As recent wildfires rage in places like Hawaii and Canada, trained healthcare professionals (HCPs) are called upon to address the urgent needs of affected communities. In Hawaii, where over 100 people have died and more than 1,000 are estimated still be missing, MDs are treating patients with serious burns and breathing complications, among other issues.

Canadian wildfires led to spike in asthma ER visits, especially in the Northeast. AP News.

Yan NS Raja Razek,Holly. Death toll from Maui’s wildfires rises to 111 -- with possibly 1,000 still missing -- as tensions escalate over the cause and response. CNN.

 

 

Reza Danesh, MD, the founder of MODO MD (a Maui-based mobile care service), began using his unit to help patients impacted by the fires. According to NBC Los Angeles, the doctor received messages from local paramedics when the fire broke out. “I knew I needed to go activate MODO for the people…I filled up the van and just went out. I brought more trauma stuff, airway stuff, respiratory meds. I had no idea what I was walking into,” Dr. Danesh told the outlet.

Klemack JC, Rendon • • K. ‘Like a horror movie’: Cedars-Sinai-trained doctor uses mobile unit to treat Maui wildfire survivors. NBC Los Angeles.

 

 

Others, like David C. Cho, MD, a plastic surgeon working on the island’s only intensive burn unit at Straub Medical Center in Honolulu, prepared for a deluge of incoming patients, he told the Honolulu Star-Advertiser. Some patients—including those with burns covering up to 70% of their bodies—had to be flown nearly 100 miles to get proper care at the Center.

Doctors rush to treat fire victims in Hawaii’s only burn unit. Honolulu Star-Advertiser.

 

 

According to Science of the Total Environment, wildfire smoke and particulate matter are associated with all-cause mortality and respiratory morbidity. Wildfires often lead to inhalation of tiny particulate matter particles (PM2.5), leading to heart attack, stroke, lung cancer, and cognitive function problems, according to Yale Medicine.

Cascio WE. Wildland fire smoke and human health. Sci Total Environ. 2018;624:586-595.

How bad is wildfire smoke for your health? Yale Medicine.

 

 

 

How MDs can help patients impacted by wildfires

 

According to Robert Katzer, MD, Professor of Emergency Medicine at the University of California, Irvine School of Medicine, the best way physicians can help patients affected by wildfire is to contact organizations like the American Red Cross or local hospitals and healthcare coalitions. Through these organizations, you can provide funding or extra resources. 

“It is not recommended for anyone to travel to the affected area to be a physician on their own,” Dr. Katzer says. “That introduces other obstacles, including finding additional resources and shelter to support that individual. To best help, a large amount of equipment and medication is needed in order for physicians to work effectively.”

When certain states declare a disaster, they may honor out-of-state licensures for HCPs coming to provide emergency medical care. Another resource MDs should know about is the National Disaster Medical System, which provides personnel, equipment, and supplies, as well as a network of partner hospitals working alongside state and local personnel to provide care at a disaster site. “Physicians can apply for one of those positions so they are able to support in a way that does not take resources away from the locals who are suffering as a result of the disaster,” Dr. Katzer says.

He goes on to say that MDs should know that disasters like wildfires are about acute emergencies as well as chronic health issues. “A disaster eliminates the infrastructure needed to provide chronic care to patients, including care for diabetes, blood pressure, psychiatric illnesses, and those who require dialysis,” he adds. “Often when a disaster occurs, these illnesses are exacerbated due to the disaster’s destabilization. All these needs are infrastructure and/or logistically intensive, and that is why it is recommended to donate money and time, if requested, to larger organizations that can provide these resource-intensive needs to that community.”

Dr. Katzer says that on-site MDs hoping to help impacted patients need to have a specific skill set: They need to know how to manage many chronic illnesses, and they need to bring large supplies of medications with them. “Usually, those who experience natural disasters lose their housing or leave all their medications behind when evacuating,” he says. It’s the little things—like a lost pair of eyeglasses, for example—that MDs will need to prepare for.

“You don’t want to be just a person on an island with a medical license,” Dr. Katzer says. “Rather, you want to have all the supplies and resources to be able to provide quality care.”

W. Lee Warren, MD, a board-certified neurosurgeon, says that his experience as a combat surgeon in Iraq has given him a unique understanding of how trauma impacts patients—including in the case of wildfires. 

“Physicians can come along to offer support by reminding people that these traumatic events will produce neurochemical changes in their brains, which will become physical and physiological changes in their bodies…Physicians should all develop a trauma-informed skill set,” Dr. Warren says.