Disaster and Emergency Resources

The Society of Critical Care Medicine is poised to respond to natural and manmade disasters and emergencies by providing a variety of resources to the critical care community. During disaster events, this site provides resources related to specific volunteer opportunities, complimentary Fundamental Disaster Management chapters, and relevant links to external organizations and institutions, as well as continuous updates from the Society and its members.

Iran and Iraq Region Earthquake
The Society is monitoring a powerful 7.3 magnitude earthquake that struck the border region between Iran and Iraq.  Reports indicate that more than 200 people are dead and 1,700 injured. There is currently no call for volunteers, but SCCM President Ruth Kleinpell, RN-CS, PhD, FCCM, has reached out to those in affected areas with messages of support as we continue to monitor the disaster and response needs.​

Donations

Gift donations of non-medical supplies for Puerto Rico through Amazon are now closed. If you would like to make a cash donation to support SCCM's Puerto Rico relief efforts or learn more about how to support SCCM's overall emergency response efforts, please contact support@sccm.org or call us at +1 847 827 68​88.

Learn more about the various ways to support SCCM at www.sccm.org/Donate

Hurricane and Tropical Storm Response
The Society continues to monitor the response to Tropical Storm Nate, as well as hurricanes Irma, Harvey and Maria. SCCM has made numerous resources available related to responding to these storms. See the Hurricane Response tab below for a full list of complimentary resources from SCCM and other organizations, updates on calls for volunteers, and more. SCCM President Ruth Kleinpell, RN-CS, PhD, FCCM, has reached out to those in affected areas with messages of support as we continue to monitor the disaster and response needs.


More Information
For more information on SCCM's emergency response or to request resources, email emergency@sccm.org.​​

 

 Hurricane Response

 

Hurricane Disaster Resources
The Society has released several complimentary disaster response related resources from its Fundamental Disaster Management (FDM) and  Preparing Your ICU for Disaster Response textbooks, as well as from Critical Care Medicine.

Centers for Disease Control and Prevention Resources

    Lessons Learned from Hurricane Katrina

    iCritical Care Podcast: Katrina Response: Caring for Evacuees
    Two Society members discuss their experiences treating evacuees of Hurricane Katrina, the level of preparedness they saw within their hospitals and what lessons they will take from this disaster.

    Katrina Response: Providing Relief on the Front Lines
    Interview with Society member Barbara McLean, MN, CCRN, CRNP, FCCM, a nurse intensivist from Atlanta, Georgia, who spent 24 hours working in the Houston Astrodome and George R. Brown Convention Center on Monday, September 5.
     
    Clinical Guidance for Carbon Monoxide (CO) Poisoning
    During a significant power outage, persons using alternative fuel or power sources, such as generators or gasoline-powered engine tools such as pressure washers, might be exposed to toxic CO levels if the fuel or power sources are placed inside or too close to the exterior of the building causing CO to build up in the structure. The Centers for Disease Control and Prevention has issued an advisory to remind clinicians evaluating persons affected by the storm to maintain a high index of suspicion for CO poisoning.

    Burns & Carbon Monoxide Poisoning
    SCCM Pod-290 Morbidity and Survival Probability in Burn Patients in Modern Burn Care​
    Michael S. Weinstein, MD, FACS, FCCM, speaks with Marc G. Jeschke, MD, PhD, about the article “Morbidity and Survival Probability in Burn Patients in Modern Burn Care*,” published in Critical Care Medicine. Dr. Jeschke works as a Professor in the Department of Surgery, Division of Plastic Surgery, and Department of Immunology at the University of Toronto. He is also the Director of the Ross Tilley Burn Centre at Sunnybrook Health Sciences Centre, Chair in Burn Research, and Senior Scientist at the Sunnybrook Research Institute in Toronto, Ontario, Canada. In this article, Dr. Jeschke and coauthors found that in the modern burn care setting, adults with over 40% total body surface area burned and children with over 60% total body surface area burned are at high risk for morbidity and mortality, even in highly specialized centers. Crit Care Med. 2015; 43(4):808-815.

    Tetanus
    Tetanus is a non-communicable disease contracted through exposure to the spores of the bacterium, Clostridium tetani, that exists worldwide in soil and in animal intestinal tracts, and as such can contaminate many surfaces and substances.

    Tetanus Immunoprophylaxis for the Injured Patient (Fundamental Critical Care Support - FCCS)

    External Resources:
    Resource Allocation
    When disaster strikes, effective management of resources can significantly influence the overall outcome of the response. If the number of victims and the complexity of their injuries are low and resources are abundant, resource allocation will have little impact on the disaster outcome. However, if there is a high number of victims with complex injuries and available resources are limited, how those resources are used will determine the outcome for some individuals. Given this,​ it is essential that critical care physicians understand and are skilled in resource management during surges in demand for critical care.
    SCCM Pod-29 CCM: Rationing in the ICU
    Robert Truog, MD, discusses his article in the April 2006 issue of Critical Care Medicine, "Rationing in the Intensive Care Unit." Dr. Truog is professor of medical ethics and anesthesia, pediatrics at Harvard Medical School, Children's Hospital Boston. The article focuses on how ICU caregivers distribute resources in the ICU. (Crit Car Med. 2006;34(4):958-963)

     

     Earthquake Response

     
    These resources may be helpful in responding to an earthquake disaster:

    iCritical Care Podcasts

    SCCM Pod-173 PCCM: Pediatric Lessons from Haiti Earthquake 
    Ericka L. Fink, MD, discusses her latest article published in Pediatric Critical Care Medicine, titled "Intensive Care for Infants and Children in Haiti in April 2010." Fink is an assistant professor of pediatric critical care medicine at the Children's Hospital of Pittsburgh and Scientist at the Safar Center for Resuscitation Research in Pittsburgh, Pennsylvania.

    SCCM Pod-122 Disaster Management in Haiti
    Barbara McLean, ACNP, CCNS-NP, a nurse from Piedmont Healthcare in Atlanta, Georgia, discusses her recent volunteer efforts in Haiti following the January 12, 2010, earthquake that devastated the area. McLean discusses general disaster management strategies as well as patient populations and care challenges specific to the event.​​

     

     Infectious Diseases

     

    Cholera​​

    Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. ​

    External Resources:

    World Health Organization (WHO) - Cholera

    Cyclosporiasis​

    ​The Centers for Disease Control and Prevention (CDC), State and Local Health Departments, and the Food and Drug Administration (FDA) are investigating an increase in reported cases of cyclosporiasis. Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis. People can become infected with Cyclospora by consuming food or water contaminated with the parasite; it is not transmitted directly from one person to another person.

    As of August 2, 2017, 206 cases of Cyclospora infections have been reported to CDC in persons who became infected in the United States and became ill on or after May 1, 2017. These cases have been reported from 27 states, most of which have reported relatively few cases. Eighteen cases reported hospitalization; no deaths have been reported. At this time, no specific vehicle of interest has been identified, and investigations to identify a potential source of infection are ongoing. It is too early to say whether cases of Cyclospora infection in different states are related to each other and/or to the same food item(s). The number of cases (206) reported in 2017, is higher than the number of cases reported by this date in 2016. As of August 3, 2016, 88 Cyclospora infections had been reported in persons who became infected in the United States and became ill on or after May 1, 2016.

    Healthcare providers should consider a diagnosis of cyclosporiasis in patients with prolonged or remitting-relapsing diarrheal illness. Testing for Cyclospora is not routinely done in most U.S. laboratories, even when stool is tested for parasites. Healthcare providers must specifically order testing for Cyclospora, whether testing is requested by ova and parasite (O&P) examination, by molecular methods, or by a gastrointestinal pathogen panel test. Cyclosporiasis is a nationally notifiable disease; healthcare providers should report suspect and confirmed cases of infection to public health authorities.

    Centers for Disease Control (CDC) – Dedicated Cyclosporiasis Informational Page​​

    Dengue

    In the past decades, the transmission of dengue and the frequency of epidemics have increased significantly, especially in tropical regions in the American continent. Dengue is a mosquito-borne infection; its vector is the mosquito Aedes aegypti. The four distinct dengue viruses (DENV-1, -2, -3, and -4) all cause a similar clinical syndrome, which ranges from no symptoms to dengue shock syndrome (DSS). ​

    External Resources:

    WHO - Dengue and severe dengue

    Leptospirosis

    Leptospirosis is an infectious disease caused by pathogenic spirochetes of the genus Leptospira, which can cause a mild, nonspecific presentation or a severe one associated with multisystem compromise and high mortality. Infection in humans occurs by direct contact with the tissue or urine of infected animals or, more frequently, indirectly by contact with water or soil contaminated by urine from infected animals.​ For areas affected by recent hurricanes, this resource may be helpful.

    Fundamental Critical Care Support (FCCS) Tropical Diseases: Leptospirosis​​

    Vibrio vulnificus

    Vibrio vulnificus should be on the radar of anyone treating skin and soft tissue infections, as well as anyone becoming toxic from an apparently minor case of gastroenteritis. These resources may be helpful.

    Zika Virus

    ​Zika virus disease is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes).

    On Feb. 1, 2016, the World Health Organization (WHO) declared Zika virus a public health emergency of international concern. Local transmission has been reported in many other countries and territories. Zika virus likely will continue to spread to new areas.

    The Society of Critical Care Medicine is monitoring developments related to the Zika virus and will continue to keep the critical care community informed.

    External Resources:

    CDC – Dedicated Zika Virus Informational Page
    WHO - Dedicated Zika Virus Informational Page

    ​Zika-related Guillian Barre

     

     Influenza

     

    ​Most influenza seasons peak nationally in the United States during January through March. The U.S. Centers for Disease Control and Prevention (CDC) has received reports of critical illness and deaths in the U.S. associated with influenza this season, but national severity indicators are not elevated at this time.

    Influenza A(H3N2), A(H1N1)pdm09, and influenza B viruses have all been detected in the U.S. this season, and influenza A(H1N1)pdm09 viruses have predominated in recent weeks. The H1N1pdm09 virus is the same virus that emerged in 2009 to cause an influenza pandemic; this virus has continued to circulate as a seasonal influenza A virus and has caused moderately severe influenza epidemics, including during 2013-2014.

    Laboratory data indicate that circulating influenza A and B viruses are similar to the virus strains included in available 2015-2016 influenza vaccines, and there are no reports of resistance to the approved neuraminidase inhibitor antiviral medications, oral oseltamivir, intravenous peramivir and inhaled zanamivir. Influenza vaccination is recommended for all persons aged 6 months and older in the United States., and it is not too late to get influenza vaccination.

    Sustained Mechanical Ventilation Outside of Traditional Intensive Care Units​ (Fundamental Disaster Management - FDM)

    External Resources:

    CDC
    U.S. influenza surveillance weekly reports:
    http://www.cdc.gov/flu/weekly/index.htm 
    http://www.cdc.gov/flu/weekly/summary.htm


    WADEM
    The World Association for Disaster and Emergency Medicine (WADEM)  is a non-operational, non-governmental, multidisciplinary organization whose mission is the global improvement of pre-hospital and emergency health care, public health, and disaster health and preparedness.

    Association for Professionals in Infection Control and Epidemiology
    APIC's site provides information related to  infection prevention.
     
    Pandemic Flu Information
    Federal government Website with influenza information.
     
    The map displays outbreaks, cases, and deaths from viral and bacterial diseases worldwide.

    iCritical Care Podcasts


    SCCM Pod-106 Discussion of H1N1 Influenza - Part I  
    Randy S. Wax, MD, discusses the current outbreak of H1N1 Influenza, the triage protocol for critical care during an influenza epidemic, the public's role in taking necessary precautions, and educational resources that are available. The background materials cited in this podcast can be found online at Christian MD, Hawryluck L, Wax RS et al. Development of a triage protocol for critical care during an influenza pandemic. CMAJ. 2006;175;1377-1381 and the International Society for Infectious Diseases. Wax is an intensivist at Mount Sinai Hospital in Toronto, Ontario, Canada, and Assistant Professor of Medicine at the Faculty of Medicine, University of Toronto. He has multiple areas of expertise, including disaster management. This podcast is the first in a series focused on the H1N1 Influenza outbreak. 

    SCCM Pod-107 Discussion of H1N1 Influenza - Part II 
    John H. Beigel, MD, clarifies the definition of influenza and discusses the evolution of viruses, speculation on the mode of transmission and the role of vaccines and therapies as they relate to H1N1 Influenza. The conversation references his recent publication in Critical Care Medicine (Beigel JH. Influenza. Crit Care Med. 2008; 36:2660-2666). Beigel is Director of Clinical Research at MacroGenics, Inc. in Rockville, Maryland, and a volunteer consultant at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. This podcast is the second in a series focused on the H1N1 Influenza outbreak.  

    SCCM Pod-108 Discussion of H1N1 Influenza - Part III 
    Naomi O'Grady, MD clarifies the strain of the current virus, discusses the difference between a pandemic and an epidemic, and outlines the prescription therapies available specific to H1N1 Influenza. O'Grady is a senior staff physician in the Clinical Center's Critical Care Medicine Department and the medical director of the department's Vascular Access and Conscious Sedation Services at the National Institutes of Health. She also is an attending physician with the Pediatric Critical Care Medicine Department of the Children's National Medical Center and an assistant professor in the Department of Internal Medicine's Division of Infectious Diseases at Johns Hopkins University School of Medicine. This podcast is the third in a series focused on the H1N1 Influenza outbreak.

    ​SCCM Pod-256 The Burden of Influenza-Associated Critical Illness Hospitalization​
    Ludwig Lin, MD, speaks with Colin R. Cooke, MD, about the article, “The Burden of Influenza-Associated Critical Illness Hospitalizations,” published in the November 2014 issue of Critical Care Medicine. Dr. Cooke is an Assistant Professor of Pulmonary Critical Care Medicine in the Department of Medicine at the University of Michigan in Ann Arbor, Michigan. In this article, Dr. Cooke and coauthors use mathematical modeling and data to examine seasonal influenza and its relationship to critical illness hospitalizations. Crit Care Med. 2014; 42(11):2325-2332.

    Video

    Treating Lethal Infectious Disease in the ICU
    Lewis A. Rubinson, MD, PhD
    Medical Director
    Critical Care Resuscitation Unit
    R. Adams Cowley Shock Trauma Center
    Baltimore, Maryland, USA

     

     Volunteer Opportunities

     
    American Red Cross
    Connect with your local chapter of the American Red Cross.

    Emergency System for Advance Registration of Volunteer Health Professionals
    Be ready for a disaster by participating in this national network of state-based registry that will licenses and credentials before a disaster happens.

    International Federation of Red Cross and Red Crescent Societies
    Learn about opportunities to get involved and help those in other countries.

    Medical Reserve Corps
    Join a national network of healthcare volunteers for emergency situations on a community level.
     
    Ready.gov
    Learn about opportunities to get involved and build capacity for first responders.
     
     

     External Resources

     

    Federal Resources

    Centers for Disease Control and Prevention (CDC)
    The CDC offers detailed information related to biological and chemical threats, as well as radiological emergencies. Resources include:

    • Guidance for travelers about potential health hazards and steps they can take to protect themselves. 
    • Information on how healthcare professionals can respond to all hazards.
    • A guide for healthcare professionals on emergency planning.

    Clinician Outreach and Communication Activity (COCA)
    SCCM is a member of COCA; this site contains many resources for COCA members, including conference call dates and updates, listing of all members and training updates.

    FEMA provides a guide on disaster survival techniques and disaster-specific information and tips for preparation and response to both natural and manmade disasters.

    Ready.gov
    Along with other disaster preparedness information for businesses and residents, this website answers such questions as How quickly can a company get back to business after a terrorist attack, tornado, fire or flood?

    Public Health Emergency
    This U.S. Department of Health and Human Services site includes information relating to federal health, medical- and health-related social services and recovery to major emergencies and federally declared disasters.

    International Resources

    World Association for Disaster and Emergency Medicine (WADEM)
    The WADEM has an international focus and offers a journal, an annual conference, and other educational materials.

    International Federation of Red Cross and Red Crescent Societies
    The International Federation of Red Cross and Red Crescent Societies is the world's largest humanitarian organization. It provides assistance to almost every country in the world

    Extracorporeal Life Support Organization
    The Extracorporeal Life Support Organization (ELSO) is an international consortium of health care professionals and scientists who are dedicated to the development and evaluation of novel therapies for support of failing organ systems. Crucial is the promotion of a broad multidisciplinary collaboration. The primary mission of the Organization is to maintain a registry of, at least, use of extracorporeal membrane oxygenation in active ELSO centers. As appropriate, registries of other novel forms of organ system support are within the purview of ELSO. Registry data is to be used to support clinical research, support regulatory agencies, and support individual ELSO centers. ELSO provides educational programs for active centers as well as for the broader medical and lay communities.

    Additional Resources

    Public Health Preparedness and Disaster Response
    The American Medical Association provides resources related to terrorism, including current news stories, AMA publications, and resources for healthcare providers. In addition, some links to federal government sites are available.

    Bioterrorism and Disaster Preparedness
    The American College of Physicians provides a list of bioterrorism information, including diagnosis, treatment, and vaccinations. Also included is information related to the psychological aspects of terrorism.

    Association for Professionals in Infection Control and Epidemiology
    Provides links to bioterrorism resources that includes detailed information about specific agents, preparation for incidents of terrorism, and links to educational sources related to bioterrorism. Also included is information related to vaccinations.

    Avian Flu Talk 
    Avian Flu Talk has organized the largest and most active bird flu discussion forum in the world. People from around the world are joining the forum to share global flu news and discuss ways to fight the imminent super flu pandemic.