bluuebunny/crossref_metadata_2025 huggingface dataset:
The Most Vulnerable Populations: Exploring the FEMA National Risk Index by Racial/Ethnic Group
Authors: Unruh Larissa
Published: June 2023

Introduction:

The US Federal Emergency Management Agency (FEMA) has created a publicly available National Risk Index (NRI) using natural disaster and community risk factor data to provide numeric and visual representations of communities’ disaster risk. Of particular interest is the index’s use of the social vulnerability and community resilience variables. This study’s purpose was to identify and explore differences in vulnerability and resilience based on racial demographic data at the census tract level. By identifying communities at the highest risk, we can address modifiable risk factors to improve natural disaster outcomes for vulnerable populations.

Method:

This project used merged data from the US Census Bureau’s 2019 American Community Survey and source data for the FEMA NRI. Using Microsoft Excel, we created scatter plots of the social vulnerability and community resilience variables by census tract and predominant racial group, and calculated the mean, standard deviation, and statistical difference between those variables by race.

Results:

In census tracts where Native Americans made up ≥50% of the population:

1) There was a positive linear association between percent of Native Americans and increased social vulnerability.

2) The average social vulnerability score (ASV) was significantly higher (ASV = 55.74) than for predominantly White tracts (ASV = 31.43) (p < 0.001).

3) The average risk score (ARS) was significantly higher (ARS = 30.18) compared to predominantly White tracts (ARS = 16.98) (p < 0.001).

4) The average resilience index score (ARIS) was significantly lower (ARIS = 51.83) than predominantly White tracts (ARIS = 55.08) (p < 0.001).

Conclusion:

Results show that census tracts with predominantly Native American populations face significantly higher natural disaster risk and social vulnerability, and have significantly lower resilience scores compared to predominantly White tracts. Using modifiable factors to improve community resilience and decrease social vulnerability, the US can better protect communities at high natural disaster risk.
Hypothermia Progression Time Course for Evacuation Planning
Authors: Oshiro Kazue , Murakami Tomikazu
Published: June 2023

Introduction:

Accidental hypothermia occurs very rarely. Japan experienced hypothermic victims in the 2011 earthquake and tsunami disaster. In northern Japan, where the largest class of earthquakes and tsunamis are estimated, study for countermeasures has been advanced. The progression of hypothermia varies significantly by individual differences and environmental factors, and it is considered to be challenging to assess its damage. We present the findings that can be the basis for damage estimation from the data of hypothermia victims experienced in mountain rescue.

Method:

From 2002 to 2020, we examined ten fatal cases of hypothermic witnessed respiratory arrest (HWRA) by companions, which led to subsequent cardiac arrest among 164 cases from mountain rescue. We collected the time course of the deceased from rescue records and calculated the time from cold exposure to symptom, exposure to incapable, and exposure to HWRA. Temperature and wind speed data were extrapolated from nearby AMEDAS and upper-air weather records, and the wind chill index (WCI) was calculated.

Results:

We obtained the time course data in seven cases of ten, five males and two females between 21 and 67 years old. The weather conditions where the seven cases were placed were -5 to -30°C of WCI. The shortest time from cold exposure to incapacity was 65 minutes, 42.9% (3/7) within 180 minutes, and the fastest time to HWRA was 90 minutes, with 57.1% (4/7) between 10 and 12 and half hours.

Conclusion:

For disaster evacuation measures, both evacuees and rescuers need specific indicators to refer to. From very little but valuable data, we consider that rescue within 10 hours is necessary for lifesaving in similar conditions. Additionally, increasing the number of cases that become incapacitated within 1-3 hours can be valuable information for considering the location of the evacuation shelter and evacuation plan.
Chemical Industry Disaster Risk Assessment During Complex Emergencies in Ukraine.
Authors: Gan Rick Kye , Delgado Rafael Castro , Bruni Emanuele , González Pedro Arcos , Alsua Carlos
Published: June 2023

Introduction:

The war in Ukraine has not only led to complex emergencies and humanitarian crises but also other severe consequences, such as the chemical industry disaster. The chemical industry is one of the principal sectors of Ukraine’s economy, and it is estimated that Ukraine has a total volume of hazardous chemical accumulation of more than 5.1 billion tons. An attack on chemical industrial facilities will lead to catastrophic consequences. This thesis aims to study the disaster risk of chemical industrial facilities and its consequences on public health and the environment during complex emergencies in Ukraine.

Method:

Observational cross-sectional risk assessment method was utilized to assess hazard, vulnerability, and exposure of the chemical industry in Donetsk Oblast, Luhansk Oblast, Kherson Oblast, Zaporizka Oblast, and Kharkiv Oblast, Ukraine. Data on chemical factories in Eastern Ukraine was collected on Google Maps and Google Earth in May 2022. Lastly, the semi-quantitative risk assessment method was utilized to describe the risk from the perspective of consequences for life and health, the environment, property, and speed of development.

Results:

Chemical industry disaster risks in Ukraine during complex emergencies in Donetsk Oblast, Luhansk Oblast, Kherson Oblast, Zaporizka Oblast, and Kharkiv Oblast are high in terms of likelihood and consequences to life and health, environment, property, and speed of development.

Conclusion:

This risk assessment enables potential chemical disaster risks in Ukraine during complex emergencies to be understood and communicated by the local community, the first responder, and till policy makers. Therefore, enable a whole-of-society approach involving risk management, disaster preparedness, and response. Further detailed risk assessment on the type of chemical and their hazards should be conducted once the situation permits.
The UNDRR/ISC Hazard Definition and Classification Review and Hazard Information Profiles and Links to the Sendai Framework, the SDGs, and the Paris Agreement
Authors: Murray Virginia
Published: June 2023

Introduction:

The 'all hazards' approach that the Sendai Framework on Disaster Risk Reduction calls for ‘to strengthen technical and scientific capacity to capitalize on and consolidate existing knowledge and to develop and apply methodologies and models to assess disaster risks, vulnerabilities and exposure to all hazards;’ (paragraph 24 j)’ needed clarification.

Method:

Following extensive scientific consultation, the United Nations Office for Disaster Risk Reduction (UNDRR) and the International Science Council (ISC) published in 2020 the UNDRR/ISC Hazard definition and classification review. This was followed by the UNDRR/ISC Hazard Information Profiles: Supplement to UNDRR-ISC Hazard Definition & Classification Review–Technical Report (2021). This Supplement consists of a description of each of the 302 hazard information profiles (HIPs), which was developed using a consultative process by scientists and experts across the globe.

Results:

The UNDRR/ISC Hazard Information Profiles (HIPs) provide a common set of hazard definitions and other information relevant to informing the strategies and actions of governments and stakeholders, and for managing the risks associated with hazards. They can be used whenever and wherever for assessment, planning, and action related to hazards. As such, they relate to the design, implementation, and monitoring of disaster risk reduction and risk-informed investments at all levels.

Conclusion:

The science-based structure of the HIPs serves to avoid confusion and duplication in the classification of hazards. It also promotes up-to-date information derived from the ‘data revolution, rigorous accountability mechanisms and renewed global partnerships’. The HIPs support the implementation of not only the Sendai Framework for Disaster Risk Reduction 2015-2030, but also the Sustainable Development Goals of Agenda 2030, the Paris Agreement and International Health Regulations (2005). In 2022 an International Science Council Policy Brief was published describing the use of UNDRR/ISC HIPs to manage risk and implement the Sendai framework for disaster risk reduction.
The Role of Self-help Women’s Groups in Disaster Risk Reduction and Community Resilience in Nepal
Authors: Khatri Jyoti , Tippett Vivienne , Durham Joanne
Published: June 2023

Introduction:

The differential impact and needs of women during disasters are highlighted in contemporary research, there is limited understanding of the distinctive contribution they make and the ways they cope. Women are the key drivers of livelihood, therefore, the economic losses resulting from natural hazards may have massive impacts on their mental health. This study examines how the self-help women's groups in rural Nepalese communities provide economic, social, socio-political, and public-health support to build safer, sustainable, and resilient communities.

Method:

In-depth open-ended interviews were conducted between January 2021–April 2021 with grassroots women leaders(n=8) representing their (women’s/mother’s) group inquiring about their activities related to risk reduction and perspectives on how they cope during natural hazards. The findings were analyzed and discussed using two analytical frameworks namely, the Sustainable Livelihood Approach (SLA) and Bronfenbrenner’s Socio-Ecological Model (SEM) as scaffolds. Data analysis followed the thematic analysis technique.

Results:

Two major themes emerged from the in-depth interviews: 1) Women are doing their part and 2) Help-seeking behavior as a barrier and facilitator. The traditional female household roles such as cooking, feeding, and caring during pre-disaster states are extended to rescuing, protecting, laborious cleaning, and providing physical and emotional support during disasters. The pre-and post-disaster care responsibility and help-seeking behavior have implications for health, safety, well-being and sustainability. The findings also suggest the inevitability of self-care for women during and post-disasters.

Conclusion:

The care roles of women involve both livelihood and health benefits for the family and the entire community. To mitigate the physical and mental health burden for women amplified during natural hazards, self-care should be a critical component of advocacy in disaster awareness campaigns and help-seeking behavior should be promoted as a strength rather than insufficiency.
A Descriptive Analysis of the Health Care Aspects of Industrial Disasters Around the World
Authors: Tin Derrick , Cheng Lenard , Hata Ryan , Hart Alexander , Hertelendy Attila , Ciottone Gregory
Published: June 2023

Introduction:

Industrial disasters can have a myriad of repercussions ranging from acute deaths, injuries, and long-term adverse health impacts on nearby populations to political fallout and environmental damage. This is a descriptive epidemiological analysis of industrial disasters occurring between 1995 and 2021 which may provide useful insight for health care systems and disaster medicine specialists to better prevent and mitigate the effects of future industrial disasters.

Method:

Data was collected using a retrospective database search of the Emergency Events Database (EM-DATS) for all industrial disasters occurring between January 1, 1995, and December 31, 2021.

Results:

1,054 industrial disasters were recorded from 1995 to 2021. The majority of these disasters occurred in Asia (720, 68.3%), with 131 (12.4%) in Africa, 107 (10.2%) in Europe, 94 (8.9%) in the Americas, and 2 (0.2%) in Oceania. Half of these disasters were explosions (533, 50.6%), 147 (13.9%) were collapses, 143 (13.6%) were fires, 46 (4.4%) were chemical spills, 41 (3.9%) were gas leaks, and 34 (3.2%) were poisonings. There were 6 (0.6%) oil spills and 3 (0.3%) radiation events.

Conclusion:

A total of 29,708 deaths and 57,605 injuries were recorded as a result of industrial disasters and they remain a significant contributor to the healthcare risks of both workers and regional communities. The need for specialized emergency response training, the potential devastation of an industrial accident, and the vulnerability of critical infrastructure as terror targets highlight the need to better understand the potential immediate and long-term consequences of such events and to improve healthcare responses in the future.
Resilience Compendium: Strategies to Reduce Communities’ Risk to Disasters
Authors: Spencer Caroline , Cross Suzanne , Archer Frank
Published: June 2023

Introduction:

The Victorian Compendium of Community-Based Resilience Building Case Studies supports place-based disaster risk reduction by promoting strategies to reduce communities’ risk before, during, and after disasters or emergencies and by strengthening community resilience through shared learning. It grew from Community Resilience Forums at Monash University, where community resilience practitioners presented their programs, explained their evolution, how they solved challenges, and shared unforeseen learnings. Forum attendees expressed an urgency for a sharing platform to help build community expertise, save precious community resources, avoid program duplication to prevent communities from reinventing the wheel. These now represent key tenets of the Compendium.

Method:

International exemplars inform the structure of the Compendium and a thematic analysis identified critical success factors for underpinning disaster risk reduction and resilience strategies.

Results:

As an Australian first, the Compendium gathered 38 programs between 2012 and 2022, which were addressed before (29), during (7), and after (17) events. Programs addressed all hazards (23), bushfires (11), heat (2), fire safety (1), and house fires (1). Twenty programs used a framework. Thirty received funding, with nine receiving less than $20,000 and five receiving more than $100,000. Twenty-nine addressed a whole-of-community perspective.

Critical success factors included: strong governance and Board support; trust, partnerships, commitment, adaptability, stamina, and community leadership; paid facilitator, local government support, external funding; and celebrating often-neglected success.

Conclusion:

Offering an innovative contribution to resilience practice and research, the Compendium supports and enables locally-led and owned place-based disaster risk reduction efforts. It supports the Sendai Framework and augments principles in the National Framework for Disaster Risk Reduction by connecting people from diverse sectors to deliver distinct, adaptable actions to help reduce communities’ risk before, during, and after disasters or emergencies. The Compendium enables communities to preserve valuable community resources offering opportunities to extend to a national or international Compendium.
Understanding Community Preparedness and Emergency Supply Kit Knowledge, Attitudes, and Practices Among the U.S. Population
Authors: Schnall Amy , Hanchey Arianna
Published: June 2023

Introduction:

During disasters households may experience lost communication and roads may become impassable; thus a common recommendation is to prepare an emergency supply kit that can be used to shelter-in-place during evacuation. The decision to prepare for disasters becomes more challenging during pandemics because individuals may be hesitant to evacuate to shelters or may be unsure of items to include in emergency supply kits. Because of this, many preparedness estimates before 2020 may no longer reflect current levels of preparedness. The aim of this research was to provide information on what actions people take to prepare for disasters, determine whether households have supply kits, and help guide next steps to better prepare for and respond to disasters during a pandemic.

Method:

We conducted descriptive statistics, chi-square analyses, and backward-step regressions on 10 questions collected through Porter Novelli’s ConsumerStyles surveys in Fall 2020 (n=3,625), Spring 2021 (n=6,455), and Fall 2021 (n=3,553) to examine factors that contribute to overall household preparedness levels and supply kit ownership.

Results:

Being married, having children in the home, and having a household income of $150,000 or more are all associated with increased preparedness levels. Persons living in mobile homes, recreational vehicles (RVs), boats, or vans are half as likely to have preparedness plans compared to those living in single family homes. While there was a significant association between level of preparedness and supply kit ownership, overall kit ownership is also lacking. While most respondents believed a kit would help their chance of survival, only a third had one. Age, sex, education level, and region of the country were significant predictors of kit ownership.

Conclusion:

This study helped close existing knowledge gaps surrounding preparedness and emergency supply kits to guide public health research and prevention strategies, including messaging, to help reduce adverse health impacts during multiple emergencies.
WHO Health EDRM Research Network and Health Data Management
Authors: Kubo Tastuhiko
Published: June 2023

Introduction:

The WHO Health Emergency and Disaster Risk Management (H-EDRM) Research Network has identified that health data collection during health emergencies and disasters is a key element to enable proper coordination and timely response, and research priorities of the network.

Method:

Focus group discussion was performed to identify key challenges which hinder accomplishment of the data collection.

Results:

It was concluded that the issue faces significant challenges including; (1) Access: Logistic issues including safety, transport and communication did not allow experts such as epidemiologists to access onsite and relevant stakeholders. It is also challenging for local public health stakeholders to accept new experts during emergencies. (2) Tools: forms or tools that are concise and operational to be accepted by frontline responders should be provided. (3) Standardization: to set standard forms or tools and its operational mechanism is essential to collect health data, otherwise collected data will be partial and fragmented. (4) Governance: overall governance of procedure and data ownership must be clarified before its implication administratively and legally. These should be endorsed by local health authorities. (5) Ethical procedure: Obtaining informed consent and conducting timely procedures is difficult. Contextually, health data collection during emergencies and disasters in many cases is inappropriate. (6) Operation: Collected data should contribute to ongoing operation in a timely manner. The discussion also found the standard tool of the WHO; the Emergency Medical Teams Minimum Data Set, which has been already used in more than ten countries and has been providing leading examples for this topic.

Conclusion:

Further research to fulfill the identified challenges and gaps will facilitate the collection and strengthen the health emergency and disaster risk management.
Compliance of the Public with Governmental Regulations and Recommended Protective Health Behavior During COVID-19: Lessons Learned from Varied Waves of the Pandemic in Israel
Authors: Kaim Arielle , Bodas Moran , Adini Bruria
Published: June 2023

Introduction:

Managing pandemics is dependent on the adherence of civil societies to directives and recommendations issued by governmental and public health authorities. In the context of the COVID-19 pandemic, hurdles were encountered by authorities regarding public compliance to orders and recommendations of protective health behavior. The objective is to investigate the factors that most powerfully enhance or impede compliance to varied measures–both regulations (i.e. lockdown, mask wearing, social distancing) and recommendations (i.e. vaccination etc.) in Israel.

Method:

A longitudinal study, based on structured questionnaires was conducted to investigate factors that enhance or impede the uptake of protective health behavior throughout two years of COVID-19.

Results:

Various factors throughout different phases of the pandemic have been identified as playing a significant role in compliance. During the initial phases of the pandemic, the most salient factors for enhanced compliance to non-pharmaceutical interventions (lockdown) were concern for family or self-health, while deterrence played little role. During the fourth wave, findings indicated that pandemic fatigue had begun to have cascading effects on vaccination efforts. Particularly at this stage, trust in authorities and even threat perception components were incapable of predicting uptake, while perceived importance of the vaccine and its effectiveness positively and significantly predicted uptake. Throughout the pandemic, a negative correlation between levels of resilience and distress symptoms and a positive correlation between resilience and enhanced compliance were identified.

Conclusion:

Utilizing tools for empowering the population rather than instilling fear or other deterrence measures are more effective approaches to increase compliance with governmental directives. Furthermore, the results highlight the importance of adapting and adjusting risk communication efforts to accommodate specific concerns and hesitations demonstrated by distinct groups during an evolving pandemic. Public health officials and authorities need to engage the public in resilience building activities to promote compliance.
World Organization for Animal Health Platform on Animal Welfare for Europe Survey on Veterinary Service Preparedness for Natural Disasters
Authors: Vroegindewey Gary
Published: June 2023

Introduction:

National Veterinary Services of World Organization for Animal Health (WOAH) are responsible for a wide range of activities including animal health, animal welfare and veterinary public health. The WOAH European Region member countries were surveyed to determine and quantify the level of capacity to respond to natural disasters, determine the types of disasters experienced, determine their levels of education and training and identify gaps in capacity and specific needs of Member Countries for disaster response.

Method:

A web-based Qualtrics survey on Animal Welfare in Natural Disasters was conducted by Lincoln Memorial University in conjunction with the World Organization for Animal Health (OIE) Platform on Animal Welfare for Europe. The 50 question survey was distributed by email link to Member Countries points of contact provide by OIE. The survey was emailed to 53 OIE European Member Countries with reminder emails to complete. Survey results were compiled and tabulated. Only aggregate data is published and presented.

Results:

Forty-nine countries responded to the survey for a 92% completion rate. Floods, earthquakes and fire were the three most commonly encountered disasters. Fifty-two percent indicated they incorporated animal welfare into their disaster planning. Thirty-one percent indicated they had no or limited legal authority to manage animal emergencies in natural disasters. The species covered in the national response plan ranged from laboratory animals at 17% to livestock at 48%. Eighty-two percent had no or limited standard operating procedures and 73% had no training to respond to animal welfare in disasters. Budgets, trained personnel, equipment/supplies and legal authority were the most frequently identified gaps

Conclusion:

The survey demonstrated there is a wide range of European Member Countries capacity to respond to animal welfare in natural disasters. This provides the baseline for the OIE Platform for Animal Welfare Europe to provide focused and actionable support to Member Countries
One Health: How to Build an Italian Model
Authors: Rossodivita Alessandra , Paganoni Catia , Rizzardini Giuliano , Saporito Tommaso , Zucchi Patrizia
Published: June 2023

Introduction:

The Concept of One Health is a cross-sectoral approach that aims at the protection of humans, animals, and the environment acknowledging their interconnection at a global, regional and local level.

The "One Health" approach is officially recognized by the Italian Ministry of Health, and in the Lombardy Region, which has included it as a pillar of the new reform law of the regional health system (LR n.22 of 2021). All international organizations, as a relevant strategy in all sectors, benefit from the collaboration between different disciplines (doctors, veterinarians, environmentalists, economists, sociologists, etc.).

Method:

Disseminating basic knowledge of the "One Health" public health approach among the hospital staff of the hospital’s Complex of Valtellina and Alto Lario (with three hospitals), in consideration of the geographic location, far from urban Hospital centers and in the Alpine Mountain area.

Promoting the culture of “One Health” through a hospital information and training campaign in recognizing the health of people, animals and ecosystems are interconnected, involving the population in cultural change. To create the basis for networks of collaboration in a multidisciplinary approach, especially at the level of human-animal interface, such as the surveillance of the emerging zoonoses in the light of the climate changes, using models from research to complex networks.

Results:

Promoting the application of an approach collaborative, multidisciplinary, inter-sectorial, and coordinated to address potential or existing risks, which originate from the interface between animal-human ecosystems. To disseminate a new public health culture based on “One Health" concepts and on future planning prospects and vision to the population as well.

Conclusion:

One Health represents a new paradigm of the vision of public health on a global level, which implies an awareness and a challenge of cultural change for the development of a more sustainable future.
Managing Hajj Mass Gathering Throughout the Pandemic
Authors: Khan Anas , Alahmari Ahmed
Published: June 2023

Introduction:

The rise of the COVID-19 pandemic caused significant concerns due to the risk of transmission in such mass gatherings. Too many variables for such a critical challenge made it more of a complex situation, with an enormous negative impact on either decision. In this paper, we aimed to summarize the experience of Saudi Arabia in hosting and managing Hajj throughout the pandemic for three seasons, the public health strategies to control the COVID-19 transmission during Hajj, and the policies and regulations that were implemented for the safe return of Hajj.

Method:

This is a summary of our experience in managing Hajj seasons throughout the COVID-19 pandemic for the period 2020, 2021, and 2022. A description of the factors, models, and tools used to assess the situation for each year, and the bundles of measures followed to mitigate the events aiming to hold a "Safe Hajj".

Results:

2020 was a unique year, with the pandemic at its height with no vaccination available. So, the decision was to hold a symbolic strict Hajj of only 1,000 pilgrims residing within Saudi Arabia. In 2021, as the World was easing restrictions and distributing vaccines, around 60,000 internal pilgrims got to perform Hajj, and 2022 hosted one million international pilgrims. That is still 40% of 2019 Hajj with 2.5 million due to considerations to avoid usual overcrowding and mandating COVID-19 full vaccination status.

Conclusion:

Our experience with the COVID-19 pandemic over the past three years has informed us that huge MGs can be conducted safely during the pandemic if adequate measures were implemented. That would include an accurate and reliable risk assessment to inform policymakers about the most effective strategies.
Management of Uncomplicated Acute Alcohol Intoxication at a Mass Gathering Event: Stop the Intravenous Fluids
Authors: Ranse Jamie , Crilly Julia , Keijzers Gerben , Mickan Sharon , Munn Matthew , Hutton Alison , Sweeny Amy , Buckland Michelle , Hamill Laura , Catherine Delany , East Katie , Hagan Stephanie
Published: June 2023

Introduction:

Uncomplicated acute alcohol intoxication (UAAI) requiring medical management is common at some mass gathering events. Most of the mass gathering literature reporting on medical management involving UAAI are single case studies. The common clinical practice for UAAI at mass gatherings reported in the literature involves intravenous fluids and antiemetics. However, emergency department evidence suggests that administration of intravenous fluids does not enhance patient outcomes, and in some cases extends emergency department length of stay and costs.

Method:

Using a retrospective cohort design of routinely collected data over a nine-year period (2010-2013 and 2016-2020), this study was set at an annual end-of-year ‘schoolies’ youth mass gathering event. The primary study aim was to determine the intravenous fluid management practices of UAAI at this event. Secondary study outcomes included patient demographic, clinical characteristics, and patient outcomes. Data were analyzed using time series and descriptive statistics. Ethical approval was obtained.

Results:

In total, 378 patients were identified with UAAI at the event over the nine-year period. The median patient age was 17 years (IQR: 17-18), with 47.2% (n=179) being male. Overall, the median length of stay was 74 minutes (IQR: 40 – 144). Only 7.9% (n=30) patients received intravenous cannulation and 6.3% (n=24) patients received intravenous fluids. Proportionately, the use of intravenous fluids for the management of UAAI decreased over the study years [2010, 28.6%; 2011, 32.1%; 2012, 15.6%; 2013, 6.3%; 2016, 2.6%; 2017, 0%; 2018, 1.8%; 2019, 0%; 2020, 0%].

Conclusion:

Some mass gathering events have a higher incidence of UAAI presentations. This is particularly true for those mass gathering events with young adults and at music festivals. Knowledge translation from the emergency department context regarding UAAI clinical management could be applied to the mass gathering event setting. This clinical management should include a conservative approach to the management of UAAI.
Feasibility of Live Video Feed Transmission from UAVs for Medical Surveillance During the 2022 Montreal Marathon
Authors: Lafortune Raphaël , Afram Eddy , Iannuzzi David , Champlain François de , Homier Valérie
Published: June 2023

Introduction:

In recent years, unmanned aerial vehicles (UAVs) have been increasingly used for medical surveillance purposes in mass gathering events. No studies have investigated the reliability of live video transmission from UAVs for accurate identification of distressed race participants in need of medical attention. During the 2022 Montreal marathon, the aim of this study was to determine the proportion of data collection time during which live medical surveillance UAV video feed was successfully transmitted and considered of sufficient quality to identify acute illness.

Method:

Four UAVs equipped with high resolution cameras were deployed at two predefined high-risk areas for medical incidents located within the last 800m of the race. The video footage was transmitted in real-time during four consecutive hours to a remote viewing station where four research assistants monitored it on large screens. Interruptions in live feed transmission and moments with inadequate field of view on runners were documented.

Results:

On September 25, 2022, 8,577 athletes registered in the Montreal marathon and half marathon. Out of the eight hours of video footage analyzed (four hours per high-risk area), 91.7% represented uninterrupted live video feed with an adequate view of the runners passing through the high-risk areas. The total interruption time was 22 minutes and 19 seconds, and the field of view was considered inadequate for a total of 17 minutes and 33 seconds. Active surveillance of drone-captured footage allowed identification of two race participants in need of medical attention. Appropriate resources were dispatched, and UAV repositioning allowed for real-time viewing of the medical response.

Conclusion:

Live video transmission from UAVs for medical surveillance of runners passing through higher-risk segments of a marathon race for four consecutive hours is feasible. Live feed interruptions and segments with an inadequate field of view could be minimized through practice and additional equipment redundancy.
Emergency Care to the Sound of Music
Authors: Varshney Kavita , Friend Caren
Published: June 2023

Introduction:

There are known higher rates of drug and alcohol consumption in music festival attendees. Patterns of MDMA use had been changing over a number of years however the festival season (Sept 2018 - May 2019) in NSW saw a dramatic rise in drug related mortality and morbidity which had not been seen in other states in Australia although similar instances had been noted overseas.

With over 70 music festivals in NSW in this period, five deaths in four months and 29 severely unwell patrons transported to NSW hospitals, the impact was significant.To support both the festival site and NSW hospitals a Health Response Team (HRT) deployment model was implemented

Method:

The planning and intervention strategies included provision of onsite specialist critical care teams to complement existing event management and paid healthcare providers. Disaster management principles, although documented, had not previously been used in the music festival setting. To deploy such a team, guidance on equipment, pharmaceutical and physical requirements were scarce. Our team developed processes and protocols for all aspects of this unique deployment.

Operational procedures included specific equipment, medications, documentation processes, and clinical protocols were developed and reviewed and refined after each festival.

Results:

The effectiveness of the teams was evidenced through the early recognition and management of severe drug toxicity seen at the five festivals to which WSLHD deployed HRTs. This management resulted in good outcomes with minimal morbidity and no deaths of the 29 festival patrons treated by the HRT noting 25 required intensive care admission.

Conclusion:

Innovative processes and collaborative arrangements enabled effective deployment to NSW music festivals. Expert HRTs were key in preventing drug related morbidity and mortality through early recognition and management of complications. Team members gained unique and invaluable experience as a result of their deployments and patients transported to hospital were managed more effectively.
Increasing Patient Tracking Compliance by Harnessing Frontline Clinician Engagement
Authors: Gabaldo Molly , Daniels Mackenzie
Published: June 2023

Introduction:

A large urban jurisdiction identified a lack of experience and knowledge in use of the established regional patient tracking system among frontline emergency department employees. Lack of nursing retention, shifted departmental priorities throughout the pandemic response, and decreased opportunities for exercising were notable causes of this identified knowledge gap. Effective patient tracking has a significant impact during response to any event with the capacity to strain the hospital and healthcare system. Mass casualty incidents pose a global threat to all jurisdictions. Recognition of this threat magnifies the importance of establishing a patient tracking system and empowering frontline staff, through education and training, to immediately implement the exercised patient tracking platform.

Method:

Bolstering hospital readiness through site visits and first-receiver clinician engagement during special event planning improved effective use of a citywide patient tracking system during planned events. “Just-in-time” training tools were developed and distributed during site visits. Notably, identification of key clinical staff at each institution was an important step in meaningful clinician engagement. Utilization of these systems during special events is an opportunity to exercise a high stakes procedure during a low stakes incident.

Results:

Site visits and training material distribution effectively enhanced first-receiver participation in patient tracking during a special event in comparison to previous special events. Users required less prompting throughout the response, and the post-intervention survey indicated an increase in user confidence levels. Increased utilization of the system improved visibility into the hospital's lived experience while engaged in the response.

Conclusion:

Targeted site visits and educational material tailored to first-receiver clinicians during special events improved patient tracking efforts throughout a large urban healthcare system. During real and planned events, person and patient tracking allows for patient load balancing across the healthcare system, assists with patient and family reunification, and directs future planning, funding, and first responder and receiver education.
Fast EMR: An Online and Offline Mobile Electronic Medical Record for Disaster Settings
Authors: Draugelis Sarah , Brown Erik , Donahue Donald , Hickman Justin , Smith Sean , Sutherland Philip , Yendewa George , Mohareb Amir
Published: June 2023

Introduction:

The absence of clinical information in the aftermath of disasters in resource-constrained environments costs lives. fEMR– fast Electronic Medical Records–is a medical records system designed for mobile clinics and has proven useful in post-disaster settings. While the original version of the system was developed for areas without access to the Internet, a new version of this system was developed in 2019 to accommodate regions with connectivity.

Method:

We reviewed the design, implementation, and usage of fEMR from June 2014 to October 2022. We used logged data of the number of users, patient encounters, and the circumstances of each deployment. We compared usage between the original fEMR system and fEMR-on-chain.

Results:

The original fEMR system was created in an iterative process by students in Computer Science classes at three different American universities. The system creates a closed intranet signal to which clinicians connect their own device to access the software. The hardware is transported to the medical team in a carry-on suitcase prior to deployment. All data are stored on a laptop that acts as a server. The online version, fEMR On-Chain, was developed under a grant, but is sustained in development through academic partnerships. Both versions are designed so that the provider can complete an encounter with as few clicks as possible and with as little input as necessary to identify patients.The original fEMR system has been deployed to mobile clinics worldwide since 2014. The system has about 14,181 patients and 16,021 clinical encounters from 12 different countries. fEMR On-Chain has been deployed to refugee and migrant settings since 2019, containing about 18,000 patients and 22,000 encounters in two different countries.

Conclusion:

Successive versions of the fEMR system have been used in a variety of conditions and settings, with usage accelerating since 2019 in refugee and migrant health centers.
Developing a Statewide System for Prehospital Routing of Burn Injuries
Authors: Kearns Randy , Short Tracee , Barrios David , Sittig Kevin , Hargrove Paige , Hector Chris , Carter Jeffrey
Published: June 2023

Introduction:

In the USA, traumatic injuries are the leading cause of death before age 45 and have significantly lower mortality if treated in a verified trauma center. Burn injuries are included in trauma statistics and represent 1.1 million injured people annually seeking medical assistance. Routing of burn injuries to ABA-recognized burn centers has yet to be assessed as it has in trauma injury. Our goal was to examine the impact of prehospital routing of burn injuries on hospital length of stay, mortality, and potential costs-of-care through a statewide care coordination center.

Method:

Our study is a retrospective statewide analysis of burn injuries from 01/01/2017 thru 12/31/2019 using the Louisiana Hospital Inpatient Discharge Database. Routing of burn patients was implemented in 2018 using the ABA burn referral criteria. Data included: total admissions with primary burn diagnosis, region, discharge status, length of stay, and raw mortality by region and state. Descriptive and comparative statistics were performed to assess the impact of routing burn-injured patients. Cost analysis was performed using Louisiana Medicaid per diem rates from 2021 at $1,907.92/day.

Results:

1,288 patients were treated in Louisiana during the study period, with 855 post-routing and 433 pre-routing. The mean length of stay was reduced from 11.84 days in 2017 to 8.82 days in 2018 (p value=0.0988), with a potential savings of 761 inpatient care days or $2.17 million. Overall mortality across the state was unchanged except in the highest volume region, where it dropped from 7.9% in 2017 to 3.6% in 2019 (54%).

Conclusion:

Burn injuries are a time-sensitive trauma. This study marks the first analysis pre and post-implementation of routing for burn injuries by a statewide care coordination center. Our study demonstrates improvement in length of stay and mortality but a continued need to examine other contributing factors, such as injury severity and concomitant trauma.
Disaster Education in Hospitals using Metaverse: Focusing on COVID-19
Authors: Wang Soon-Joo , Park Seon Young
Published: June 2023

Introduction:

During the COVID-19 pandemic, it became difficult to conduct face-to-face training and practice for disaster medial education. As an alternative to this, it was proposed to build a metaverse world using virtual and augmented reality(XR) technology and implement disaster training education within it. Therefore, the authors investigated the process and effects.

Method:

The authors conducted training of healthcare workers through software implementing a metaverse called MediBase and NurseBase, which was created for doctors and nurses in hospitals to respond to disasters such as COVID-19. The trainees were given a practical orientation after basic theoretical education, attached a VR headset, and performed a medical response to a virtual disaster according to their judgment, and the records and debriefing were organized and analyzed.

Results:

The satisfaction of trainees with education reached a maximum of 88%. Even in the part where the correct choice was made in the theoretical evaluation, the time was delayed or the wrong choice or behavior appeared in the metaverse practical education and training.

Conclusion:

In disaster situations that cannot be implemented identically to reality and most disaster education and training that cannot target actual patients, metaverse-based disaster medical education and training is expected to become a more effective alternative in the future.
Emerging Technologies for the Early Location of Entrapped Victims Under Collapsed Structures and Advanced Wearables for Risk Assessment and First Responders Safety in SAR Operations, Search and Rescue Project
Authors: Cintora Ana , Colmenar Carmen , Martínez Carmen , Lozano Jose , Horrillo Cristina , Montero Carmen , García Ricardo , Morenilla Rosa , Gómez Cristina
Published: June 2023

Introduction:

Natural disasters and catastrophes are challenges faced by emergency services. These are dangerous environments in which there are life-threatening victims as in other CBRN incidents, which can add great risks for nearby populations and the environment. The main objective of this project is the development and testing of new technologies that increase the safety and efficiency of the work of first responders in disasters.

Method:

The SnR consortium, with 28 partners, has designed, implemented, and tested new technologies, with an advanced communication and monitoring system for professionals, victims, and other first responders, with innovative positioning and assistance ICT that facilitate the exploration and evaluation of disaster areas.

These technological advances are validated and evaluated with performance, efficiency, and usability indicators, in laboratories and in real working conditions, through a total of seven case studies, in seven different countries, covering a wide range of representative disaster scenarios.

Results:

The development of a new communication and monitoring system for professionals and victims, coordinated on the Concorde platform, together with chemical alert sensors, synchronized with smartwatches, smart uniforms, and pediatric immobilizers, are some of the tools tested. The pilots carried out to confirm the usefulness of the 26 technological tools designed and tested in the field, which have helped to reduce the damage and casualties that can occur in S&R operations.

Conclusion:

In conclusion, the H2020 European Search and Rescue project (S&R), through the development of new technologies, offers a holistic approach to the effective response to emergencies and provides increased capabilities and resources to first responders in the field, increasing their effectiveness and safety. This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement (No. 882897).
Using Novel Technologies to Implement Belize's First Formal Prehospital Emergency System
Authors: Friesen Jason
Published: June 2023

Introduction:

Belize has no formal prehospital emergency medical system, leaving the majority of acutely sick and injured persons overwhelmingly dependent on private transport. To address this issue, a collaboration of public and non-profit partners worked with the Belize National Fire Service to implement the country's first formal prehospital emergency medical service using novel communications technologies. With new resources and vehicles already donated to the fire service, the collaboration focused specifically on the communications component of the response system, specifically to improve the handling of incoming requests for emergency assistance from the public, as well as to improve the process of dispatching prehospital personnel using readily-available mobile technologies.

Method:

Working with the Belize National Fire Service, program partners implemented the country's first emergency communications center, trained new dispatchers, field-tested the dispatch technology through intensive training sessions, and launched the system in the capital district of Cayo.

Results:

Launched in June 2022, the program has thus far achieved the following outcomes:

Active Dispatchers: 26

Active Responders: 104

Emergencies Dispatched: 156

Average Scene Response Time: 7m45s

Conclusion:

Over the past year, partner NGOs Trek Medics and Empact Northwest have worked collaboratively to implement a first-ever centralized emergency dispatch system for the Belize National Fire Service, using a novel cloud-based dispatch software running on readily-available mobile phones and mobile. In addition to drastic improvements in response performance, satisfaction among system managers and response personnel is high, with plans currently underway to scale the program nationally.