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9 - Interventions for acutely injured survivors of individual and mass trauma

from Part III - Clinical care and interventions

Published online by Cambridge University Press:  09 August 2009

By
Douglas Zatzick
Edited by
Robert J. Ursano ,
Carol S. Fullerton ,
Lars Weisaeth  and
Beverley Raphael
Douglas Zatzick
Affiliation:
Department of Psychiatry University of Washington School of Medicine
Robert J. Ursano
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Carol S. Fullerton
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Lars Weisaeth
Affiliation:
Universitetet i Oslo
Beverley Raphael
Affiliation:
University of Western Sydney
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Summary

Introduction

Natural and human-made disasters entail the threat of physical injury. Injured trauma survivors initially receive care in the acute care medical setting. For example, the Centers for Disease Control report that within 48 h after the September 11, 2001 attack on the World Trade Center, 1 103 physically injured survivors were triaged through five acute care facilities in New York (Centers for Disease Control and Prevention, 2002). Injured survivors of mass disasters have been identified as a high-risk group that may require specialized early screening and evaluation procedures (United States Department of Defense et al., 2001; United States Department of Health and Human Services, 2003).

Trauma exposure when coupled with physical injury confers a higher risk for the development of post-traumatic stress disorder (PTSD) (Abenhaim et al., 1992; Green, 1993; Helzer et al., 1987; Hoge et al., 2004; Koren et al., 2005). Between 10% and 40% of hospitalized adolescent and adult injury survivors in the United States may go on to develop symptoms consistent with a diagnosis of PTSD (Holbrook et al., 2001; Marshall & Schell, 2002; Michaels et al., 1999b; Ursano et al., 1999; Zatzick et al., 2002a, 2002b, 2004c, 2006). Among injury survivors, PTSD is often complicated by comorbid, depressive symptoms (O'Donnell et al., 2004; Shalev et al., 1998b; Zatzick et al., 2004c, 2006) and medically unexplained somatic complaints (Engel et al., 2000; Katon et al., 2001b; Zatzick et al., 2003).

Keywords

acute care mental health servicesinjured patientsmass disastersmental health professionalspost-traumatic stress disordertrauma care systems
Type
Chapter
Information
Textbook of Disaster Psychiatry , pp. 190 - 205
Publisher: Cambridge University Press
Print publication year: 2007

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