bluuebunny/crossref_metadata_2025 huggingface dataset:
Foot Injuries at Music Festivals–One of the Most Common Presentations to On-site Medical Services
Authors: Munn Matthew , Hanrahan Page , Mema Silvina
Published: June 2023

Introduction:

Foot injuries are a common patient presentation at music festivals, and are resource-intensive patient encounters by virtue of their comparative volume. There are no published accounts devoted to these ubiquitous, typical, predictable festival injuries leading to presentation to on-site medical services for treatment.

Method:

A retrospective chart review was performed of visits to medical services for first aid or medical care involving feet at a multi-day music festival in Canada. Data extracted included demographics, injury characteristics, and type of footwear. Encounters were classified as initial or repeat visits, and repeat visits were assessed for having had previous dressings applied.

Results:

Over the five day festival period, foot care visits accounted for 416 of 1129 (37%) patient presentations for minor care. Most common injuries were blisters (51%), ankle sprains (10%), lacerations (8%), abrasions (6%), and bug bites (6%). Footwear was reported as shoes (28%), shoes and socks (28%), flip-flops (19%), sandals (28%) and bare feet only (5%). The most common blister sites were toes (48%) and the posterior heel (17%). 12% of cases were repeat visits, and 50% of repeat visits were for dressings failure.

Conclusion:

Foot injuries make up a significant portion of presentations, and often re-presentations, to medical services at music festivals. Preparation for these common injuries should include (1) a dedicated and purposeful bandage selection and supply, (2) provider training in best foot care practices, including bombproof, danceable dressings, and (3) educational resources to inform attendees of risks and provide preventative upstream measures that might allow them to avoid injury.
The Role of Nurses in the Reclassification Exercise of the Japan Disaster Relief Search and Rescue Team (the JDR Rescue Team)
Authors: Ohyama Futoshi , Minamida Teppei , Oishi Saori , Yamaguchi Naoki , Sakamoto Yoshiko , Takekawa Reiko , Hirokawa Masahito , Akamatsu Yukiko , Yamasaki Noriko , Sung Junho , Takahashi Mirai , Takami Hiroki , Sakamoto Taigo , Ihara Noriyuki , Inoue Junichi
Published: June 2023

Introduction:

The JDR Rescue Team has successfully completed the INSARAG External Re-Classification (IER) process, which evaluates the operational capability and capacity of Urban Search and Rescue (USAR) teams and has achieved the highest “Heavy” reclassification in November 2022. Two nurses participated in the IER process as part of the medical unit of JDR Rescue Team. In addition, ten registered nurses cooperated as Exercise Control (EXCON).

Method:

Summarize the JDR Rescue Team and medical unit and make observations on what nurses did in the IER.

Results:

The JDR Rescue Team is dispatched by the Government of Japan in response to large-scale disasters overseas. The task force team has 75 members from various specialties, including the rescuer, and medical unit. The medical unit consists of one medical manager, 2 doctors, and two nurses. There are currently about 50 registered medical unit members in our team, and of these, a total of 23 nurses are registered. The role of nurses during the IER process, includes a 36-hour non-stop scenario-based exercise. The team nurses are involved in various roles, such as Confined Space Medicine (infusion for patients, assisting on-site amputation), caring or treating injured rescuers and search dogs, providing health and welfare monitoring and operating a decontamination system. The EXCON nurses were involved in managing the simulation. One of their key roles was to play as a victim realistically so as to provide a sense of tension for the simulation.

Conclusion:

The JDR Rescue Team has more medical unit members than those in other countries. In particular, teams with so many nurses are rare. nurses played a vital role in this IER. The contribution of nurses is identified in order to make the international USAR team more strong and more flexible.
Thicker Posterior Subcutaneous Adipose Tissue (SAT) and Slighter Difference of SAT During the Peri-arrest Period are Associated with Favorable Neurological Outcomes at Hospital Discharge in Patients with In-Hospital Cardiac Arrest
Authors: Zhou Tingyuan , Cao Yu
Published: June 2023

Introduction:

Subcutaneous adipose tissue (SAT) and bony thorax will deform and conduct driving force during cardiac arrest (CA). The association between short-term prognosis and deformation of adult thorax for patients acquired return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR) was unclear.

Method:

Clinical records and CT images were collected from eligible patients admitted to the hospital who received CPR and achieved sustained ROSC from May 31st, 2019 to June 30, 2021. The patients were divided into different groups according to discharge outcome, then into three subgroups according to the ventilation mode before and after CPR. After that, patients with the same ventilation mode before and after CPR are combined and analyzed.

Results:

Records from 1663 patients were reviewed. After selection, 70 patients were included into this study. Significantly thicker posterior SAT post-compression was found at the 7/8/10/11 spinous process plane in patients with favorable neurological outcome (p<0.05). For patients receiving same kind of respiratory support before and after CPR, significantly thicker posterior SAT pre-compression at the 6/7/8/9/10/11 spinous plane and thicker posterior SAT post-compression at the 7/8/9/10/11/12 spinous plane (p<0.05). For patients without mechanical ventilation before or after CPR, significantly thicker posterior SAT post-compression was found at the 10/11 spinous plane in patients with favorable neurological outcome (p<0.05). For patients receiving mechanical ventilation before or after CPR, thicker posterior SAT post-compression was found at the 10/11/12 spinous plane was associated with favorable neurological outcome. No difference was found in the bony thorax within a different vertebral plane after subgroup analysis (p>0.05).

Conclusion:

Thicker posterior SAT and greater SAT depth difference after compression was associated with favorable neurological outcome at the discharge of patients who obtained ROSC after CA. A shorter duration of chest compression (<6 minutes) doesn’t cause calculable changes in patients’ bony thorax in patients who obtained ROSC after CA.
Updated Comprehensive Framework for Disaster Evaluation Typologies
Authors: Wong Diana , Dam Jacqueline Van
Published: June 2023

Introduction:

The Comprehensive Framework for Disaster Evaluation Typologies (CFDET) was originally developed in 2017 with minor updates in 2018 (CFDET2.0). CFDET was created to unify and provide agreement on the identification, structure and relationships between multiple evaluation typologies found in the disaster setting. Since the publication of this framework, the world has witnessed unprecedented disaster-related events including two (2) Public Health Emergencies of International Concern (PHEIC): COVID-19 and Monkey Pox as well as the emergence and continuation of armed conflict in various countries around the world. This work presents CFDET3.0 which incorporates updates on international disaster frameworks, disaster health updates and evaluation guidelines.

Method:

A scoping literature review on international disaster frameworks, disaster health updates and evaluation guidelines has been undertaken and included reviewing peer-reviewed and grey literature.

Results:

The scoping literature review revealed updates on the following important publications:

World Health Organization (WHO) Health Emergency Disaster Risk Management (H-EDRM) (2019);

International Health Regulations;

Universal Health Coverage (UHC);

Climate Change Conference (COP27);

Fragile and Conflict-affected Contexts (FCAC);

Public Health Emergencies of International Concern, and

Updated evaluation standards, guidelines, evidence-based reviews and knowledge management.

Conclusion:

Incorporation of these international updates into CFDET2.0, strengthens global health and international disaster health responses with a focus on disaster health evaluation. The updated framework will be referred to as CFDET3.0. Future research is scheduled to develop a series of toolkits that will support an improved disaster evaluation process.
Implementation of Hospital Disaster Preparedness and Response Plan in Nepal: A Mixed Study in 3 Public Hospitals of Nepal
Authors: Singh Prinka , Lamine Hamdi , Eriksson Anneli
Published: June 2023

Introduction:

Considering the need for hospital disaster preparedness post-Nepal earthquake 2015, the Ministry of Health and Population of Nepal developed a Hospital Disaster Preparedness and Response Plan (HDPRP) for mass casualty management. However, until now, there is no scientific literature on how the district hospitals, which are the major health service providers in Nepal, implemented their HDPRP during mass casualty incidents (MCIs). So, this study aims to understand how the HDPRP was implemented during MCIs in three district public hospitals of Nepal.

Method:

A mixed sequential QUANT-QUAL study was designed. Out of seven districts under the severely hit category by Nepal Earthquake 2015, three districts were selected randomly. For the quantitative component, the WHO hospital emergency response checklist was adapted which was self-administered in each hospital. Based on a scoring system, each hospital was placed in one of three categories (effective, insufficient, unacceptable), to assess the level of HDPRP implementation. For the qualitative component, semi-structured interviews were conducted to understand how the HDPRP was implemented in each hospital. An inductive thematic analysis was carried out. All information was collected for the most recent management of MCI reported in the hospital.

Results:

Out of three hospitals, two hospitals have effectively implemented their HDPRP, whereas one has insufficient implementation. Three themes emerged during the data analysis: enablers in implementation of HDPRP, barriers in implementation of HDPRP, and recommendations for the future. Multiple enablers and barriers were identified for the implementation of HDPRP, and the recommendations were identified for the hospital, hospital staff, and external stakeholders.

Conclusion:

Implementation of HDPRP as per the protocol is difficult due to many external and internal factors that arise while managing the MCIs. The findings of this study provide the basis for the Ministry of Health and Population and district hospitals for the future update of HDPRP and planning of MCIs.
Significance of the “Coordination Headquarters for Healthcare and Medical Support” in Japan; comparison with Emergency Medical Team Coordination Cell (EMTCC)
Authors: Nakamori Tomoki , Toyokuni Yoshiki , Kondo Hisayoshi , Kubo Tatsuhio , Koido Yuichi
Published: June 2023

Introduction:

The Japan Disaster Medical Assistance Team (DMAT) was established in 2005. Although it had become possible to gather medical teams at an early stage in the fields of health and welfare, there had still been a lack of personnel. In 2017, the Japanese government decided to establish the Health and Medical Coordination Headquarters when we had major disasters. Not only the medical team, but also the public health nurse and the welfare team gathered at this headquarter, and activities that integrated health, medical care, and welfare started from an early stage. On the other hand, WHO indicates to establish EMTCC within the Ministry of Health, in order to manage and coordinate EMT activities and aggregate data.

Method:

The Japanese Headquarters and the EMTCC were compared in terms of their functions and issues.

Results:

In Japanese headquarters, the director of the local public health center will be the director, and the secretariat for the headquarters will be run by supporters. Participants in the headquarter meeting include leaders of public institutions involved in health risk management. Furthermore, leaders of unions such as medical, dentist, pharmacists and nurses on the side of supporters, leaders of medical, healthcare, and welfare will participate. To establish EMTCC, WHO dispatches a coordinator, information manager, and data analyst.

EMTCC collects medical information by using Minimum Data Set (MDS), which is similar to Japanese Surveillance in post extreme emergencies and disasters (J-SPEED). The most significant difference is that EMTCC does not deal with health and welfare issues.

Conclusion:

Regarding medical care, information is summarized in a similar way at headquarters. These facts indicate the Japanese headquarters management experience is applicable to EMTCC.
Web-Based Multistate Disaster Rehearsal of Concepts Exercises
Authors: Little Charles , Noll Samantha , Nielsen Brianna , Ellen Steve , Nally Britta , Persson Carolyn , Price Connie
Published: June 2023

Introduction:

The Mountain Plains Regional Disaster Health Response System (Mountain Plains RDHRS) works to build disaster capacity across US Federal Region VIII, a rural western six-state region. It conducts an annual rehearsal of concepts and exercises to identify gaps and inform policy development. In 2022, a multi-state exercise was conducted involving responders from individual hospitals coordinating with Healthcare Coalitions and State Public Health. These responses rolled up to a multi-state emergency operations center overseen by the Mountain Plains RDHRS.

Method:

A fictitious mass multi-state botulism incident generated a pediatric surge across the region. Individual patient cards with demographic information were given to a set of hospitals in participating states. The communication pathways within states were identified. Communication between local and regional pediatric transfer centers were assessed. Overall situational awareness was tracked.

The exercise format was incident occurrence and notifications by normal channels and a Zoom conference call held on day one. Situational awareness and patient movement occurred in multiple Zoom rooms on day two. An after-exercise review occurred by Zoom on day three including all participants from the exercise.

Results:

There was generally good information flow within states, but minimal information exchange across states There was poor regional situational awareness with a lack of complete patient lists and transfers. The Mountain Plains RDHRS planned to exceed the hospital’s patient capacities with a large number of pediatric patients to practice patient movement across state lines. Instead the hospitals showed a surprising willingness to keep and manage critical pediatric patients instead of transferring to tertiary care pediatric centers. This was identified as a consequence of the COVID-19 experience.

Conclusion:

Web-based exercises vertically spanning responses from individual hospitals to multi-state regional entities are feasible. This exercise demonstrated multiple gaps in regional disaster response.
Public Conformism with Health Regulation is Crumbling as COVID-19 Becomes a Chronic Threat – A Cohort Study
Authors: Bodas Moran , Wine Leora
Published: June 2023

Introduction:

Three years into the COVID-19 pandemic, experience and studies have shown that public behavior significantly contributes to the disease spread increase or reduction. As the pandemic becomes a chronic threat, maintaining public trust to comply with health regulations proves challenging as people develop pandemic fatigue. This study aims to analyze the long-term trends in public attitudes toward the COVID-19 pandemic and compliance with health regulations.

Method:

A longitudinal cohort study was performed from February 2020 until January 2022, collecting data from nationally representative samples (N=2,568) of the adult population in Israel. Data Collection was timed with the first five morbidity waves of the COVID-19 pandemic. We examined public trust in Israeli health regulations, public panic, worry, and compliance with health regulations, particularly self-quarantine.

Results:

The data shows that public trust in health regulations in January 2022 is at an all-time low (25%) compared to the maximum value measured in March 2020 (~75%). The perceived worry from COVID-19 is steadily declining, whereas the perception of public panic is increasing as the pandemic progresses into a chronic threat. While public compliance with self-quarantine was reported to be close to 100% in the early stages of the pandemic, it has dropped to 38% in early 2022, mainly when compensation for lost wages is not offered. Regression analysis suggests that trust is a significant predictor of compliance with health regulations.

Conclusion:

The findings, spanning more than two years of the pandemic, highlight the importance of maintaining public trust as a significant driver of public compliance with health regulations. The "fifth wave" of the pandemic resulted in an all-time low in public trust. The Israeli public, usually highly compliant, shows signs of crumbling conformity. Decision-makers ought to consider means to foster public trust.
Evaluating the Effect of Brief Disaster Education on Emergency Department Staff: Can Short, Low-cost Education Improve Disaster Readiness of Non-DMAT Healthcare Personnel?
Authors: Moon Sungbae , Kim Jung Ho
Published: June 2023

Introduction:

Some incidents require early deployment of emergency department personnel not designated as disaster medical assistance team (DMAT). Although not as trained as DMAT members, they should be aware of basic disaster response concepts and knowledge. Educating disaster readiness to every healthcare staff in emergency departments would be ideal but it is very costly in both time and expense. To overcome this problem, we tried to evaluate the effectiveness of teaching basic concept and knowledge to non-designated personnel in a short-session and measure the effect.

Method:

This study is a before-and-after comparison study. From July 2020 to July 2022, a two-hour education was given to volunteers among doctors, nurses, paramedics and administrative staff working in emergency departments across four hospitals in Korea. Educational sessions consisted of basic disaster concept, pre-deployment DMAT preparations, initial actions required on incident site, key elements of incident response (command, control, safety, communication), and triage. Attendees were given a pretest before the session and another test after the session. Chi-square test and Wilcoxon rank test were used to compare the results.

Results:

Total of 105 volunteers participated in the study. Participants were mostly nurses (62.9%) followed by paramedics (23.8%). Overall knowledge level reported to be increased, including knowledge regarding DMAT deployment (29.5% to 93.3%, p<0.001), DMAT personnel (26.7% to 94.3%, p<0.001), DMAT-designated equipment (23.8% to 60.0%, p<0.001), initial response (27.6% to 69.5%, p<0.001) and patient transport priority (74.3% to 94.3%, p<0.001). Questions testing triage and rate of participants answering every question showed improvement with post-test median score of 67% and rate of 1.0% to post-test median score of 100% and rate of 35.2%, respectively (both p<0.001).

Conclusion:

Educating non-DMAT personnel in emergency departments with a short session showed significant improvement in basic knowledge of disaster response. It may help institutions with limited resources.
The WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (Health EDRM RN)
Authors: Kayano Ryoma , MacDermot Makiko , Huda Qudsia , Chan Emily , Murray Virginia , Abrahams Jonathan
Published: June 2023

Introduction:

WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (Health EDRM RN) is a global expert network, launched in 2018, aiming to strengthen the scientific evidence for managing health risks associated with all types of emergencies and disasters, and to foster global collaboration among academia, government officials and other stakeholders. The Health EDRM RN’s activities are in line with WHO Health EDRM Framework, which support Sendai Framework for Disaster Risk Reduction 2015-2030.

Method:

Health EDRM RN’s strategic direction is discussed and advised by its Core Group that consists of focal points of WHO HQ responsible unit, all six Regional Offices, WHO Center for Health Development (Secretariat), RN co-chairs, and key external stakeholders. Based on the strategic direction, the Secretariat facilitates global, regional, and local collaborative activities with the RN participants and partners. As of 2022, over 250 global experts participate in the network.

Results:

Following the results of the Core Group Meeting in 2019, 2020 and 2021, multiple activities and results were generated including the identification of five Health EDRM key research areas. WHO Guidance on Research Methods for Health EDRM developed in collaboration with over 150 global experts, initiation of the project to establish WHO Health EDRM Knowledge Hub for developing WHO Health EDRM Research Agenda and aligning with UNDRR research agenda on thematic areas including developing a special supplement on mid-term review of Sendai Framework implementation in health. The 2022 Core Group Meeting, held on October 27, 2022, agreed to promote knowledge dissemination and implementation research for better outputs for regions and countries.

Conclusion:

WHO Health EDRM RN will continue its unique function as the platform of global experts and stakeholders to produce, disseminate, and apply knowledge. Participation and engagement by more and broader experts are expected.
Trauma Skill Stations to Improve ED Staff Confidence and Engagement
Authors: Sery Amanda
Published: June 2023

Introduction:

Particular skills are critical when participating in trauma response. Engagement and practice with these skills can help build staff confidence, however, ensuring competency across all staff can prove challenging. Establishing a training utilizing skill stations can positively affect staff experience and confidence measures on predetermined dates to capture all team members is a way to ensure confidence in skills vital for patient care in ED settings. Execution of the “skill station” exercises at measured intervals demonstrated improved confidence in trauma skills by ED staff. Exercises with specific skill-oriented practicum offer low-cost, dynamic training opportunities. Improving confidence and competence in critical trauma-related clinical skills directly improves patient outcomes.

Method:

Six trauma skill stations were created, aimed at specific skill-based practices. These measured skill competencies include arterial line setup, rapid blood infuser use, defibrillator use, chest tube management, pelvic binder application, and tourniquet application. Competency was reached when participants could effectively perform the skills through teach-back technique.

Results:

Qualitative feedback demonstrated that nurses felt more confident responding to a patient needing trauma interventions in an ED setting. Nursing staff were more engaged with trauma skills in their scope. All participants were able to appropriately and adequately teach-back the skill with 100% accuracy. Improved knowledge retention will be measured in future training sessions.

Pre and post-tests could be utilized to demonstrate more dynamic results. This measurement tool will be utilized in the formal training process moving forward to capture baseline and improvement data more objectively.

Conclusion:

This low-cost and highly efficient method of strengthening novice nurses’ trauma skills competency and confidence can be utilized across various skills and departments. More confident nurses show improved readiness to respond to a patient in need of trauma interventions.
Global Burden of SARS-CoV-2 on Health Care Workers’ Mortality and Morbidity
Authors: Wong Diana , Rumsey Michele , Heslop David
Published: June 2023

Introduction:

Unfortunately, before SARS-CoV-2, a global workforce crisis in health care had already been flagged internationally and is only expected to grow. Health care workers are the critical driving force underpinning all health systems. A skilled workforce takes years to develop, and staff shortages have enduring negative impacts on patients, patient safety, and the ability to deliver Universal Health Coverage.

Method:

A scoping literature review on health care worker mortality and morbidity resulting from SARS-CoV-2 was undertaken and included reviewing the peer-reviewed and grey literature.

Results:

Four opportunities for improving the protection of health care workers during a pandemic were identified:

1)

Strengthening data collection and reporting standards of health care worker mortality and morbidity due to SARS-CoV-2

2)

Improving the protection of health care workers

3)

Accelerating the vaccination of health care workers against SARS-CoV-2, and

4)

Addressing gender inequities in health care

These four approaches provide opportunities for improvement and are only preliminary steps in addressing the ‘perfect storm’ that the shortage of global health care workers and the ongoing SARS-CoV-2 pandemic have created.

Conclusion:

The global community has a unique opportunity to protect health care workers and improve pandemic preparedness and response. The health and socioeconomic impact of SARS-CoV-2 has been unprecedented, and health care workers have borne the brunt of this pandemic. We owe our health care workers more. Without a well-trained and adequately resourced health care workforce that is prepared to face the next pandemic, we as a global community will not be able to deliver global health care or global security at the level that is required.
From Two hours to Two Seconds: Using the Red Cross Red Crescent Health Information System (RCHIS) to Complete the WHO Emergency Medical Teams - Minimum Data Set Reporting
Authors: Clarke Lauren , Holl Felix , Archer Laura , Raffort Thomas , Serres Elvire , Saaristo Panu
Published: June 2023

Introduction:

Standardization of data collection and reporting within EMT’s is challenging. In past deployments, the Red Cross Red Crescent Type one and two facilities (Emergency Response Units- ERU’s) have collected data by hand using paper-based form and Excel spreadsheets. This process can be laborious, time consuming and often inaccurate.

Method:

RCHIS is both an electronic medical record (EMR) and health information system (HIS). RCHIS has been designed to produce pre-made reports including the MDS in seconds extracting data from the patient records. Through significant testing and pilot deployments in a domestic type one fixed clinic, the rapid production of reports such as the MDS has increased compliance and accuracy with reporting.

Results:

The utilization of an EMR and integrated HIS system for increasing compliance and accuracy with the MDS has been hugely successful. An in-depth analysis of the export data was done to confirm the 100% accuracy within the MDS report.

Furthermore, feedback from users and managers within the ERU’s expressed the excitement for the ease of reporting not only to the EMTCC, but also to IFRC and back-donors. Moving forwards, this data collection will also be used to collect essential data to audit and improve the quality of care provided within the RCRC ERU’s.

Conclusion:

In conclusion, the utilization of RCHIS within a domestic ERU (equivalent to an EMT type one or two) has been hugely successful. The next steps will involve the deployment of RCHIS within an international deployment.
Emergency Management Risks in MEM Region South–An Operational Perspective
Authors: O'Brien Cian , Fitzgerald Mary Rose , Cheung Aoife , O'Sullivan David
Published: June 2023

Introduction:

Distilling from the National Risk Assessment for Ireland, the Regional Working Group for Major Emergency Management Region South (Cork and Kerry) assessed threats in the region and 22 hazards were identified which were distributed over the natural, transportation, technological and civil categories. The hazards were plotted on an Interagency (Health, Police and Local Authority) Emergency Management Risk Matrix

Method:

A three-hour ‘Introduction to Emergency Management’ educational program was developed in May 2022 with the aim of introducing frontline members of the Principal Response Agencies (Health, Police and Local Authority) across the Cork and Kerry region to the concept of emergency management. As part of this educational session, participants (N = 55) were given an overview of the regional risks as identified through the risk assessment process by the Regional Working Group for Major Emergency Management. As part of a breakout session, course participants were asked to identify their perspective on ‘worst case scenario’ risks.

Results:

An analysis of the operational risks identified by members of the Principal Response Agencies (Police, Health and Local Authority) were categorized into the four risk sub-headings: natural, civil, technical and transport and compared with the strategic regional risk assessment. The differences identified based on the comparative analysis, detailed that those holding operational portfolios identified that concurrent risks, as evidenced during the Cyberattack on the Health Service Executive in May 2021 during a wave of the global pandemic in Ireland were a perceived 'greater' risk that those traditional risks identified in the regional risk assessment.

Conclusion:

This study highlights the importance of engaging operational staff when developing regional emergency management risk assessments. The requirement to consider and incorporate concurrent emergency management risks is vital to ensure that the Cork and Kerry regions are prepared for future events.
NO FEAR Project–Re-thinking Scene Security
Authors: Rafalowski Chaim
Published: June 2023

Introduction:

The NO FEAR project is dealing with operational aspects of the response to security-related incidents. Recent attacks globally demonstrate the complexity of the scenes and the fact that by nature the scene is not safe, though EMS personnel are intervening in those unsafe environments.

Method:

During a series of workshops with different EMS providers and managers the following ideas have been discussed: 1) Acceptable risk is part of EMS work 2) EMS personnel should be trained to conduct a personal risk assessment on-site and take appropriate action 3) EMS personnel on site should not think about the "large scene" but on the specifics of their site of operations

Results:

This new way of thinking requires a shift of paradigm in EMS, which for many years was "safety first" or "don't engage unless the scene is safe", ignoring the change like deliberate attacks against the population.

Conclusion:

Recent attacks present new threats and risks for EMS personnel, coupled with public expectations (who are on the scene providing assistance to their fellow injured citizen) are a call to EMS leaders to re-think the way we teach and address scene safety in security related incidents.
International Military Vaccination Efforts During the COVID-19 Pandemic: A Literature Review
Authors: Davis Terri , Hertelendy Attila , Hart Alexander , Ciottone Gregory
Published: June 2023

Introduction:

The COVID-19 pandemic created a public health crisis worldwide. Mass vaccination efforts in some cases were initiated without adequate civilian manpower due to critical medical staffing shortages. The governments of many nations deployed their military assets to fill gaps in care and to initiate projects to promote vaccinations. The COVID-19 pandemic created a unique international military vaccination response to an infectious disease disaster.

This literature review highlights creative solutions, abilities utilized, projects completed, overall effectiveness, and lessons learned by the military community worldwide to support their vaccination efforts within their countries. By collating this information into a single document, the collective global experience can be better analyzed and this information utilized to develop a framework for future disaster preparedness and mitigation planning efforts.

Method:

Medline (PubMed), GoogleScholar and the JSTOR Security Studies collection were searched for English language articles from January 1, 2020 and onwards. Keywords used included civil-military coordination, military, COVID-19, vaccination, vaccine. Titles were initially screened for relevance. The abstracts were then reviewed for a decision on inclusion. Article inclusion was determined by author consensus based on relevance to the objectives. Key papers were also hand searched for additional unidentified references.

Results:

Data collection and analysis planned for completion by January 2023.

Conclusion:

The COVID-19 pandemic created a public health need for mass vaccination distribution that was assisted by militaries throughout the world. This literature search demonstrates the ways in which military resources contributed to COVID-19 vaccination efforts, including creative techniques, successes and opportunities for future improvement.
The Public Health Emergency Response Model of COVID-19 Pandemic in North-eastern Part of Thailand
Authors: Srithongtham Orathai , Kitpati Rungrueng , Kratet Chulapon , Nak-ai Worayuth , Srisukkam Taweewun , Buraman Tossaphong , Limpathepakorn Ploypailin
Published: June 2023

Introduction:

The pandemic of COVID-19 in the northeastern part of Thailand established the response mechanism to COVID-19.

Method:

This study aimed to explore the PHER model of the COVID-19 pandemic in three provinces located in northeastern Thailand. The target group was 78 people who were responsible for COVID-19 response from the sub-district, district, and provincial levels. The data was collected through in-depth and group interviews following the non-structure interview guide and data was analyzed by content analysis.

Results:

Two levels of the PHER model were: 1) The response of the provincial level related to national and global situations. The provincial’s measure of the COVID-19 response was run by the Provincial Communicable Disease Committee (PCDC) and followed by the COVID-19 Epidemic Administrative Center (CEAC). The core team was a public health subcommittee who ran the Emergency Operation Center (EOC) and COVID-19 pandemic. The PCDC launched the provincial measure, risk communication response to COVID-19, and issues of the pandemic from CEAC and EOC. 2) The response inside the provincial level two components of the structure were the PCDC and the PEOC and the district EOC. They composed the Situation Analysis Team (SAT) and Joint Investigation Team (JIT), which was an operation to surveillance, investigation, real-time situation and reported to PEOC and PCDC as the issues of measures decision. Thailand’s identity of the PHER model was the village and sub-district on behalf of the Communicable Disease Control Unit (CDCU) and Community COVID-19 Respond Teams (CCRTs) in which members were Health Volunteer (HV), Village’s leader, and Local organization. Core activities were screening the risky group and surveillance: Home or Local quarantine and Home isolation (HI) or community isolation (CI) of rehabilitation from Covid-19 post treatment.

Conclusion:

The strengthening of PHER depended on the CCRTs and CDCU which supported the PEOC and PCDC to prevent and control Covid-19.
Media Mortality Surveillance during Winter Storm Uri, United States – 2021
Authors: Hanchey Arianna , Schnall Amy
Published: June 2023

Introduction:

On February 13, 2021, Winter Storm Uri hit the United States beginning in the Pacific Northwest, heading across the central US, and eventually exiting on the East coast. By February 16, roughly 73% of the continental United States had snow coverage leading to ten million households without power. To understand the disaster-related causes and circumstances of death for Winter Storm Uri, we activated media mortality surveillance to help inform preparedness and response efforts.

Method:

We searched the internet for key terms related to the winter storm, including storm name and type (e.g., winter storm), location-specific terms (e.g., state, county, city), mortality-related terms (e.g., death, mortality), cause of death (e.g., exposure, motor vehicle collision, carbon monoxide), along with other information learned from previous days (e.g., name of individual). We compiled and coded data into a standardized media mortality surveillance database and conducted descriptive statistics.

Results:

Between February 13 and March 2, 2021, the media reported 136 storm-related deaths from nine states. The winter storm had the largest impact in Texas (n=91). Of decedents with sex data available (n=91), the majority (58%) were male. For decedents with age data available (n=93), the majority (91%) were adults. Exposure to extreme temperatures (47%) was the most common cause of death, followed by blunt force trauma (15%), CO poisoning (7%), and fire (7%). Roughly one-third of deaths (34%) were indirectly related to the winter storm with motor vehicle collision (13%) representing the top indirect circumstance. Twenty-six deaths (19%) have an unknown circumstance and cause of death.

Conclusion:

This was the first time we activated media mortality surveillance for a winter storm providing timely data for public health action. Media mortality surveillance continues to be a useful tool in assessing the impact of a disaster and guiding response efforts.
Attitudes of Members of Public to Mass Casualty Incidents in Singapore
Authors: Yeong Yao Qun , Kong Sean , Ponampalam R
Published: June 2023

Introduction:

Mass casualty incidents result in mass casualties at short notice and stress healthcare systems. Research shows the critical potential role laypersons have by providing time critical intervention, on-scene, while awaiting arrival of emergency services, thus reducing mortality.

This study aims to demonstrate the attitudes of laypersons to responding to mass casualty incidents in Singapore.

Method:

Laypersons were invited to participate in a pilot course aimed at training laypersons principles and interventions for mass casualty incidents. This was developed by the Disaster Volunteer Corps of Singapore General Hospital Department of Emergency Medicine. Respondents were invited to answer a questionnaire which aimed to explore knowledge and prior experiences, willingness, attitudes, and readiness. Descriptive statistics were analyzed, and free-text responses were categorized into various headings by theme.

Results:

A total of 29/30 course enrollees responded to the questionnaire. Twenty (69%) participants were female. The median age was 50 years old (IQR 35-56.5). Most of the participants were employed (82.7%) and were Singapore Citizens (89.7%).

65.5% had no previous experience with first aid, and none had experience with MCIs. Understanding of mass casualty incidents was poorly understood, 1.42/5 (±0.56).

Respondents were most willing to assist in conventional disasters as compared to other types. Competency in voluntary role and altruism were the most important motivators as compared to compensation which was the least.

Overall, there is a high understanding that Singapore is at risk of disasters but most respondents do not have emergency plans in place for disaster situations.

Conclusion:

This study shows that while laypersons are willing, most do not have the knowledge or experience to respond to mass casualty incidents. This mirrors previous studies in Singapore relating to attitudes and knowledge of laypersons to CPR and AED.

More research and intervention is needed into the attitudes and willingness of members of public and mass casualty incidents.
Supporting the Emergency Management Pipeline: How Institutions of Higher Education can Increase the Emergency Management Career Goal for Students to Enhance Disaster Preparedness and Response Globally
Authors: Kenary Judith
Published: June 2023

Introduction:

The local, national, and global disasters have increased the demand for Emergency Management professionals. Institutions of higher education can play a key role to support and respond to this demand. One institution of higher education responding to this demand is Anna Maria College (AMC). AMC is a four-year, independent, Catholic institution accredited by the New England Commission of Higher Education, which was formerly known as the New England Association of Schools and Colleges. Established in 1946 by the Sisters of Saint Anne, the College was founded to increase access to quality education, educational innovation, and respect for service to others through development of the total human being. AMC offers exceptional professional programs at all degree levels, especially in community-oriented professions, propelling students to lives of civic, spiritual, and personal consequence. Based on the number of public safety majors and their networks, an area of interest has become how the college could contribute and respond to the demand for emergency managers.

Method:

These search resources were used: Chronicle, HigherEd jobs, Indeed, GoogleScholar Emergency Management majors curriculum, with searches from 2012 onward. Keywords used included emergency management jobs, higher education emergency management curriculum, public safety and community networking, disaster, and emergency preparedness, and filling the emergency management pipeline.

Results:

Data collection and analysis planned for completion by February 2023.

Conclusion:

Higher education can support the pipeline to narrow the gap and respond to the demands for trained and educated community members in disaster and emergency preparedness. Higher education responses include strategies such as, creative emergency management curriculum and community networking.
A Delphi Consensus Study to Define Non-Consultant Hospital Doctor Competencies Essential for a Focussed Curriculum in Major Emergency Management
Authors: Dasari Kantikiran , McCarthy Nora
Published: June 2023

Introduction:

In this era of increasingly fragile hospital systems, major emergency preparation is firmly being placed under the spotlight. The response to major emergencies requires the mobiliZation of numerous resources to ensure an effective, coordinated response. Yet, studies confirm a global deficit in the knowledge and skills of staff responding to these events in Ireland. Non-consultant hospital doctors (NCHDs) provide a useful and necessary surge response during these events, but currently there are no training programs specifically focused on their major emergency training requirements. The aim of this research was to define the essential elements of a focused curriculum for non-consultant hospital doctors responding to a major emergency (ME).

Method:

A two-step process was employed. Initially, a comprehensive ME competency set was compiled from relevant literature, consulting field-specific experts and from current ME training programs. A sample of experts was paneled from several acute hospitals in Ireland using purposive and snowball recruitment. A modified Delphi process, using on-line surveys, was utilized to identify the competencies deemed essential for NCHDs responding to an ME event.

Results:

Three Delphi rounds were required to complete this study. Of the 116 initial survey items, 68 competencies were confirmed as essential NCHD competencies, a total reduction of 40%. A 70% consensus rate was applied to 71 survey items in the final round, resulting in an agreement in 68 competencies (96%). A preponderance of the rejected competencies were specific to managerial and administrative tasks, whilst many retained competencies related to direct clinical care.

Conclusion:

This study has defined the essential elements of a curriculum for NCHD doctors responding to a major emergency in Ireland, using the Delphi methodology. This derived competency set should be useful to national bodies, regional organizations, and hospital stakeholders to allow the creation of bespoke NCHD major emergency training programs.
A Comparative Study of Business Continuity Planning in Long-Term care Settings in the U.S. and Japan Based on Literature Review
Authors: Ikari Ryoko , Bell Sue
Published: June 2023

Introduction:

Business continuity planning (BCP) ensures that critical healthcare operations are not interrupted and are recovered quickly, in the event of a disaster. BCP has an important role in avoiding adverse health impacts, particularly in long-term care settings. The purpose of this study is to conduct a literature review and comparison of the U.S. and Japanese BCP in long-term care to identify and compare challenges and desirable approaches in each country to support older adults.

Method:

We systematically searched PubMed, CINAHL, Japan Medical Abstracts Society and EMBASE databases, gray literature, and conducted a hand search of high-impact journals for studies published between 2000 and 2022 that assessed BCP in the United States and Japan.

Results:

From the literature, a challenge identified in the U.S. is the limited coordination within and across regions and between healthcare institutions and long-term care settings. The advantages are that an established structure of planning, training and evaluation is in place, with evidence from recent disasters showing net positive effects. In Japan, a significant challenge is that, despite an emphasis on continuity in the provision of medical care and welfare to individuals, cooperation between BCP at healthcare institutions and BCP at long-term care facilities is underdeveloped. The advantage is that BCP at medical institutions is incorporated into the national healthcare plan in Japan, making it easy to design BCP protocols and plans according to local needs.

Conclusion:

Future research should focus on two points. 1) In the U.S., there is a need for evaluation of BCP cooperation and coordination among healthcare networks, especially in long-term care settings. 2) In Japan, it is necessary to promote BCP in healthcare sectors and accumulate training and evaluation across the fields of medical institutions and long-term care facilities.
Appropriate Imaging Modalities in the Emergency Department for Assessment of Renal Stones
Authors: Bilal Muhammad , Heerden Xander , Jansen Charissa , Kelly T Paul , Wickham Bryce , Molloy Michael S.
Published: June 2023

Introduction:

Urolithiasis prevalence is approximately 15-20%, the third most common urological presentation to emergency departments (ED). In the ED, renal stones are usually diagnosed by clinical presentation, but imaging modalities play a role in confirmation and exclusion of hydronephrosis. 85% of stones are calcium oxalate/calcium phosphate, which are radio opaque, and 15% are radiolucent uric acid or cysteine stones. Non-contrast CT scans have 95% and 97% sensitivity and specificity rates, while x-rays have 57% and 76% respectively. In Wexford General Hospital, radiology prefers plain film x-rays prior to CT scans in assessing kidney stones.

Method:

The aim of this study was to assess the sensitivity of x-rays in patients undergoing low dose non-contrast CT for kidney stones and to apply this information to clinical practice. A retrospective audit was conducted using NIMIS/PACS from December 1, 2021-March 31,2022. All patients who underwent CT KUBS for evaluation of renal stones were included, and CT KUB findings were compared with initial x-ray findings.

Results:

A CT KUB was performed on 56 patients to assess renal stones, and 29 patients had renal stones. Among 29 patients, 21 had x-rays and CT scans performed, and 12 had x-ray findings that indicated renal stones, indicating 57% sensitivity. The study found 36 patients had x-rays for renal stones, but no CT scan was scheduled for 15 patients who might have undiagnosed radiolucent stones.

Conclusion:

Radiological imaging plays a central role in the management of suspected renal stones. CT KUB is a useful tool for evaluating patients with radio-opaque kidney stones as well as detecting radiolucent stones and renal pathologies that can be missed with plain radiographs. Low-dose CT KUB is recommended as a first-line investigation for renal stone patients to reduce radiation risks and unnecessary abdominal x-rays while assisting clinicians in accurately diagnosing patients and excluding other possible causes.