Psychiatric issues in medical-surgical disaster casualties: a consultation-liaison approach.
Psychiatrists can increase the efficacy of their response to disaster victims in the immediate aftermath of a disaster if they utilize a consultation-liaison approach to assessment and management of casualties. Medical-surgical disaster responders use an algorithmic, stepwise approach to assess disaster or trauma victims. This approach ensures that patients with life-threatening injuries who are not expectant are treated first. Then, secondary physical assessments ensure proper triage of other victims so that disaster response resources are used most wisely. A tertiary psychiatric assessment can assist with differential diagnosis of post-disaster neuropsychiatric symptoms and signs to ensure valuable medical-surgical resources are targeted to the correct patients. Psychiatric triage can also identify those victims most in need of early preventive and therapeutic psychiatric intervention.
Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, AE 09012, USA. james.rundell@ramstein.af.mil
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D004189:Disaster Planning; D004190:Disasters; D006801:Humans; D009104:Multiple Trauma / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D010348:Patient Care Team; D011570:Psychiatry; D011613:Psychotherapy; D012017:Referral and Consultation; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D014218:Triage