The Potential Benefits of DEPOC in Mental Health Management During The COVID-19 Pandemic

Background Poor mental health management is a rising concern among healthcare practitioners, as threats of burnout, self-harm, and suicide are gradually becoming issues in the field and have been exacerbated by the COVID-19 pandemic. Acute stress management is increasingly important to prevent the development of post-traumatic stress disorder, and a simplified method for its strategic implementation is essential. Methods Providing a method for healthcare practitioners to manage stressful cases can simultaneously offer support in the critical moments following traumatic events while addressing the origins of burnout. The acronym DEPOC - Debriefing/Defusing, Experience extracted from the event, Personal stress management techniques, Outcome of the event was uncontrollable and Closure/Counsellor - offers a structured framework for healthcare practitioners to address their emotions following distressing incidents. DEPOC is available as a presentation and can be summarized into multilingual poster and pamphlet formats to be posted in high-impact areas. Results DEPOC was presented to nearly 200 medical practitioners and trainees who believed knowledge of the acronym would be beneficial prior to clinical experience, wishing they had known about DEPOC for prior traumatic experiences. The established feedback led us believe we must share the experience and supplementary posters on DEPOC, as it is a vital component in healthcare education regardless of how experienced a healthcare professional may deem themselves in coping. Conclusions The COVID-19 pandemic has left healthcare professionals vulnerable to developing acute stress disorders. DEPOC is a simplified example of a technique used to address stress in healthcare practitioners. By offering a multilingual, standardized method to manage the aftermath of traumatic events, DEPOC addresses this concern.

Mental health conditions after snakebite: a scoping review

IntroductionSnakebite is a neglected tropical disease. Snakebite causes at least 120 000 death each year and it is estimated that there are three times as many amputations. Snakebite survivors are known to suffer from long-term physical and psychological sequelae, but not much is known on the mental health manifestations postsnakebite.MethodsWe conducted a scoping review and searched five major electronic databases (Ovid MEDLINE(R), Global Health, APA PsycINFO, EMBASE classic+EMBASE, Cochrane Central Register of Controlled Trials), contacted experts and conducted reference screening to identify primary studies on mental health manifestations after snakebite envenomation. Two reviewers independently conducted titles and abstract screening as well as full-text evaluation for final inclusion decision. Disagreements were resolved by consensus. We extracted data as per a standardised form and conducted narrative synthesis.ResultsWe retrieved 334 studies and finally included 11 studies that met our eligibility criteria. Of the 11 studies reported, post-traumatic stress disorder (PTSD) was the most commonly studied mental health condition after snakebite, with five studies reporting it. Estimate of the burden of PTSD after snakebite was available from a modelling study. The other mental health conditions reported were focused around depression, psychosocial impairment of survivors after a snakebite envenomation, hysteria, delusional disorders and acute stress disorders.ConclusionThere is a need for more research on understanding the neglected aspect of psychological morbidity of snakebite envenomation, particularly in countries with high burden. From the limited evidence available, depression and PTSD are major mental health manifestations in snakebite survivors.

PTSD as the second tsunami of the SARS-Cov-2 pandemic

Since the first cases, the coronavirus disease (COVID-19) rapidly spread around the world, with hundred−thousand cases and thousands of deaths. Post-traumatic stress disorder (PTSD) is a common consequence of major disasters. Exceptional epidemic situations also promoted PTSD in the past. Considering that humanity is undergoing the most severe pandemic since Spanish Influenza, the actual pandemic of COVID-19 is very likely to promote PTSD. Moreover, COVID-19 was renamed severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). With a poor understanding of viruses and spreading mechanisms, the evocation of SARS is generating a great anxiety contributing to promote PTSD. Quarantine of infected patients evolved to quarantine of ‘infected’ towns or popular districts, and then of entire countries. In the families of cases, the brutal death of family members involved a spread of fear and a loss of certainty, promoting PTSD. In the context of disaster medicine with a lack of human and technical resources, healthcare workers could also develop acute stress disorders, potentially degenerating into chronic PTSD. Globally, WHO estimates 30–50% of the population affected by a disaster suffered from diverse psychological distress. PTSD individuals are more at-risk of suicidal ideation, suicide attempt, and deaths by suicide – considering that healthcare workers are already at-risk occupations. We draw attention towards PTSD as a secondary effect of the SARS-Cov-2 pandemic, both for general population, patients, and healthcare workers. Healthcare policies need to take into account preventive strategy of PTSD, and the related risk of suicide, in forthcoming months.

First experience with xenon in treatment of severe trauma in children

Introduction. The authors discuss their first experience of applying the inert gas xenon (Xe) for relieving a persistent pain syndrome (PPS) and acute stress disorders (ASD) in children with severe injuries.Material and methods. Seven children with severe trauma were taken into the trial: the five with severe combined trauma after a terroristic attack (Kerch, 2018) and the two with multiple dog bites. All victims had PPS and ASD after the survived fear of death. Xenon had 15–30 % concentration in oxygen . Xe-therapy lasted for 15–20 minutes.Results. During Xe-sessions, patients were sedated. BIS-index decreased from 95.5 ± 2.5 to 86.5 ± 5.0 U (p < 0.05); mean values by Ramsay scale decreased from 5.5 ± 0.5 to 2.7 ± 1.2 scores (p < 0.05). Pain intensity by Numeric Rating Scale for Pain decreased from 4.1 ± 1.8 to 1.1 ± 0.4 scores (p < 0.05). Five sessions were needed for controlling PPS and refusing of analgesics; 12 session for phantom pains; 3 sessions for sleeplessness; 5 sessions for erasing tragic events from the memory.Conclusion. 15–30 % Xe inhalations were effective in controlling PPS and ASD in children with severe injuries.

Trauma Exposure in Posttraumatic Stress and Acute Stress Disorders

This chapter reviews the literature on the association between traumatic stress exposure and rates of both posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) among children and adults. It begins by reviewing current definitions of PTSD and ASD, which vary substantially across diagnostic systems. The chapter highlights research linking large-scale events, such as natural disasters and acts of terrorism, with the emergence of PTSD and ASD, as well as the literature on the impact of individual traumatic events, such as sexual assault, child sexual abuse, and medical trauma. The chapter concludes by noting several important directions for future research in the area of trauma exposure and traumatic stress.

Peculiarities of providing care in various emergencies

Air crashesAttention is focused on providing care to the relatives (identifying the bodies of the perished, talking to investigators, filling out the requisite documentation, etc.), resolving social issues (organizing funerals, informing various services of what had happened, etc.).FiresSpecial attention is paid to the victims with burns at the inpatient facilities of hospitals.Terrorist actsProvision of care depends on the duration of the emergency and the number of people involved; in the case of a continual stress, in the phase of isolation the medical-psychological care is provided to victims’ relatives. At later stages–it is provided to the victims and their relatives.Natural disastersAre of a special nature, as they are always sudden and there exists a threat that a great number of people may become victims.Organizational measures in the acute period of an emergency:– coordinating the work of specialists of the local, regional and federal level;– interacting with non-governmental organizations;– setting up a 24-hour “hotline” service (“HL”) on the basis of a medical institution;– deploying facilities for providing care to victims, their relatives, and to “secondary victims”.Principles of medical-psychological care:– urgent care must be provided jointly with psychiatrists/psychotherapists at the places, where the victims are located;– individuals with the most severe stress reactions must be identified and observed by psychiatrists/psychotherapists;– appropriate and prompt intervention should be made to relieve acute stress disorders;– therapeutic interventions should not be a hindrance to victims’ participation in the urgent evacuation and interrogation expedients as well as completing social tasks.Disclosure of interestThe author has not supplied his declaration of competing interest.