily on U.S. military ships and combat support units. Donations of glucose meters proved valuable, but were not fast enough or adequate for the large numbers of diabetic victims involved in the disaster. The researchers said that stockpiles of POCT supplies tailored to the needs of the particular disaster should be made readily available. The findings were published in the October 2006 issue of the American Journal of Clinical Pathology.

"In terrorist actions involving isotopic contamination or infectious agents, POCT can detect pathogens and facilitate care of isolated or quarantined patients,” said lead author Gerald J. Kost, M.D., Ph.D., director of the POCT Center at UC Davis. "Dedicated mobile medical units equipped with POCT instruments and intensive care unit modules can move to sites in need of help during the first week, as observed during Katrina.”



Related Links:
University of California Davis School of Medicine
Chulalongkorn University