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Care Provided by VA Mobile Clinic Staff During Northridge Earthquake Relief

Published online by Cambridge University Press:  28 June 2012

Thomas Weiss ,
Linda Weiss ,
David Teeter  and
Jane Geraci
Thomas Weiss*
Affiliation:
Merck and Co., Inc. West Point, Pennsylvania, USA
Linda Weiss
Affiliation:
Upstate New York Veterans Administration Health Care Network, Albany, New York, USA
David Teeter
Affiliation:
VA Office of Emergency Medical Preparedness Training and Development, Indianapolis, Indiana, USA
Jane Geraci
Affiliation:
Houston Center for Quality of Care and Utilization Studies: A VA Health Services Research and Development (HSR&D) Field Program, andBaylor College of Medicine, Houston, Texas, USA
*
DrPH Manager, Outcomes Research and Management (WP39-70); Merck &Co., Inc., PO Box 4; West Point, PA 19486-0004 USA E-mail: [email protected]
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Abstract

Introduction:

From 25 January 1994 to 02 February 1994, staff aboard four Veterans Affairs Mobile Clinics treated Northridge Earthquake victims. This study examined the types of conditions treated by Clinic staff during the disaster.

Methods:

A descriptive case series using 1,123 ambulatory encounter forms was undertaken. Case-mix was assessed by classifying diagnoses into 120 possible diagnostic clusters.

Results:

Forty-five percent of patients were infants or children and 60% were female. The primary diagnoses were characterize by acute conditions: 1) upper respiratory infection (34.6%); 2) stress reactions (11.9%); 3) otitis media (10.1%); and injuries (8%). Two-thirds of the infants and children either had an upper respiratory infection (46.4%) or otitis media (20.1%). Increasing age indicated an increased likelihood of stress and anxiety reactions.

Conclusion:

The results provide additional information for agencies involved in planning for and responding to disasters. Based on the types of conditions diagnosed at the United States Veterans' Administration mobile clinics (i.e., a high prevalence of acute conditions, including stress and anxiety reactions, and the large numbers of children), staff trained in primary care, mental health, and pediatrics should be considered for relief missions that begin several days after an event resulting in a disaster.

Keywords

agedemographyDepartment of Veterans Affairsdiagnosesdisaster medicinedisaster preparednessemergency clinicshypertensionmobile health clinicspsychological conditions
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 14 , Issue 3 , September 1999 , pp. 84 - 90
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1999

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References

1. Leor, J, Poole, K, Kloner, RA: Sudden cardiac death triggered by an earthquake. N Engl J Med 1996;334:413–419.CrossRefGoogle ScholarPubMed
2. Carr, SJ, Leahy, SM, London, S, Sidhu, S, Vogt, J: The public health response to Los Angeles' 1994 earthquake. American Journal of Public Health 1996;86:589–590.Google Scholar
3. California Seismic Safety Commission: Public safety issues from the Northridge Earthquake of January 17, 1994: A compendium of issue statements by the commissioners of the Seismic Safety Commission. California Seismic Safety Commission; March, 1995.Google Scholar
4. Veterans Health Administration: Hurricane Andrew After-Action Report. Washington: Department of Veterans Affairs, Veterans Health Administration, Emergency Medical Preparedness Office; 10 November 1993.Google Scholar
5. Weiss, TW, Gregor, PJ, Wray, NP, Ashton, Evaluation of the Department of Veterans Affairs Mobile Clinics. M, , Menke, T, Bundy, JK, Ramzel, EA, Christian, CE: E VA Health Services Research and Development Service Project # SDR 91-015. Houston: Houston Center for Quality of Care and Utilzation Studies: A United States Veterans' Administration Health Services Research and Development Field Program; 1995.Google Scholar
6. Weiss, TW, Gregor, PJ, Bundy, JK, Wray, NP: Using DVA's mobile clinics for disaster relief. Lessons Learned from Hurricane Andrew. Houston: Houston Center for Quality of Care and Utilzation Studies: A United States Veterans' Administration Health Services Research and Development Field Program, HCQCUS 93-02; 1993.Google Scholar
7. Leonard, RB, Stringer, LW, Alson, R: Patient-data collection system used during medical operations after the 1994 San Fernando Valley Northridge Earthquake. Prehosfital and Disaster Medicine 1995;10:178–183.CrossRefGoogle ScholarPubMed
8. Karaffe, MC (ed): International Classification of Diseases. 9th revision, 4th ed, clinical modification, 1992. Los Angeles: Practice Management Information Corporation; 1992Google Scholar
9. Schneeweiss, R, Rosenblatt, PA, Cherkin, DC et al. : Diagnostic clusters: A new tool for analyzing the content of ambulatory medical care. Medical Care 1983;21:105–122.Google Scholar
10. Schneeweiss, R, Hart, GL: Diagnostic content of ambulatory primary care: Implications for resource utilization. Journal of Ambulatory Care Management 1988;11:13–22.CrossRefGoogle ScholarPubMed
11. National Heart, Lung, and Blood Institute: The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Washington: National Institutes of Health, National Heart, Lung, and Blood Institute. NIH Publication No. 93-108; March 1994.Google Scholar
12. Longmire, MC, Burch, J, Broom, LA: Morbidity of Hurricane Elena. Southern Medical Journal 1988;81:1342–1346.Google Scholar
13. Noji, EK: Natural disasters. Critical Care Clinics 1991;7:271–292.CrossRefGoogle ScholarPubMed
14. Boyce, WT, Chesterman, EA, Martin, N, Folkman, S, Cohen, F, Wara, D: Immunologic changes occurring at kindergarten entry predict respiratory illnesses after the Loma Prieta earthquake. Journal of Developmental and Behavioral Pediatrics 1993;14:296–303.CrossRefGoogle ScholarPubMed
15. Alson, R, Alexander, D, Leonard, RB, Stringer, LW: Analysis of medical treatment at a field hospital following Hurricane Andrew, 1992. Annals of Emergency Medicine 1993;22:1721–1728.CrossRefGoogle Scholar
16. Maj, M, Starace, F, Crepet, P, Lobrace, S, Veltro, F, De Marco, F, Kemali, D: Prevalence of psychiatric disorders among subject exposed to a natural disaster. Acta Psychiatrica Scandinavica 1989;79:544–549.CrossRefGoogle ScholarPubMed
17. Webster, RA, McDonald, R, Lewin, TJ, Carr, VJ: Effects of a natural disaster on immigrants and host population. Journal of Nervous and Mental Disease 1995;183:390–397.Google Scholar
18. Cardena, E, Spiegel, D: Dissociative reactions to the San Francisco Bay Area earthquake of 1989. American Journal of Psychiatry 1993;150:474–478.Google Scholar
19. Papadatos, Y, Nikou, K, Potamianos, G: Evaluation of psychiatric morbidity following an earthquake. International Journal of Social Psychiatry 1990;36:131–136.CrossRefGoogle ScholarPubMed
20. Aghababian, RV, Teuscher, J: Infectious diseases following major disasters. Annals of Emergency Medicine 1992;21:362 367.Google Scholar
21. De Ville de Goyet, C, Lechat, MF: Health aspects in natural disasters. Tropical Doctor 1976;6:152–157.CrossRefGoogle ScholarPubMed
22. Bissell, RA: Delayed-impact infectious disease after a natural disaster. Journal of Emergency Medicine 1983;1:59–66.CrossRefGoogle ScholarPubMed
23. Morbidity and Mortality Weekly Report: Coccidiomycosis following the Northridge Earthquake—California, 1994. Morbidity and Mortality Weekly Report 1994;43:194–195.Google Scholar
24. Leonard, RB, Spangler, HM, Stringer, LW: Medical outreach after Hurricane Marilyn. Prehospital and Disaster Medicine 1997;12:189–194.Google Scholar
25. Quarantelli, EL: Delivery of Emergency Medical Services in Disasters. University of Delaware Disaster Research Center, book and monograph series #15; December, 1977.CrossRefGoogle Scholar
26. Tierney, KJ: Emergency medical care aspects of the Loma Prieta Earthquake. University of Delaware Disaster Research Center, Article #234, 1992. Reprinted from International Symposium of Building Technology and Earthquake Hazard Mitigation (Buffalo, NY: NCEER, 1992): pp 225–250.Google Scholar
27. Gunn, SWA: Earthquakes. In: Baskett, P, Weller, R (eds.), Medicine for Disasters. Boston: Wright Press; 1988.Google Scholar
28. Lechat, MF: The epidemiology of health effects of disasters. Epidemiologic Reviews 1990;12:192–198.CrossRefGoogle ScholarPubMed
29. Anonymous: Disaster epidemiology. Lancet 1990;336:845–846.Google Scholar
30. Logue, JN: Disasters, the environment, and public health: Improving our response. American Journal of Public Health 1996;86:1207–1210.Google Scholar
31. Quarantelli, EL: Ten research-derived principles of disaster planning. Disaster Management 1982;2:23–25.Google Scholar
32. Quarantelli, EL: The delivery of disaster emergency medical services: Recommendations from systematic field studies. The University of Delaware Disaster Research Center. Reprinted from Disaster Medicine. 1983;1:41–44.Google Scholar
33. Noji, EK: Disaster epidemiology: Challenges for public health action. Journal of Public Health Policy 1992;13:332–340.CrossRefGoogle ScholarPubMed
34. Taylor United States Veterans' Administration: Future directions for study. University of Delaware Disaster Research Center, book and monograph #12. Reprinted from: Disasters: Theory and Research (Quarantelli, EL, Editor). Beverly Hills: Sage Publications, Inc.; 1978.Google Scholar
35. Ricci, E, Pretto, E: Assessment of prehospital and hospital response in disaster. Critical Care Clinics 1991;7:471–484.CrossRefGoogle ScholarPubMed