bluuebunny/crossref_metadata_2025 huggingface dataset:
(A328) Food and Water Risk Assessments during Disaster Operations
Authors: Burke R.L.
Published: May 2011

Although the exact burden of foodborne disease is unknown, diarrheal diseases kill approximately 2.2 million people annually. Even in developed countries foodborne illness is estimated to affect over 20% of the population annually. During natural disasters existing food safety and security measures may be damaged and mission priorities during emergencies may prevent inspection agencies from conducting normal inspections and enforcing government regulations. This breakdown in the food safety infrastructure may lead to increases in foodborne diseases within the local population and relief workers. The risk in this latter group is possibly magnified by their immunologic naïveness to local pathogens and an outbreak among relief workers can severely impact support operations, interfere with the aid delivery, and may result in the loss of life. In addition to natural disease transmission, there is the potential for terrorist organizations to target relief workers through deliberate contamination of the food and water supplies. Consequently, relief agencies should consider both food safety and security during disaster operations. A Food and Water Risk Assessment (FWRA) is a tool for identifying potential high risk food items and practices in local food sources and facilities and examines the overall food operation, the food facilities and equipment, water potability, cleaning and sanitation, pest control, employee health and sanitation, food security, and the source of the food items. The FWRA identifies risk items and provides mitigative control measures designed to reduce the residual risk to acceptable levels and minimize potential disruption of mission operations. Although the ultimate goal is protecting the health of the relief workers, the FWRA can also be used as a tool to improve the food safety practices of local food facilities and suppliers which will in turn help to reduce the incidence of foodborne disease among the local population during the disaster relief operations and beyond.
(A327) The Importance and Benefit of Disease and Injury Surveillance within Relief Operations
Authors: Burke R.L.
Published: May 2011

Disease and injuries are expected consequences of disasters, either as direct result of the initial disaster or due to a collapse of the pre-existing public health infrastructure. While relief efforts are primarily directed at treating existing and preventing further disease and injury among victims of the disasters, it is also important to remain aware of the health impact on individuals and organizations providing assistance. The potential immune naïveness of relief workers may predispose them to contracting diseases which are normally not a concern for the local population. If significant numbers of relief workers are affected this can severely impact an organizations ability to provide assistance and may lead to a worsening of the situation. Even a simple surveillance program can provide early warning of potential problems in order to timely implement control measures which will prevent further illness and minimize mission impact.
(A333) The Potential use of Social Media in Animal Emergency Response
Authors: Case H.
Published: May 2011

Social networking has been utilized for information sharing and communication since the beginning of time. Current communication technology allows for rapid information sharing across social networks through the increased utilization of social media—Facebook, Twitter, Flickr etc. Social media tools have been used increasingly in recent emergency response efforts including the response to the 2010 earthquake in Haiti and the BP oil spill in the US Gulf Coast. Veterinarians have been engaged in emergency preparedness and response activities for many years. The American Veterinary Medical Association founded in 1863 and representing approximately 83% of United States veterinarians and the American Veterinary Medical Foundation, established by the AVMA in 1963, have been active in emergency preparedness and response including the development of a world class veterinary disaster response program (VMAT) since 1993. Animals and humans share a special bond in the United States. According to the 2007 AVMA U.S. Pet Ownership and Demographics Sourcebook there are 72 million dogs, 81.7 million cats, 11.2 million birds and 7.3 million horses in U.S. households. Approximately 60 percent of all U.S. households own at least one pet and 64 percent own more than one pet. Following Hurricane Katrina in 2005 thousands of animals received veterinary medical care at the Lamar Dixon Animal Shelter in Baton Rouge, LA. Social networking was utilized by responders to obtain supplies yet current social media capabilities were not utilized to enhance veterinary medical response and care at the largest disaster animal shelter in US history. Several challenges (volunteer management, lack of veterinary supplies, and referral of critical veterinary patients etc.) in veterinary disaster response could be met through utilization of targeted social media messaging. Social media has the potential to enhance the efficiency and quality of disaster veterinary medical response now and into the future.
(A334) Disaster Medicine Center Evolution (Structure and Activities)
Authors: Kipor G.V. , Goncharov S.F. , Borisenko L.V. , Bobi B.V. , Pichugina N.K.
Published: May 2011

The requirements of coping with emergencies on the national level include the necessity to modify the structure of disaster medicine centers that deal with major emergencies. Sharing the responsibility for the management of emergency response and preparedness also is important. The evolution of disaster medicine service is key for disaster risk activities. The goal of this presentation is to show the center subunits and their tasks based on strict management under the leading the Ministry of Health and Social Development of Russian Federation. The main units of the disaster medicine center are proposed in view of the relationship to the regional and municipal centers and local medical facilities. The participation of corresponding-level centers in emergency response is dictated by the emergency scale, characteristics of the event, number of injured, number and capacities of local (regional) medical facilities, and other needs in emergency response management. The system of supply management during emergencies comprises a network of warehousing conserving the federal, regional, and local reserves of medical products is revised regularly. The new, information-sharing, automatic, geo-informational system manages the distribution of supplies for any event and evaluates the presence of resources and personnel around any focal point where any natural or technological emergency occurs. Such an informational system is being discussed for the revision of supplies and management on the international scale. The issues of field practice are proposed and suggestions on the modern coordinating mechanisms will be discussed.
(A337) State Failure as a Factor in International Global Medical Operations: Network Modeling
Authors: Trufanov A. , Rossodivita A. , Aminova M. , Tikhomirov A. , Caruso A. , Umerov R.
Published: May 2011

Introduction

In order to counteract disasters and emergencies, it is necessary to build cooperation and collaboration among all entities and actors. Field teams of rescuers require support from the State experiencing a disaster. The responses to the earthquake in Haiti demonstrated a lack of cooperation and collaboration and the rescuers encountered concomitant difficulties. Thus, the problems in the field are not only related to natural and technological aspects, but also social and political contexts. It is time to explore the role of the impact of State power on national and international disasters and emergencies. One modern and fruitful instrument for analysis of these complicated social and group processes is Complex Network modeling. Complex Network tools have been applied successfully to understanding and counteracting such threats as they relate to the spread of infectious diseases and/or to terrorist activities. Another significant utilization of the Complex Network approach is to develop good governance, management, and organizational processes in national and corporate landscapes.

Methods

Based on a Complex Network Scope, a novel, three-layer network model of public connections for diverse State regimes for further simulation is proposed. Quantitative assessments and practical processes should be implemented for countering global disasters using international and interdisciplinary teams. Contrary to the known hierarchical layer approach for knowledge acquisition, this new model describes an overall national Society Network by dividing the approach into the three layers: (1) Formal (State), as hierarchical governments structures; (2) Informal (presented by different long-term sustainable link groups); and (3) Informal (aquatinters with short term links (“weak ties”).

Results

According to each of these layers, one of three types of network topologies exist: (1) hierarchical; (2) scale-free; and (3) random, respectively.
(A306) Primary Care in the First 72 Hours Post Disaster: A Crazy Idea or a Sensible Inclusion for Foreign Medical Teams?
Authors: Redwood-Campbell L.
Published: May 2011

The use and number of Foreign Field hospitals and Foreign Medical Teams being mobilized after sudden onset disasters in the past decade has increased significantly. Examples include Haiti (2010), China (2008) Pakistan (2005), and Iran (2003). Foreign medical teams do not just work in field hospitals anymore and new trends of how FMTs are engaged need to be taken into consideration. After sudden impact disasters, there is undoubtedly a high need for surgical response. The role of primary care, immediately after a disaster or emergency has sometimes been described as low priority and therefore not needed during the initial response to disasters and emergencies. This oral presentation will review trends in the primary care needs post disaster and the literature around it. Using the Health Resource Availability Mapping System (a model that is derived from the standard health cluster tool and used for collection, collation and analysis of health sector information) and modified to sudden onset disasters, which primary health services when will be reviewed. Discussion and brainstorming encouraged!
(A340) The Role of Field Hospitals in Severe Environments — Guidelines to Prepare and Build a Field Hospital during a Disaster
Authors: Rossodivita A.
Published: May 2011

Introduction

Facing the threats of disasters due to natural hazards and terrorist attacks, communities and nations are strategically preparing to respond rapidly to such incidents with the appropriate medical services. Both natural and complex disasters may produce a massive number of casualties that outstrip the ability of the local healthcare system to provide the required care. Damage to the healthcare infrastructure will further compromise the delivery of health services. Field hospitals (FHs) may provide care for the injured and act as a substitute for destroyed hospitals in the aftermath of sudden-onset disasters. A FH is a large mobile medical unit that temporarily provides care to casualties on-site before they can be transported safely to more permanent hospital facilities. The concept was inherited from the battlefield (such as the mobile army surgical hospital (MASH)). A FH is defined as a mobile, self-contained, self-sufficient healthcare facility capable of rapid deployment and expansion or contraction to meet immediate emergency requirements for a specified period of time. The FH may be dispatched temporarily with personnel or donated without personnel.

Methods

Field hospitals have been focused on providing emergency trauma care for the initial 48 hours following the sudden-onset disasters, but they tend to continue operations much longer after the on-set. The aim of this study was to assess the timing, activities, and capacities of the FHs deployed after a disaster, especially in severe environments, and provide guidelines on the implementation and deployment of a FH during a disaster. In particular, the activity of Italian Field Hospitals utilized during disasters, humanitarian emergencies, and mass-gatherings events will be described.

Conclusions

Field hospitals have been used successfully during disasters, and now have a crucial role in supporting affected populations and damaged healthcare infrastructures. Field hospitals also play a role in the international community response.
(P1-1) The Daily Risk
Authors: Saenz M.C. , Cappo Lertora C.
Published: May 2011

Background

Can Health Professionals do something to diminish the risks in big cities? Civilian society is in need of protection and training when emergencies occur. The objective is to develop the capacity to feel competent when daily violence occurs and to diminish the risks of possible tragic, daily and unexpected events. Inexperience and lack of knowledge has a direct impact on Public Health. Through orientation and training with appropriate tools we prevent and diminish the effects on daily catastrophes: insecurity, violence, loss of material things, mourning to elaborate for loss after tragedies, car accidents, effects on financial emergencies, social alert states, etc.

Methodology and Objective

Through questionnaires and observation directed to city residents data was generated for evaluation. We reached the conclusion that non-government organizations (NGO) and government organizations (GO) together can diminish the effects of daily tragedies. Approximately 4500 citizens were trained directly and indirectly to give them the tools and techniques to support groups in communities in order to diminish the risk among high impact psychosocial events and abrupt events produced by nature or men that expose persons to disruptive situations that need to be solved. The modules include First Aid, Psychological Support, Debriefing and Stress.

Conclusion

Diminishing the risks depends on the people's vulnerability, resilience, social, institutional and family support groups and training. The use of participative techniques allows participants to assimilate the content of the course directed to men and women from different ages. It is necessary to generate an emergency culture for a society at risk.
(P1-14) Incident Command and Rescue during a Building Collapse
Authors: Arikan R. , Durusu M. , Arziman I. , Kandis H. , Erdogan N. , Eryilmaz M. , Erdil A.
Published: May 2011

On 11 December 2006, at 8:20h, five flats of a building containing 10 apartments collapsed due to a heater explosion. Four injured patients were transferred to a military hospital with the help of bystanders. Approximately 200 people gathered at the scene. People who were trapped in the building were rescued. The building was surrounded by safety tape. The first injured patient was discovered 4 hours after the collapse. The patinet was transferred by the National Medical Rescue Team. Rescue activities were terminated after 36 hours. A total of eight dead, including five children, and five injured people were recovered from the building. Six of the eight injured patients had superficial wounds. Two patients were monitored: one with head trauma and another with liver contusion and costa fracture.

Discussion

The explosion occurred during working hours, which contributed to the low number of injuries and deaths. The top floor of the building had the highest survival rate. Bystanders entered the scene through the safety tape, and complicated the rescue efforts.

Conclusions

Rescue efforts during disasters require a high level of education. Otherwise, it becomes impossible to control the crowd and prevent chaos. Also, considering the direction of the building collapse during the rescue activities might enable reaching more people in a shorter time period. Coordination by the departments taking part in the rescue efforts is just one of the key issues affecting a successful response.
(P1-17) Zürich Rescue System for Mass Gatherings: 19 Year Experience with Disaster Risk Reduction, Risk Management, and Rescue Organizations
Authors: Mariotti S.
Published: May 2011

Zürich is divided by a river and > 6 km lakeside labyrinth of small streets in the old city. Since 1992, Zürich hosts the street parade, which is the biggest event in Switzerland and one of the biggest in Europe. It is an event of techno parties, and nearly one million people gather along the lake and the old city. Medical assistance is provided by the emergency system of Zürich in cooperation with the fire department, police department, as well as the emergency systems of the neighborhoods, civil protection, and Volunteers. This mass gathering is unique because almost 16 km2 of the city and old city and four of the six bridges that connect the two sides of the city are closed and dedicated to the Streetparade, which complicates rescue operations. Since it is impossible for an ambulance to get to injured persons in the crowd, and very difficult to transfer patients to a hospital, many stationary medical units and two boats are used in the city, each with a combination of emergency doctors, paramedics, firefighters, and volunteers, who also can build mobile units and an advanced medical unit in a shelter that has rooms for 108 patients. Every mobile unit has a GPS system that permits the Operational Headquarters to have an overview. This system has been helpful in this particular event, permitting medical personnel to reach the injured persons in short time and to treat the majority of the patients in situ, minimizing the necessity of transport. In 2010, 680 patients were treated 680, of which, only 42 were transported to a hospital. No deaths due to panic attacks of lack of emergency response have occurred in the past 19 years.
(P1-21) Medical Disaster Relief after the 2009 American Samoan Tsunami: Lessons Learned
Authors: Partridge R. , Bouslough D.B. , Proano L. , Soliai-lemusu S. , Avegalio F. , Anesi A.
Published: May 2011

Background

Tsunamis most commonly occur in the “Ring of fire” in the Pacific due to frequency of earthquakes and volcanic activity. Damaging tsunamis occur 1–2 times yearly. On September 29, 2009, an earthquake on the Pacific floor caused a tsunami that struck American Samoa, Samoa and Tonga, with only 20 minutes warning.

Objective

To evaluate the disaster response in American Samoa by emergency medical services (EMS), the territorial hospital, and the Department of Health.

Methods

A retrospective review of EMS logs, public health records, hospital emergency department charts, and key-informant interviews over a 2-week period. Descriptive statistics were used to evaluate data.

Results

Three 5-meter waves struck the American Samoan islands, with land inundation as far as 700 meters. Many low- lying villages, including the capital city Pago Pago were affected. A total of 33 people (8 male, 23 female, including 3 children) were killed by the water, with approximately 150 significantly injured. EMS runs increased 250% from normal daily averages, with island-wide responses significantly delayed by flood damage. The hospital in Pago Pago, situated near the shore and only 10 meters above sea level, utilized 75 staff to evacuate 68 in-patients to high ground as soon as tremors were felt. This process was completed in 20 minutes with no associated morbidity or mortality. Patient injury patterns for the event are similar to recent literature reports. Mobile clinics and alternate care sites established at outlying dispensaries were used to decentralize healthcare from the hospital. DMAT/DMORT teams from Oregon and Hawaii supported local healthcare initiatives. Post-disaster public health surveillance focused on identifying and limiting food/water-borne illnesses, dengue fever, and influenza-like-illness outbreaks, as well as disaster related PTSD.

Conclusion

The disaster response to the tsunami in American Samoa was effective. Disaster planning was appropriate and rapidly implemented. Post-disaster public health emergencies were minimized.
(P1-23) The Potential Terrorist Possession of Weaponized Plague in North Africa: A Forensic Epidemiology Case Study and Discussion of Principles in Tizi Ouzou, Algeria
Authors: Allswede M.P. , Binyamin T.
Published: May 2011

Background

A report of black death, presumably pneumonic plague (Yersinia Pestis) occurred in the terrorist group Al Qaeda in the Land of Islamic Maghreb (AQLIM) in 2009. Up to 40 members of AQLIM are reported to have perished rapidly.

Discussion

The event was managed by Algeria, but questions remain as to the nature of this event and the level of investigation that was applied. This paper is a discussion of the principle elements of a forensic epidemiology investigation that should have, but did not take place in Algeria. The need for improved forensic epidemiology investigation capability is illustrated in this event due the unique problems inherent in the investigation of intentional outbreaks.
(P1-26) Abdominal Trauma: Arteriography versus Laparotomy
Authors: Abrassart S.
Published: May 2011

Selective non-operative management of abdominal visceral lesions is one of the most important and challenging changes that occurred in trauma patient care over the last 20 years. The main advantage of this type of management is the avoidance of unnecessary/non-therapeutic laparotomies. Trauma surgeons who deal with this type of treatment are worried of missed abdominal injuries. Modern diagnostic tools (spiral computed tomography, ultrasound, angiography, laparoscopy) allow trauma surgeons to accurately characterize the lesions to be addressed non-operatively. This presentation discusses the main elements of selective, non-operative management of principle solid visceral lesions (liver, spleen, and kidney). The advantages and limitations of the main diagnostic instruments used for evaluation of trauma patients allocated to non-operative management will be highlighted. Polytrauma patients in a Leve-1 trauma center over the last five years were selected and outcomes were analyzed. Pancreatic trauma remains an operative injury. However, surgeons must temper the enthusiasm for non-operative management of patients with solid organ injury, and exclude patients who would best be treated with surgery from this management scheme. Emergency care of the patients according the golden hour and team ability must be considered.
(P1-27) Jumbo Air Crash: A Serious Disaster Management Question
Authors: Lévy F.
Published: May 2011

The new jumbo jets, such as the Airbus680, which can transport 600 to 800 passengers, need special consideration in case of a crash, especially if the crash occurs near the airport. Survival parameters depend on the effect of the brutal deceleration and the high probability of thermic effects due to fire, but also the toxicity of the smoke. These new jets requires a different approach to planning for crashes. The scale of the disaster will be totally new in terms of numbers of casualties, numbers of fatalities, and numbers of family members to for whom to provide psychological and technical information. In addition, the problem of identification of the victims will be heightened, and will require more forensic teams. There is, in fact, only one way to manage this kind of disaster: international cooperation and coordination.
(P1-29) Catastrophe Management Plan, Simulations and Results – An Experience of a Private Hospital in Brazil
Authors: Tucherman M. , Vaidotas M. , Sako Y.K. , Akamine N. , Smaletz D. , Barros C.G.
Published: May 2011

Introduction

The terms catastrophe and disaster have been frequently heard worldwide due to situations like earthquakes, floods and events provoked by man as the September 11th and Anthrax attack. Catastrophe means all situations where material and human resources available in a healthcare facility are not enough to assist a large number of victims admitted at the same time. Accreditation requires having a plan to manage effectively those situations, assessing safely as much victims as possible.

Objective

To describe the catastrophe plan and its management in a private hospital.

Methodology

Hospital Albert Einstein is located close to a huge soccer game stadium and near to the State Government Hall. This was the reason to have a plan focusing on casualties with a large number of victims. The literature was revised to choose the triage methodology. Triage to identify the priority of patients' assessment based on their condition, possibility of treatment and determining discharge for those without visible risk. Simulation was implemented, followed by debriefing to register lessons learned.

Results

An algorithm was developed with a crisis center and defining care and support areas in the organizations to manage the victims at Emergency Room and triage field. The plan was effectively deflagrated twice: 47 victims from a bus accident and 25 from a policeman strike. Debriefing was done in all opportunities and communication is the main issue; 15 simulations have been done for training purpose, with specific goals.

Conclusion

Hospital is a high risk environment itself for an internal or external incident depending on its localization. A disaster plan is necessary to improve everyone safety, to organize resources, to respond effectively to such situations and take the organization back to regular operation as soon as possible. Simulations are essential to guarantee staff competency and organization support and response to adverse situations.
(P1-32) Training Needs Assessment of the Public Health Nurse (Phn) Competency at Health Post in Nepal
Authors: Lamsal S. , Badhu A.
Published: May 2011

Objective

This study aimed to assess the training needs of public health nurses (PHN) and compare the job performed by them with job descriptions.

Materials and Methods

A descriptive study was conducted by utilizing triangulation research method. It was conducted in Eastern and Central regions of Nepal with 13 PHNs (of 13 districts among 75 districts of Nepal) and their supervisors were included as the samples. Data was collected by using standardized tools.

Results

The mean age of the PHNs was 43.69 ± 9.4 years. Near half (46%) had 10 to 20 years job experienced. Most of the respondents (85%) had done PCL Nursing. All most all (92%) subjects had undergone some in-service education. Most of them (57%) used to visit health posts. The majority of PHNs (85%) assisted in planning and implementation of program for a health post. The Majority (85%) were involved in educational activities. Most (85%) were used to supervise the staffs working at health post. The majority of PHNs (77%) were not involved in research activities. Most of them (85%) prioritized the needs of training on recent concepts to bridge the gap between traditional and recent concepts of public health.

Conclusion

PHNs have broad areas of nursing expertise and opportunities for work if needed in a sufficient manpower at the district level. Most of them completed PCL nursing a number of years previously and therefore need training on recent advances and need to recruit more PHNs to improve public health services in Nepal.
(P1-36) Mass Casualty Incident Awareness of Remote Location Staff in Western Australia
Authors: Goswami R.
Published: May 2011

Introduction

The state of Western Australia has a remote population spread throughout an immense area. Remote health and retrieval is strained on a day-to-day basis, let alone in mass casualty incidents (MCIs). Anecdotally, remote medical staff has minimal training in MCI response. There is no research into how aware these staff is on principles of MCI response.

Methodology

An online survey was devised to ascertain the awareness and knowledge of medical staff most likely to be involved in a disaster. Demographic as well as questions in scenario format were disseminated to rural general practitioners (GPs), nurses and paramedics. Data was collected over a 4-month period.

Results

117 surveys were completed online. Analysis revealed an astute awareness of resources and environment in a potential MCI but triaging was poor and complex decision-making results were equivocal. Trained respondents handled scenarios better than experienced (MCI involvement or planning) respondents.

Conclusions

In general, remote medical staff is aware of only certain MCI principles. Further training is warranted. Voluntary feedback from these staff also strongly corroborated this view.
(P1-39) Support for Functionally Insufficient Key Disaster Hospitals by Dmat for Large-Scale Disaster in Japan
Authors: Kodama T. , Ohara H. , Jinbo D. , Shiozawa H. , Fujino T. , Motodate N. , Wada T. , Matsumoto J. , Taira Y.
Published: May 2011

Background

Japanese Disaster Medical Assistance Team (DMAT) has important duties to support and reinforce functionally insufficient key disaster hospitals in the large-scale disasters. However, it is difficult for Japanese DMAT to fulfill these duties in the current circumstances, because the DMAT consists of individual institutions and Teams have less experience to work in the other institutions. To resolve the issues, disaster drills for some DMATs which consist of several institutions have been held since 2008. We evaluated the effectiveness of the drills and educational system.

Methods

Investigation was performed by surveillance questionnaires to 129 participants in the drill (staffs from DMATs, Red Cross and local government, and sham patients). The questionnaires are: A. Was the cooperative medical practice performed smoothly? B. Was the support for hospitals conducted effectively?, C. Was the medical record for wide-area transportation completed? (for our staffs only), D. Was our activity enough? (for participants excluding us), and E. Was the drill beneficial?

Results

85 participants including 30 staffs in our institution answered the questionnaires (65.9%). The number of participants who answered ‘Yes’ was as follows: A. 48 (56.5%), B. 64 (75.3%), C. 8 (26.7%), D. 44 (83.0%) and E. 81 (95.3%).

Discussion

Although the cooperative medical practice was not so smooth, it was recognized that members in DMATs got mutual trust by their high knowledge and skills. And it was suggested that DMAT could not command and control the hospital staffs without their understanding the equipments and documentations used by DMAT. And it is ideal to change the mindset of hospital top managements towards the disaster medicine through the repeated drills.

Conclusion

The repeated disaster drills at the local area is essential to make DMAT function sufficiently.
(P1-42) The Educational Effects of a Triage Program in Senior High School
Authors: Suzuki K. , Tanaka H. , Takyu H. , Ninomiya N.
Published: May 2011

Background

Japan is one of the world's famous countries for natural disaster. Seven years ago, The Japanese government indicated the necessity of providing disaster prevention education in schools. However, such education has not yet been introduced.

Objective

The aim of this study was to evaluate the 90min triage program in senior high schools.

Method

Sixty nine students attended the program. The effects of the program were evaluated using pre and post examination by paired t-test and McNemar's test.

Result

Compare pre-test with post-test, the average score of the tests was a significant increased. Compare pre-questionnaire with post-questionnaire, the number of interested students in a regional disaster drill has increased.

Discussion

The results showed that this program increased the interest in disaster prevention and provided students with a chance to participate in disaster drills in their own resident area.

Conclusion

Carrying out this program in senior high schools, would provide students with a chance to learn disaster prevention.
(P1-48) Rethinking the “Disaster Club” as a Student Interest Group on a Health Professions Campus
Authors: Mcclure D. , Engelke H. , Mackintosh S.
Published: May 2011

Disaster preparedness and response requires an integrated response by all aspects of the health professions. The most successful outcome can occur when interprofessional cooperation exists between community, first responders, and the many facets of health professions. At Western University Health Sciences we have replaced our interprofessional disaster club with a disaster focused element in several other health professional interest clubs. The primary coordination is centered in the Public Health Club which is composed of students from many of our medical colleges. The public health club mirrors our community disaster response in that preventive medicine and preparedness lies in our public health program. Public health interest such as rabies prevention and education on world rabies they are centered in our public health club with support from our faculty expertise in public health. Educational components such as wilderness medicine fit well into the human emergency and critical care student group. Both human and veterinary emergency and critical care student group's natural interest lies in triage and first response. Student interest groups or clubs that focus on community outreach in medicine, nursing, dentistry and veterinary shelter medicine have a take the lead in emergency sheltering for vulnerable populations. Using the model presented here, disaster preparedness is promoted as routine extensions of daily professional endeavors. By building upon student interest groups we can build a culture of connectivity across the professions. Extending student club supported training endeavors to the community surrounding can allow the disaster responder community to meet on neutral ground. Western University Health Sciences is uniquely situated in Los Angeles County and our faculty and students reside in neighboring Orange Riverside and San Bernardino counties. At a private health professions university, our focus is to provide educational opportunities in a real-world setting which is integrated with community.
(P1-60) Clinico-Epidemiological Pattern and Management Options in Patients with Ocular Injuries in the Emergency Room of a Rural Hospital
Authors: Baisakhiya S. , Bhatt M. , Agrawal A.
Published: May 2011

Aims and Objectives

Successful patient outcomes in the setting of ocular emergencies depend on correct recognition and assessment as well as appropriate initial management. The purpose of this study is to describe the clinico-epidemiological findings and management options in patients with ocular injuries in the emergency room of a rural hospital.

Material and Methods

In this retrospective review the records of patients who were treated for ocular trauma from June 2010 to December 2010 in the emergency room of MM Institute of Medical Sciences and Research, Mullana (Ambala) were reviewed. The following data for all patients were recorded: age, sex, date and time of injury, involved eye, circumstance and mechanism of injury, initial visual acuity, details of appropriate investigation, immediate management and outcome.

Results

A total 46 patients were included in the study. Young adult male patients were more commonly involved. Most of the patients presented within 12hours of injury. Left eye was involved in 14 patients; right in 12 and 10 patients had injuries to both eyes. Most common mode of injury was mechanical. The patients who sustained bilateral ocular injuries were due to chemical burns (7 cases) and electrocution (3 cases). Most of the patients were managed conservatively. The surgical treatment offered were repair of corneal tears, removal of foreign bodies. The visual outcome was excellent in most of the patients.

Conclusions

Ocular injuries can have wide range of etiological factors and presentation and assessment of ocular emergencies can be made difficult by a lack of sophisticated facilities. However, a concise patient history, general observation and basic ocular tests can lead to a firm diagnosis and thereby appropriate management.
(P1-63) Post-Tsunami Hospital Evacuation Preparedness Improved by Development of Portable Medical Supply Caches
Authors: Bouslough D.B. , Peters E. , Peters C. , Tuato'o S.
Published: May 2011

Background

On September 29, 2009, an earthquake-caused tsunami struck American Samoa with only 20 minutes warning. Personnel successfully evacuated patients from the hospital within 20 minutes. The organization and transportation of medical supplies required for patient care took 90 minutes.

Objective

To describe a hospital evacuation exercise designed to identify critical medical supplies, and test their transport, and use in a field-hospital setting.

Methods

A retrospective review of hospital emergency preparedness and Boy Scout Eagle Project minutes, participant surveys, and key-informant interviews was performed. Descriptive statistics were used to evaluate data.

Results

Unit supervisors hospital-wide were tasked with designing portable supply caches for the care of typical unit patients for 72 hours. Nine hospital units participated (ED, Surgery, Medicine, Pediatrics, Labor & Delivery, Maternity, Nursery/NICU, ICU, Hemodialysis) in the exercise. Unit evacuation teams (1 physician & 2 nurses) carried caches by foot to a nearby field clinic site (1/4 mile). Cache transport times ranged from 3 minutes (maternity ward) to 15.5 minutes (hemodialysis), averaging 11.2 minutes. Hospital leadership arrived in 4 minutes, and maintenance staff with portable power and oxygen in 23 minutes. Fifty-seven community volunteers (age 9 months – 60 years) under Eagle Scout candidate leadership were prepared as moulaged mock patients. Unit teams used evacuated supplies to provide medical care for 6 mock patients each, listing missing or insufficient supplies at exercise end. Cache supply deficits noted by participating teams included: portable oxygen (66%), blood pressure cuffs (44%), thermometers (44%), select pharmaceuticals (44%), and others. Reported cache deficits and exercise lessons learned were reported hospital-wide for incorporation into preparedness planning.

Conclusion

The hospital unit medical supply cache exercise was effective in addressing prior evacuation deficits. Hospital collaboration with community service volunteers provides exercise realism for participants and increases community awareness for emergency preparedness.
(P1-65) Simulation Haute Fidélité Et Medecine De Catastrophe
Authors: Ronchi L.A. , Julien H.
Published: May 2011

L'exercice medical ou soignant en conditions de medecine de catastrophe se detache de l'exercice classique du fait du nombre important de victimes a traiter en un laps de temps reduit. S'y surajoute, en contexte chimique, le port d'une tenue de protection reduisant de maniere significative les performances du soignant qui la porte. Il est donc necessaire de proposer aux equipes amenees a exercer dans ces conditions des seances d'entrainement visant a acquerir la competence requise en pareilles circonstances. Une premiere etape a ete franchie avec la validation de realisation en tenue de protection des gestes (perfusion intraveineuse ou intraosseuse, controle des voies aeriennes superieures, ventilation assistee) utiles dans ce contexte. L'etape suivante qui vient de s'ouvrir vise a “immerger” le soignant dans une ambiance quasi-reelle (port de la tenue de protection, victime realiste et surtout dynamique, reagissant aux diverses actions entreprises). Il lui sera ainsi possible d'acquerir non seulement la gestuelle mais egalement la mise en pratique des notions enseignees lors des formations theoriques, avec un resultat beaucoup plus parlant et plus rapidement evaluable. Le cout eleve, au moins pour l'instant, des mannequins constitue un ultime obstacle pour la realisation d'exercices veritablement realistes associant de nombreuses victims
(P1-68) Experiences from the “Emergency Care for Trauma” Course for Support of Health System in Afghanistan as a NATO ISAF Medical Force
Authors: Durusu M. , Cicek E.I. , Akyildiz R. , Arziman I. , Kaldirim U. , Eyi Y.E. , Tuncer S.K. , Eryilmaz M.
Published: May 2011

Introduction

The experiences Afghan medical personnel gained from the “Emergency Care for Trauma” course are described in this presentation.

Method

The course was conducted 14–15 April, 2010 in Kabul, Afghanistan. It was evaluated retrospectively for: (1) course curriculum; (2) training instructors; (3) participant characteristics; (4) participant evaluations and course of events; (5) preparation; (6) execution; and (7) results.

Results

The course included 13 hours of theoretical discussion, six hours of skill practice stations, and 19 hours of training. The organization committee was composed of a president, two secretaries, six trainers, and six assistant trainers. There were three language interpreters. A total of 24 medical personnel attended the course. Pre- and post-tests were administered to the participants in order to evaluate the effectiveness of the course. Simultaneous translation was performed during the training sessions. The correct response rates for test questions increased from 34.6% prior to the course, to 80.3% after the course. At the end of course, reviews from the participants were discussed.

Discussion

The participants suggested that the course should be repeated every six months. It was decided that there should be more time for the practical portion of the course. It was determined that the course would be integrated into the Afghan health system.

Conclusion

Post-graduate courses are important components of the modern health care system. In many developed countries, these courses have become compulsory and are conducted regularly. However, standardized and regularly performed courses should be supported in developing countries.
(P1-70) Enduring Impacts of Explosive Remnants of War
Authors: Mcaslan A.
Published: May 2011

More than 175 million landmines have been deployed since the end of World War II, including > 65 million since 1980. They differ from other weapons by remaining active in the ground long after hostilities have ended. They lie in fields and woodlands, alongside roads and footpaths, and in villages, creating a humanitarian problem with social, economic, and environmental dimensions. In addition to the threat from landmines, many areas of former conflict are contaminated by sub-munitions, unexploded ordnance, discarded weapons, improvised explosive devices (IEDs) and other hazardous debris of war. The victims of landmines and unexploded ordnance inevitably are the poorest and most vulnerable members of societies. It is the subsistence farmer, nomads and their herds, and fleeing refugees who are most affected. Economic necessity forces people to enter known mined areas in search of food and water, to graze livestock, or to gather thatch for their homes. Because landmines are designed to maim, their victims often require extensive treatment for long periods of time. The first aid administered to victims often is rudimentary; in some cases, inappropriately applied tourniquets result in amputations that otherwise might not have been necessary. Much has been achieved since the international community first was made aware of the threat from landmines in countries emerging from conflict in the 1990s. Over the past 20 years, the work of a few non-governmental organizations (NGOs) operating independently in Afghanistan, Angola, and Cambodia has developed into an international program involving the United Nations, the national authorities of 78 mine-affected countries, donor governments, and < 100 NGOs and demining companies. However, more must be done to develop sustainable national capacities. It is particularly necessary for the international community to assist national authorities develop effective and affordable local medical and rehabilitation capabilities.
(P1-71) Can a Thick Snow Layer be Protective in Mine Injuries: Case Report
Authors: Durusu M. , Ilica A.T. , Eryilmaz M. , Ozyurek S.
Published: May 2011

Despite their low mortality rate, mine injuries have high rate of morbidity. Depending on the severity, different levels of amputation may be required for the affected extremities. A mine injury composed of an atypical condition because of thick layer of snow is described in this presentation. A 21-year-old man was taken to the emergency department because of a mine injury. He had severe pain on his right heel. He was injured in an explosion in a rural state that had 50–60 cm of snow on the ground. Vascular access was provided and cast immobilization was applied to the right foot. The patient then was carried by ambulance helicopter. Vital signs were normal. Right ankle movements were limited and painful, and there were minimal edema and hematoma on both sides of the patient's heel in physical examination. Neither motor sensorial nor vascular deficit was determined. Comminuted calcaneus fractures were observed in x-ray and in the computerized tomography. A short leg circular cast was applied during follow-up. The cast was taken off at the end of the second month, and rehabilitation began. The follow-up was complete at the end of the sixth month with complete recovery. Mine injuries are special military injuries the sometimes affect civilians. In these injuries, lower extremities often are affected and amputation may be required. This case is similar to high-falling calcaneus fractures. This may have occurred as a result of an upwards blast impact that may have been weakened because of the thickness the layer of snow. Thick layers of snow may help protect civilians from mine injuries. This potential protective affect may be useful for researchers aiming to decrease mine injuries.
(P1-76) Descriptive Study of Poisoning Victims Patients at a Tertiary Medical Center in Northern Thailand
Authors: Inboriboon P.C. , Narongchai P.
Published: May 2011

Background

Poisoning is a public health problem that effects all ages, genders, and ethnicities, but certain populations are at increased risk. Unintentional poisoning disproportionately affects lower- and middle-income countries. The epidemiological pattern of poisoning can differ significantly within countries. In Thailand, national poisoning data is collected by voluntary reporting to a poison control center in the capital, Bangkok. Limited poisonings are reported from Chiang Mai, a province in Northern Thailand, though it has the highest suicide rate in the country.

Objective

The aim of this study is to describe poisoning epidemiology, examine differences between intentional and unintentional poisonings and, to develop a multivariate predictive model of intentional poisonings in Northern Thailand.

Methods

A total of 550 poisoning admissions were identified at Chiang Mai's University Hospital from 01 January 2005 to 31 December 2005. Demographic data were collected retrospectively by manual chart review. Chi-square and t-tests were used to examine differences in poisoning by intent. A step-wise logistic regression analysis was performed to develop a predictive model of intentional poisonings. Factors significantly associated with intentional poisoning were used in a logistic progression model to identify predictors of intentional poisoning.

Results

Younger age was significantly associated with intentional poisoning. There was no demonstrated difference in gender and poisoning intent. Predictors of intentional poisonings were use of chemical agents, high-risk medications (analgesics and psychiatric), unemployment, and younger age.

Conclusions

Interventions should focus on factors that put young adults and the unemployed at greater risk for intentional poisonings. Further interventions are also needed to limit access to potentially lethal doses of chemical agents and high risk medications.