Acciones para implementar la recepción masiva de intoxicados en los hospitales durante las emergencias químicas / Actions to implement mass reception of intoxicated people in hospitals during chemical emergencies

Introducción: El sistema de recepción masiva de intoxicados en los hospitales, durante las emergencias químicas, tributa a las fases de la etapa de respuesta del ciclo de reducción de riesgos de desastres, pero necesita de su implementación en la práctica. Objetivo: Elaborar una secuencia de acciones que permita implementar el sistema de recepción masiva de intoxicados en los hospitales en situaciones de emergencias químicas. Método: Se revisaron y analizaron fuentes bibliográficas entre 2005 y 2017. Se realizaron consultas individuales a personas vinculadas al tema, que permitieron la primera aproximación. Se empleó el criterio de expertos sobre la utilidad y viabilidad para la validación de los resultados. Resultados: Se elaboró una secuencia de acciones para la implementación del sistema de recepción masiva de intoxicados derivados de emergencias químicas en los hospitales, que se corresponden con las fases de la etapa de respuesta del ciclo de reducción de riesgos de desastres y con los subsistemas fundamentales del sistema. Esta asumió tres fases: fase 1, de alerta o preparación, que incluye las acciones de preparación hospitalaria; la fase 2, de alarma o ejecución, en las que se ejecutan las acciones de recepción masiva de intoxicados; y la fase 3, o de recuperación, que comprende las acciones de rehabilitación y restablecimiento. Conclusiones: La secuencia de acciones concebida permite implementar en la práctica el sistema de recepción masiva de intoxicados derivados de emergencias químicas en los hospitales; está compuesta por tres fases: preparatoria, ejecutoria y recuperativa; es integral, participativa y reproducible por cualquier institución hospitalaria(AU)

Introduction: The system of mass reception of intoxicated people during chemical emergencies, in hospitals, is linked to the phases of the response stage of the disaster risk reduction cycle, but needs to be implemented in practice. Objective: To elaborate a sequence of actions that allows to implement the system of massive reception of intoxicated people in hospitals, in situations of chemical emergencies. Method: Bibliographical sources were reviewed and analyzed between 2005 and 2017. Individual consultations were made to people linked to the topic, which allowed the first approximation. The criterion of experts on the utility and viability for the validation of the results was used. Results: A sequence of actions was developed for the implementation of the system of mass reception of intoxicates derived from chemical emergencies in hospitals that correspond to the phases of the response phase of the disaster risk reduction cycle and; with the fundamental subsystems of the system. This took three phases: phase 1, alert or preparation, which includes the actions of hospital preparation, phase 2, alarm or execution, in which actions of mass reception of intoxicated are carried out, and phase 3, or recovery, which includes rehabilitation and recovery actions. Conclusions: The sequence of actions conceived allows to implement in practice the system of mass reception of intoxicates derived from chemical emergencies in hospitals. It is composed of three phases: preparatory, executory and recuperative; It is comprehensive, participatory and reproducible by any hospital institution(AU)

Concepción teórica de la recepción masiva de intoxicados en los hospitales durante emergencias químicas / Theoretical conception of mass reception of intoxicated people in hospitals during chemical emergencies

Introducción: La recepción masiva de intoxicados en los hospitales, derivados de emergencias químicas, se sustenta en postulados teóricos generales de estas emergencias, los siniestros con víctimas en masa y la teoría de los sistemas. Debe tributar al ciclo de reducción de riesgos de desastres. Objetivo: Diseñar una concepción teórica de la recepción masiva de intoxicados derivados de emergencias químicas, para los hospitales, que tribute a las fases de la etapa de respuesta del ciclo de reducción de riesgos de desastres. Métodos: Se realizó una investigación en sistemas y servicios de salud, entre los años 2005 y 2017. Se revisaron y analizaron fuentes bibliométricas e infométricas y se consultaron expertos en el proceso de concreción del resultado, por método de consenso para determinar la pertinencia. Resultados: Se concibió la recepción masiva de intoxicados en los hospitales como un sistema, que asumió cuatro subsistemas: el preparativo, ejecutivo y recuperativo como fundamentales, y el de aseguramiento, para garantizar el funcionamiento de estos. Todos están relacionados entre sí, con dependencia significativa entre ellos. Se caracteriza por ser: flexible, objetivo, participativo, oportuno, aceptable, adecuado y selectivo. Conclusiones: El enfoque sistémico de la recepción masiva de intoxicados en los hospitales como consecuencia de las emergencias químicas, constituye un referente de gran valor teórico para su comprensión integral como fenómeno complejo, su estructura está conformada por cuatro subsistemas: el preparativo, ejecutivo, recuperativo y el de aseguramiento, y tributa a las fases de la etapa de respuesta del ciclo de reducción de riesgos de desastres(AU)

ABSTRACT Introduction: The mass reception of intoxicated people in hospitals, resulting from chemical emergencies, is based on general theoretical postulates of chemical emergencies, mass casualty events and systems theory, which must contribute to the disaster risk reduction. Objective: To design a hospital theoretical conception for mass reception of intoxicated people resulting from chemical emergencies. This conception should contribute to the response phases of the disaster risk reduction. Methods: This is a research on health systems and services conducted from 2005 to 2017. We reviewed and analyzed bibliometric and infometric sources and we consulted experts. To determine the relevance, we focused on the process of result concretion and consensus method. Results: The mass reception of intoxicated patients in hospitals was conceived as a system of four subsystems. The basic are preparatory, executive and recuperative subsystems. The assurance subsystem guarantees the operation. All subsystems relate to each other with significant dependence between them. This system is flexible, objective, participatory, timely, acceptable, adequate and selective. Conclusions: The systemic approach of the mass reception of intoxicated patients in hospitals resulting from chemical emergencies constitutes a valuable theoretical reference for its basic comprehension as a complex phenomenon. Four subsystems structures it: preparatory, executive, recuperative and assurance. It contributes to the response phases of the cycle for disaster risk reduction(AU)

Mass poisoning after consumption of a hawksbill turtle, Federated States of Micronesia, 2010

BACKGROUND: Marine turtles of all species are capable of being toxic. On 17 October 2010, health authorities in the Federated States of Micronesia were notified of the sudden death of three children and the sickening of approximately 20 other people on Murilo Atoll in Chuuk State. The illnesses were suspected to be the result of mass consumption of a hawksbill turtle (Eretmochelys imbricata). An investigation team was assembled to confirm the cause of the outbreak, describe the epidemiology of cases and provide recommendations for control. METHODS: We conducted chart reviews, interviewed key informants, collected samples for laboratory analysis, performed environmental investigations and conducted a cohort study. RESULTS: Four children and two adults died in the outbreak and 95 others were sickened; 84% of those who ate the turtle became ill (n = 101). The relative risk for developing illness after consuming the turtle was 11.1 (95% confidence inteval: 4.8–25.9); there was a dose-dependent relationship between amount of turtle meat consumed and risk of illness. Environmental and epidemiological investigations revealed no alternative explanation for the mass illness. Laboratory testing failed to identify a causative agent. CONCLUSION: We concluded that turtle poisoning (also called chelonitoxism) was the cause of the outbreak on Murilo. The range of illness described in this investigation is consistent with previously reported cases of chelonitoxism. This devastating incident highlights the dangers, particularly to children, of consuming turtle meat. Future incidents are certain to occur unless action is taken to alter turtle-eating behaviour in coastal communities throughout the world.

Mass illness due to datura poisoning: A case report.

This report concerns an incident of multiple non-fatal poisonings due to datura, which was mixed in sweetmeat disguised as "prasad". The accused wished to kill his mother-in-law, but the "prasad" was consumed by many others also, who suffered from the manifestations of datura poisoning. However they responded well to routine treatment, and there were no fatalities.

Mass poisoning with jatropha curcas - A case report.

In India, accidental poisoning due to ingestion of plant seeds is common among children, especially under 12 years of age. It varies from relatively mild poisoning to fatal poisoning. Since unripe fruits of Yellow Oleander (Cerbera thevetia; Thevetia peruviana) resemble the fruits of Jatropha curcas, and symptoms such as vomiting, diarrhoea, and abdominal pain are common to both when ingested, differentiating the two is occasionally difficult. In this paper, the authors share their experience of a mass poisoning with Jatropha curcas that was initially mistaken to be due to Cerbera thevetia.