Richard M Zoraster

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The chronically ill are often the hardest hit by disruptions in the healthcare system--they may be highly dependent on medications or treatments that suddenly become unavailable, they are more physically fragile than the rest of the population, and for socioeconomic reasons they may be more limited in their ability to prepare or react. Medical professionals(More)
INTRODUCTION Management of mass-casualty incidents should optimize outcomes by appropriate prehospital care, and patient triage to the most capably facilities. The number of patients, the nature of injuries, transportation needs, distances, and hospital capabilities and availabilities are all factors to be considered. Patient maldistributions such as(More)
Ecological disasters impact large populations every year, and hundreds of nongovernmental organizations, thousands of aid workers, and billions of dollars are sent in response. Yet, there have been recurring problems with coordination, leading to wasted efforts and funds. The humanitarian response to the December 2004 Earthquake and Tsunami in Asia was one(More)
INTRODUCTION Patients with polycythemia vera are at high risk for vaso-occlusive events including cerebral ischemia. Although unusual, acute ischemic stroke may be an initial presentation of polycythemia vera. It had been previously assumed that cerebral ischemic events were due to increased blood viscosity and platelet activation within the central nervous(More)
International health care providers have flocked to Haiti and other disaster-affected countries in record numbers. Anecdotal articles often give "body counts" to describe what was accomplished, followed months later by articles suggesting outcomes could have been better. Mention will be made that various interventions were "expensive," or not the best use(More)
Hospitals are physical structures with the same risk as other large buildings; the physical plant is vulnerable to acts of nature and man. When hospitals need to evacuate the patient population, logistical support for patient transport will be required. However, a disaster impacting a hospital will likely also affect the surrounding community, and transport(More)
Documentation of the patient encounter is a traditional component of health care practice, a requirement of various regulatory agencies and hospital oversight committees, and a necessity for reimbursement. A disaster may create unexpected challenges to documentation. If patient volume and acuity overwhelm health care providers, what is the acceptable(More)
OBJECTIVE To develop optimal hospital evacuation plans within a large urban EMS system using a novel evacuation planning model and a realistic hospital evacuation scenario, and to illustrate the ways in which a decision support model may be useful in evacuation planning. METHODS An optimization model was used to produce detailed evacuation plans given the(More)