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Tsunami Japan 2011

15,000 dead, 230,000 still without homes in 2013 living in temporary housing. The magnitude-9 earthquake caused a tsunami after the subduction earthquake. The tsunami hit the nuclear power plant, causing a level 7 nuclear meltdown.

The total damage has totaled to $300 billion dollars.

Minutes before the shakes the citizens in Japan were alerted. An hour after the shakes the first tsunami waves hit. Most of the people died from drowning. The waves covered 217 square miles-much more than expected. The tsunami caused a cooling system failure because the power and back up power couldn’t handle the damaged cooling system and radioactive water continue to leak from Fukushima.

Radioactive chemicals have been detected in North America in 2014 and 2015. Cesium-134 has been detected as far south as Eureka, Ca, 100 miles off shore.

 

The World Health Organization (WHO) measures the nuclear levels and reports the levels to be safe. Unfortunately 42 species fish in Japan are still reported to have unsafe levels of radioactive isotopes and the levels haven’t been dropping like expected. Many fisheries are closed. The long term effects of the nuclear meltdown in Fukushima are still unknown and the concerns of cancers developing are still to come.

 

Amazing facts

Here are some of the amazing facts about the Japan earthquake and tsunami.

  • The earthquake shifted Earth on its axis of rotation by redistributing mass, like putting a dent in a spinning top. The temblor also shortened the length of a day by about a microsecond.
  • More than 5,000 aftershocks hit Japan in the year after the earthquake, the largest a magnitude 7.9.
  • About 250 miles (400 km) of Japan’s northern Honshu coastline dropped by 2 feet (0.6 meters), according to the U.S. Geological Survey.
  • The jolt moved Japan’s main island of Honshu eastward by 8 feet (2.4 meters).
  • The Pacific Plate slid westward near the epicenter by 79 feet (24 m).
  • In Antarctica, the seismic waves from the earthquake sped up the Whillans Ice Stream, jolting it by about 1.5 feet (0.5 meters).
  • The tsunami broke icebergs off the Sulzberger Ice Shelf in Antarctica.
  • As the tsunami crossed the Pacific Ocean, a 5-foot high (1.5 m) high wave killed more than 110,000 nesting seabirds at the Midway Atoll National Wildlife Refuge.
  • In Norway, water in fjords pointing toward Japan sloshed back and forth as seismic waves from the earthquake raced through.
  • The earthquake produced a low-frequency rumble called infrasound, which traveled into space and was detected by the Goce satellite.
  • Buildings destroyed by the tsunami released thousands of tons of ozone-destroying chemicals and greenhouse gases into the air.

 

 

http://www.livescience.com/39110-japan-2011-earthquake-tsunami-facts.html

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Responding to Disaster: Boston 2013

The Boston Marathon bombing occurred on April 15th, 2013 when two homemade pressure cooker bombs exploded near the finish line just 12 seconds apart, ultimately killing 3 individuals and injuring 264 others. The winners of the marathon had crossed the finish line two hours prior, but 5,700 runners remained on the course and hundreds of thousands of spectators were still in the surrounding areas.

The Boston Emergency Medical Services, Boston Police Department, and Boston Fire Department were all on site and were able to quickly dispatch additional responders to the scene. First responders near the finish line quickly converted the runner’s first aid tent to an emergency triage unit. From there patients were triaged and transported to trauma centers throughout Boston.

Maureen Hemingway, a nurse at Massachusetts General Hospital (MGH), wrote an account detailing the response of the level 1 trauma unit to the disaster. According to Hemingway, staff first learned of the bombing moments after it occurred through their personal cell phones and social media accounts. The Boston emergency medical system had notified hospital leaders of the bombing but it took time for this information to be disseminated through the hospital emergency notification system. Although social media accounts may not provide completely accurate information, they allowed perioperative staff to prepare for an influx of wounded patients prior to receiving official information from the hospital leaders. By the time individuals arrived at the trauma center, all necessary ORs were staffed and ready.

In terms of emergency preparedness, the timing of the disaster was fortunate. A major shift change was to occur at MGH at 3pm. With the news of the bombings the hospital was able to retain the day shift staff, boosting the 88 scheduled nursing team members to 180. This increased staffing was essential for assisting with patient identification, obtaining blood products, count procedures, and procuring supplies that weren’t readily available.

Overall it seems that emergency services and trauma centers in Boston were very well prepared to handle this disaster. It was fortunate that due to the nature of the event, there were many enforcement agencies and healthcare providers already on site. Being in a well developed metropolitan area helped get people off the streets and out of immediate danger. As for those that were injured, there were adequate volunteers available with the knowledge and skills necessary to properly triage. Once triaged, Boston had the resources and infrastructure necessary to promptly get individuals to appropriate trauma centers for treatment.

I think the environment this disaster occurred in played a very large role in how well it was handled. Had this disaster occurred in a similarly dense area without proper resources or infrastructure, I think there would have been more injuries with worse outcomes.

 

Hemingway, M., & Ferguson, J. (2014). Boston Bombings: Response to Disaster. AORN Journal, 277-288. doi: http://dx.doi.org/10.1016/j.aorn.2013.07.019.

Fukushima Daiichi Nuclear Power Plant and Chernobyl Disaster

I chose Fukushima Daiichi Nuclear Power Plant because I experienced a similar disaster of Chernobyl nuclear power plant explosion many years ago in Ukraine. I lived about 60 miles away from Chernobyl and remember all the details of the event. Even though I was not at the actual place, this type of the disaster covers a much bigger area and requires many more people to help and respond. Chernobyl disaster happened in 1986 and was caused by the failure of control of a fission chain reaction, whereas the Fukushima-1 accident (happened in 2011) was a loss-of-coolant accident in which the reactor cores of three units were melted by decay heat after losing the electricity supply (Imanaka et al., 2015). In the case of the Chernobyl accident, the explosion occurred inside the reactor core, and the reactor materials themselves were dispersed into the atmosphere. In Fukushima-1 accident, the reactor cores did not explode and the radioactivity discharge was mostly composed of gaseous and volatile radionuclides emitted from the damaged and melted reactor cores. Two hydrogen explosions occurred at Fukushima-1 under the roof of the reactor building of Unit 1 and Unit 3, but they were not inside the containment vessels (Imanaka et al., 2015). As a result, the release of the radioactive materials was far less from the Fukushima accident than that released from Chernobyl.

 

Even though it was extremely dangerous to be among the first responders for both disasters, a huge number of people responded and helped in these disasters. On the day of the Fukushima disaster, 50,000 members of the Japanese Self-Defense Forces (SDF) were sent to aid in the relief work of the earthquake (Mizushima, 2012). That number was increased to 100,000 in two days. Two hundred workers from SDF were immediately sent to inject water to the plant’s cooling systems (Mizushima, 2012). The first responders for the Chernobyl disaster were the firefighters. The first 28 people who responded died within a month (U.S.NRC, 2013). Additional 106 workers received high enough doses to cause acute radiation sickness. About 200,000 cleanup workers in 1986 and 1987 received doses of between 1 and 100 rem. Consider that the average annual radiation dose for a U.S. citizen is about 0.6 rem. Chernobyl cleanup activities eventually required about 600,000 workers, although only a small fraction of these workers were exposed to elevated levels of radiation (U.S.NRC, 2013).

 

Due to the high levels of radiation, the government ordered that the contaminated areas had be evacuated in both disasters. I was evacuated with many other local people (especially children). The hospitals, resort centers, and many other facilities opened up their doors for the refugees from the contaminated areas. I still had a couple of months before the summer break in my school and one of the local schools took me without any questions or paper work. Regular screenings were initiated in Ukraine to monitor the radiation levels and the health condition of the people who were exposed to high levels of radiation. Everybody showed so much kindness and compassion to the fellow citizens during this hard period in my country. I am sure it was a similar situation in Japan and people helped each other as well. Similarly, the governor of Fukushima Prefecture ordered an evacuation of residents and others within a 2 km, 3 km, and eventually 20 km radius of the Fukushima Daiichi Nuclear Power Plant for the towns of Okuma and Futaba. Regular screenings were also initiated in Japan among the population potentially exposed to the radiation (Akiyama et al., 2012).

 

The international response in both disasters was also amazing. The United States offered a lot of technological help and also provided more than $400 million for the assistance with Chernobyl disaster (U.S.NRC, 2013). United Nations organization spent about $50 million to help reduce the effects of Chernobyl (Belarus Foreign Ministry, 2008). European Commission and G7 countries contributed about one billon euros towards the construction of a new safe confinement structure around the Chernobyl nuclear reactor (World Nuclear Association, 2015). The United States responded to the Fukushima disaster immediately and utilized their marine corps located in the military bases in Japan (Mizushima, 2012). These types of disasters affect multiple countries and many generations. It is important for the countries to provide technological, financial, and moral assistance for each other during the time of this kind of hardships.

 

Akiyama, N., Sato, H., Naito, K., Naoi, Y., & Katsuta, T. (2012, September). The Fukushima Nuclear Accident and Crisis Management: Lessons for Japan-U.S. Alliance Cooperation. The Sasakawa Peace Foundation. Retrieved November 30, 2015, from https://www.spf.org/jpus/img/investigation/book_fukushima.pdf

Belarus Foreign Ministry. (2008). Chernobyl Disaster. Retrieved November 30, 2015, from http://chernobyl.undp.org/russian/docs/belarus_23_anniversary.pdf

Imanaka, T., Hayashi, G., & Endo, S. (2015). Comparison of the accident process, radioactivity release and ground contamination between Chernobyl and Fukushima-1. Journal of Radiation Research, 1(3), 1-6.

Mizushima, A. (2012, December). The Japan-US “military” response to the earthquake, and the strengthening of the military alliance as a result. Retrieved December 1, 2015, from http://fukushimaontheglobe.com/the-earthquake-and-the-nuclear-accident/whats-happened/the-japan-us-military-response

U.S. NRC. (2013, May). Backgrounder on Chernobyl Nuclear Power Plant Accident. Retrieved November 30, 2015, from http://www.nrc.gov/reading-rm/doc-collections/fact-sheets/chernobyl-bg.html

World Nuclear Association. (2015). Chernobyl Accident1986. Retrieved November 30, 2015, from http://www.world-nuclear.org/info/Safety-and-Security/Safety-of-Plants/Chernobyl-Accident/

Hurricane Stan

In October of 2005, Hurricane Stan tore through Central America and Mexico and dropped 20 inches of rain (Thomas, 2007). In the remote communities of the Sierra Madre mountain range of Guatemala, the hurricane’s rain caused catastrophic mudslides that swept entire communities away. In Guatemala alone, Hurricane stan killed over 650 people and directly affected over 500,000 (Thomas, 2007). There were many complicated factors that affected both access and treatment of victims. It is important to note that the majority of communities in this region are indigenous Mayan. Their history with the Latino majority of Guatemala is tumultuous and includes years of bloody genocide. Many of the remaining Mayan communities in the Sierra Madres still carry distrust of outsiders (Thomas, 2007). The government sent soldiers to help search for survivors and treat the wounded, but some were reminded of the soldiers that came and decimated entire communities in the early eighties. Entire communities turned away outside help and conducted their own searches (Associated Press, 2005). The region is rugged, with many communities only accessible by foot, so there were many logistical challenges in reaching communities, assessing their needs, and getting supplies delivered, especially during during and immediately after the mudslides when ground was unstable. Most of the population in the mountains live in poverty and lived in small hand built homes (Thomas, 2007). Recovery took years and for many was never complete (Thomas, 2007). I think it would have been very difficult to be a healthcare provider in that situation because of how incredibly limited resources were and hard it was to reach people. When I was in this region last summer, I thought about the hurricane and mudslides. It was easy to see how disastrous they had been, and if it happened again today I’m not sure the outcome would be any better. A positive outcome was how well many communities banded together to support each other and some successful community organizations that were born (Thomas, 2007). I hope that some of these groups have plans they could enact quickly that would help them locate and support those affected should another disaster occur.

 

Associated Press, (2005). Guatemala halts recovery efforts after mudslides. Retrieved from                

           http://www.nbcnews.com/id/9588034/ns/weather-weather_news/t/guatemala-halts recovery-

          effort-after-mudslides/#.Vl0EAMo0q3I

 

Thomas, K. (2007). Hurricane Stan and Social Suffering in Guatemala. ReVista: Harvard Review of

          Latin America. 6(2), 48-51.

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The Boston Marathon Bombings

Hi everyone, it’s Breehan

The Boston Marathon bombings occurred on April 15, 2013, a terrorist attack caused by pressure cooker bombs set off on the street near the marathon’s finish line by two young men. Three people died almost instantly and over 170 people were injured.

 

Although many had to have amputated limbs, many suffered from hypovolemic shock, some had to be resuscitated and some had significant burns. However, every one of the 170 injured people survived.

 

A 2013 article by the New Yorker magazine explained the prompt and heroic efforts of the healthcare workers, including many nurses’ quick thinking and actions that saved these peoples’ lives.

 

A silver lining to the tragedies of 9/11 and the shooting at the movie theatre in Aurora, Co. is the fact that healthcare workers were/are better prepared for acts of terrorism on American soil. Pre-hospital emergency healthcare workers quickly turned the runners’ first-aid tent into a mass-casualty triage unit.

 

Brigham and Women’s Hospital and Massachusetts General’s nurses, doctors, techs and other staff immediately heard of the incident through social media and designated themselves into teams to prepare for triaging patients as well as the many emergency surgeries that were to come. They quickly cancelled the scheduled surgeries and patients due to come in that day and focused on the tasks at hand.

 

Nurses stayed on late and those who had the day off came in to help and stayed for multiple days, taking turns to sleep and eat.

 

Because of the successful and quick responses, I don’t see any specific barriers for the patients to access the much-needed emergency care. The survivors were all extremely lucky.

 

From a socioeconomic perspective, I think that being in a large affluent city where there are world-class hospitals and healthcare professionals was a huge help. I have no doubt that unfortunately if this had occurred in a rural town or in a third-world country that lacked such prompt and competent resources, then many more casualties would have occurred.

 

If I were a nurse on-scene during this tragedy, I feel like I would definitely be ready. My passion is emergency medicine and feeling like I am actually saving someone’s life would be an amazing feeling not only to help that patient but for their family and loved ones. I think with the proper training, I could remain calm, especially with my team by my side.

 

I do feel like we are prepared for the next disaster. It is sad that these incidents do occur but like I stated before, the only silver lining is that we as nurses are ready to run in to help while others run out.

 

 

Here is a link to the article if you want to read further. It is a well-written interesting article: http://www.newyorker.com/news/news-desk/why-bostons-hospitals-were-ready

 

Reference

Gawande, A. (2013, April 17). Why Boston’s Hospitals Were Ready. The New Yorker. p. 14-17.

 

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