1. The PA’s Role in Responding to Large Scale Health Emergencies

2. Should I respond? Do I have to? Dr. Carlo Urbani Historical precedents Professional ethical guidelines

3. What are the costs? Health and Safety Time and financial Nature of the work Self Care

4. How do I do this? American Red Cross www.redcross.org Medical Reserve Corps www.medicalreservecorps.gov Medical Teams International www.medicalteams.org National Disaster Medical System www.hhs.gov/aspr/opeo/ndms/index.html Salvation Army www.salvationarmyusa.org

5. References American Academy of Physician Assistants (2007). Physician assistants and medical response to disasters and emergencies: amending state laws. Available at: http://www.aapa.org/gandp/disasters.html, accessed on November 4, 2007. American Academy of Physician Assistants (2007). Public health crisis/disaster response. EXTERNAL 2007 – 2008 AAPA Policy Manual. Available at: http://www.aapa.org/manual/external.pdf, accessed on November 4, 2007. American Academy of Physician Assistants (2007). The physician assistant in disaster response: core guidelines. Adopted 2006. Available at: http://www.aapa.org/manual/18- ThePAinDisasterResponse.pdf, accessed on November 4, 2007. American Medical Association. Disaster Preparedness. Available at: http://www.ama- assn.org/ama/pub/category/6206.html, accessed on November 4, 2007. Atas, J.G.; Irvin, C.B. Management of evacuee surge from a disaster area: solutions to avoid non- emergent, emergency department visits. Prehospital and Disaster Medicine. 2007 May- Jun; 22(3): 220-3. Boland, Richard. Can It get any worse? Frontiers of Health Services Management. 2006, 23(1), 31- 4. Cosgrave, J.; Telford, J.. The international humanitarian system and the 2004 Indian Ocean earthquake and tsunamis. Disasters. 2007; 31 (1): 1–28. Dirkzwager, J.E.; Grievink, A.; Morren, M., et al. Use of mental health services among disaster survivors: predisposing factors. BMC Public Health. 2007; 7: 173. Dyregov, A.; Kristoffersen, J.I.; Gjestad, R.; Voluntary and professional disaster workers; similarities and differences in reactions, Journal of Traumatic Stress. 9(3), 541-556.

6. Erich, J.. As good as advertised: mobile hospital shines in Katrina response. Emergency Medical Services. February 2007. Guerra, F.; Jernigan, D.B.; Jhuhg, M.A., et al. Chronic disease and disasters medication demands of Hurricane Katrina evacuees. American Journal of Preventative Medicine. 2007 Sep; 33(3): 207- 10. Infectious Diseases Section, Louisiana State University Health Science Center. Eight months later: Hurricane Katrina aftermath challenges facing the infectious diseases section of the Louisiana State University health science center. Clinical Infectious Diseases. 2006; volume 43: 485–489. Iserson, K.V.; Heine, C.E.; Larkin, G.L. et al. Fight or Flight: The Ethics of Emergency Physician Disaster Response. Annals of Emergency Medicine. 2007 July; 20(10). Jhung, M.; Shahab, N.; Rohr-Akegrini, C. et al. Chronic disease and disasters: medication demands of Hurricane Katrina evacuees. American Journal of Preventative Medicine. 2007; 33(3): 207-210. Long, M.; Meyer, D.; Jacobs, G.. Psychological distress among American Red Cross disaster workers responding to the terrorist attacks of September 11, 2001. Psychiatry Research. 149 (2007), 303- 308. Medical Reserve Corps. Volunteers building strong, healthy, and prepared communities. Available at: http://www.medicalreservecorps.gov/HomePage, accessed October 30, 2007. National Disaster Medical System. Disasters and emergencies. Available at: http://www.hhs.gov/aspr/opeo/ndms/index.html, accessed October 30, 2007. Rebmann, T.; English, J.F.; Carrico, R.. Disaster preparedness lessons learned and future directions for education: Results for focus groups conducted at the 2006 APIC Conference. American Journal of Infection Control. 2007; 35:374-81. Reilley, B.; Herp, M.; Sermand, D., et al. SARS and Carlo Urbani. New England Journal of Medicine. 2003; 348:1951-1952. Telford, John. The international humanitarian system and the 2004 Indian Ocean earthquake and tsunamis. Disasters. 2007 Mar; 31(1): 1-28 Wickramasinghe, K., Ishara, M.H., Liyanage, P., et al. Outcome-based approach in development of a disaster management course for healthcare workers. Annals of the Academy of Medicine Singapore. 2007 Sep; 36(9): 765-5. Young, D. New law targets disaster response confusion. American Journal of Health-System Pharmacy. 2007; 64(7): 687-8.