bluuebunny/crossref_metadata_2025_split huggingface dataset:
Let’s Rock and Roll Baby! Strengthening Skills to Deliver Basic Obstetric Care in Sudden Onset Disasters
Authors: Jane Kass , Lawrey Emma 
Published: May 2019

Introduction:In 2017 the New Zealand Medical Assistance Team (NZMAT) were verified by the World Health Organization (WHO) as an Emergency Medical Team Type 1. During the verification process, the WHO highlighted the need for further NZMAT capability in the specialty areas of reproductive, sexual, and maternal health. The NZMAT consists of doctors and nurses from many different clinical subspecialties but with a predominance of emergency and rural medicine or general practice. Due to the subspecialist nature of hospital medicine in the New Zealand environment most GPs, emergency physicians, and nurses have very little exposure to normal labor and birth in their day-to-day work and limited exposure to obstetric complications.Methods:To increase the knowledge and skill level of the NZMAT, a two day Basic Emergency Obstetric Care (BEOC) course was designed by Kass Jane, a midwifery educator, researcher, and member of NZMAT, in consultation with the NZMAT Clinical Director Emma Lawrey.Results:This presentation will outline the curriculum design, the course delivery, and the feedback from participants on this inaugural BEOC for the NZMAT, as well as the findings of a post-course review and plans for further BEOC courses for NZMAT members.Discussion:This presentation will address why courses of this type have value, especially where the delivery of basic obstetric care in a low technology or austere environment may translate into skills for other Australian clinicians wishing to work either in a humanitarian or developing world context.
Low-Cost Tabletop Simulation for Disaster Triage
Authors: Bonney Joseph , Osei-Ampofo Maxwell , Nuhu Zakaria Ahmed 
Published: May 2019

Introduction:Disaster Medicine training in most parts of the world is done in a practical manner to allow users to practice the skills of triage and resource allocation.Aim:To develop a low-cost tabletop simulation and measure its effectiveness from the user perspective.Methods:A modified Delphi approach was used in developing a low-cost tabletop simulation exercise. Simple playing cards were used as patients with specific vitals and injuries. Two Hundred trainees of the National Ambulance Service were used to test the exercise. All the participants had an equal chance to triage a patient and arrange transport to an appropriate facility.Results:All participants expressed their satisfaction in the design and implementation of the tabletop exercise. Over 90% showed interest in replicating the exercise in their respective setting due to the low-cost nature of the setup. During the exercise6. 0% of the patients were triaged correctly, while 80% were transported from the scene in an orderly manner. All the participants agreed on the useful and educational value of the exercise.Discussion:The use of a low-cost tabletop exercise in disaster medicine training is essential for low- and middle-income countries to promote education, and has been shown to be acceptable and feasible.
Novel Delivery of Meaningful EMS and Disaster Medicine Content to Residents and Medical Students
Authors: Flax Lindsay , Liu E. Liang , Miller Brian , Morshedi Brandon , Fowler Raymond L. , Swienton Raymond E. , Mugele Josh , Klein Kelly 
Published: May 2019

Introduction:Residency education delivery in the United States has migrated from conventional lectures to alternative educational models that include mini-lectures, small group, and learner lead discussions. As training programs struggle with mandated hours of content, prehospital (EMS) and disaster medicine are given limited focus. While the need for prehospital and disaster medicine education in emergency training is understood, no standard curriculum delivery has been proposed and little research has been done to evaluate the effectiveness of any particular model.Aim:To demonstrate a four-hour multi-modal curriculum that includes lecture based discussions and small group exercises, culminating in an interactive multidisciplinary competition that integrates the previously taught information.Methods:EMS and disaster faculty were surveyed on the previous disaster and prehospital educational day experiences to evaluate course content, level of engagement, and participation by faculty. Based on this feedback, the EMS/Disaster divisions developed a schedule for the four hour EMS and Disaster Day that incorporated vital concepts while addressing the pitfalls previously identified. Sessions included traditional lectures, question and answer sessions, small group exercises, and a tabletop competition. Structured similarly to a strategy board game, the tabletop exercise challenged residents to take into account both medical and ethical considerations during a traditional triage exercise.Results:Compared to past reviews by emergency medical faculty, residents, and medical students, there was a precipitous increase in satisfaction scores on the part of all participants.Discussion:This curriculum deviates from the conventional education model and has been successfully implemented at our 3-year residency program of 66 residents. This EMS and Disaster Day promotes active learning, resident and faculty participation, and retention of important concepts while also fostering relationships between disaster managers and the Department of Emergency Medicine.
Preparing for Disaster: Behind the Scenes of Maintaining and Deploying an Emergency Medical Team…Equipped. Prepared. Ready.
Authors: Schobben Matthew , Acharya Inda , Alves Dinorah Caeiro , Eadie Juno , Morrow Melanie , Trewin Abigail , Sekulich Hollie 
Published: May 2019

Introduction:Deploying an EMT to respond to a sudden onset disaster entails significant operational activities and support back home to deploy and support a responding team. These activities also include peacetime operations, exercising, innovation, engagement, training, and development of both team members and operational staff to further knowledge and experience.Aim:To exhibit the operational activities and complexities of maintaining a deployable cache of equipment and consumables for deploying a self-sustaining Emergency Medical Team (EMT). This includes the elements of managing a high-performance team, human resource management ensuring the readiness of personnel to rapidly respond, maintaining World Health Organization (WHO) international standards for EMTs, and the operational aspects and support behind the scenes to deploy a team.Methods:Analysis of operational activities and support for pre-deployment, deployment, and post-deployment phases including preparedness through innovation, collaboration, development, and maintenance of a high-performance team and cache.Results:The analysis of operational activities behind the scenes of deploying EMT maps the unique complexities of maintaining and deploying a high-performance team at all stages of deployment, demonstrating the success of a team in the field is attributed to the support and activities of the team back home to deploy them.Discussion:There is substantial preparation and behind the scenes operational activities that are undertaken to deploy and support a deployed EMT. Lessons learned from each deployment build on the operational capacity of staff deploying a team and on the future directions, innovations, and practices of a deployed team in the field.
Preparing Health Care Professionals for Public Health Disaster Management
Authors: Witt Regina Rigatto , Oliveira Alexandre Barbosa , Miranda Elaine Silva , Rocha Cristianne Maria Famer , Pires Collective health student Natalia Silva , Silva Nursing student Laura Lucas , Silva Marcio Haubert , Paz Potiguara Oliveira , Rodrigues Carla Daiane Silva , Menegat Robriane Prosdocimi , Jung Walnice 
Published: May 2019

Introduction:Disasters are a major challenge for public health because of damage caused by death, injury, or illness that exceeds health services’ ability to respond. Health professionals and students require awareness and understanding of particular aspects of disaster planning, mitigation, response, or recovery. In Brazil, despite the increase in the number and intensity of disasters, there is no formal acceptance regarding the need to integrate disaster content into curriculum guidelines (1)Aim:To develop and test referential and models for disaster management health professional education.Methods:Competence-based education has been proposed. The methodology adopted was developed by the Association (2) and adapted to be used in the Brazilian context. An initial literature search was performed in MEDLINE via PubMed, Google Scholar, Lilacs, and Scielo databases using disaster and competencies as descriptors.Results:Articles and documents in Portuguese, Spanish, and English were identified for: public health (21), nursing (20), multi-professional (16), psychology (4), pharmacy (4), dentistry (2), medicine (1), veterinary (2), and nutrition (1). Data were organized according to a proposal from the literature (3) Selection of benchmarks for the preparation of education models identified 27 referential, three of them developed in Brazil.Discussion:Application and evaluation of the methodology developed with undergraduate students of the Federal University of Rio Grande do Sul consisted of an initiative to prepare health care professionals for disaster management.
The Role of the Nurse Disaster Preparedness Coordinator at a Large Suburban Teaching Hospital
Authors: Weeks Beth 
Published: May 2019

Introduction:Mass casualty incidents, whether man-made or natural, are occurring with increasing frequency and severity. Hospitals and health systems across the United States are striving to be more rigorously prepared more such incidents. Following a mass shooting in 2012 and significant growth and expansion of our hospital and health system in the following years, a need was identified for more staff to support preparedness efforts.Aim:To discuss the roles and responsibilities of Nurse Disaster Preparedness Coordinator (NDPC), a dedicated position in the Emergency Department (ED).Methods:The role of Nurse Disaster Preparedness Coordinator was implemented in 2016, is a part-time position in the Emergency Department and reports to the ED Manager while working closely with the ED Director of Emergency Preparedness and the hospital Emergency Manager. The role addresses all areas of the emergency management continuum, from planning and mitigation to response and recovery.Results:The NDPC’s responsibilities fall into the categories of all-hazards preparedness, chemical, biological, radioactive, nuclear and explosive (CBRNE) response, and general nursing practice. All-hazards preparedness includes ED staff training, policy and procedure development, and liaising with hospital emergency manager to coordinate hospital-wide efforts. CBRNE response includes the training and maintenance of a patient decontamination team, a high-risk infectious disease team, and their equipment. General nursing practice addresses research, nursing indicators as they apply to disasters, promoting evidence-based practice, and community outreach.Discussion:A dedicated Nurse Disaster Preparedness Coordinator has allowed transition from intermittent larger exercises to a regular and frequent exercise schedule and better application of full-scale exercises. Overall, the creation of the role has strengthened hospital readiness for mass casualty incidents while alleviating the vast scope of emergency management responsibilities for a large suburban hospital.
The System of Disaster Dispatch Team Corresponding to the Nuclear Disaster of Nagasaki University
Authors: Nozaki Yoshihiro 
Published: May 2019

Introduction:After accidents of Fukushima Daiichi power plant, the Japanese Government distinguished some medical institutions corresponding to the nuclear disaster by roles and functions. Nuclear Regulation Authority is managing these medical institutions. The Nagasaki University was designated as two centers for “the advanced radiation emergency medical support” and “nuclear emergency medical support”. We established “Headquarters for Nuclear Disaster Response and Preparedness in Nagasaki University” (NDRP) and prepared for emergency ordinarily. The staff of headquarters are mainly concentrating their power on the network construction and joint training with each facility. We are improving the dispatch system of nuclear emergency medical assistance team, but some problems were found through the experiences of some trainings.Aim:To stimulate discussion and listen to opinions from several facilities.Methods:The dispatch system of nuclear emergency medical assistance team imitated the system of Japan Disaster Medical Assistance Team (DMAT). Specifically, activity days of all teams are limited, and all teams should come under the command of the head of support acceptance medical institution of a disaster area. Particularly the main duties of the dispatch team, which is sent from the nuclear emergency medical support center, are unification and adjustment of the team activities from other facilities. Some other duties include offering appropriate medical care to patients at the disaster area and support of patients’ transportation from the hospital at the disaster area to “advanced radiation emergency medical support center” or “nuclear emergency medical support center.”Discussion:In training the many facilities that participated, we realized that we couldn’t proceed with each activity quickly and smoothly without support from the nuclear emergency medical assistance teams from outside the boundaries of disaster areas. We need to clarify the problems that are obtained from trainings and improve the current system corresponding to a nuclear disaster with efficiency.
Transformative Surgical Team Training
Authors: Gill Amanda , Read David , Williams Jodie , Holian Annette 
Published: May 2019

Introduction:Sudden onset disasters exceed the capabilities of local health services. Emergency Medical Teams (EMTs), including the Australian Medical Assistance Team (AUSMAT), are a vital element of the Australian Governments capacity to respond to regional and international sudden-onset disasters. AUSMAT has the capacity to deploy an EMT Type 2 surgical field hospital and has been successfully verified by the World Health Organisation (WHO). All AUSMAT members must complete AUSMAT Team Member training. The National Critical Care and Trauma Response Centre, Darwin, Australia is responsible for all AUSMAT training.Aim:To educate and train the Surgical Team (perioperative nurses, surgeons, and anesthetists) in preparation for AUSMAT deployments in the austere environment.Methods:Prior to 2015, the surgical AUSMAT training was conducted via two courses: one for perioperative nurses and a separate course for surgeons and anesthetists. In 2015, the course was redesigned with the aim of collaborative training with all the Surgical Team Members. The new Surgical Team Course (STC) engages all three professions to learn alongside each other and discuss potential difficulties in techniques, the daily running of the operating room, and ethical discussions.Results:Since the rejuvenation of the STC, 15 surgeons, 17 anesthetists, and 18 perioperative nurses have completed the course. The attendees are familiarized with operational and clinical guidelines, the surgical field hospital, and operating room equipment including CSSD. A pivotal component of the course focuses on the essentials of medical records and Minimum Data Set reporting for EMTs as defined by WHO.Discussion:Since 2015, the NCCTRC has successfully run two courses. The revised collaborative model for AUSMAT STC has enhanced the quality of the program and subsequent learning experiences for participants.
Unexpected Lessons from a Mass Casualty Simulation: Strategies for Management of the Minimally Injured Can Increase Efficiency and Decrease Chaos
Authors: McIsaac Joseph , Gentz Brenda , McFadden Patricia , Coleman John 
Published: May 2019

Introduction:The SALT Triage system has been advocated as an easy-to-use sorting and treatment system for mass casualty incidents (MCI). Minimally injured (GREEN) patients tend to be in the majority and may cause impediments to access and treatment of the most critically injured (RED). By identifying flaws in MCI communications that impair effective patient care, responders can be more effective.Aim:To discover strategies that effectively manage the minimally injured and leverage their help, increasing triage efficiency and treatment of the immediate casualties.Methods:Direct observation, after-action debriefing, and literature search.Results:The literature was vague regarding recommendations on a bystander and trained provider communication best practices. Feedback from standardized patients (actors) and participants during a structured debriefing following a 2018 American Society of Anesthesiology MCI exercise suggested that triaging providers under stress may communicate poorly, contributing to increased patient anxiety, disruptive behavior, and less effective team dynamics during a disaster. Strategies suggested include: eye contact; therapeutic touch (culturally appropriate); using slow, clear, reassuring speech; clearly explaining what is happening and why (sickest (RED and YELLOW) first priority, minimal (GREEN) next, expectant (BLACK) last); acknowledging their emotional state and their grief (not ignoring them); assigning nontechnical tasks to those capable of helping (putting pressure on a wound, moving casualties, or comforting the injured, dying, and the emotionally distraught).Discussion:Bystander engagement has been repeatedly identified as a means to increase the capacity of first responders to provide care to patients during an MCI. Utilization and management of the minimally injured and any uninjured bystanders and responders can become a force multiplier for the triage/treating responders. Developing a best practice dialogue to be used in training first responders could help improve many of these issues and augment current MCI training programs.
International Emergency Medical Teams in the Aftermath of the 2015 Nepal Earthquake
Authors: Amat Camacho Nieves , Karki Khem , Subedi Shiva , von Schreeb Johan 
Published: May 2019

AbstractIntroduction:International Emergency Medical Teams’ (I-EMTs) response to disasters has been characterized by a late arrival, an over-focus on trauma care, and a lack of coordination and accountability mechanisms. Analysis of I-EMT performance in past and upcoming disasters is deemed necessary to improve future response.Objective:This study aimed to describe the characteristics, timing, and activities of I-EMTs deployed to the 2015 Nepal earthquake, and to assess their registration and adherence to the World Health Organization Emergency Medical Teams’ (WHO-EMT; Geneva, Switzerland) minimum standards compared to past disasters.Methods:An online literature search was performed and key web sites related to I-EMT deployments were purposively examined. The methodology used is reported following the STARLITE principles. All articles and documents in English containing information about characteristics, timing, and activities of I-EMTs during Nepal 2015 were included in the study. Data were retrieved from selected sources to compile the results following a systematic approach. The findings were validated by the Nepalese focal point for the coordination of I-EMTs after the earthquake.Results:Overall, 137 I-EMTs deployed from 36 countries. They were classified as Type I (65%), Type II (15%), Type III (1%), and specialized cells (19%). Although national teams remained the first responders, two regional I-EMTs arrived within the first 24 hours post-earthquake. According to daily reporting, the activities performed by I-EMTs included 28,372 out-patient consultations (comprising 6,073 trauma cases); 1,499 in-patient admissions; and 440 major surgeries. The activities reported by I-EMTs during their deployment were significantly lower than the capacities they offered at arrival. Over 80% of I-EMTs registered through WHO or national registration mechanisms, but daily reporting of activities by I-EMTs was low. The adherence of I-EMTs to WHO-EMT standards could not be assessed due to lack of data.Conclusion:The I-EMT response to the Nepal earthquake was quicker than in previous disasters, and registration and follow-up of I-EMTs was better. Still, there is need to improve I-EMT coordination, reporting, and quality assurance while strengthening national EMT capacity.Amat Camacho N, Karki K, Subedi S, von Schreeb J. International Emergency Medical Teams in the aftermath of the 2015 Nepal earthquake. Prehosp Disaster Med. 2019;34(3):260–264.
Effects of index selection on the carcass composition of sheep given eitherad libitumor controlled amounts of food
Authors: Lewis R. M. , Emmans G. C. , Simm G. 
Published: May 2019

AbstractSheep of a line (S) selected on an index to increase lean weight and decrease fatness at an age, and a control line (C), were given a high quality food at different levels including ad libitum. Live performance was measured from about 21 to 114 kg live weight. The carcasses of each line were analysed for lean, fat and bone at three widely varying weights in both males and females. Level of feeding did not affect the extent to which S was superior to C in either the level of fatness in the carcass (0·86 as much) or the ratio of lean to fat (1·28 as much). The lean to bone ratio was slightly greater in S (1·028 of the value of C; P 0·05) and was higher on the lowest level of feeding compared with the two higher levels used (P 0·05 in one experiment on females and P 0·001 in another on males). On ad libitum feeding the S line grew 1·19 times as fast and was 1·17 times as efficient compared with C. These advantages to S decreased as level of feeding decreased to become virtually zero at the lowest level of feeding used, which allowed C to grow at only 0·53 of the rate seen on ad libitum feeding. On ad libitum feeding growth was well described by a Gompertz growth function of the form W = (Z/B) exp(-exp (G0 –B t)). The maximum growth rate is (Z/e). Line S had a value of Z that was 1·10 that of C averaged across the two sexes. A Spillman function W = W0 + (A-W0) (1-exp (-k F)) was used to describe weight, W, in terms of cumulative intake, F. It worked well for ad libitum feeding and for the two restricted regimes used. The value of the combined parameter (A k) varied across treatments in the same way as efficiency did.
Anorexia and food utilization in nematode infected lambs on pasture
Authors: Thamsborg S. M. , Agergaard N. 
Published: May 2019

AbstractThe influence of naturally acquired nematode infections on food intake and utilization was investigated in grazing lambs. It was first demonstrated in a pilot study with penned lambs that the application of chrome-oxide in a ruminal bolus could be used for comparison of food intake in infected and uninfected lambs on grass. In a field trial, repeated in two consecutive seasons, 48 lambs grazed on clover grass in six groups. Three stocking rate groups were grazed on contaminated pastures (I-low, I-medium and I-high) and three groups on clean pastures (U-low, U-medium and U-high). Faecal dry-matter (DM) output of individual lambs was estimated in August each year by the chrome-method. DM intake and food conversion efficiency were calculated based on hand-picked herbage samples and in vitro assessment of digestibility. Substantial worm burdens, increasing from year 1 to year 2, were observed and some lambs had clinical symptoms in the 2nd year. In year 2, lambs on contaminated pastures had significantly lower DM intake (proportionately 009 lower), higher faecal protein losses and lower food conversion efficiency compared with the uninfected lambs on clean pastures. The effect of infection on food intakes was eliminated if corrected for body weight. The study showed that if exposure to nematode infections is large enough, increased protein losses in faeces and anorexia may contribute to reduced performance in lambs in late season.