Subject(s)
Coronavirus Infections/therapy , Hospital Information Systems/organization & administration , Intensive Care Units/organization & administration , Surge Capacity , Australia , Coronavirus Infections/epidemiology , Data Collection , Humans , Pandemics , SARS-CoV-2 , Ventilators, Mechanical/supply & distribution , WorkforceABSTRACT
Sudden onset disasters (SODs) have affected over 1.5 billion of the world's population in the past decade. During the same time, developing nations have faced a sustained increase in the burden of non-communicable disease (NCD) with extra pressure placed on health systems. The combined increase in SODs and the NCD epidemic facing the world's most disaster-prone nations will present new challenges to emergency medical teams (EMTs) during disaster response. This report details the experience as an EMT during the Typhoon Haiyan disaster of 2013, with particular reference to the challenges of diabetic management in a surgical field hospital. The incidence of diabetes in this surgical cohort exceeded that of the population by a factor of four. The steps to prepare for and treat diabetes in the field provide a useful model for the management of NCD in the deployed field hospital environment after a disaster. McDermott KM , Hardstaff RM , Alpen S , Read DJ , Coatsworth NR . Management of diabetic surgical patients in a deployed field hospital: a model for acute non-communicable disease care in disaster. Prehosp Disaster Med. 2017;32(6):657-661.
Subject(s)
Cyclonic Storms , Diabetes Mellitus, Type 2 , Disaster Planning/organization & administration , Military Medicine , Mobile Health Units , Wounds and Injuries/surgery , Clinical Protocols , Humans , International Cooperation , PhilippinesSubject(s)
Arthritis, Infectious/etiology , Iatrogenic Disease , Infectious Disease Transmission, Professional-to-Patient , Shoulder Joint , Streptococcal Infections/transmission , Streptococcus mitis/isolation & purification , Aged , Contrast Media , Humans , Injections, Intra-Articular , Male , MasksABSTRACT
BACKGROUND: Abdominal tuberculosis (ATB) poses a significant diagnostic, management, and resource challenge. In Australia, an increasing number of tuberculosis (TB) cases are being reported, and we describe our experience of ATB in an Australian tertiary institution. METHODS: All diagnosed cases of tuberculosis (TB) at the Royal North Shore tertiary hospital campus of the University of Sydney are entered prospectively into a central registry. Cases of ATB encountered between September 1991 and November 2011 were identified and retrospectively reviewed. RESULTS: In all, 841 cases of TB were identified, of which 20 were abdominal (2.4 %). Median age at presentation was 34 years (range: 22-79 years), and 55 % of patients were women. None of the patients were born in Australia and 11 patients were of South Asian origin. The most common presenting symptom was abdominal pain (65 %). Diagnosis was based primarily on histology (90 % sensitivity), and the sensitivity of PCR analysis in this series was low (44 %). Eleven of the patients required laparoscopy or laparotomy. 40 % of cases involved the peritoneum, and disease was also seen in solid organs (liver, spleen, pancreas, adrenal gland) and bowel (esophagus, small bowel, colon). CONCLUSIONS: In our local experience ATB was seen exclusively in the immigrant population. The presentation of ATB varies greatly, necessitating a high index of suspicion within the context of abdominal symptoms in high-risk groups. The role of surgical involvement is indispensable for both diagnosis and management of ATB-related complications. Surgeons should remain mindful of the diagnosis in an age of increasing worldwide incidence.
