bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Registry Software for Road Traffic Injury Patients at Apex Trauma Centre in India: An Innovation
Authors: Kaushik Gaurav , Gupta Amit , Kumar Subodh , Soni Kapil Dev , Sharma Ankita 
Published: May 2019

Introduction:A trauma registry is a disease-specific data collection composed of a file of uniform data elements that describe the injury even, demographics, prehospital information, diagnosis, care, outcomes, and costs of treatment for injured patients.Aim:To establish a trauma registry system on an electronic platform enabling data capturing through Android phones.Methods:A software has been developed for the registry data collection for road traffic injury patients arriving at JPNATC, AIIMS, New Delhi. The software has been designed to use in the Emergency Department on Android phones/laptops with internet access.Result:A detailed registry data set has been prepared to enter prehospital, in-hospital, and post-discharge details of all the admitted patients. This includes demographic data, prehospital data, injury event data, vital signs within 24-hrs of arrival, ED disposition (date and time), operative procedures within 48 hours of arrival, chest x-ray (date and time), CT (date and time), ventilation days, ICU-stay days, hospital disposition (date and time), injury coding data (region, severity level, ISS, AIS, ICD-10) and Others, e.g., first neurosurgical consultation (date and time) and first blood transfusion (date and time). There are two panels for this software; one for user panel and another for the administrative panel. User panel is being used for data collection by the trained data collectors 24/7 at the emergency department on a rotation basis. The administrative panel is accessible to only the investigator or other authorized persons. The administrative panel and user panels are password protected. The entered data is being saved in a spreadsheet in the backend and can be used for periodic data quality check and data analysis.Discussion:There is no trauma registry in India so far for the road traffic injury patients. Present innovation would lay the foundation of national Trauma Registry in India.
Rescue Operations in Underground Mines: Caring for Patients in a Challenging Environment
Authors: Karlsson Sofia , Saveman Britt-Inger , Gyllencreutz Lina 
Published: May 2019

Introduction:Major injury incidents in underground metalliferous and mineral mines are rare, but if, e.g., a major fire would occur, it is the emergency medical service (EMS) together with the mining company and rescue service who perform the rescue operation. Therefore it is important to develop safe and efficient rescue operation procedures for all the organizations involved, especially the EMS personnel.Aim:To examine EMS personnel’s perceptions and experiences regarding underground mining incidents.Method:Individual interviews were performed with 13 Swedish EMS personnel. The interviews were transcribed verbatim and analyzed with qualitative content analysis.Results:The theme “providing the same care in a difficult environment” emerged. Depending on the type of incident, the EMS personnel considered if the injured mining workers could be cared for either outside or in the mine in order to access and care for the injured mining workers as quickly as possible. The EMS personnel mentioned that it was difficult to make the decision if they should enter the mine or not due to the uncertainty of their safety. They also considered that it could be harder to accomplish the same level of care as in other incidents due to the difficult environment. In some instances, they cannot drive their ambulance vehicles into the mine, so they have to prioritize which equipment to bring as well as consider how to transport the patients.Discussion:The results identify some of the difficulties the EMS find challenging. Therefore the results could be used in finding solutions and making the EMS prepared for an effective and timely response for injured in underground mines.
Research on Design of a Disaster Medicine Course for Clinical Medical Student
Authors: Wan Zhi , Hu Hai 
Published: May 2019

Introduction:Currently, there is no uniform and standard disaster medicine course for students in medical school.Aim:To design a disaster medicine course model based on knowledge structure, teaching and evaluation methods according to experts’ advice and interest of undergraduates majoring in clinical medicine.Methods:The first and second level catalog defined as chapters and sections for the disaster medicine curriculum were drafted based on literature and summary of fragmentary experience. The teaching syllabus with methods of teaching and evaluation was initially outlined. The expert consultation form and student questionnaire were designed and validated. Experts in disaster medicine in China were consulted and students in our medical school were investigated. Delphi Methods was used and the chapters and sections were adjusted and weighed according to experts’ advice through the Analytic Hierarchy Process. The teaching and evaluation methods for each knowledge module were obtained based on suggestions from experts and students.Results:A total of 31 experts were consulted. 320 students were inquired. By two rounds of consultation with Kendall coordination coefficient W value 0.207, chi-square value 128.781(p=0.01), consensus about the knowledge structure for the curriculum were achieved, which consisted of 6 chapters (as Introduction to disaster medicine, incident command, medical knowledge and skills in disaster, public health, ethics in disaster, information management, with the weights of 0.1486, 0.1999, 0.4209, 0.0785, 0.0748, 0.0774 respectively)and 25 sections. Teaching methods for different knowledge module were determined, which included lecture, demonstration, case discussion, drill and sand table simulation. And the evaluation methods were affirmed as a quiz, written examination, skill test and teamwork test assessed by intra-group and inter-group evaluation.Discussion:Through scientific investigation of experts in disaster rescue and undergraduates majoring in clinical medicine, a disaster medicine course model for clinical medical students was established.
Resilience Training of Regional Medical Command and Control
Authors: Pettersson RN Jenny , Jonson Carl-Oscar , Berggren Peter , Woltjer Rogier , Hermelin Jonas , Prytz Erik 
Published: May 2019

Introduction:Resilience is often described as a desirable holistic approach to disaster preparedness. However, the term has a wide variety of meanings and is hard to operationalize and implement in disaster management. A goal for the EU H2020 project DARWIN was to operationalize resilience for incident management teams.Aim:To test the resilience operationalization by analyzing command team behaviors in a major incident exercise and trace observations to resilience theory.Methods:A regional medical command and control team (n=11) was observed when performing in a functional simulation exercise of a mass casualty incident (300 injured, 1800 uninjured) following the collision of a cruise ship and an oil tanker close to the Swedish coast. Audio and video recordings of behaviors and communications were reviewed for resilient behaviors based on the DARWIN guidelines using the “resilience markers for small teams” framework (Furniss et al., 2011).Results:A total of 121 observed instances of resilient behaviors were found in the material. In 95 cases (79%) the observed behaviors followed a priori hypothesized connections between resilient strategies and general markers. Certain marker-strategy combinations occurred frequently, such as 18 observations where the strategy “understand crucial assumptions” occurred together with the marker “adapting to expected and unexpected events.”Discussion:Resilience has the potential to contribute to a more holistic disaster management approach. The findings that the observations, in general, correspond to the expected relationship between theoretical concretization and contextualization supports the DARWIN effort to operationalize resilience theory. This is a prerequisite for developing observational protocols for training and further studies of resilient behaviors in disaster management teams.
Sleep in Emergency Services Workers: What Do We Know and Why Does It Matter?
Authors: Ferguson Sally , Aisbett Brad , Wolkow Alexander , Jay Sarah , Ridgers Nicola , Vincent Grace 
Published: May 2019

Introduction:Emergency service workers perform physical work while being subjected to multiple stressors and adverse, volatile working environments for extended periods. Recent research has highlighted sleep as a significant and potentially modifiable factor impacting operational performance.Aim:This presentation would (a) examine the existing literature on emergency service workers’ sleep quantity and quality during operations, (b) synthesize the operational and environmental factors that impact sleep (e.g., shift start times, shift length, sleeping location, smoke, noise, heat), and (c) assess how sleep impacts aspects of emergency service workers’ health and safety, including mental and physical health and performance.Methods:This presentation would be based on a narrative review conducted by the authors which used a systematic search strategy of health-related databases. Articles that were not relevant, duplicate or from non-peer-reviewed sources were excluded.Results:Sleep is restricted during emergency service deployments, particularly when shifts have early start times, are long duration, and/or when sleeping in temporary accommodation (e.g., tents, vehicles). Shortened sleep impairs cognitive but not physical performance under simulated emergency services conditions.Discussion:Depending on the organization and jurisdiction, these findings warrant re-evaluation of existing policies, formalization of beneficial but currently ad-hoc practice, or provide support for current procedures. Work shifts should be structured, wherever possible, to provide regular and sufficient recovery opportunities (rest during and sleep between shifts), especially in dangerous working environments where fatigue-related errors have more severe consequences. For agencies to continue to defend local communities against natural hazards, strategies should be implemented to improve and manage emergency service workers sleep and reduce any adverse impacts on work.
Strategies to Decrease Nurses’ Stress in a Federal Medical Station (FMS) Medical Needs Shelter in the U.S. after a Hurricane Disaster
Authors: Smith Montray , Hines-Martin Vicki 
Published: May 2019

Introduction:National Disaster Medical System (NDMS) Disaster Medical Assistance Teams (DMATs) are used to provide medical care when local and state resources are overwhelmed in response to natural and human-made disasters. The stress these professionals experience during these events requires intentional and therapeutic interventions to support emotional and mental resilience. Evidence-based interventions will be presented.Aim:DMATs were deployed after Hurricane Maria to work in a Federal Medical Station (FMS), at the Coliseum Bencito, Manati, Puerto Rico. The FMS was operated through a collaboration of federal agencies and non-government agencies. Community infrastructure was impacted, including two damaged area hospitals, overwhelming available resources with increased patient care demands. The facility provided acute care and short-term services around the clock for a 10-day period, serving several hundred clients, in and around the municipality of Manati.Methods:Several strategies were utilized to decrease stress levels while nurses worked at the FMS included having a safe and secure environment, sharing stories with peers, taking scheduled breaks, utilizing physical activities (Zumba), and having designated sleeping areas. Additional strategies used for clients were relief supply choices, allowing one person to stay with special needs client, and bereaved care.Results:Nurses were able to decrease stress levels to themselves and clients while working with community partners providing acute and chronic health care needs at the area where health care services were impacted. Verbal and written feedback was provided during formal and informal meetings as well as receiving client comments on the services given at the facility.Discussion:Contribution to practice-heightened emotional responses in a disaster setting are expected and should be a focus of intervention even with health care providers. Nurses were able to employ disaster nursing knowledge, including mental health strategies in this setting and be able to better address the needs of others.
Study on the Effectiveness Evaluation of Personal Protective Equipment for Health Care Staff Trained with Graphical Interpretation and Operation
Authors: Sha Yang , Jian-Ping You , Hui-Lan Zhang , Hong-Xia Luo 
Published: May 2019

Introduction:Proper use of personal protective equipment (PPE) is essential when facing emerging infectious diseases. Proper training methods can promote the use of the PPE correctly.Aim:To explore the effect of the training method of sequential operation training on medical staff to master PPE penetration and removal skills, and to study the memory attenuation after training.Methods:Fifteen medical staff with no experience of PPE operation in a hospital were trained to wear PPE in accordance with WHO standards by illustration and sequential operation method. The training included 30 minutes of theoretical teaching and 60 minutes of practical exercises. At the end of the training and 1 week after the training, the training objects were evaluated for PPE operation. A 2.5 x 2.5 cm fluorescent agent was applied on 6 parts, such as hands, chest, abdomen, and knees, to simulate contamination. After taking the PPE off, the parts of the whole body and the inner layer of clothing that were fluorescently contaminated were recorded. The whole operation process was recorded by video to evaluate whether the operation was correct. The error rates of two operations and the contamination position and frequency were compared.Results:The error rate of the operating PPE after training was 18.6%, rising to 31.9% after 1 week (Z=16.0, P<0.05). After the training, the average number of contaminated PPE removal was 1.96±1.56, which rose to 2.96±2.03 one month later. The difference was statistically significant (Z=8.92, P<0.05). The main vulnerable sites are the wrist, chest, abdomen, and left calf.Discussion:Illustrative sequential operation training is an important means to improve the way for medical staff to wear PPE, but it must be completed more than once to ensure that medical staff can firmly master the skills of wearing and removing PPE.
A Study on the Process of Donning and Doffing Personal Protective Equipment of Health Care Workers (HCWs) in China
Authors: Hong-Xia Luo , Hui-lan Zhang , Jian-Ping You , Sha Yang 
Published: May 2019

Introduction:Personal protective equipment (PPE) is a necessary item in the period of unknown and high risk emerging infectious disease. It is not only the necessary requirement of strict isolation but also the last line of defense to protect medical staff.Aim:To determine the frequency and sites of contamination of personnel during the process of using Chinese PPE.Methods:Recruit 56 health care workers (HCWs) who worked in front-line clinical to test PPE issued by the Chinese Center for Disease Control for preventing Ebola virus. Eight batches of HCWs were divided to conduct simulations of contaminated PPE removal using fluorescent lotion. Then the frequency and sites of contamination of personnel were recorded after removal of contaminated PPE. The method of visual observation was used to determine contamination.Results:The frequency of easily contaminated parts included: left hand and wrist (7 times), left calf (7 times), front chest center, left and right chest (6 times each), and left abdomen (5 times). Mistakes in the process of wearing PPE included: clothing touching the ground (20.00%), N95 air mask tightness not checked (13.33%), glove air-tightness not checked (4.44%), protective clothing zipper not checked (4.44%). Mistakes in doffing PPE included: clothes touching the ground or the inner surface is polluted (20.00%), the wrong method of removing N95 mask (14.44%), touching the pollution goggles mirror with hands (12.22%), incomplete washing steps, insufficient time and frequency of hand hygiene (11.11%).Discussion:It is necessary to carry out training on PPE donning and doffing for Chinese medical workers.
To Sedate or Not to Sedate? Lessons Learned from a Novel Pediatric Simulation-Based Training Curriculum for Procedural Sedation Privileges in Acute Care Pediatricians
Authors: Severin Paul , Robin Beverley 
Published: May 2019

Aim:To develop a simulation-based pediatric procedural sedation curriculum for acute care attending physicians to achieve and maintain privileges in this important skill.Methods:Neonatal and pediatric intensive care physicians participated in simulation-based sedation training to achieve and maintain sedation privileges. Participants were required to review pediatric sedation materials prior to participation. Demographic data were collected prior to the simulations, and all participants completed a pre-test to assess their baseline knowledge. Sessions were held in the simulation center or neonatal intensive care unit (depending on group), and the attending physicians, in pairs, participated in two high-fidelity mannequin scenarios (sedation for a painful procedure; hypoxia during sedation). Simulations were followed by a facilitated debriefing session while utilizing a standard performance checklist. All participants completed a program evaluation at the conclusion of their training.Results:Neonatal (n=11) and pediatric (n=9) intensive care attending physicians participated in the sedation simulation training. The program was well received and 100% rated it as “excellent” or “very good”. All participants strongly agreed the instructors allotted time for questions/answers, 100% strongly agreed the debriefing/feedback was effective, 95% strongly agreed instructors had a thorough knowledge and understanding of the program, were supportive, and facilitated learning, and 95% strongly agreed the equipment and physical environment were conducive to learning. Participants reported that simulation-based training and the use of a standardized checklist during facilitated debriefing were very helpful and effective for sedation training. Additionally, many participants indicated the desire for more simulation-based training.Discussion:Simulation-based sedation training is a feasible, easy to implement, and viable learning technique for acute care physicians.
Using Security Guards and Civil Volunteers as First Responders in Medical Emergency Response - Tasks, Needs, and Challenges
Authors: Pilemalm Sofie 
Published: May 2019

Introduction:Public sector challenges have initiated new forms of collaboration between emergency response organizations, occupations from other societal sectors, and civil citizens, not the least in socio-economically vulnerable areas. As collaborations emerge, there is a need to explore the tasks, needs, and challenges of the new resources when providing medical emergency response.Aim:To explore two cases of 1) security guards and 2) organized civil volunteers collaborating with the ambulance services and municipal rescue services, and identifying relevant tasks, needs and challenges. The presentation will focus on their dispatch on medical alerts. A brief comparison of the two groups will also be performed.Methods:A case study approach was applied involving interviews and workshops with security guards, civil volunteers, ambulance services, and rescue services personnel.Results:The civil volunteers are dispatched on medical alerts concerning heart failures and accidents requiring first aid, including stopping major bleedings. The scope of tasks of security guards is broader since they are also dispatched on suicide and assault alerts. Needs in both cases include, e.g., proper training, joint exercises, equipment in terms of defibrillators, torquedos, and first aid kits, and proper ICT/GPS positioning support for dispatching. Challenges are mainly organizational and legal where security guards are somewhat protected by their own employer (e.g., through agreements, trauma support, and safety measures such as receiving a hepatitis vaccine) while civil volunteers do not have sufficient protection in any of these respects.Discussion:Both groups are useful resources in future medical emergency response since they are often close to the incident site and can provide first response while waiting for the professional resources, thereby saving lives and reducing consequences of trauma. However, they need to be better integrated into the professional emergency response system.
Weaknesses and Capacities Affecting the Prehospital Emergency Care for Victims of Road Traffic Incidents in the Greater Kampala Metropolitan Area: A Cross-Sectional Study
Authors: Balikuddembe Joseph Kimuli , Ardalan Ali , Khorasani-Zavareh Davoud , Nejati Amir , Raza Owais 
Published: May 2019

Introduction:Prehospital emergency care is a vital and integral component of health systems, particularly in resource-constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities, and trauma caused by road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the prehospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA).Methods:A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims’ pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions, respectively. Data were descriptively analyzed, and a principal component analysis was employed to identify the most influential weaknesses and capacities affecting the prehospital emergency care for the victims of RTI in the GKMA.Results:From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 20164. key weaknesses and 5 key capacities were identified to affect the prehospital emergency care for RTI victims in the GKMA. Although some strengths exist, (e.g., ambulance facilitation, EMS structuring, and coordination), the key weaknesses affecting the pre-hospital care for victims were noted to relate to the absence of predefined EMS systems, particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment, insufficient skills/training of the first responders, inadequate EMS resources, and avoidable delays to respond and transport RTI victims to medical facilities.Discussion:Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.