Providing pharmacy services in a basketball arena: Reflections on building a pharmacy in a COVID-19 surge facility.

PURPOSE: As Coronavirus disease 19 (COVID-19) has spread globally, hospital systems have seen an increasing strain on their ability to accommodate the growing caseload. This demand has led countries to adopt varying surge-facility or alternate care site (ACS) models to manage patient overflow. This report describes the experience of setting up pharmacy services at a city-run surge facility in Philadelphia. SUMMARY: The COVID-19 Surge Facility at the Liacouras Center (CSF-L) was initially developed to serve as a site for patients convalescing from acute inpatient stays in order to free up healthcare resources in surrounding hospitals. The CSF-L site required a distinct set of services to provide the desired level of care. This report details the preparations and challenges faced by the CSF-L pharmacy team in this endeavor, including identifying a pharmacy location that met regulatory requirements, obtaining proper licenses, coordinating drug procurement, filling staffing requirements, developing a formulary, defining the pharmacy and medication management workflow, and ensuring safety protocols were followed. This report explains the rational for developing certain processes and suggests alternative options and ideal plans for developing future pharmacy services in an ACS. CONCLUSION: Identifying a pharmacy leadership team early in the ACS planning process can lead to more efficient plans for pharmacy services. This report details the important steps taken, decisions made, and challenges faced in setting up pharmaceutical services at a COVID-19 field hospital.

Ethical Considerations of Triage Following Natural Disasters: The IDF Experience in Haiti as a Case Study.

Natural disasters in populated areas may result in massive casualties and extensive destruction of infrastructure. Humanitarian aid delegations may have to cope with the complicated issue of patient prioritization under conditions of severe resource scarcity. A triage model, consisting of five principles, is proposed for the prioritization of patients, and it is argued that rational and reasonable agents would agree upon them. The Israel Defense Force's humanitarian mission to Haiti following the 2010 earthquake serves as a case study for the various considerations taken into account when designing the ethical-clinical policy of field hospitals. The discussion focuses on three applications: the decision to include an intensive care unit, the decision to include obstetrics and neonatal units, and the treatment policy for compound fractures.

Telecommunications in Israeli field hospitals deployed to three crisis zones.

A field hospital overseas requires various types of communication equipment. This study presents the communications equipment used by three Israeli field hospital delegations to earthquake sites at Adapazari, Turkey, in 1999, Port-au-Prince, Haiti, in 2010 and Minamisanriku, Japan, in 2011. The delegations to Turkey and Haiti were relatively large (105-230 personnel) and were on the site early (three to four days after each event). The 55-person delegation to Japan arrived later and was established as an outpatient community hospital. Standard military VHF radios were the only effective tool up to 5 km, until cellular coverage was regained (1-2 weeks after each event). International communication was good. While short-wave communication (telephone and Internet) was used in Turkey, a direct satellite channel was set up in Haiti. In Japan, BGAN Inmarsat provided efficient Wi-Fi for all needs. Motorola walkie talkies were not efficient beyond the immediate vicinity. This paper recommends continued use of military-specification equipment alongside newer modalities, particularly in situations where infrastructure is damaged.

Skeletal injuries sustained during the Haiti earthquake of 2010: a radiographic analysis of the casualties admitted to the Israel Defense Forces field hospital.

PURPOSE: To report the distribution and types of skeletal injuries demonstrated on the images taken at the field hospital following the Haiti 2010 earthquake. METHODS: Following the January 12, 2010, earthquake, the State of Israel dispatched a field hospital to Haiti, managing 1,111 patients from January 17, 2010, to January 26, 2010. Four hundred and seven patients (37 %) had 684 radiographic images, most of them (87 %) due to presumed skeletal injuries. RESULTS: There were 224 limb fractures (excluding the hands and feet), with 77 % of them in the lower limbs (30 % femur, 17 % tibial shaft, 16 % ankle). Out of 37 axial skeleton fractures, 30 involved the pelvis (21 anterior posterior, three vertical shear, three lateral compression, three combined). Nine traumatic dislocations (five hips, three shoulders, one knee) were reduced. After reviewing all the digital radiographs, on a PACS-compatible radiography screen, few false diagnoses (2 %) were encountered, with none of them affecting the management of these injuries. CONCLUSIONS: To the best of our knowledge, this is the first report of the radiological results emerging from a field hospital following a mass casualty event. Laptop personal computer-based workstations provide an adequate solution for radiographic image viewing in a field hospital setting. Recognition of the prevalence and distribution of skeletal injuries can improve the preparedness of such delegations before departure in the future.