bluuebunny/crossref_metadata_2025 huggingface dataset:
(P1-22) Emergency Management Plan for H1N1 Major Epidemic Event – An Experience of a Private Hospital in Sao Paulo – Brazil
Authors: Tucherman M. , Vaidotas M. , Sako Y.K. , Akamine N. , Smaletz D. , Barros C.G.
Published: May 2011

Objective

To describe the Emergency Management Plan for H1N1 Major Epidemic Event to reduce the impact of the patients in a general emergency department.

Method

Einstein hospital has a catastrophe management program which is regularly tested for several scenarios: accidents, fire, and biological attack among others. Special concern is given for pandemics since we need to keep employees' fit to keep the hospital running as usual.

Results

On April 24, WHO issued an alert about the rising cases of influenza virus H1N1. Immediately we provided a plan of care for suspected or confirmed cases based on WHO and CDC guidelines. On April 29 increased level of alert to Phase 5 (pandemic imminent). The crisis management group created a multidisciplinary team with actions directed to Einstein's doctors and staff, 6,000 registered professionals, engineering, emergency care, laboratory, occupational medicine, hygiene, waste disposal, among others. Communication was maintained with government to update the official guidelines. Two specific drills were performed to train staff and support teams. Debriefings were made to all participants and lessons learnt were incorporated.

Results

Official figures showed that in São Paulo until August 2 have been reported 6,383 cases, 11.8% (756 cases) of these were reported by HIAE. From 5 May 2009 to 05 December 2009, 1,324 cases were reported. There were only four deaths of patients with influenza A H1N1 and two acquired in hospital and the daily business were not compromised by the epidemic showing the importance of a crises management plan.

Conclusion

The methodology of realistic simulations has showed effectiveness in the planning of how to manage Major Epidemic Events and improvement actions from this exercise has been showing best results for the patient flow and safety whenever this kind of situation happens at Hospital Albert Eisntein.
(P1-28) Primary Health Care (PHC) Approach in Emergencies and Disasters
Authors: Redwood-campbell L. , Papowitz H.
Published: May 2011

This presentation will focus on outlining the issues and challenges to developing a framework for a PHC approach for emergencies and disasters. The emphasis will be how the use of the PHC principles to achieve equity and social justice can improve disaster response. These approaches include; universal coverage/equity, community participation, intersectoral collaboration and the use of appropriate technology. Discussion will include; the revitalization of PHC and the role of PHC in emergencies and the challenges of the PHC approach in emergencies. Responding to emergencies from the perspective of disaster risk management, community based health work force and self care will be reviewed. Finally, pre-emergency preparedness focusing on community based benchmarks, community based disaster management planning and strengthening health systems based on PHC will be discussed.
(P1-31) The Determinants of Competency for Emergency Medical Technician-II in Taiwan
Authors: Jhang Y. , Luu S. , Yang Y.
Published: May 2011

Background

The formal training for Emergency Medical Technician (EMT) in Taiwan was legislated by Emergency Medical Care Services Act in 1995. Very little research discusses the competency of EMTs. The purpose of this study was to assess the determinants of competency for the EMT-II in Taiwan.

Method

In June 2005, a cross-sectional survey was targeted on firefighters with EMT-II certificate and having a minimum work experience of three months in central Taiwan. Kirkpatrick's (1994) four-level model guided the development of conceptual framework and questionnaire. Structural Equation Modeling (SEM) was adopted for the analysis.

Results

One thousand and seventy-three EMT-IIs were included in the study. Majority of them were male (99.4%) with an average age of 34.46 years old. Among them, 96.5% were careered EMTs with 130.33 months of field experiences. The competency of EMT-II was measured by 4 indicators of error reduction, quality improvement, achievement orientation, and efficiency improvement. The construct of ‘Capability Enhancement’ dominated EMT-IIs' ‘Competency’, followed by ‘Length of Time for Field experience’, ‘Instructor Expertise’, ‘TA Expertise’, and ‘Willingness to Learn’. Both ‘Age’ and ‘Total Course Time’ had a negative effect on ‘Competency’. ‘Capability Enhancement’ was mainly influenced by ‘Practice Absorption’ and ‘Theory Absorption’, followed by “Willingness to Learn”, ‘Instructor Expertise’, ‘Total Course Time’, ‘TA Expertise’, ‘Self Confidence’ and ‘Practicum Time in Ambulance Station’. However, the construct of ‘Teaching Technique” imposed a negative effect on ‘Capability Enhancement’.

Conclusion

The SEM model explains 75.7% of the variances in competency for EMT-IIs. The ‘Competency’ is dominated by ‘Capability Enhancement’. Improving the quality of course, instead of time, and recruiting younger EMT-IIs may advance the competency. Modification of ‘Teaching Technique’ may enhance the capability of EMT-IIs.
(P1-34) Chinese Undergraduate Nursing Student's Attitude and Understanding of Disaster
Authors: Yin H. , Wang L. , Lu H. , Yu X. , Arbon P. , Zhu J.
Published: May 2011

Objective

To identify attitudes and understanding of Chinese undergraduate nursing students towards disaster, therefore providing information for the development of a disaster nursing curriculum in the Chinese context.

Methods

A total 214 undergraduate nursing students (Year 1 to 4) in one medical university in China were surveyed in 2010.

Results

The majority of undergraduate nursing students (94.9%) were concerned about disaster, 46.7% of them thought they were very knowledgeable about disaster, while 39.3% of them stated they were moderately knowledgeable about disaster. The most popular way for the students to get information about disaster was television (88.3%), followed by internet (67.8%) and newspaper (45.8%). Only 33.6% of them said they gained information from the university. Earthquake (93.7% of students) and flood (36.1% of students) were mentioned by the students as examples of disasters that have occurred in China. The majority of students said the Wenchuan earthquake (2008) was the disaster that had the greatest impression on them. Five aspects were identified from their description of disaster, which included the cause, category, characteristic, impact and type of disaster. 36.4% of students were certain that disaster would happen again in China. A further 50.9% felt disaster was likely. Flood and earthquake were considered the most likely future disasters. 71% of nursing students strongly agreed that being prepared for disaster was important. The main reasons were better preparedness could decrease the damage to property and the incidence of death and injury. However, the level of understanding of the effects of disaster and the exposure of students to education about disaster health response was limited.

Conclusion

Knowledge and skills for disaster preparedness of nursing students should be strengthened in the medical university.
(P1-41) Utilization of a Cadaveric Model in Pericardiocentesis Training
Authors: Inboriboon P.C. , Lumlertgul S.
Published: May 2011

Background

Pericardiocentesis is rare but life saving procedure that all emergency physicians should be competent in performing. Improper technique can place patients at significant risk for iatrogenic injury. Proper training is needed to familiarize physicians with proper pericardiocentesis technique.

Training Model

In order to facilitate training of this relatively rare procedure, a cadaveric pericardiocentesis model was developed. Described is a step by step procedure for creating a cadaveric model that can be used to train and evaluate providers in pericardiocentesis competency.

Utilization

This unique teaching innovation can be utilized in a variety of settings to train providers, including those in resource limited environments. It has already been utilized in the training of emergency medicine residents in Thailand and in the United States.
(P1-44) Health Emergency and Disaster Management Training for Health Professionals
Authors: Godamunne A.U.K. , Fernando D.M.G. , Tennakoon S.U.B.
Published: May 2011

Background

Sri Lanka has learned, with contributions from a 30-year war and a tsunami, that disasters happen when and where least expected. Thus the Health Emergency and Disaster Management Training Centre (HEDMaTC) of the Faculty of Medicine, University of Peradeniya was established to prepare Sri Lankan healthcare workers for all forms of health disasters.

Description

HEDMaTC conducts training programmes for health professionals, including medical doctors, nurses, emergency technical officers, ambulance drivers and porters. As these are adult training programmes practical methods of training such as drills, workstations, group work and hands on training have been used, in addition to lectures. Emergency care equipment, specific kits and techniques and desktop exercises are used to demonstrate protocols of emergency management and discuss principles of risk management, disaster management concepts, conceptual and technical challenges in measuring disasters and their impact on public health and its effective management. Participants prepare action plans for their individual institution based on the knowledge gained and are discussed in follow up programmes a month later.

Outcome

HEDMaTC is the only institution in Sri Lanka that is accredited by the Ministry of Health, Sri Lanka to train their staff in disaster management. HEDMaTC has trained 200 personnel in Public Health Emergency and Disaster Management, 117 in Sexual and Reproductive Health Services in Crises and 1034 in pre-hospital emergency care. The trained personnel were mobilized to the North and East of the country to handle healthcare issues, ranging from administration to ground work, of almost 300,000 displaced civilians in 2009 with a very satisfactory outcome.

Recommendations

The training methods used in these programmes are especially beneficial in adult training and it is to be recommended. We also recommend that HEDMaTC to be developed as a regional training center for South Asia.
(P1-49) Development of the Disaster Drill for the Staff Member at the Hospital of the Region in Japan
Authors: Arishima T. , Higashioka H. , Tanaka K. , Hayano D. , Matsui N. , Hayashi M.
Published: May 2011

A hospital disaster drill is commonly carried out based on the activities assigned beforehand by the occupational description. However, it is difficult for each staff the role is fixing to understand the global image of a disaster correspondence in a hospital disaster when their role is assigned and fixed. We have developed the understandable drill about the whole practice at each hospital in disaster. We keenly realized the necessity of a standard disaster medicine. Therefore we have developed the disaster drill which can be held per hospital. As a goal of a course, each hospital personnel could understand the global image of the disaster, and aimed at the daily course which can master necessary minimum skill to correspond a disaster in each hospital. From the reasons above, we created the course which consisted of a lecture, individual skill training, and a gross training. As essential skill, it starts with (1) management of disaster countermeasures office (2) management of triage post (3) treatment at room (4) support of conveyance between hospitals (5) information control. In order to employ these individual skill booths efficiently we divided attendances into five groups. Five hospitals started from 2008, were carried out 11 times, and about 500 persons took this disaster drill on a course. We expect that cost to bellower, the course to be simpler, and the quality of training will improve by holding this course repeatedly.
(P1-50) Pilot Study: The Challenges of Full Scale Radiation Decontamination Drills with Special Needs Populations
Authors: Joshi N.K. , Arquilla B. , Roblin P.
Published: May 2011

Special needs populations are often excluded from emergency preparedness plans, despite their vulnerability. As defined by the CDC one aspect of special needs is physical disabilities which include mobility issues. In 2009 the CDC reported 16% of the US non-institutionalized population as having a physical disability. The literature is limited and empirical evidence on addressing the needs of disabled individuals in disaster preparedness is sparse. This demonstrates the need for guidelines on how to plan for the needs of individuals with physical disabilities during disasters. In July 2010 a coalition of hospitals in Central Brooklyn, NY, University Hospital Brooklyn, Kings County Hospital Center, and Kingsbrook Jewish Hospital Center conducted full scale radiological decontamination exercises which incorporated people with physical disabilities. The exercises utilized the same set of drill participants; 17 total victims and 4 victims with physical disabilities that included 2 wheelchair bound nonmobile victims. The exercise required the HAZMAT teams to address in their decontamination plan the use of accessible equipment for nonmobile individuals. As a pilot study, we hypothesized that the hospitals would be unprepared to decontaminate special needs victims, especially the nonmobile victims based on guidelines published by the US Department of Health and Human Services. By conducting this exercise we found that the hospitals were unprepared to effectively decontaminate special needs victims. We also had a secondary finding that showed that the exercise failed to reach the primary goal also because of the artificiality of the drill. By utilizing healthy actors to assume the role of special needs victims, we found that many of the challenges of special needs victims were bypassed. We share the lessons learned in this drill in both the decontamination of special needs victims and how to prevent the short cuts that can occur in drills that simulate real life scenarios.
(P1-53) Effectiveness of “Understanding Disasters” Training Among Health Care Professionals and Responders in China
Authors: Lin C.L.Y. , Hung K. , Chan E.Y.Y. , Lee P.P.Y.
Published: May 2011

Background

Knowledge about disasters plays an essential role in managing and responding to disasters and emergencies, especially among a group of health care professionals who are actively or will potentially be involved in disaster and emergency settings. A set of training materials that aims to enhance understanding of disasters and their impact of health has been developed. This project aims to examine the effectiveness of the disaster knowledge training to improve technical knowledge and perceptions of health impact of disasters in health care professionals and responders.

Methods

“Understanding Disasters” training was provided to 300 health care professionals during May to October. Each of the participated attendees filled a pre- and immediate post-training survey that contains socio-demographic information and 20 items measuring various knowledge of disasters.

Results

287 individuals completed the questionnaires (95% response rate). Findings demonstrated that training may effectively enhance one's knowledge about disasters, especially by clarifying the myths and misunderstandings towards disasters. Respondents demonstrated an enhancement of knowledge in 70% of the questions (14/20). Of note, while the whole sample exhibited an enhancement in knowledge, non-clinical staff appeared to have more statistical significant gained in knowledge than clinical based trainee.

Implication

Although disasters cannot be controlled, human impacts of disaster can be mitigated if appropriate training might be offer. This study demonstrates that training program might be useful to enhance better understanding of health impact of disasters.
(P1-55) Ten Commandments for Emergency Preparedness Deployment – A Basis for Quality Model
Authors: Wilhelm Kafil M. , Otits L. , Ashcenazi M.
Published: May 2011

Hospitals are obliged to maintain emergency preparedness plan to support the army's rear. Hospital preparedness plans contain several scenarios that are aimed to provide an answer to different crisis situations. The basis of these scenarios is common to all situations. Haifa region three hospitals cooperation in emergency preparedness plans extracted Ten Commandments for utmost emergency deployment: a. Creating a clear management policy b. Assigning high proficiency qualified key persons. c. Creating a multidisciplinary management team: Physician, nurse and administrator, with the notion that there is only one manager. d. Emergency activities are similar as possible to routine level. e. Using am assignment method for f. Clear and elaborated checklists are the basis for emergency activities. g. Trainings and drills are a solid basis for knowledge. h. High materials and infrastructure availability and stocks. i. Accessible communication channels. j. Debriefing is the basis for organizational learning and quality improvement. These Ten Commandments are the milestones for a quality model, developed for emergency preparedness. The quality model outlines our constant quest to achieve a state of the art emergency preparedness system in a region that has been involved and is prone e to a variety of emergency scenarios. Ten Commandments for Emergency Preparedness Deployment – a Basis for Quality Model.
(P1-56) Recent Scientific Writing about Consequences of Disasters on the Health of Worker
Authors: Maltais D. , Gauthier S.
Published: May 2011

Recent Scientific Writings about Consequences of disasters on Workers Danielle Maltais, Ph.D. and Simon Gauthier, M.Sc. University of Quebec in Chicoutimi (UQAC) When an application of emergency measures is issued following a natural or technological disaster, or a disaster caused by human negligence, in many countries social workers and nurses play a central role in the support to the victims not only during the period of social disturbance but also at the time of the return to a normal life. These workers sometimes find themselves plunged within various intervention sectors where work conditions are often difficult. Once juxtaposed to the characteristics attached to disasters (nature, suddenness, duration, intensity, etc), the characteristics of the workers (intervention skills, training received, intrinsic efforts made, etc) and to the characteristics of the organizations (expectations towards their employees, organizational support offered to the employees, extrinsic efforts required, etc), these conditions increase their level of vulnerability by exposing them to environments harsh to manage. This vulnerability experienced by the workers in an emergency period can be reflected through symptoms such as anxious disorders and exhaustion. This poster will present the major findings of recent studies in this field (impact of disaster on the psychological health of workers) while under lighting personal, contextual and organizational factors which either contribute to the presence of psychological health issues for the workers or facilitate their resilience.
(P1-57) Develop New Mechanism of Capacity Building of Disaster Preparedness in China
Authors: Zhang W. , Huang B. , Miao S. , Yao J. , Zhang B. , Li Q.
Published: May 2011

Background

China is one of the countries most affected by natural disasters, it is an important restricting factor for economic and social development. However, Disaster Medicine training is not included in medical education curriculum in China, continual training is separated among public health professionals and clinical personals.

Methods

WHO provides technical and financial support for public health emergency preparedness through intensive training and workshop. We intended to develop a new working mechanism under the support of WHO and MOH, China for capacity building of disaster preparedness in China with the combination of public health professionals and clinical personals though TOT training.

Results

Through the new mechanism, public health professionals from CDC system and clinical personals from hospitals could benefice mutually fro each side and strengthen the effectiveness for the disaster preparedness.

Conclusion

The new mechanism increases the effectiveness of capacity building for disaster preparedness, TOT training should transit from national level to local level.
(P1-58) Frailty, Dementia and Disaster: An E-Learning Initiative for Health Care Providers
Authors: Maltais D. , Gibson M. , Hardy L. , Ruthe S. , Balazs M.
Published: May 2011

Frailty, Dementia and Disaster: an e-learning initiative for Health care providers D. Maltais1, M. Gibson2, L. Hardy3, S. Ruthe4, 1University of Quebec, Chicoutimi 2St. Joseph's Health Care London, London 3Health and Social Services, Yukon Territory Government, Whitehorse 4Emergency Program, Corporation of the District of Oak Bay, Victoria, Canada.

This poster describes the development, piloting, evaluation, and dissemination of the e-learning tool: “Frailty, Dementia and Disasters: What Health Care Providers Need to Know”. The purpose of the e-learning tool is to contribute to international efforts to reduce the disproportionate vulnerability of older adults in emergencies and disasters. Key literature on geriatric emergency preparedness and response issues, including the roles and responsibilities of health care providers, was identified and synthesized. Content was piloted in a facilitated workshop in Ontario. A Canada-wide health provider reference group provided feedback on the transition from a traditional powerpoint presentation to an e-learning format. The evaluation process included facilitated review of the tool by health care providers in two in-person workshops in each of Yukon and Quebec and in an independent review by health care providers in British Columbia (virtual). The learning objectives of the e-learning resource are to help health care providers, administrators and policy makers understand the: · disproportionate vulnerability of older adults who are frail and those who have dementia, in emergencies and disasters; · components of the emergency management cycle and how they apply to this target population; · best practice resources that can be used to improve emergency preparedness, response, recovery and mitigation; and · role of health care organizations and providers in emergency management for these older adults. The e-Learning tool is hosted with open access on www.dementiaknowledgebroker.ca (DKB), a platform facilitated by the CDRAKE - the knowledge exchange theme of the Canadian Dementia Knowledge TranslationNetwork (CDKTN).
(P1-69) Joint Military and NGO Vaccination Campaign in Remote Areas in Haiti
Authors: Paladino L. , Lucchesi M.
Published: May 2011

Introduction

The January 12 2010 7.0-magnitude earthquake's epicenter hit just 10 miles west of Porte-au-Prince and its 2 million inhabitants at 4:53 pm.

Problem

Although assistance arrived to major ports and cities from all corners of the globe, access from rural and remote areas to centralized hospitals remained difficult. Many of the injured were without access to transportation even a month after the earthquake. Earthquake victims in remote areas have less access to wound care and running water, and therefore more pone to infection and tetanus.

Response

Our group was comprised of a civilian mobile medical team able to negotiate difficult terrain by foot with vehicle support provided by the 82nd Airborne military. The military support supplied vehicles and experience needed to tackle the difficult terrain. Because the vaccines are temperature sensitive, delivery of them to remote areas with long travel times in hot climates is logistically difficult and requires coordination. In order to assure vaccines would not be wasted, they were picked up from the WHO the morning of deployment and stored in coolers without direct contact with ice. An advance team would arrive to the target site first to coordinate with local community leaders and gather patients with tetanus prone wounds in a central area. A second team would transport the amount of vaccine needed as estimated by the advance team.

Result

Our group vaccinated approximately 300 people without access to the centralized hospitals per day using this system, with no vials of vaccine wasted or spoiled.
(P1-72) Advanced Surgical Cooling Garment to Combat Heat Stress in CBW Ppe and Hot Surgical Environments
Authors: Mcisaac J.
Published: May 2011

Introduction

Heat stress is an occupational hazard for all personnel requiring Personal Protective Equipment (PPE). Even “breathable PPE” increases measurable heat stress in active troops and surgical personnel. A novel negative-pressure, semipermeable surgical cooling vests for use in the operating theater was jointly developed by Mountain Laurel Biomedical, Hamilton Sundstrand, and Hartford Hospital.

Materials and Methods

Surgical personnel alternated between wearing cooling garment vs no cooling under their surgical gowns (PPE) during surgical procedures lasting up to several hours. Tympanic temperatures were monitored for safety. A questionnaire was completed after the conclusion of surgery to assess perception of comfort. Trials began at ∼18 deg C, but ambient temperature was increased to 24 deg C (40–50% RH) for the third series of trials. Results: The study was terminated prematurely. After wearing the cooling vest, surgeons refused to complete additional control trials due to the heat. They demanded to use the cooling device for all surgery, even outside the protocol! Vest wearers remained dry and reported a statistically significant (p < 0.0001) greater level of comfort compared to control subjects. The weight, fit, and mobility restriction of the vest was not clinically significant.

Conclusion

Active cooling and drying using a negative pressure cooling vest improves subjective thermal comfort with minimal perceived impact on mobility during surgical procedures. This technology may have utility in other fields that utilize PPE. The Chemical Biological Warfare (CBW) ensemble, in particular, is a promising candidate. Heat stress from PPE ensemble even if “breathable” -Cooling at ∼100 watts with 18 deg C water -Semipermeable membrane allows condensation removal. Wearer stays cool and dry. -Negative pressure prevents coolant loss if punctured -Minimal perceived restriction of shoulder, neck, and waist range of motion - Light weight ∼1.5 lbs. (0.68 kg) - Quick disconnects allow options for cooling source.
(P1-89) Psychosocial Tsunami- Financial Crisis
Authors: Saenz M.C.
Published: May 2011

Psychosocial Tsunami Financial Crisis Tragedies produced by nature have patterns similar to psychosocial emergencies. The disruptive effects impact on Public Health. Unemployment covers society and doesn't allow personal aptitudes to emerge and sinks people in hopelessness. There is a perception of constant risk. People are in alert with all the effects of sharp and chronic stress and in some occasions Post Traumatic Stress.

Objective

To get an efficient answer to reality from this impoverished group with severe effects facing working uncertainty and unsatisfied basic needs. To avoid the social tragedy to be a big wave that sinks a big part of the population very quickly. To train people on the importance of work to get a better quality life for each participant, the family and community.

Methodology and Diagnosis

6200 people were trained in twenty months and motivated to work in a population of 95000 citizens approximately. They got a salary and social security financed by the government and articulated with the NGO. They were organized according to working experience and abilities and a supervisor was elected every ten people. Each participant had been polled to reach these conclusions. Industrial security, health care, and group work abilities were some of the syllabus topics. Some of the tasks performed were: painting, gardening, public places embellishment and fixing, administrative duties, river cleaning, etc.

Conclusion

90% of labour inclusion among unemployed people. Acknowledge from the participants of their working abilities. To generate hope in uncertainty diminishing violence. Generate space to diminish stress with impact in cardiology matters, addictions and pathologies. The disruptive effects of financial crisis are diminished considerably in these groups.
(P1-90) Guidelines for Psychosocial Support for Uniformed Services
Authors: Te Brake H. , Rooze M.
Published: May 2011

In the Netherlands in 2010, the multidisciplinary guidelines for the psychosocial support of uniformed services organizations (USOs) were developed. These guidelines are accepted as a national standard for psychosocial support for police, firebrigade, ambulance services, the Ministry of Defence, and coast guard. This presentation will focus on the backgrounds, development, and status of these guidelines, and an outline of the contents will be given. Members of USOs consistently are exposed to potentially shocking events. It was recognized that there is a need in the field for clarity and unambiguity about the organization of psychosocial care to this group. The goal of the guidelines is to guarantee optimal psychosocial support and care after experiencing disasters and shocking events, so that stress-related health problems among members of the emergency services are prevented. The guidelines are evidence-based, i.e., they are based on the results of the latest scientific studies, knowledge from experience (best practices), and other considerations. Consensus was reached that the promotion of the existing means of recovery of the USO member, and the facilitation of these means by peer support structures, are the key to a successful psychosocial support system. The peer support system has an important role in recognizing those affected with psychological and/or serious clinical symptoms that require diagnosis and/or treatment. Diagnosis and treatment should be exercised by mental health professionals. Therefore, they must be readily available, but should only be deployed when necessary. Three phases in the psychosocial support for USO members are discerned: (1) preparation (selection, information and training); (2) peer support and monitoring, (3) and referral for professional care (if necessary). The guidelines provide recommendations for the USO for each of these phases. National guidelines such as these should be discussed internationally to see whether they can provide a basis for further (international) implementation and use.
(P1-93) Apathy Syndrome
Authors: Eryilmaz M. , Bilgitekin M.H. , Biyikli D.K. , Altintas H. , Celikmen F. , Durusu M. , Arikan R. , Arziman I. , Sengul A.
Published: May 2011

Summary Apathy syndrome is the apathy attribution of persons, foundations, nations or global world against the preparations and arrangements to avoid progression of disaster. In this article, it is aimed to review the collected opinions of authors who are studying causes of apathy syndrome. The factors of avoiding to be prepared against natural disasters can be classified under three main topics; personal, social and cultural. The personal factors or the factors depending on persons are discussed in three sub topics, respectively emotional factors, mind-related factors and behavioral factors. Particularly “resistivity against changes” and “unwilling to abandon habits” are emphasized as the major reasons. The topic, social factors, can be sorted out as insufficient administrative/political volition acting against disaster and being undeveloped among the cultural factors preventing disaster preparations, believing and mystical meaning giving onto “disaster” expression have been reserving spectacular space. Individuals and society are perceiving disaster as a divine punishment and this perceive makes meaningless to get prepared. Consequently, it is evaluated that sensitive to country conditions, culture, sexual discrimination of society, age and special disability circumstances, and also versatile, deep and penetrating, keeping continuity, analytically approaching formal education can resolve disaster troubles of countries. Authors of this article have emphasized crucially to establish an academy of disaster contributed every kind of disciplines as soon as possible in the world.
(P1-103) Utilization of a Pediatric Disaster Coalition as a Model for Regional Pediatric Disaster Planning
Authors: Foltin G. , Flamm A. , Cooper A. , Sagy M. , Greenwald B.M. , Conway E. , Shah V. , Biagas K. , Abularrage J. , Uraneck K. , Gonzalez D. , Treiber M. , Goldfeder M. , Tunik M. , Frogel M.
Published: May 2011

Purpose

There remains a lack of comprehensive pediatric emergency preparedness planning worldwide. A disaster or mass-casualty incident (MCI) involving pediatric patients could overwhelm existing pediatric resources within the New York City (NYC) metropolitan region. The NYC Department of Health and Mental Hygiene (DOHMH) recognizing the importance to plan for a MCI with a large number of pediatric victims, implemented a project (the Pediatric Disaster Coalition; PDC), to address gaps in the healthcare system to provide effective and timely pediatric care during a MCI.

Methods

The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from the NYC pediatric/children's hospitals, DOHMH, Office of Emergency Management, and Fire Department (FDNY). Two committees addressed pediatric prehospital triage, transport, and pediatric critical care (PCC) surge capacities. They developed guidelines and recommendations for pediatric field triage and transport, matching patients' needs to resources, and increasing PCC Surge Capacities.

Results

Surge recommendations were formulated. The algorithm developed provides specific pediatric triage criteria that identify severity of illness using the traditional Red, Yellow, and Green categories plus an Orange designation for continual reassessments that has been adopted by FDNY that has trained > 3,000 FDNY EMS personnel in its use. Triaged patients can be transported to appropriate resources based on a tiered system that defines pediatric hospital capabilities. The Surge Committee has created PCC Surge Capacity Guideline that can be used by hospitals to create their individual PCC surge plans. 15 of 25 NYC hospitals with PCC capabilities are participating with PDC planning; 5 have completed surge plans, 3 are nea completion, and 7 are in development. The completed plans add 92 surge beds to 244 regularly available PICU beds. The goal is to increase the PCC surge bed capacity by 200 + beds.

Conclusions

The project is an effective, multidisciplinary group approach to planning for a regional, large-scale pediatric MCI. Regional lead agencies must emphasize pediatric emergency preparedness in their disaster plans.
(P1-105) The Surgical Care of Children with Gunshot Wounds in a Children's Field Hospital
Authors: Petlakh V.I. , Rozinov V.M. , Jandiev S.I. , Ivanov D.J. , Shabanov V.E.
Published: May 2011

Introduction

The treatment of victims with gunshot wounds has gained importance over the past 10–15 years due to continuous military conflicts and the increase in terrorist and criminal acts. Since 1992, a group of pediatric surgeons has been trained to treat gunshot wounds in both children and adults in field hospitals of the Russian Service of Disaster Medicine in Northern Caucasus.

Methods

Two working models of a Children's Field Hospital (ChFH) were reviewed. In the first model, a ChFH was implemented for 14 months (April 2001–July 2002) during a military conflict in the Chechen Republic. There were no other hospitals rendering medical aid to children in the area. In the second model, a field hospital was created for children following a terrorist act in Beslan, Northern Ossetia in 2004.

Results

Over the 14 month period, the Chechen Republic ChFH rendered medical aid to 102 adults and 20 (16.4%) children with gunshot wounds. Self-made explosives and unexpected munitions were blamed for explosive trauma in children. Two children died in the ChFH, and one child with amputated lower limbs was transported to Moscow for prosthetics placement. Three hundred eleven children presented to ChFH, including 55 children not requiring medical aid, and 256 wounded children, who were divided into 3 groups: 5 dying; 52 wounded and requiring emergency treatment; and 199 wounded who were transported to hospitals in Vladikavkaz after receiving initial medical aid at the ChFH. In total, 47 operations were performed, including seven abdominal and chest surgeries. Re-animation aid was provided at the Intensive Care Department of the ChFH for the stabilization of the critically wounded prior to their evacuation.

Conclusion

In the situation of mass admissions of wounded patients, the most important considerations are triage and the arrangement of operations according to urgent indications.
(P1-105) Osteosynthesis of Children with Femur Fractures from Traffic Accidents
Authors: Rozinov V.M. , Jandiev S.I. , Petlakh V.I.
Published: May 2011

Introduction

The growing number of children suffering polytrauma from traffic accidents dictates the expansion of the indications for osteosynthesis. Elastic-stable intramedullary osteosynthesis (ESIN) is the optimum treatment of fractures of long bones in children.

Methods

Closed intramedullary osteosynthesis of diaphyseal femur fractures with flexible nails was performed in 74 patients (76 fractures) during 2006–2010. The patients were children ages 1–8 years. Titanium elastic nails (TEN) (Synthesis, Switzerland) were used in the procedures. AO Foundation recommendations were adhered to when selecting the size of the implant (i.e., diameter approximately 1/3 the diameter of the femur medullar canal at its narrowest part).

Results

There was a prevalence (n = 53) of simple fractures (Ð3 by AO classification) in this group of patients. Sixteen children had Ð2-type fractures, five with spiral (Ð1), and two with slanting (Ð2) fractures. There were no type Ð1 or Ð3 complex fractures in this group. Good functional results of closed intramedullary osteosynthesis with TEN at diaphyseal fractures of the femur in children with isolated and associated damages were achieved. There were no post-operative complications. This method provided stability of osteosynthesis, which allows activating patients in the short- term, i.e., during the post-operative period.

Conclusion

Treating femur fractures in children with ESIN provides optimum treatment of polytrauma. Osteosynthesis without exposure to the area of damage, and the early activation of children can prevent infectious complications and contractures.
(P2-3) Analysis of Chest Compression Rate and Its Affect on the Quality of Chest Compressions
Authors: Emberts Z.T. , Schwab J.H. , Williams A.L. , Birnbaum M.L. , Padjen P.D. , Bhattacharya A. , Olson S.K.
Published: May 2011

Background

In the last 50 years of modern-era cardiopulmonary resuscitation (CPR), survival rates remain dismal, worldwide. International CPR guidelines recommended a compression rate of at least 100 per minute. There is little evidence documenting if and to what extent high compression rates affect the quality of chest compressions.

Objectives

An objective of this study was to evaluate the effect mean compression rate (MCR) had on the overall quality of chest compressions. Investigators hypothesized that MCRs > 110 would result in a smaller percentage of adequate: compressions (PAC); depth (PAD); and recoil (PAR).

Methods

In this observational pilot study, basic life support providers were recruited from prehospital and in-hospital settings to provide 10 minutes of continuous chest compressions, based on the 2005 American Heart Association guidelines. An adequate compression was defined as a compression that was > 35 mm, had full recoil, and correct hand position. Data were recorded using the Laerdal PC Skill reporting System.

Results

Ninety four (91.3%) of 103 participants completed 10 minutes of compressions. Rescuers represented a variety of backgrounds, average age of 35.5 ± 11.0 years. Fifty eight (56.2%) rescuers had performed CPR in the last two years, and 54 (52.4%) practiced prehospital EMS. Providers that did not complete the entire 10 minutes tended to have a higher MCR than those completing 10 minutes, 114.2 ± 19.3 vs. 105.8 ± 15.4 respectively. Within the first two minutes, rescuers with a MCR > 110 delivered 45% of their compressions adequately, compared to 60% when a rescuer's MCR was < 110. This initial disparity was primarily due to decreased PAR, not decreased PAD. After 2 minutes, higher MCRs correlated with decreased PAC, due to decreased PAD.

Conclusions

Data indicates a higher MCR results in decreased PAC, PAD, and PAR, likely attributed to increased rescuer fatigue.
(P2-8) Analysis of the Performance of Emergency Medical Services Management of 51 Mass-Casualty Incidents in Israel
Authors: Jaffe E.
Published: May 2011

Introduction

Between February 2002 and January 2004, a total of 51 terrorism-related mass-casualty incidents (MCIs) occurred in Israel.

Objective

The objective of this study was to analyze data provided in After Action Reports (AAR) held by Magen David Adom (MDA), after each MCI.

Methods

Information relating to the type of MCI, location, number of ambulances dispatched in five-minute intervals from time of notification, and number of casualties evacuated by urgency in five-minute intervals from the start of the incident was analyzed.

Results

There were 34 MCIs in 2002, 15 in 2003, and two in 2004. More MCIs (24%) occurred on Wednesdays, and more MCIs occurred during the 05:30–08:59 (18%), 12:00–14:59 (20%), and 17.00–19.59 (24%) time slots. More MCIs occurred in the Jerusalem (24%) area, followed by Tel Aviv (16%). Twenty-six percent of the MCIs resulted from explosions in open areas, 22% in buses, 20% from shootings, and 28% from explosions in semi-closed and closed areas. The mean dispatch time of the first ambulance after notification was 48 seconds. An average of 14.25 ambulances were dispatched in the first five minutes, followed by eight, three, and three in the five-minute slots following. An ANOVA indicated a significant difference in dispatch times by towns/cities (p = 0.05). The average arrival of the first ambulance was 6.4 minutes, and evacuation of the first urgent casualty was 13.6 minutes, the last evacuation was 26.5 minutes after arrival. More urgent casualties (45%) compared to 20% non-urgent were evacuated in first 15 minutes; the majority of non-urgent victims (79%) were evacuated after 16 minutes. The mean number of dispatched ambulances ranged from 37.9 to 26 in urban versus rural areas, respectively. The number of ambulances actually used for evacuation in urban and rural areas was 55% and 44%, respectively.

Conclusions

Information analyzed from AAR is useful for improving Standard Operating Procedures and structuring continuing education interventions for MCIs.
(P2-9) Patient Allocation to Hospitals During Mass-Casualty Incidents
Authors: Ruettger K. , Lenz W.
Published: May 2011

Due to the limited resources of specialized hospital departments, the allocation of patients to different hospitals according to the severity of their condition is an extraordinarily complex and time-critical problem. The emergency capacity was determined for all medical centers (n = 135) in the State of Hessen, for patients of the various hospitalization triage categories (red, yellow, green), for normal working hours, for weekends and nights, including logistic specifications of a potential helicopter landing. This data was entered into a state register. Using the data from the “acute-care-register”, a Ticket System was developed that allows the operations management to assign patients according to the severity of their condition, urgency and necessary specialization (e.g., neurosurgery, ophthalmology, pediatrics) to a hospital without exceeding the admission and/or treatment capacity of the hospital/facility. During a non-critical period, the order of allocations depending on the distance of the clinic to the site of the emergency is planned in advance so that no further modifications are necessary during the acute intervention phase of an emergency response. Additional notification of hospital capacities for severe casualties provided during the emergency response can be easily and immediately supplemented. Due to the relatively low frequency of such emergency responses, a cost-effective concept that is easily adaptable to the respective fields of application has been discovered. The system is a sticker set customized for the respective rescue teams. The sets will be carried permanently in the rescue equipment by the organization manager of the rescue service team. The equipment is not dependent on electronic components. The cost per sticker set is approximately US$50. Keeping track of the patient allocations is assured.
(P2-15) Problems of Permanent Threat of Impact on Persons Authorized as Drivers
Authors: Umyerov R.A. , Rossodivita A. , Trufanov A. , Memetov R.N.
Published: May 2011

Introduction

People using public transportation have to put their health and even their lives in the hands of personnel authorized to drive the vehicles. But, organizers are taking unprecedented measures to protect transportation from diverse threats. However, there is often overwhelming evidence of the weak effectiveness of pertinent measures.

Method

There is a permanent threat of possible physical and/or psychological impact on persons authorized as drivers, which leads to a possible threat to the health and lives of others. Such events can be divided into two groups: (1) pre-driving; and (2) in-driving. Anthropogenic impacts while pre-driving and in-driving periods stimulate feelings of fear, which comprises different components.

Results

In the pre-driving group, drivers face overwhelming mental health impacts. This includes fear for their lives and health, fear of responsibility for family, friends, and passengers. In the in-driving group, the variation of physical and mental impacts determines the addition of fears of other categories.

Conclusion

Integrated sensors for measuring levels of blood pressure, sweating, heart rate, respiratory rate, and changes in the retina of the eye should be implemented. This hardware and software should process information about drivers. They would provide instant alerts on changes in the indicators.