Lessons Learned from Hurricane Maria in Puerto Rico: Practical Measures to Mitigate the Impact of a Catastrophic Natural Disaster on Radiation Oncology Patients
| Autor: | Hiram A. Gay, Roberto Santiago, Betty Gil, Carlos Remedios, Pedro J. Montes, Javier López-Araujo, Carlos M. Chévere, Winston S. Imbert, Julia White, Douglas W. Arthur, Janet K. Horton, Reshma Jagsi, Rachel Rabinovich, Sushil Beriwal, Akila Viswanathan, Beth A. Erickson, Ramesh Rengan, David Palma, Billy W. Loo, James A. Kavanaugh, Jeff Bradley, Sue S. Yom, Paul M. Harari, Omer Lee Burnett |
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| Rok vydání: | 2019 |
| Předmět: |
Cancer Research
Natural Disasters medicine.medical_treatment 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Radiation oncology Dose escalation Humans Medicine Radiology Nuclear Medicine and imaging Natural disaster Radiation Emergency management Cyclonic Storms business.industry Puerto Rico medicine.disease Radiation therapy Uterine cervix Harm Oncology 030220 oncology & carcinogenesis Radiation Oncology Medical emergency business Limited resources |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 105:E612-E613 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2019.06.1137 |
| Popis: | Purpose Although the wind, rain, and flooding of Hurricane Maria in Puerto Rico abated shortly after its landfall on September 20, 2017, the disruption of the electrical, communications, transportation, and medical infrastructure of the island was unprecedented in scope and caused lasting harm for many months afterward. A compilation of recommendations from radiation oncologists who were in Puerto Rico during the disaster, and from a panel of American Society for Radiation Oncology (ASTRO) cancer experts was created. Methods and materials Radiation oncologists throughout Puerto Rico collaborated and improvised to continue treating patients in the immediate aftermath of the storm and as routine clinical operations were restored gradually. Empirical lessons from the experience of radiation therapy administration in this profoundly altered context of limited resources, impaired communication, and inadequate transportation were organized into a recommended template, applicable to any radiation oncology practice. ASTRO disease-site experts provided evidence-guidelines for mitigating the impact of a 2- to 3-week interruption in radiation therapy. Results Practical measures to mitigate the medical impact of a disaster are summarized within the framework of "Prepare, Communicate, Operate, Compensate." Specific measures include the development of an emergency operations plan tailored to specific circumstances, prospective coordination with other radiation oncology clinics before a disaster, ongoing communications with emergency management organizations, and routine practice of alternate methods to disseminate information among providers and patients. Conclusions These recommendations serve as a starting point to assist any radiation oncology practice in becoming more resiliently prepared for a local or regional disruption from any cause. Disease-site experts provide evidence-based guidelines on how to mitigate the impact of a 2- to 3-week interruption in radiation therapy for lung, head and neck, uterine cervix, breast, and prostate cancers through altered fractionation or dose escalation. |
| Databáze: | OpenAIRE |
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