Introduction
People are typically affected by diseases, accidents, and disasters. These may include Ebola infection and tragedies, such as explosions and floods, which may lead to injuries. In this case, when individuals are exposed to some of these threats, they may experience shock resulting from blood poisoning, severe burns, electrocution, and injuries from falling or collapsed buildings. Risks to the body can cause damage or conditions that affect blood flow by contributing to different types of shock, multiple organ failure, and various health complications.
Cardiogenic, Hypovolemic, Obstructive, and Distributive Shocks
Cardiogenic shock (CS) occurs when the heart has some dysfunctions, such as a languid heart rhythm, rapture of the septum, or muscles that support the valves. Either of these cardiac abnormalities can make it impossible for the organ to pump sufficient oxygen and blood to the brain and other parts (Standl et al., 2018). Conversely, hypovolemic shock (HS) is caused by severe blood or fluid loss from the body due to excessive internal bleeding from cuts or other injuries.
At times the heart does not get adequate blood to supply to the rest of the body. This medical emergency is called an obstructive shock (OS), caused by a blockage. For example, a blood clot may decrease the heart’s diastolic filling, ultimately reducing cardiac output. Alternatively, distributive shock (DS) transpires when the blood vessels become highly dilated, impairing blood distribution (Standl et al., 2018). This condition can be caused by spinal cord trauma, asthma attacks, or severe allergic reactions. However, septic shock is a type of DS resulting from a severe bacterial infection responsible for sepsis.
CS is triggered by ischemia, a condition in which the blood flow is decreased in various body parts. Ischemia contributes to myocardial dysfunction that sequentially aggravates the former. Other changes that can contribute to the development of CS include hibernating and stunning myocardium. Alternatively, changes in body function concomitant with HS include blood or fluid loss from the body affecting the supply of oxygen to other tissues (Standl et al., 2018). Due to this shortage, the body usually responds by sending the remaining blood to the heart and the brain. This leaves the remaining organs without oxygen, and the tissues react by producing lactic acid, resulting in acidosis, making most of them stop working.
OS is caused by physical obstruction of circulation either outside or into the heart. The blockage either prevents the heart from ejecting the blood, as in the case of left ventricular outflow obstruction or inhibits blood from entering the right heart during diastole, as in cardiac tamponade. Lastly, the pathophysiology of DS involves abnormally flaccid blood vessels, as in sepsis shock syndrome-induced vasodilation. This reduces the pressure driving blood flow to the body’s organs and prevents them from receiving sufficient oxygen to function correctly.
The Risks of Morbidity and Mortality and Preparation of Floods
Floods have adverse effects on human life because they bring contamination and different ailments to the affected populations. This is because floodwaters may contain raw sewage, poisonous chemicals, and runoff from factories or hazardous waste sites, which may pollute water supplies, causing diseases, such as cholera and typhoid (Denchak, 2019). The contamination of water sources may also cause eye or skin infections. In addition, floods may create a breeding ground for the growth of vectors and pathogens, resulting in illnesses, such as malaria and dengue fever. Even after the waters recede, mold and bacteria may multiply, escalating respiratory conditions, including asthma (Denchak, 2019). Similarly, floods have been linked to a high mortality risk due to drowning or injuries caused by accidents. According to research, flooding causes over 100 fatalities in the United States yearly (Denchak, 2019). This proves that floods present high risks for morbidity and mortality.
Various measures can be implemented in the preparation and prevention of floods. Regarding preparations, individuals living in flood-prone areas need to sign up for their community’s warning systems to get flood alerts (Denchak, 2019). Similarly, individuals need to plan an evacuation procedure by identifying where to reside or how to communicate with friends and relatives in case of flooding. In case of a looming flood, individuals should prepare an emergency kit containing water, food, first-aid supplies, prescriptions, and essential documents (Denchak, 2019). Flood prevention may be achieved through building green spaces to absorb the rainwater and adopting current building codes. The National Flood Insurance Program may assist homeowners in flood-prone areas to move to higher grounds (Denchak, 2019). Thus, adequate preparation and prevention can significantly mitigate the effects of floods.
How to Set Up for Disaster Closet in the Emergency Department
Emergency departments (EDs) are critical in responding to natural disasters. Therefore, it is crucial to set up emergency closets in the EDs to ensure a swift and effective response to the victims of calamities, such as floods, hurricanes, or infectious disorders. In this case, the disaster closet should be located at the front of the department to enhance staff awareness and accessibility. The contents of the disaster closet may include personal protective equipment, including gloves and masks, respirators, chemical suits, airway supplies, first-aid kits, flashlights, and portable ventilators (Whitman & Mattord, 2019). In addition, the closet should have emergency drugs with clear labels to avoid cases of wrong administration. Equally important, communication radios in the form of walkie-talkies should be included in the closet to convey messages between the staff in case of a blackout.
All emergency response team members ought to have access to the disaster closet to ensure a quick and effective response in case of a disaster. Similarly, the emergency cabinet should not be closed to promote easy access to necessary resources during a catastrophe. There is a need to perform frequent drills on various occurrences, such as infectious diseases, exposure to chemical weapons, fire incidences, and natural calamities, including hurricanes and tsunamis (Khorram-Manesh et al., 2021). These drills may help instill the appropriate skills in the emergency response staff to respond effectively to disasters.
Pathophysiology of and the Difference Between First, Second, and Third-Degree Burns
The pathophysiology of the burns is characterized by inflammatory reactions resulting in rapid edema formation. In this case, increased vasodilation, extravascular osmotic activity, and microvascular permeability contribute to the excessive accumulation of fluid volume in the tissues. These responses are caused by the direct impact of heat on the microvasculature, consisting of venules, arterioles, and capillaries. These microvessels create a network that regulates local perfusion necessary for maintaining tissue function and health. In addition, the reactions are also due to the immediate effects of burn agents on chemical mediators of inflammation (Abdulkhaleq et al., 2018). These specialized substances include histamine, peptides, and eicosanoids, which are released to mediate the inflammatory process by preventing further tissue damage.
These mediators cause vasodilatation, vasoconstriction, and capillary permeability, leading to the development of edema both in the burn area and adjacent organs. The additional water absorption from underlying tissue into the injury increases the pressure in the wound and causes ischemia in the already damaged tissue (Wurzer et al., 2018). As the most extensive body organ, the skin offers immunologic defenses and prevents fluid loss. When it is damaged through burns, these functions are compromised, making the patient susceptible to systemic sickness, sepsis, and multiple organ failure.
A first-degree burn is superficial and affects only the epidermis or the outer layer of the skin. This injury is temporary, and healing time may be quicker. Its main symptoms include redness, mild pain, and inflammation, which occurs as the wound heals (Noorbakhsh et al., 2021). Conversely, second-degree burns are partially deeper and, therefore, destroy the epidermis and the lower layer of skin known as the dermis. The wound may have severe pain and appear blistered, red, and inflamed. However, third-degree burns are more penetrating and severe because they destroys the epidermis and dermis and affect deeper tissues (Noorbakhsh et al., 2021). The wound site may appear charred and feel numb since the nerve endings are damaged.
The first and second-degree burns heal or get better on their own, with recovery occurring within two to three weeks without scarring but with pigment alterations to the skin. However, depending on the severity of the wound, a third-degree burn may lead to shock (Noorbakhsh et al., 2021). In addition, without medical attention, the injury may heal with severe contracture and scarring. There is no specific timeline for total spontaneous healing for this type of wound.
The Pathogenesis and Progression of Ebola
Ebola virus disease (EBD) is a severe ailment with high fatality rates. The infection is transmitted to humans from wild animals and later spreads to other people through direct contact. EBV enters the human body parenterally, through skin breaks or the mucous membrane (Centers for Disease Control and Prevention [CDC], 2022). Once in an individual’s system, the virus infects different cells, including hepatocytes, monocytes, fibroblasts, macrophages, and dendritic cells (CDC, 2022). The incubation period of this disease varies depending on the infection route. Subsequently, EBD moves from the original infection site through the macrophages or monocytes to the regional lymph nodes and later to the spleen and liver via the bloodstream (Furuyama & Marzi, 2019). In the advanced phases of the ailment, the kidney and liver functions become impaired, resulting in acute metabolic compromise, shock, convulsion, and death caused by multi-organ failure and mucosal bleeding (Furuyama & Marzi, 2019). The multi-organ failure occurs about two weeks after the appearance of the initial symptoms.
Following the 2014 EBD outbreak, several safety concerns were addressed. They include identifying and isolating infected patients to prevent further virus spread. In addition, contact tracing was used to identify target individuals exposed to the disease to slow down the risk of infection. Similarly, quarantining affected persons significantly helped guarantee other uninfected persons’ safety (Tuncer et al., 2018). Not to mention, personal protective gear assisted in ensuring the safety of the healthcare workers, thus lessening the risk of spread and cases of fatality. Moreover, the safe burial procedures significantly helped curb the infection rate.
Conclusion
Diseases, accidents, and disasters usually make people susceptible to medical emergencies, such as cardiogenic hypovolemic, obstructive, and distributive shocks. For example, Ebola may lead to sepsis, which develops as the body tries to fight off pathogens. In other cases, accidents from floods, fire, and chemical explosions can also cause injuries or conditions that directly affect blood flow, resulting in multiple organ failures and numerous health complications.
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