Drug Topics - October 8, 2007 - (Page 40)

40 DRUG TOPICS OCTOBER 8, 2007 www.drugtopics.com CONTINUING EDUCATION yond clinics. For example, “points of distribution” (PODs) are often organized to deliver food, water, ice, etc. Pharmacists can help staff PODs and offer assistance to victims who gather there. While medication supplies may not be on hand at the POD, a pharmacist can identify victims in need and help them connect to other resources. Also, sometimes basic OTC medications, such as ibuprofen, are invaluable to victims and these are easily distributed at PODs. Depending on the scale of the disaster, there may also be large numbers of victims who are residing in emergency shelters. Often, these victims left their homes with only a few items (or were indigent before the disaster). They may not have brought their medications with them to the shelter, or in the event of a protracted disaster, they may be in need of refills. A pharmacist seeking to help in the aftermath of a disaster can certainly find ample opportunities at emergency shelters. The provision of care at emergency shelters should be coordinated with shelter managers, and often shelters have nursing and mental health professionals on staff. The shelter staff can assist in the identification of residents in greatest need of drug therapy services. In some disaster situations, victims may remain in the disaster area itself. Sometimes this is due to emotional shock, or perhaps because the victim is unable or unwilling to travel to an emergency shelter. In post-Katrina Mississippi, teams of clinicians canvassed the disaster area in search of victims. Pharmacists were quickly integrated into these teams. The mobile outreach activity essentially involved the healthcare team driving through the disaster area in a van, sometimes with an escort of law enforcement officers while in restricted areas. Upon encountering people in the disaster area, the team would offer help. For example, an elderly man with hypertension was living in a tent next to what was left of his home. While he could not be immediately persuaded to evacuate by the outreach team, the pharmacist was able to identify his medication needs and arrange to have them delivered to the man (along with a psychologist who was eventually able to convince him to accept transport to a local shelter). trained in providing basic psychological support. This skill set is invaluable in the aftermath of a disaster. A fairly simple yet powerful form of care is to invite a victim to talk about his or her experiences. Often, active listening and empathic support is effective in helping a victim cope with stress. Such interactions also provide pharmacists with an opportunity to educate patients about stress reactions. For example, it may be helpful for the pharmacist to describe the symptoms of severe traumatic stress (dissociation, hallucinations, suicidality, etc.) so that the victim will know to seek help if such symptoms emerge. In some situations, a caring, compassionate pharmacist may encounter a victim who discloses significant distress, and the pharmacist can then help the victim obtain attention from a mental health professional. Another type of case involves a victim who is seeking medical attention but is actually struggling with traumatic stress. For example, a patient may present several times to an emergency clinic with the same vague complaints of pain, fatigue, gastrointestinal distress, and so on that do not appear to have a medical etiology. The patient may be seeking attention and reassurance, or he or she may be confusing mental distress with physical symptoms. Again, talking with the victim about his or her recent experiences and making an appropriate referral may prove helpful. A challenge in post-disaster care is helping those with preexisting psychiatric conditions. Individuals with chronic, persistent mental illness are often underserved in general; they may have been in need of psychiatric and psychological treatment before the disaster, but did not receive it adequately. Some individuals will have been indigent and isolated before the disaster, yet are forced (e.g., by mandatory curfews or evacuation orders) to reside in emergency shelters. Other psychiatric patients may have been stabilized before the disaster, but the disaster exacerbated their symptoms. Or they may be deprived of access to stabilizing treatment (medications, psychotherapy, etc.), triggering a relapse of psychiatric symptoms. Finally, it has been found that some individuals with serious, persistent mental illness may converge upon a disaster area (perhaps due to their pathology or the access to shelter and food, etc.). For example, a pharmacist visited a shelter in the Mississippi Gulf Coast area and was asked by a shelter staff member to meet with an adult male who had arrived at the shelter two days before and was behaving oddly. The pharmacist initiated a conversation with the man and learned that he had recently been discharged from a psychiatric hospital in another state. He watched the television coverage of Hurricane Katrina and abruptly decided to hitchhike to Biloxi, where he Provision of basic psychological support Following a large-scale disaster, perhaps the most important needs among victims are for basic supplies and/or medical attention. However, the stress of a disaster event is significant for all victims. First responders need to be mindful of psychological reactions among victims and other first responders. These reactions can be complex and varied, and they may be easily overlooked or given low priority. Many pharmacists interact with patients routinely and often and are, therefore, experienced and http://www.drugtopics.com

Table of Contents Feed for the Digital Edition of Drug Topics - October 8, 2007

Drug Topics - October 8, 2007 Latebreakers Latebreakers in Depth Letters Rx Care Community Practice JP at Large 150 Years of American Pharmacy Hospital Practice Are You Getting Pharmacy's Message Across? Self-Care Government and Law Legal Q&A The Pharmacist as First Responder in Disaster Relief Technology Update New Products Advertisers Index Statement of Ownership Classified Viewpoint

Drug Topics - October 8, 2007

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