Orthopaedic care provided by the 14th combat support hospital in support of humanitarian and disaster relief after hurricane Maria in Puerto Rico

On September 20,2017 Hurricane Maria,a category 4 hurricane,made landfall on the eastern coast of Puerto Rico.This was preceded by Hurricane Irma,a category 5 hurricane,which passed just off the coast 13 d prior.The destruction from both Hurricane Irma and Maria precipitated a coordinated federal response which included the Federal Emergency Management Agency(FEMA)and the United States military.The United States Army dispatched the 14^th Combat Support Hospital(CSH)to Humacao,a city on the eastern side of the island where Maria made landfall.The mission of the 14^th CSH was to provide medical humanitarian aid and conduct disaster relief operations in support of the government of Puerto Rico and FEMA.During the 14^th CSH deployment to Puerto Rico,1157 patients were evaluated and treated.Fifty-seven operative cases were performed to include 23 orthopaedic cases.The mean age of the orthopaedic patients treated was 45.7 years(range 13-76 years).The most common operation was irrigation and debridement of open contaminated and/or infected wounds.Patients presented a mean 10.8 d from their initial injury(range 1-40 d).Fractures and infections were the most common diagnoses with the greatest delay in treatment from the initial date of injury.The deployment of the 14^th CSH to Puerto Rico was unique in its use of air transport,language and local customs encountered,as well as deployment to a location outside the continental United States.These factors coupled with the need for rapid deployment of the 14^th CSH provided valuable experience which will undoubtedly enable future success in similar endeavors.

Necessity for disaster-related nursing competency training of emergency nurses in China

Purpose::Discuss on the disaster-related nursing competency training of Chinese emergency nurses.Methods::By retrieving concerned literatures,summarize the current situation of disaster responses of Chinese emergency nurses and the impact factors of disaster-related nursing competencies.Results::The disaster preparedness of emergency nurses in China is at a medium level and must be improved.The impact factors include the educational degree,gender,disaster relief experience,training,and mechanisms for domestic disaster relief.Conclusion::As a direct response to disaster,emergency nurses should improve the comprehensive ability of disaster nursing by systematic disaster nursing education and professional training.

Incorporating transportation network modeling tools within transportation economic impact studies of disasters

Transportation system disruption due to a disaster results in ＂ripple effects＂ throughout the entire transportation system of a metropolitan region. Many researchers have focused on the economic costs of transportation system disruptions in transportation-related industries, specifically within commerce and logistics, in the assessment of the regional economic costs. However, the foundation of an assessment of the regional economic costs of a disaster needs to include the evaluation of consumer surplus in addition to the direct cost for reconstruction of the regional transportation system. The objective of this study is to propose a method to estimate the regional consumer surplus based on indirect economic costs of a disaster on intermodal transportation systems in the context of diverting vehicles and trains. The computational methods used to assess the regional indirect economic costs sustained by the highway and railroad system can utilize readily available state departments of transportation （DOTs） and metropolitan planning organizations （MPOs） traffic models allowing prioritization of regional recovery plans after a disaster and strengthening of infrastructure before a disaster. Hurricane Katrina is one of the most devastating hurricanes in the history of the United States. Due to the significance of Hurricane Katrina, a case study is presented to evaluate consumer surplus in the Gulf Coast Region of Mississippi. Results from the case study indicate the costs of rerouting and congestion delays in the regional highway system and the rent costs of fight-of-way in the regional railroad system are major factors of the indirect costs in the consumer surplus.

Emergency logistics scheduling with multiple supply-demand points based on grey interval

This study aimed to address the problem of post-disaster emergency material dispatching from multiple supply points to multiple demand points.In large-scale natural disasters,it is very important for multiple emergency material supply points to serve as sources of materials for multiple disaster sites and to determine emergency material scheduling solutions accurately.Furthermore,the quantity of emergency materials required at each disaster site is uncertain.To address this issue,in this study,we developed an emergency material scheduling model with multiple logistics supply points for multiple demand points based on the grey interval numbers.To optimize the proposed multi-supply-point and multi-demand-point emergency material scheduling mode,a multi-objective optimization algorithm based on a genetic algorithm was used.Experimental results demonstrate that the multi-objective optimization method can solve the emergency logistics scheduling problem better than the particle swarm optimization multi-objective solution algorithm.Additionally,the multi-supply point and multi-demand point emergency material dispatch model and optimization algorithm provides robust support for emergency management system decision-makers when they need to respond quickly to disaster relief activities.