Drug Topics - October 8, 2007 - (Page 43)

43 that they are hydrated and eating properly; SAMHSA recommends that first responders avoid junk food, alcohol, caffeine, and tobacco, and make sure there is ample time for restful sleep. They should also stay in touch with loved ones and keep connected to life outside of the disaster area. It may also be helpful for responders to keep personal journals of their experiences; relief deployments pass quickly, and they may later be grateful that their experiences are written down for them to remember. SAMHSA also recommends that first responders reward themselves after shifts: If possible, they should enjoy a special meal, a warm shower, listen to music, or relax with fellow first responders to recuperate. Finally, first responders should be mindful that stress reactions can persist even after deployment as a first responder has ended. Reentry into one’s “normal” life and routine may be difficult. This difficulty is intensified when first responders are not given the opportunity to discuss their experiences with or provide feedback to their supervisors. Reentry is further complicated when the first responder’s efforts are either unrecognized or not well understood. It may take several days for the first responder to rest and recuperate before he or she is able to resume normal functioning. Even then, it is not unusual for first responders to experience some residual stress for the first few weeks after a disaster deployment. The “normal” stress reactions include difficulty sleeping, acute illness, recurring thoughts about the disaster, appetite problems, etc. More serious reactions that may merit clinical attention include flashbacks, recurring nightmares, substance abuse, social isolation, anhedonia, depression, intense anxiety, emotional numbness, hypervigilance, or a heightened startle response. It is therefore important that upon reentry, the first responder talk to loved ones about the signs of severe stress reactions. In this way, the first responders’ social support systems can celebrate their return, acknowledge their efforts, and monitor adjustment to normal routines. Should symptoms persist or become severe, it may be necessary for the first responder to seek help from a mental health professional. However, it appears that for the vast majority of first responders, reentry adjustment is complete within several weeks. Furthermore, most first responders report that they derive long-lasting personal satisfaction from their efforts and experiences. Conclusion Disaster events can occur practically anywhere, at any time, and take on many forms (e.g., windstorms, earthquakes, wildfires, terrorist attacks, etc.). Formal disaster response plans may exist at the local, state, and federal levels, although experiences from recent disasters sug- gest that clinicians from the local community are often involved in disaster relief efforts. Pharmacists may play multiple, important relief roles in the aftermath of a disaster. It is prudent for pharmacists to anticipate the possibility that they will be thrust into the disaster relief role, perhaps within their own local communities. As a first responder, a pharmacist may be involved in staffing emergency clinics, where he or she may participate as part of a multidisciplinary treatment team. In this capacity, the pharmacist may consult with other healthcare professionals about medication issues as well as interview patients to determine their current medication needs. The pharmacist as first responder may also be responsible for ensuring the safe, legal storage and distribution of medications in the disaster area. This activity is especially important because of the common problem of a sudden influx of donated medications, some of which are unsafe, expired, short-dated, or of limited practical use. The safe storage of medications in a disaster area can be especially challenging in the absence of power, stable refrigeration, climate control, and/or potable water. Pharmacists may also participate in providing clinical assistance to victims gathering at PODs. These PODs are essentially centralized gathering sites where food, water, and other basic supplies are distributed to victims. A pharmacist at a POD may be involved in assessing victims’ medication needs, making referrals to nearby clinics and pharmacies when indicated, and distributing OTC medications that are often in short supply after a large-scale disaster. In some mass disaster events, it may not be possible for all victims in need of pharmacy services to find their way to clinics, hospitals, PODs, etc. Victims who are residing at emergency shelters for extended periods of time are often in need of medication refills, yet have no means to access a pharmacy. Therefore, a pharmacist serving as a first responder may coordinate with emergency shelter managers to meet with residents, assess their medication needs, and coordinate follow-up care and refills where appropriate. Beyond providing services to emergency shelter residents, pharmacists may also engage in mobile outreach activities. In this role, the pharmacist may travel as part of a multidisciplinary team through the disaster area and assist in providing medical and medication care to victims. All first responders will find that a significant portion of their activities is devoted to the compassionate care of victims. The psychological reactions to a disaster event are complex and diverse: All victims will be affected by the disaster, but to varying degrees. In the aftermath of a disaster, pharmacists will likely find themselves engaged in the provision of basic psychological support. This support essentially takes the form of

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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