bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a Tool Measuring Nurses’ Competence for Disaster Response
Authors: Marin Sandra Mara , Witt Regina Rigatto 
Published: May 2019

Introduction:Disasters are situations of complexity and unpredictability that require the performance of teams from various instances with preparation and qualification to assist the victims, recover the environment, and restore living conditions. Health services are essential in the response to a disaster, and nurses all over the world play a significant role in these disasters.Aim:To develop a valid and reliable scale to identify nursing competencies in disasters.Methods:Competencies were selected from those related to the framework developed by the International Council of Nurses. A methodological study was developed in two stages: I) validity of content and appearance verification and II) verification of applicability and reliability with test-retest. The participants of stage I were eight specialists in emergencies and disasters in Brazil. In stage II, 326 nurses from the Emergency Mobile Assistance Service in Southern Brazil participated. Data analysis utilized the Content Validity Index and Interest Reliability Index. Psychometric properties of the instrument were measured with Cronbach’s alpha coefficient; applicability and test-retest reliability with the use of the t-test and intraclass correlation coefficient and factorial validity.Results:Forty-one competencies of 51 were organized in three domains according to Factor Analysis. Cronbach’s alpha values showed good internal consistency. There was no significant difference between the test and retest scores. The intraclass correlation coefficient values were adequate. The instrument showed reproducibility and adequate applicability.Discussion:This tool will assess nurses’ competencies for disaster response and provide evidence for the development of educational policies in disasters, creating a reliable and prepared workforce to respond more effectively during a disaster.
Development of an Active Learning Program for a Community Utilizing a Scenario Participating as Simulated Rescuers and Sufferers in an Earthquake Prone Area of Japan
Authors: Takeda Taichi 
Published: May 2019

Introduction:Major earthquakes with a magnitude of 8-9 are anticipated to occur in the next 30 years at a 60 percent chance on the southern coast of Japan. Since the most part of our Prefecture is likely to be damaged by tsunami and landslides, residents are expected to take a self-reliant approach on the initial several days after the earthquakes and tsunami.Aim:To improve the resilience of the local communities we have developed and applied an educational program of disaster response.Methods:An active learning program was designed on roles of rescuers and sufferers, and conducted two-hour sessions for high school students using a scenario in which they encountered an earthquake during a field trip. Half of the participants were assigned to play students on a field trip and asked to discuss options as a small group to survive and secure their safety in an isolated situation after an earthquake. They exchanged ideas to stay alive, cooperate with local residents and request disaster assistance using very short radio messages to the appropriate counterpart. The other half of the participants were assigned to be school administrations and asked to estimate the situation of sufferers. Their task as a small group was to organize assistance based on the best assumption from the limited information of the isolated students and local villagers.Results:After the sessions, the participants expressed their discovery in the discrepancy of situational recognition between the two groups and they learned about assumption-based planning as well as good information sharing.Discussion:Through this program, the participants experienced simulated situations and learned perspectives from both sides; providing relief as rescuers and receiving aid as sufferers. The participants were motivated to share and utilize their knowledge and skills to make their community resilient to disasters.
The Diagnostic Value of Ultrasonic Measurement of Inferior Vena Cava Diameter Respiratory Variability on Volume Response Evaluation of Geriatric Hip Fracture
Authors: Li Yang , Cen Yuan 
Published: May 2019

Aim:To evaluate the value of ultrasonic measurement of the respiratory variability of inferior vena cava (IVC) in the preoperative volume-response evaluation of elderly hip fracture patients.Methods:Volume-loading tests were carried out in elderly patients with hip fractures requiring surgical treatment from August 2017 to February 2018. The maximum diameter (IVCe) and minimum diameter (IVCi) of the IVC were measured by ultrasound, and the variation of IVC (IVC-CI) was calculated before surgery. SV was monitored by a FloTrac/Vigileo system, and positive volume responsiveness was defined as ΔSV increasing by more than 15%. The sensitivity and specificity of IVC-CI to volume responsiveness evaluation was analyzed by ROC, and the correlation between IVC-CI and ΔSV was analyzed by Spearman correlation analysis.Results:Ultrasound measurements and volume-loading tests were successfully performed in 39 of the 44 patients. Among them 21 cases were volume responsiveness positive (group R) and 18 cases were volume responsiveness negative (group N). Before the volume-loading test, IVCi in group R was significantly smaller than group N and IVC-CI was significantly larger than group N (P<0.05), while the difference between IVCe and group N was not statistically significant (P>0.05). After the volume-loading test, the differences between IVCe, IVCi, IVC-CI, and group N were not statistically significant (P>0.05). Area under curve (AUC) of IVC-CI to assess volume responsiveness in geriatric hip fracture patients was 0.80±0.08 (0.65-0.95, P=0.001), with a 20.69% cut off value, 77.78% sensitivity, and 76.19% specificity. Through the Pearson correlation analysis, IVC-CI and Δ SV were positively correlated with the coefficient r = 0.367 (P<0.05).Discussion:As a rapid and noninvasive monitoring method, ultrasonic measurement of the respiratory variability of inferior vena cava in assessing the volume responsiveness of geriatric hip fracture patients can provide guidance for perioperative fluid management.
Disaster and Mass Casualty Incident Responses by Doctor Car
Authors: Kuno Masamune , Suzuki Kensuke , Unemoto Kyoko , Tagami Takashi , Nakayama Fumihiko , Kaneko Junya , Saito Ken , Sato Shin , Tanaka Chie , Fukuda Reo , Kudo Saori , Kitahashi Akiko 
Published: May 2019

Introduction:Ambulances with physicians, known as Doctor Car, and Tokyo DMAT are the two prehospital care systems responsible for medical team dispatch in the Tokyo area. While there are 25 designated hospitals for DMAT, Doctor Car is only available at four hospitals. Our hospital incorporates both systems. While the prehospital care system must be utilized at the time of disaster, Doctor Car was dispatched 418 times in 2017, and the use of DMAT is less than ten times per year.Aim:To review the past disaster responses of our hospital.Methods:The study reviews three cases where our hospital responded to mass casualty incidents and disasters with either Doctor Car or DMAT. The first case was the treatment of crush syndrome caused by a collapsed parking slope. It took more than 24 hours for the rescue, in which the team treated patients during transport and at the hospital. The second case was our response to a mass stabbing incident committed at a facility for the disabled. In collaboration with the onsite rescue team, we conducted triage, hemostasis, transfusion, etc. The third case was caused by a fire in a building under construction. We provided treatments like triage and tracheal intubation on the spot.Results:Because paramedics are allowed to conduct only a limited amount of treatments, dispatch of the medical team to the site is effective.Discussion:For a medical team to be effective at the dispatched site, the team must be accustomed not only to the specific need of medical care during disasters but also prehospital medical care, which may include the abilities to ensure safety during transport and on-site and adapt to the prehospital environment. Doctor Car is a useful way to realize such abilities.
Disaster Preparedness and Management in Pakistan: A Systematic Review
Authors: Shahbaz Sana 
Published: May 2019

Introduction:Since its inception about 66 years ago, Pakistan has experienced a variety of both natural and man-made disasters like earthquakes in 2005 and 2015 and widespread flooding in 2010. Pakistan has also experienced a range of politically motivated violence, bombings in urban areas, as well as mass shootings. Such events generate a large number of casualties. To minimize the loss of life, well-coordinated prehospital and in-hospital response to disasters is required.Aim:To identify all the existing peer-reviewed medical literature on prehospital and in-hospital disaster preparedness and management in Pakistan.Methods:The search was conducted using PubMed and Hollis plus search engines in accordance with the PRISMA guidelines. The articles selected included articles on both natural and man-made disasters, and their subsequent prehospital and in hospital management. The following search terms and keywords were used while searching PubMed: mass casualty incident preparedness and management Karachi, mass casualty incident preparedness, disaster preparedness Karachi, and disaster management Karachi. To search Hollis plus, we used the terms: mass casualty incident preparedness and management Pakistan, mass casualty incident Pakistan, mass casualty incident preparedness and management Karachi, and disaster preparedness Karachi. We selected only peer-reviewed articles for a literature search and review.Results:The reviewed articles show a lack of data regarding disaster management in Pakistan. Almost all the articles unanimously state the scarcity of planned prehospital and in-hospital management related to both man-made as well as natural disasters. There is a need for planned and coordinated efforts for disaster management in Pakistan.
Emergency Ambulance Dispatch and Drive Times: An Analysis of Prehospital Vehicular Response in the Kingdom of Bhutan
Authors: Kincaid Jenevieve , Mize Charles , Dorji Mila 
Published: May 2019

Introduction:The Kingdom of Bhutan is a small, mountainous country with limited financial resources. Its population is scattered in hard-to-reach villages with poor road access. Ambulance drivers piloting Toyota Landcruisers provide the majority of the country’s emergency response and are dispatched by the national emergency response center (Health Help Service/112) to calls in the nation’s twenty districts.Aim:By collecting and analyzing prehospital response data, we aimed to describe Bhutanese emergency medical response (EMS) ambulance activities and make system-wide recommendations to improve the speed of emergency vehicle dispatch, reduce the time between ambulance activation and ambulance arrival on scene, and adequately describe emergency vehicle drive time as it relates to distance driven.Methods:The following data was compiled in Excel: Dispatch center phone records, EMS ambulance activation times, drive times, vehicle geospatial data, and written records of ambulance drivers. No identifiable data was collected.Inclusion Criteria: All prehospital calls from 2017 and 2018 where complete data was available.Exclusion Criteria: Complete data unavailable, i.e. geographic data without a matching call or report.Statistical Tools: SPSS Statistics Version 25, NVivo 12-12.2.0.3262.Results:Preliminary analysis of the data shows a significant difference between data collected and data previously reported, the speed of emergency vehicular response and dispatch, drive times, and distance traveled. Facility transfer rather than scene response was found to take more time.Discussion:Due to adverse road conditions, lengthy drive times, and an inadequate number of personnel and satellite ambulance locations, we recommend optimizing ambulance location using an optimization model that will minimize the number of ambulances needed and maximize response time. Future considerations may include adding a ground arm to the Bhutan Emergency Aeromedical Retrieval team, or a second aeromedical team in the eastern part of the country.
An Emergency and Disaster Course on Responding to Community and Family Healthcare Problems with Interprofessional Education for Undergraduate Medical, Nursing, and Dietitian Students
Authors: Ariani Madelina , Donna Bella , Sutono Sutono , Hartriyanti Yayuk , Fitriana Fitriana , Wilasto Nandyan , Rahayu Gandes 
Published: May 2019

Introduction:Emergencies and disasters need inter-discipline and inter-professional approaches because many problems in a disaster are due to poor coordination and collaboration. The disaster events during a decade in Indonesia highlighted the limitations of the healthcare system in responding to large-scale public health problems. Disaster health preparedness is the key to an effective response to any problems in community and family. Thus, education for health students has become a priority.Aim:Preparing fourth-year health students to be aware of disaster health problems in family and community with an inter-professional approach.Methods:Faculty of Medicine, Public Health, and Nursing UGM were prepared for the fourth year undergraduate health students through a semester “Emergency and Disaster Course” under Community Family and Healthcare with the Inter-professional Education Program, first given in 2016 for four hundred students. Mix method between class lecture, training skill, and simulation. The course goals are to (1) educate students on disaster health management, (2) understand the health preparedness and disaster family kit, and (3) define the principle of health worker’s role and collaboration in disaster.Results:The course was well received and at the 2017-2018 session was improved based on students and faculty feedback. Disaster knowledge of students changed. However, they still had a problem in communication between professions. And addition, they became aware of the function and each role of health profession competency during a disaster.Discussion:A course for fourth-year health students about emergency and disaster health management is extremely relevant because they will be health workers soon. They must have good awareness, knowledge, and attitude to cope with disaster health problems in the future.
An Emergency Medical Triage Tool for Swiftwater Rescue
Authors: Jaslow David , Zahustecher Nathaniel , Ellinger Fred , Zecher Derek , Overberger Ryan 
Published: May 2019

Introduction:Climate change and overdevelopment increase the intensity and frequency of flash flooding, which may generate more swiftwater rescue (SWR) incidents. Rescue personnel may fail to properly risk stratify (triage) these victims due to limited medical and/or variable SWR training, or due to an adverse rescuer-to-victim ratio. Some victims may attempt to refuse medical evaluation due to lack of awareness of incident-related morbidity and/or comprehension of risk.Aim:To develop an SWR emergency medical triage tool.Methods:A cross-sectional literature search identified SWR-related medical conditions. A flow diagram reliant upon incident history, chief complaint, and observational exam rather than interpretation of vital signs was created to guide medical decision-making.Results:Every SWR victim should receive a medical screening exam focused on six clinical categories—drowning, hypothermia, hazmat exposure, physical trauma, psychological trauma and exacerbation of pre-existing disease. Drowning potential is identified by dyspnea, new cough or a history of (even brief) submersion. Shivering SWR victims and those with altered mental status but no shivering are assumed to be hypothermic. Any victim with open skin lesions/wounds who was immersed in floodwater and anyone who has swallowed floodwater is contaminated; these victims require decontamination and possible antibiotic therapy. SWR victims injured upon entering the water or from contact with either water-borne stationary or floating objects require trauma evaluation. Distraught victims and those who exhibit exacerbation of pre-existing organ-system disease also require ED evaluation.Discussion:Most SWR course curricula are oriented towards technical rescue; they do not address comprehensive medical decision-making. We present a rapid medical screening exam designed to determine which SWR victims require an ED evaluation. Such a triage tool will assist rescuers to simultaneously honor patient autonomy and avoid risky and uninformed refusal of medical aid. Simplified medical decision-making should enable the application of this tool worldwide.
Emergency Patients with Mental Crisis Accessing Emergency Medical Services in Thailand
Authors: Wachiradilok Porntip 
Published: May 2019

Introduction:Emergency responders face an increasing number of calls involving people with behavioral and mental crisis issue. Integrated multi-agency schemes involving ambulance, police and mental health services are now being developed to provide urgent and emergency care pathways for these vulnerable patients.Aim:The objectives were to study the situation, characteristics, issues, and accessibility to emergency medical services (EMS) and appropriate treatment for emergency patients with a mental crisis in Thailand.Methods:The sample included 26,511 mental crisis patients accessing EMS. Data were obtained from the database of the Information Technology for Emergency Medical System between 2015-2017 and from stakeholders from four provinces distributed regionally using focus groups and in-depth interviews. The data were analyzed using descriptive statistics and content analysis.Results:The number of patients with mental crisis accessing EMS increased in the past three years. Most patients are male in the working age group from the Northeastern area during the raining and winter season, especially between September and October. During patient encounters with maniacal attacks, assistance will be requested from the police and the emergency medical units. The response depends on the experience and community capability. The emergency responder teams had insufficient knowledge and skills. Emergency rooms in most hospitals lack specific caring unit. Psychiatric hospitals have different criteria for admitting patients. Most had no fast track system and even refuse admittance.Discussion:Mental crisis patient calls with EMS were rising. However, accessibility to appropriate service centers was still an issue. Most hospitals lack prioritized access and staffs had insufficient knowledge and skills. Cooperation among the police, emergency medical operation team and the rapid psychiatric emergency team is need to be reinforced.
Emergency Response Training Program for Theme Parks: Experiences of Taiwan
Authors: Hsiau Yawen , Liu Yu-Han , Lin Chi-Chun 
Published: May 2019

Introduction:“Tailor-made” training programs have been started in two theme parks in North and East Taiwan after the dust explosion of Ba-xien theme park in 2015. The training programs emphasized several areas. They work to strengthen the incident command system (ICS) and the skills of first responders, especially evacuation, placement, triage, and first aid, as well as to assist the park’s cooperation with local disaster response units, such as the fire department and Health Bureau.Methods:The first step was to find out the practical problems of the two theme parks, and then make a one-year, tailor-made training program according to the needs of parks and different levels of staff: senior supervisors, middle-level district supervisors, and frontline colleagues. After the phased training, the training results are inspected in the non-scripted exercise mode.Results:It was found that the staff are relatively familiar with the evacuation process and placement of tourists. The initial emergency responses such as triage, first aid skills, and patient transport gradually improve after several drills. The ICS operation and communication also became more effective and efficient. The regional emergency response units could understand these theme parks capability and how to cooperate with them.Discussion:The experience of emergency response training and exercise in these two theme parks has shown that such a model is feasible and should be valued.
Enhancing the Effectiveness of Disaster Simulations through Contemporary Simulation Design and Technology
Authors: McNamee Sarah , Wullschleger Martin , Donohue Andrew , Campbell Don , Watkins Nathan , Brazil Victoria 
Published: May 2019

Introduction:Simulation is often employed to test mass casualty and disaster response planning within hospitals, but it is resource intensive and needs to achieve high-quality recreation of scenarios to be effective. The delivery of large-scale interdisciplinary team and system simulation requires consideration of physical safety, system integrity for real patients, simulation team communication, and effective dissemination of outcomes.Aim:To describe challenges and potential solutions for effective delivery of disaster simulations, drawn from simulation service experience at Gold Coast Hospital and Health Service (GCHHS).Methods:This case study reviews strategies used to deliver a large-scale multi-team in-hospital disaster and trauma simulation, involving more than 75 participants drawn from paramedic/ambulance, emergency, trauma service, anesthetics, perioperative, surgical, and hospital administrative teams.Results:Issues reviewed include simulation delivery team composition and briefing, safety strategies, matching simulation methodology to exercise objectives, the use of real-time communications technologies and apps for real-time communication and performance tracking, and leveraging the simulation experience for observers by narrated Facetime stream. Following the simulation, a debriefing was conducted with participants to address performance, communication and interfaces, strengths and weaknesses, and overall opportunity for improvement. Facility-wide dissemination of messages through standardized reporting, infographics, and video vignettes were also reviewed.Discussion:Simulation is an engaging way to assess protocols and practices for disaster response within a tertiary hospital, and effectiveness can be enhanced through the strategic use of contemporary techniques and technologies.
Environmental Factors at Mass-Gathering Events: Considerations for Health Research and Evaluation
Authors: Hutton Alison , Ranse Jamie , Lund Adam , Turris Sheila , Munn Brendan , Gray Katy 
Published: May 2019

Introduction:This poster will document the environmental domain variables of a mass gathering. They include factors such as the nature of the event, availability of drugs or alcohol, venue characteristics and meteorological factors.Method: A systematic literature was used to develop a set of variables and evaluation regarding environmental factors that contribute to patient presentation rates.Results:Findings were grouped pragmatically into factors of crowd attendance, crowd density, venue, type of event, mobility, and meteorological factors.Discussion:This poster will outline a set of environmental variables for collecting data at mass gathering events. The authors have suggested that in addition to commonly used variables, air quality, wind speed, dew point, and precipitation could be considered as a data points to be added to the minimum standards for data collection.