Healthcare Delivery Aboard US Navy Hospital Ships Following Earthquake Disasters: Implications for Future Disaster Relief Missions.

摘要

Since 2005, the US Navy has provided ship-borne medical assistance during three earthquake disasters. Because Navy ship deployment for disaster relief (DR) is a recent development, formal guidelines for equipping and staffing medical operations do not yet exist. The goal of this study was to inform operational planning and resource allocation for future earthquake DR missions by (1) reporting the type and volume of patient presentations, medical staff, and surgical services; and (2) providing a comparative analysis of the current medical and surgical capabilities in a hospital ship and a casualty receiving and treatment ship (CRTS). Three earthquake DR operations were reviewed retrospectively: (1) USNS Mercy to Indonesia in 2004, (2) Mercy to Indonesia in 2005, and (3) USNS Comfort/USS Bataan to Haiti in 2010. For three missions, 986 patient-encounters were documented. Of 1,204 diagnoses, 80% were disaster-related injuries, over half of which were extremity trauma. Aboard hospital ships, health care staff provided advanced (Echelon III) care for disaster-related injuries and various non-disaster-related conditions. Aboard the CRTS, staff provided basic (Echelon II) care for disaster-related injuries. Our data show that musculoskeletal extremity injuries in sex- and age-diverse populations comprised the majority of clinical diagnoses. Current capabilities and surgical staffing of hospital ships and CRTS platforms influenced their respective DR operations, including the volume and types of surgical care delivered.