bluuebunny/crossref_metadata_2025 huggingface dataset:
(A188) Foot and Mouth Disease Continuity of Business Planning for the U.S. Dairy Industry
Authors: Hullinger P.J. , Bickett-Weddle D. , Goldsmith T. , Roth J. , Zack J.
Published: May 2011

If foot-and-mouth disease (FMD) was detected in the United States (U.S.), a national animal health emergency would be declared and livestock and allied industries would feel the immediate impacts of animal and product movement restrictions, animal quarantines, disease surveillance activities and other necessary measures implemented to control the disease. These control measures, while necessary to contain the outbreak, would have impacts on the normal business practices of uninfected livestock producers in affected regions, and potentially disrupt interstate commerce. Such impacts would be most disruptive to industries producing perishable products and utilizing ‘just-in-time’ supply models. One significantly impacted sector would be the U.S. dairy industry whose operations rely upon daily animal, product and other supportive movements, and do not have the capacity to store milk for more than 24-48 hours. Disruption of normal milk movement in the U.S. could affect the provision of milk and milk products, as well as create significant milk disposal, environmental and animal welfare issues. The challenge of controlling and eliminating FMD while at the same time maintaining the long term viability of the U.S. dairy industry, represents a complex and multifaceted challenge. The United States Department of Agriculture (USDA) is collaborating in preparedness initiatives and pre-event, academia-facilitated emergency management planning efforts with states and livestock industries. A key element, critical to a successful outcome from this initiative is the involvement of industry throughout the process. One such effort is the ‘Secure Milk Supply’ (SMS) Plan project and its initial goal is to develop agreed upon processes and procedures to pick up, transport, and pasteurize milk from uninfected farms in FMD control areas thus helping to maintain business continuity for dairy producers, haulers, and processors. This presentation will describe the current approach to FMD control in the U.S., issues of special relevance to the dairy industry and the progress and planned future directions of the USDA sponsored SMS Plan.
(A204) Importance of Emergency Response Program Organizations in Coping with the Increasing Risk of CBRN Events
Authors: Ranghieri M. , Guidotti M. , Rossodivita A.
Published: May 2011

Introduction

One of the most prevalent issues identified by Emergency Response Program Organizations (ERPOs), is the inability to care for an overwhelming number of contaminated patients within a civilian community. Even when emergency responders successfully decontaminate and triage large numbers of patients at the scene, it is unlikely that neighboring hospitals are prepared and equipped to receive such a large amount of patients and treat them within the boundaries of the existing healthcare system. Thus, planners must avoid any collapse of the healthcare system and may need to redistribute existing resources to enhance and facilitate patient outcome. As a response to this issue, ERPOs should develop an alternative healthcare facility: the Off-Site Triage, Treatment and Transportation Center (Off-Site Center). This Center is a temporary patient clearinghouse to be disassembled once the flow of new patients has diminished to the point that they can be handled by the existing healthcare systems.

Methods

The Off-Site Center is intended to care for patients who have been triaged as “Minimal” at the scene, those patients who are worried that they might have been exposed to contamination, and those who self-refer to the Center.

Results

Planners, administrators, first responders, medical professionals, and public health and emergency management personnel must evaluate the Concept of Operation for the Off-Site Center in order to increase their level of preparedness and provide effective mass-casualty care.

Conclusions

In this report, some general guidelines will be provided for the efficient planning and management of an Off-Site Center. A practical example will be also illustrated: a case study in Bergamo during a May 2010 National Meeting of the Italian Association of Alps Infantry Troops.
(A214) Road War: A 200-Vehicle Crash, Special Report
Authors: Khalifa G.E.A.
Published: May 2011

The last thing the world needs is another war.1 Everyday about 3000 people die and 30,000 people are seriously injured on the world's roads.2 Furthermore, for people who survive the crash, additional suffering and frustration occur because of administrative, legal, and social barriers.3 Since transport to hospital usually takes 30–45 minutes, the ‘golden hour’ in which 48% of deaths occur is spent mainly in the prehospital environment.4 On March 11, 2008 at 7:30 AM a very foggy morning, a major car crash occurred on the high way from Abu Dhabi to Dubai. Initial scene response was conducted by Abu Dhabi traffic police Abu Dhabi Police Ambulance and Rescue Sections helped by Dubai. Casualities were transported to 2 hospitals in Abu Dhabi; Al Mafraq and Al Rahba. The Authors describes Al Rahba hospital response that received 159 causalities (almost half of the causalities).

Results

Three victims died immediately on scene. Most of the causalities were triaged and re triaged as Priority 3 (green), suffered from extremity trauma, were treated and discharged. Twenty patients were triaged as Priority 2 (yellow) and were admitted to the hospital, Three patients were priority one (red) were admitted to the ICU, one of them died 10 days later due to severe head and chest injuries.
(A216) Ashmore Reef Boat Explosion: A Nightmare Scenario that Became a Reality
Authors: Leclercq M.G. , Robertson A.G.
Published: May 2011

At approximately 06:15h on 16 April 2009, there was an explosion and subsequent fire onboard the Suspected Illegal Entry Vessel (SIEV) 36. The vessel was located in the vicinity of the Ashmore Reef, approximately 610 kilometers north of Broome in Western Australia (WA). Onboard were members of the Royal Australian Navy (RAN), 47 asylum seekers, and two crew members. Traveling with SIEV 36 were the RAN Patrol Boats, HMAS Childers, and HMAS Albany. The explosion resulted in five deaths and a large number of casualties with severe burn injuries, and a smaller number with concurrent trauma injuries. The Ashmore Reef incident was unique in that it involved the medical management and evacuation of 44 injured foreign nationals (31 seriously injured) in an extremely remote location. It resulted in an unprecedented health response from multiple agencies including local, regional, and state governments, commonwealth government agencies, non-government organizations, and private industry. The mission objective for this incident was to retrieve and evacuate multiple seriously injured casualties and stabilize them for safe transport to definitive care. The mission objective was achieved for the Ashmore Reef incident with no further deaths. As with all disasters, many lessons have been learned, and recommendations have been formulated. The logistic requirements to successfully complete such a mission have been reinforced as a result of this incident, as this was the most logistically challenging mass-casualty incident in WA history.
(A217) Success Indicators of Emergency Medical Management: A Building Collapse Disaster
Authors: Satapathy S. , Banerjee A. , Bahl A.
Published: May 2011

A four-story building collapse in east Delhi, India in November 2010 claimed 66 lives and left 130 injured. It is considered one of the worst such disasters in Delhi. This disaster included massive rescue operations to pull out those trapped under the debris. The nodal hospital, which did not have a well-defined hospital disaster management plan, managed the disaster extremely well. The success indicators included a SMART triage, autopsy and tagging/labeling dead bodies, public notification system, effective hospital networking for patient transfer and getting injured family members together, excellent media management, important dignitaries' management, important decision-making processes, and commendable teamwork. The critical aspects of management proved as a key indicator for the successful management. The paper discusses the details of the case study and analyzes each indicator in greater focus. The lessons learned are critically evaluated.
(A219) Development of a Hospital Disaster Plan for Countries with Limited Resources
Authors: Plani F.
Published: May 2011

The Chris Hani Baragwanath Hospital (CHBH) in South Africa is the largest in the world, with 2,900 beds. Its trauma unit boasts 15 resuscitation bays, while the triage area has space for 40 stretchers. There are 5,000 trauma resuscitations performed yearly, out of 50,000 patients seen in the Trauma Emergency Department. There is an eight-bed Trauma Intensive Care Unit (ICU) and a 56-bed Trauma Ward. There also are 25 stepdown beds, 70 outlying beds, a six-bed Burn ICU, 20-bed ward, and a 24-bed shortstay ward. There are about 80 resuscitations and 70 trauma emergency operations weekly. However, the hospital is severely limited in financial and human resources, with only 2–3 interns, two registrars, and one trauma consultant on-call. The hospital is at > 130% bed occupancy. The CHBH was designated as the main disaster hospital for the 2010 FIFA World Cup, due to its proximity to the 96,000-seat Soccer City. Nominal disaster plans existed, but there were no resources, preparations, or knowledge, as was the case with most other government hospitals. The Trauma Directorate developed a new plan for the World Cup, future mass-casualty incidents at CHBH, and for other resource limited hospitals. The plans are centered on four critical issues: (1) preparedness of hospital structure and staff; (2) dissemination of the plan; (3) disaster training; and (4) the development of “Disaster Bags” for 350 casualties A free disaster course trained > 400 staff members on in-hospital triage and trauma management. All hospital staff were allocated specific functions in case of disasters. This is the first time the CHBH has had an integrated disaster plan, with separate equipment allocation, through private funding, and involving all disciplines.
(A225) Lessons Learned at the Commonwealth Games: A Mass-Gathering Sporting Event in New Delhi, India
Authors: Madan A.
Published: May 2011

Mass gatherings can be religious, political, socio-cultural, or sporting events, and vary in the form of processions, car races, conferences, fairs, etc. New Delhi hosted the 2010 Commonwealth Games, a mass gathering spread over a duration of 10 days with different venues and a high density of participants, spectators, security personnel, volunteers, and high-profile guests. Various organizations were involved in the planning and implementation of the games which called for a collaborative and coordinated effort to make the event a success. Security coverage was required for 23 sporting, 32 training, and seven non-sporting venues. Security arrangements were of utmost importance and required training, mobilization, and deployment of army, police, and other emergency workers, as well as establishing Standard Operating Procedures for responses to chemical, biological, radioactive, and nuclear events and availing specialized equipment. Areas of public health interventions in mass gathering include mass-casualty preparedness, disease surveillance and outbreak response, safety of water, food, and venues, health promotion, public health preparedness and response, pest and vector control, coordination and communication, healthcare facility capacity, and medical supplies. Methods adopted for the study included interviews with the stakeholders of the Commonwealth Games and use of secondary data to cite examples and support arguments. Existing knowledge must be documented and made available for use in planning for future mass gatherings. The size, duration, and interest of such events demands special attention toward preparedness and mitigation strategies to prevent or minimize the risk of ill health and maximizing the safety of people involved.
(A226) Establishing a Framework for Synchronizing Critical Decision Making with Information Analysis during a Health/Medical Emergency
Authors: Paturas J. , Pelazza J. , Smith R.
Published: May 2011

Background

The Yale New Haven Center for Emergency Preparedness and Disaster Response (YNH-CEPDR) has worked in the United States with state and local health and medical organizations to evaluate critical decision making activities and to develop decision making tools and protocols to enhance decision making in a time sensitive environment. YNH-CEPDR has also worked with international organizations and US federal agencies to support situational awareness activities in simulated and real world events.

Objectives

During this session YNH-CEPDR will share the best practices from recent events such as the H1N1 response and the Haiti Earthquake. Participants will be engaged in discussions regarding overall framework for successful information collection, analysis and dissemination to support decision making based on these experiences. This session will also incorporate concepts provided by the US National Incident Management System (NIMS) and the Incident Command System (ICS), specifically through the development of Situational Reports (SitReps), Incident Action Plans (IAP) and Job Action Sheets as methods to implement the framework and concepts discussed. Participants will be led through a series of scenario-based discussions to allow application of critical decision making factors to their organization. At the conclusion of the session, participants will be able to identify next steps for enhancing the synchronization of critical decision making and information analysis within their organizations.
(A229) Financing Emergency and Disaster Treatment: A Proactive Funding Approach
Authors: Oladimeji E.K. , Adebiyi B.O. , Akeredolu D.
Published: May 2011

Financing the care and treatment of victims of emergencies and disasters is a critically important area for policy. It needs deliberations to evolve policies that will be relevant, robust and enduring. This is more so as the ideological and political leanings of a people determine what will be allowed and what policies endure. The sustainability of the funding model makes a large impact on the success of the treatment, in this case the specialized treatment needed in the traumatic event of emergency and disaster. The paper defined emergencies and disasters and observed that though the timing of funding is critical in the events, the volume and complexity of funding is higher in the latter. The paper reviewed the several current models in use today, particularly with locus on costs which should be incorporated in a payment model, including flag fall or set-up costs (for instance managing new patient records), consumables, investigations (such as pathology and diagnostic imaging) and pharmacological services (prescriptions, logistics of procurement under crisis, etc,) staffing costs which in public hospital emergency departments often do not vary within a shift i.e. emergency departments rarely draw staff from ward areas to the emergency departments to assist with unpredicted demand peaks- but which may become significant in event of disasters. These models are essentially public funded. The paper also highlighted the political underpinnings which make each of the current models popular in each of the ideological settings. The pros and cons associated with the models are reviewed in depth. The paper concludes, after the ideological/funding analysis, by recommending a private/public mix of funding. Details of this proactive funding approach are given and ways to modify and adapt them to different ideological (political) backgrounds suggested.
(A230) Emergency Medical Preparedness for Disaster Risk Reduction: The Role of Health Sector Personnel - An Overview
Authors: Mulam B.R.
Published: May 2011

Efficient management of disasters has received increased attention globally. It has been realized by all countries in the world that no development is sustainable if human life is vulnerable to major Disaster risks. Disaster Preparedness and Response are the most important components of an effective Disaster Management strategy. The objective of Disaster Preparedness is to ensure that appropriate systems are in place and personnel are trained to provide immediate response to victims in the event of any Disaster. Medical response is one of the most critical, most important and of immediate requirement in any Disaster situation. The success or failure of any Disaster Management operations will depend to a great extent on the success achieved by the Medical and Health sector since most of the Deaths and illnesses caused by disasters are preventable health risks. Though Disaster Management is the responsibility of every organization and institution, the Health Sector has a key role to play, as it is the lead sector. Hence, health personnel play a very important role in reducing disaster risks. This paper briefly examines the role and responsibilities of Medical and Health personnel and provides an overview of Emergency medical preparedness for reducing disaster risks. The concept of Disaster Medicine in dealing with the public health management of Disasters and Emergency Medical Preparedness, including the Prevention, Response, Relief and Rescue operations of Health Management while addressing various issues like casualty area management and Hospital Management etc through various strategies and actions will also be discussed. The Impact of Disasters on Health and how they can be best managed to reduce the number of mortalities and morbidities resulting from Disasters will be examined. The need for ensuring Community Participation in Health Management and prevention of health risk through Immunization and vaccination, proper food & nutrition, maintenance of hygienic and sanitation, adequate system of garbage disposal, Vector control and Research and Epidemiological studies will also be discussed. Prof. Bhaskara Rao, Mulam, Specialist, Policy, Planning and Related Issues, SAARC Disaster Management Centre (SDMC), New Delhi
(A233) Preparedness For A Mega Mass-Casualty Event (MMCE)
Authors: Blumenfeld A.
Published: May 2011

A Mega Mass-Casualty Event (MMCE) is a unique and exceptional event, that results in a very large number of casualties (500–5000) needing emergency care in the prehospital and hospital settings. This type of event usually goes beyond the capabilities of a certain region and requires reinforcement of resources from adjacent and remote regions. Due to its exceptional nature, a MMCE dictates a different organization of all emergency services and agencies involved. As a result of the recent experience, and in order to adequately prepare for such future events, a novel MMCE doctrine was developed by a committee of diverse emergency professionals. This doctrine was transferred to guidelines referring to MMCE recognition and the following series of actions that need to taken at all levels. It holds organizational, operational, and clinical aspects, as well as command and control elements. In November 2009, a large-scale drill of 1,000 mock casualties was performed in order to validate and evaluate the MMCE plan. This drill emphasized the need for the involvement of all pertinent emergency services and agencies, and their optimal collaboration and coordination, subjected to regional and national headquarters' command and control. In addition, the need for dedicated educational programs and o-going training was recognized. It was accepted that adequate planning is obligatory for better outcomes in the future.
(A235) Australian Medical Assistance Teams in Australia
Authors: Robertson A.G. , Leclercq M.G. , Poke S.
Published: May 2011

Western Australia (WA) was one of the first states in Australia to deploy medical team members to the tsunami-stricken regions of the Maldives and Banda Aceh in 2004. This early experience led the WA Department of Health to develop and pilot these teams locally and to progress a national model for their future development, which could be implemented further by other Australian jurisdictions. Further experience with these teams in Yogyakarta after the 2006 Java earthquake, Karratha after Tropical Cyclone George in 2007, Ashmore Reef after the 2009 boat explosion, Samoa after the 2009 tsunami, and during the Pakistan floods in 2010 have signaled both the utility of the Australian Medical Assistance Teams (AUSMATs) and the commitment by the Australian Commonwealth and State Governments to utilize these teams in both domestic and international settings. This presentation will examine the implementation of the AUSMAT model in Australia over the last five years, the modifications to the original model to suit the unique geographical and resource challenges faced by Australian teams, both within and outside Australia, and the lessons learned from recent team deployments. The challenges of delivering health care over vast, sparsely populated distances, and the inherent and increasing natural and industrial disaster threats in the Asia-Pacific region, have contributed to the modification of the model to ensure that the AUSMATs are flexible, modular, and capable of responding to a variety of major incidents. The national model continues to evolve to ensure that well prepared, equipped and trained civilian AUSMATS remain able to effectively deploy to a mass casualty situation in Australia's area of interest.
(A236) National Guidelines on the Management of the Dead after Disasters
Authors: Bhardwaj J.R. , Sachdeva T.S.
Published: May 2011

Despite technological advancements, India is vulnerable to disasters. Disasters of any etiology have the common denominator of a large number of deaths in a short span of time. Thus, the Administration is saddled with the indomitable task of retrieving and recovering dead bodies, then identifying them to enable the handing over of the remains to their next-of-kin. Initial media focus is often based on the myth that dead bodies cause epidemics. Therefore, bodies often are placed in mass burials or mass cremations universally, without being identified and without preserving the individuality of the deceased. This culminates into social, psychological, emotional, economic, and legal repercussions (financial compensation, property rights, inheritance, and issues of remarriage) regarding the legacy of the deceased, thereby exacerbating the damage caused by disasters. With the paradigm shift from the erstwhile response-centric approach after the enactment of the Disaster Management Act in 2005, to the holistic management of disasters, the National Disaster Management Authority embarked on the task of formulating the guidelines on this sensitive and vital issue. These Guidelines are designed to provide not only technical information, but also dwell on administrative aspects that will support the correct approach in handling dead bodies with the highest possible quality of standards/measures, and functioning in an interdisciplinary manner to ensure positive identification of victims. Management of the dead after disasters is under the ambit of the Incident Response System being incorporated in the National, State and District “all hazard” Disaster Management Plans are intended to achieve the desired aim that no unidentified body should be laid to rest.
(A239) Programa Hospital Seguro Y Unidad Médica Segura En México
Authors: Cruz Vega F. , Cruz Flores P. , Cruz Flores P.
Published: May 2011

El programa se estableció en el año 2006 dentro de la Coordinación General de Protección Civil de la Secretaría de Gobernación e incluye un Comité Nacional de Evaluación, Diagnóstico y Certificación integrado por todas las instituciones del Sector Salud Público, Privado y Social Se han acreditado cerca de 700 evaluadores de más de 2,700 que han tomado el curso. Se han realizado más de 1,700 autoevaluaciones y se han evaluado de 205 hospitales. En el marco legal se ha integrado el Programa Hospital Seguro en la Ley General de Protección Civil, se ha incluido en la Norma Oficial Mexicana que tiene relación con instalaciones de salud, se ha logrado el acceso al Fondo de Prevención de Desastres que maneja la Secretaría de Gobernación y se ha establecido que previo a la Certificación de Calidad del Consejo de Salubridad General (que incluye los criterios internacionales de la Joint Commission) sea evaluada como Hospital Seguro. De los hospitales calificados como no seguros ya se han evacuado dos (que serán demolidos) con alternativa de construir nuevos con alto nivel de seguridad. En un gran número de hospitales se han mejorado los sistemas de detección de incendios, rutas de evacuación y escaleras de emergencias, entre otros
(A240) Preparación De Hospitales De Alta Complejidad Ante Un Saldo Masivo De Victimas
Authors: Ruiz R.B. , Ramírez G.P. , Reyes F.R.
Published: May 2011

Objetivo

Preparativos de los “Hospitales de Alta Complejidad” ante la presencia de un evento con un saldo masivo de víctimas, dando una respuesta oportuna, eficiente y eficaz de los recursos, salvando al mayor número de víctimas y disminuyendo las secuelas.

Método

Se relata la experiencia de la Unidad Hospitalaria La Paz, (de Alta Complejidad) que atiende frecuentemente a saldo masivo de víctimas en la Ciudad de Puebla, Pue., México.

Desarrollo

La presencia de 2 o más pacientes críticos en una sala de urgencia normalmente ocasiona caos, disminuyendo la eficacia de sus recursos, aumentado la mortalidad y/o las incapacidades. Los hospitales que son clasificados por su mayor capacidad resolutiva como “Alta Complejidad”, que deben de recibir a las víctimas de prioridad I, (lesiones que ponen en peligro su vida de manera inmediata) destinando recursos mediante la preparación de un “Plan en caso de Desastre Externo” que contempla las acciones a desarrollar el antes, durante, y después del ingreso al hospital, cubriendo los criterios internacionales para dar atención a 100 víctimas de diferentes prioridades, iniciando con la realización del 1er. TRIAGE afuera de la sala de urgencias, arriba de la ambulancia, para corroborar o ratificar la clasificación prehospitalaria e ingresar o referir a las víctimas con prioridad I al área de reanimación inmediata en donde son atendidos por 5 a 6 médicos y enfermeras por cada 2 pacientes, resolviendo sus prioridades, posteriormente el jefe de cirugía realiza un 2do. TRIAGE para distribuir a las víctimas en las áreas de Cuidados Intensivos, Cirugía u Hospitalización con base a sus prioridades.

Conclusiones

El propósito es salvar al mayor número de víctimas en la atención de un saldo masivo de víctimas, realizando un “Plan en caso de Desastre Externo” mediante la organización del personal Médico, de Enfermería y Administrativo.
(A241) Impacto Socioeconómico Del “Huracán Karl” Sobre Instalaciones De Salud En Veracruz, México Con Una Población De 7 Millones 600 Mil Habitantes En Septiembre Del Año 2010
Authors: Cruz Flores P.
Published: May 2011

Impacto Socioeconómico del “Huracán Karl” sobre instalaciones de salud en Veracruz, México con una población de 7 millones 600 mil habitantes en Septiembre del año 2010 Resumen. El huracán Karl, decimotercer ciclón tropical de la temporada de huracanes en el Atlántico de 2010, se originó en el mar Caribe e impactó en la península de Yucatán como una tormenta tropical fuerte, hasta emerger al golfo de México donde se reorganizó gradualmente hasta alcanzar la categoría 3 (huracán mayor) en la escala de Saffir-Simpson e impactó la costa oriental de México el 17 de septiembre del año 2010. Preparativos. El 16 de septiembre, el Gobierno Federal, la Comisión Federal de Electricidad, la Central Nuclear Laguna Verde, la Secretaría de Defensa Nacional, la Secretaría de Gobernación y de Marina desplegaron elementos humanos y materiales para el auxilio a la población. El Sector Salud igualmente se preparó tomando las medidas convenientes bajo el concepto de Hospital Seguro de la OPS/OMS. Impacto En el estado de Veracruz (más de 7 millones 600 mil habitantes), el Huracán Karl tocó tierra cerca de las 11:30 am del 17 de septiembre a 15 km al norte del puerto de Veracruz alcanzando una potencia de 195 km por hora. Las lluvias torrenciales del fenómeno inundaron las calles y avenidas del centro histórico del puerto, alcanzando el agua de 40 centímetros a 1 metro de altura, hacia el sur del Estado y en zonas periféricas llegó hasta los 2 metros de altura. Provocó serios daños desde su inicio a la infraestructura de salud, como la suspensión de electricidad pública, daño al sistema de distribución de agua potable, ruptura de ventanales e inundación de un hospital así como de varias Unidades de Medicina Familiar.
(A244) El Riesgo De La Interrupcion
Authors: Saenz M.C.
Published: May 2011

Justificació n

El desastre deja de ser un momento de disrupció n en la cotidianeidad y quienes está n ante la coordinació n de gestió n de estrategias de respuesta son responsables de generar efectos no iatrogé nicos en la salud pú blica. La mayorí a de las catá strofes no son sorpresivas ni inmanejables. Observamos que la discontinuidad en las acciones genera desorden y mayor sufrimiento humano. Los costos de estas situaciones no son solamente econó mico- financieros, sino que generan pé rdida de vidas, bienes, desequilibrios psico-sociales, deterioro del medio ambiente y profundas crisis polí ticas y econó micas-financieras.

Metodologí a

Mejoramos en cada evento en el que se trabajo, la eficiencia y la capacidad de planificació n operativa con base en datos “ cientí ficos en el manejo de instrumentos especí ficos y evaluaciones rá pidas de dañ os.

Evaluamos

seis eventos trá gicos en el paí s, incendio, atentado, inundació n, guerra, en 10 añ os y el efecto de la evolució n de las acciones normatizadas y no interrumpidas para evaluar la eficiencia y la eficacia de las acciones no interrumpidas en estrategias de respuesta logí stica.

Conclusió

La contenció n psicosocial y evaluació n de los Recursos Humanos se impone como una tarea ineludible en la logí El rol del á mbito de la Salud y de la comunicació n es de fundamental importancia ante los impactos psicosociales previstos tragedia. Amenazas, riesgos y vulnerabilidades, recursos de acrecentamiento de la resiliencia deben estar contemplados en todo trabajo que busque disminuir el sufrimiento humano Gestionar la crisis era resolver lo caó tico, gestionar los riesgos es evitar lo caó tico. Programas “ help to help” la, consideració n de la Resiliencia, burn-out y stress se incluye en situaciones de emergencia y desastres. La discontinuidad del aprendizaje de estrategias de respuesta es iatrogé nica.
(A245) Le Secours À Personnes, De La Difficulté D'une Doctrine Unique
Authors: Bassetti J.
Published: May 2011

Il n'est pas d'hommes politiques ou de grands responsables qui ne souhaitent l'égalité du citoyen face aux agressions, chacun recherchant au travers d'une doctrine unique une réponse adaptée en tout point du territoire et chaque jour de l'année. Meme si les types de détresse ont évolué et le recours au centre d'appel est devenu habituel, demandant aux secouristes professionnels de s'adapter le vrai drame ou le chronomètre et les compétences sont essentiels, reste le challenge des services de secours. Mais comment, dans le panel des différentes formations techniques et des types de matériel, adapter dans une doctrine que l'on voudrait unique, une marche générale des opérations efficiente. Le secours á personnes que l'on pense réserver exclusivement aux professionnels de santé ne doit il pas être aussi la préoccupation du sauveteur citoyen. La premiùre minute reste essentielle, elle est quelque soit le type d'agression de la responsabilité du premier maillon de la chaine du premier témoin sur les lieux. Alors doctrine unique, difficile, utilisation des compétences, surement. Un code des bons gestes á effectuer au bon moment au bon endroit semble capital, un référentiel sur les responsabilités de chacun indispensable et l'égalité des chances un objectif.
(A246) Secourisme Aux Permis De Conduire: Quel Programme Retenir?
Authors: Lauwick P.
Published: May 2011

La réalisation de gestes de secours adaptés par le premier témoin diminue la mortalité et réduit les séquelles pour les survivants après accident et détresse vitale. L'Académie Nationale de Médecine Française a souhaité, dans un rapport adopté en juin 2010 une systématisation des obligations de formation de la population au secourisme, soulignant le retard de la France en la matière. L'Automobile Club Médical de France (ACMF) souhaite rebondir sur la dynamique induite par ce travail afin de concevoir un programme spécifique de premiers secours aux accidentés de la route. Il souhaite une généralisation rapide de son enseignement à tous les candidats aux permis de conduire. L'objectif d'avoir lors de chaque accident du trafic un premier témoin capable de maintenir la survie des victimes en attendant l'arrivée des secours professionnels est clair. Le contenu de cet enseignement et les modalités pédagogiques sont en cours de réflexion par un groupe réuni à l'initiative de l'ACMF. Cette proposition sera soumise à l'observatoire national du secourisme en charge de la validation des contenus. La séquence de formation ainsi retenue aura vocation à devenir le module de base pour la formation des usagers de la route, à l'image du module “Alerter-Masser-Défibriller” dans le domaine de l'urgence cardiaque. Nous présenterons donc les principales causes et les statistiques estimées de morts évitables par l'intervention des premiers témoins.Puis nous décrirons les gestes réalisables par tout citoyen formé: alerte rapide et adaptée, prévention des sur-accidents, libération des voies aériennes supérieures, arrêt des saignements visibles. Ce programme sera une formation courte, pratique et gestuelle.
(A247) Infirmier Pompier
Authors: Iacino J.
Published: May 2011

Infirmier Pompier L'infirmier sapeur pompier est aujourd'hui en France un maillon fort de l'organisation des secours. Originaire d'exercices très variés, il dispose d'une culture commune aux sapeurs pompiers mais aussi á ses collègues infirmiers sur l'ensemble du territoire. Doté de moyens performants il arrive en renfort de ses collègues secouristes rapidement sur les lieux des détresses mais aussi prend une part active dans l'ensemble des missions qui leurs sont confiés comme la médecine d'aptitude, le soutien sanitaire, la médecine préventive. Il est au centre d'un réseau complexe, aidé par tous les outils des nouvelles technologies de communications disponibles et l'avancée de la télémédecine. Acteur incontesté des secours de proximité, il a néanmoins mis de longues années avant de trouver sa place et n'est á ce jour que difficilement accepté. Incompréhension, méconnaissance, absence d'explications, les ë képis noirs Â / voient en cet officier un parvenu qui n'a pas mérité ses galons. Mais savent ils réellement ce qu'il en est ? Comme á l'hôpital, l'infirmier doit savoir tout faire, sans faire tout. Il doit se limiter á des règles professionnelles dictées par le bon sens médical mais aussi par le corporatisme important enclin chez nous. L'infirmier, un acteur aux multiples facettes mais au seul uniforme.
(A251) Factors of Diarrheal Outbreak, Bihar Floods-2008
Authors: Gupta S. , Kumar A.
Published: May 2011

Flood is one of the most common disasters and contributes to many-disaster related deaths worldwide. According to the EM-DAT database, floods account for 38.7% of all incidences, 6.2% of the deaths and every year 43% of world population is affected by flood. There are various factors which magnify the impact of flood to the community in the catchment area. The nature and extent of the flood is determined by the physical location and topography, and by the built environment. The built environment comprises of the existing political, social and economic structures inherent in a community. In the post-flood period, the risk of diarrhoea is significantly higher for those with lower educational level, living in a household with a non-concrete roof, drinking tube-well water (vs. tap water), using a distant water source and unsanitary toilets. The 1998 Bangladesh flood study confirms that low socio-economic groups and poor hygiene and sanitation groups are most vulnerable to flood-related diarrhoea (Annya et al., 2010). The Bihar flood of 2008 affected 100 villages out of which Supaul, Araria, Saharsa, Madhepura and Purnea were the most severly affected districts. Nearly 2.5 million people were affected by the floodwater. Various disease outbreaks are a common phenomenon in a post flood scenario. In Bihar, the population witnessed outbreaks of malaria, diarrhoea, measles and cholera. This paper examines the various factors causing diarrhoeal spread in the five flood affected districts of Bihar. Also, the paper analyses the above factors in terms of most contributing and least contributing factor towards diarrhoeal outbreak. The methodology used for the study is the statistical tool of Standard Multiple Regression Analyses where several independent variables will predict the dependent variable. The various independent variables have been taken all the five affected districts in Bihar floods. They are malnutrition, population density, awareness levels, socio-economic conditions, literacy, extent of flood and availability of health facilities. These independent variables will determine how much each predicts the dependent variable and as a result help in analysing the linear relationship between the dependent and independent variables.
(A255) Medication Preparedness during Wildfire Evacuations
Authors: Mayner L. , Stratton S.J.
Published: May 2011

Introduction

During wildfires, many are evacuated with little time to collect personal items. Evacuees who depend on daily medication for ongoing medical conditions often arrive to evacuation shelters without medication and with little knowledge of what they require. This problem is reported for evacuees in the 2008 Orange County California (USA) Freeway Triangle Wildfires.

Methods

Data was obtained retrospectively from Orange County Health Care Agency records regarding people who required medication while housed in evacuation shelters. Descriptive data was analysed using SPSS 17 and STATA 11.01.

Results

40,000 persons were evacuated during the wildfires. Sixty of the evacuees aged from 6 to 82 years were without necessary medications. Of the sixty, there were 26 females and 34 males. People requiring medication would present to a public health nurse in the shelter whom would contact the Disaster Health Officer to arrange scripts for medication. Of the 60 people, 67% were unable to contact a primary physician and 75% were able to be issued a script for needed medication. The most common prescribed medication was albuterol for asthma and lung disease, then narcotic pain relief medication and next medication for cardiovascular / hypertension conditions.

Conclusions

Results show that life sustaining medication was required by people housed in an evacuation shelter. These people may not have had time to retrieve necessary medication if they had to evacuate quickly or may not have had an adequate supply of medication at the time of evacuation. Thus far there has been very little published on this issue however, our results show there is a need for pre-planning on behalf of people living in wildfire prone areas who require daily medication and are at risk for sudden evacuation. Our findings also highlight the important role provided by health workers in evacuation shelters in providing assistance for medication purposes.
(A259) Objective Triage in the Disaster Setting: Will Children and Expecting Mothers be Triaged Like Others?
Authors: Kouliev T.
Published: May 2011

Introduction

The study of disaster triage is made difficult by the complex emotional response of potentially lifesaving intervention that a triage officer must make decisions based on a succinct and efficient algorithm.

Methods

We designed a survey of triage professionals in Chicago, Philadelphia, and Beijing to identify sources of emotional bias that lead to failure of the START triage protocol that result in a lack of correlation between triage priority and clinical outcomes.

Results and Conclusions

Among our subjects, we observed that a pediatric victim is uniformly overtriaged when compared to less injured victims. We examine the possible reasons behind the consistency of this selection, explain the means we used to minimise bias, and propose avenues for further research and clinical implementation of better triage systems and guidelines.
(A274) Mass-Gathering Event Risk Scoring Model: A Score to Predict Risk Level and Medical Usage Rate during Metropolitan Mass Gatherings
Authors: Revello A. , Marzio A.
Published: May 2011

Background

During the planning phase of a mass gathering, it is important to organize the most suitable healthcare responses to assure primary, emergency, and major accident care, with the best balance between available resources and costs.

Objectives

This study tries to develop a Mass-Gathering Event Risk Scoring Model (MGE-RS) to predict Medical Usage Rate (MUR) that can assist emergency medical services providers in planning for mass gatherings across a variety of events and venue types in a metropolitan area.

Methods and Results

This study includes 48 mass gatherings in Rome (35 mass gatherings; 2005–2006) and Milan (13 mass gatherings; 2009–2010). All 35 mass gatherings in Rome had > 100,000 attendees (100,000 to 5,000,000), while the 13 mass gatherings in Milan had a median of 100,000 attendees (50,000–200,000). The median patient presentation rate (PPR) was 0.5 patients/1,000 persons: this rate is close to PPRs for mass gatherings reported in the literature (0.5–2.0 patients/1,000 attendees). For each event, the predicted MURs, calculated using the Arbon Model and the MGE-RS Model, were compared with the actual MUR. The MGE-RS scoring model uses a formula that assigns points based on known information (type of event, place, duration, crowd, health system facilities) to predict the risk. The MGE-RS score ranged from 16 to 77. There are five risk levels, each one corresponds to an expected MUR from 1.5 to 45. In the events studied, the predicted MUR calculated with the Arbon model corresponded in 60% of cases (20% under/overestimation); the MGE-RS was in range in 88% of cases (0% underestimated; 12% overestimation).

Conclusions

The MGE-RS seems to be a provider-friendly tool to be used in planning phase, and is able to give an acceptable estimation of the risk level and expected MUR for a mass gathering, without underestimating the estimated MUR during the planning phase.
(A280) Safety of Rural Hospitals during Flood: A Case Study on Begusarai District of Bihar, India
Authors: Chatterjee R. , Nisha D.
Published: May 2011

Introduction

India is one of the most flood prone countries in the world, flooding annually about 9 million hectares and accounting for one-fifth of global flood deaths. Approximately 56.5 % of flood-affected Indians live in Bihar. Out of 38 districts in Bihar, 22 are flood prone, including Begusarai. The life line to the community is the Primary Health Center (PHC) which is at stake during a disaster such as floods.

Methods

To study the status of primary health care in rural parts of Begusarai during recurring floods, a survey was undertaken to analyze the preparedness and response mechanism at various hospital levels. The status of rural hospitals during a flood was represented by a case study on the PHC of Bakhri block of Begusarai district. To determine the prevailing situation during floods, the chief medical officers of each level of health care centers were interviewed.

Results

The PHC of Bakhri caters to a population of about 408,896, which is four times the normal load for a PHC. In 2007, it was affected severely by flooding from the Baghmati River. The PHCs that were studied perennially face a shortage of human resource and infrastructural support. This is compounded by unsafe locations and structural hazards associated with the hospital building, rendering the working conditions unsafe for the medical team during disasters.

Conclusion

This paper envisages the functionality and challenges of healthcare providers during floods despite their limited available resources. The prevailing case scenario demonstrates the challenges in rural India, and the best practices for safe rural hospitals in coping with disasters in a resource-poor setting will be discussed.
(A281) Protecting and Preparing Critical Hospital Infrastructure — Redundancy, Security, and Disaster Response
Authors: Robertson A.G. , Leclercq M.G. , Wilkinson C.
Published: May 2011

Western Australia (WA) currently is undergoing a major rebuild of its key metropolitan and regional hospitals, with the planned construction of a major tertiary hospital, pediatric hospital, and several large general hospitals in the metropolitan area, and a range of small and medium size hospitals in WA over the next five years. Protecting these hospitals from major internal failure and external assault, while preparing them to cope with mass casualties, has been a major focus of the WA Department of Health over the last five years. This program has involved capital investment in current infrastructure, including critical asset protection, and detailed planning to ensure that the new health infrastructure will have both the redundant systems, to allow for continued operations in a range of infrastructure failure and disaster scenarios, and the facilities to deal with a mass-casualty incident. This presentation will review the implementation of this critical infrastructure program, the evolving issues facing hospitals working to ensure their continued operations in a range of scenarios, the security and infrastructure threats facing major hospitals, and the planning required to ensure that these threats are addressed at an early stage of hospital development. Issues as diverse as the placement of underground garages to minimize bomb threats, the location of helicopter landing pads, and the consideration of how to lock down hospitals to prevent the uncontrolled access of contaminated patients, are some of the challenges that need measured consideration and a planned response. The preparations and planning for such contingencies, and the infrastructure to facilitate continued operations and an appropriate disaster response, are key elements in protecting critical health infrastructure.