bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of an Evacuation Exercise for Residential Aged Care Facilities Using the Emergo Train System (ETS)
Authors: Cronan Karl , Winn Linda 
Published: May 2019

Introduction:Events such as the Sydney Quakers Hill Nursing Home fire highlighted the great need for robust evacuation plans for Residential Aged Care Facilities (RACFs). However, plans alone are not sufficient and routine exercises are necessary to test the capability of a facility’s emergency plan. Current methods of exercising facility evacuations, such as live drills, are limited and only test isolated elements of the evacuation process, which fall drastically short of being able to simulate the real-time resources and procedures required to perform a large scale evacuation of a RACF.Aim:To develop an exercise tool that assists Residential Aged Care Facilities (RACF) to evaluate their evacuation procedures using quantifiable data, based on real-time and providing minimal disruption to existing residents.Methods:Utilizing the existing ETS framework, an aged care resident patient bank was developed by NSW Health Emergency Management Unit, including:
A bank of 200 residents from data sourced from the Australian Institute of Health and Welfare.Layout for the resident gubers and Summary Care Plans.Resources and equipment routinely used in RACF’s.Real-world testing of the prototype in exercises across NSW, AustraliaMortality and morbidity data to measure outcomes.Validation of the exercise tool nationally and internationally.Results:A bank of residents was developed to test evacuation systems and processes, in a scalable, realistic simulation based on patient outcomes. This will result in improved planning and process, empowerment of RACFs, better patient outcomes, and increased resilience and preparedness.Discussion:A significant investment of data, time, and effort has gone into producing this resident bank for use in RACF evacuation exercises across NSW Australia. A presentation delivered at the ETS World Congress in the Netherlands (2018), by NSW Health Emergency Management Unit, showcased the relevance and suitability of this tool across the world.
Multiple Patients with Burn Injury Induced by a Chemical Explosion Managed by Physician-staffed Helicopters
Authors: Yanagawa Youichi , Kondo Akihiko , Nagasawa Hiroki , Takeuchi Ikuto , Jitsuiki Kei , Osaka Hiromichi , Ishikawa Kouhei , Omori Kazuhiko 
Published: May 2019

Introduction:The management of chemical and explosive events is critical to reducing morbidity and mortality. However, initial patient care considerations and protective actions for staff are unfamiliar to most frontline clinicians.Methods:This study evaluated an Incident report.Results:On December 1, 2017, a factory of chemical industries in Japan exploded. Dust forming as a byproduct from the crushing and packing process of the resin for ink exploded at the facility. A local fire department requested the dispatch of two physician-staffed helicopters (known as a doctor helicopter [DH] in Japan). The first party of emergency services established a headquarters and first-aid station. However, this area was feared to be at risk of a second explosion. Physicians performed re-triage for all 11 burned patients. Three severely injured patients were transported to emergency medical service centers either by ground ambulance or the DH without undergoing any decontamination. The physician who escorted the patient by ground ambulance complained of a headache. One of the severely injured patients was treated at a local hospital and then transported to an emergency medical service center after undergoing decontamination and intubation. Fortunately, all patients who were transported to medical facilities obtained a survival outcome.Discussion:Chemical, biological, radiological, nuclear, and explosive incidents are rare, but can be fatal for responders to this kind disaster. As such, all who work at such scenes should be prepared and train adequately to ensure they have the knowledge and skill to both manage patients and protect themselves from harm.
Chemical Warfare Agent Terrorist Attacks in Latin America and the Caribbean Region (CWA-LAC)
Authors: Argote Killiam A , Molloy Michael , Hart Alexander , Voskanyan Amalia , Sarin Ritu R , Ciottone Gregory R 
Published: May 2019

Introduction:In the past five decades, the region of Latin America and the Caribbean (LAC) has been subject to several types of terrorist attacks, with most committed by local terrorist organizations. However, there have also been attacks by international terrorist groups. Internationally, terrorist attacks are increasing in both frequency and complexity. Significant concerns exist regarding the use of Chemical Warfare Agents (CWAs) in civilian settings. Asphyxiants (e.g. cyanide), opioids (e.g. fentanyl), and nerve agents (e.g. sarin) represent some of the most lethal CWAs. To date, there is very little published data on their use in the LAC region despite the fact that the recent attacks in Syria have sparked international interest in the use and regulation of CWAs.Aim:To improve civilian health service preparedness in response to CWAs attacks by describing the types of agents historically used within the LAC region.Methods:Information was extracted and analyzed from the open-source Global Terrorist Database hosted by the University of Maryland, regarding CWA-LAC from January 1, 1970, to December 31, 2017.Results:During the forty-seven year period reviewed, there were 29,846 terrorist attacks in the LAC region, with 63.6% occurring in the southern region. Twenty-nine CWA attacks were reported, with the most common agents being tear gas (37%) and cyanide (29.6%). The most frequent targets were religious figures/institutions (22.2%), law enforcement (18.5%), and government agencies/personnel (18.5%).Discussion:Cyanide is one of the most prevalent agents used for chemical weapons attacks in the LAC region. Preparedness should be enhanced for CWA terrorist attacks, especially those involving cyanide, given its life-threatening nature, prevalence, and the existence of reversal agents. First responders, physicians, and nurses should be aware of this potential hazard and be trained to respond appropriately. Additionally, regional stockpiles of antidotes should be considered by governmental bodies within the LAC region.
A National Model for Tactical Emergency Medical Support in Finland
Authors: Hallikainen Juhana , Lund Vesa 
Published: May 2019

Introduction:Tactical Emergency Medical Response (TEMS) originated in the 1990s in Finland. It is a nationally standardized joint-effort with EMS and police special units, such as SWAT.Aim:To describe a national system of TEMS in Finland.Methods:In Finland, TEMS is a national response system of specially trained paramedics and pre-hospital doctors, working normally in HEMS or a local physician staffed rapid response car. There is a two-tier selection to get accepted in the basic course. The police run background checks for all participants before they are accepted to the course. The course itself is four days and it covers the basics of police tactics, protective gear, penetrating wounds, evacuation, etc. After graduating from the basic course, the paramedic/doctor is qualified to participate in missions. Although healthcare professionals are involved, a TEMS mission is under the police command and is used as one of the police’s special teams to operate in areas where normal EMS cannot be allowed for safety reasons. TEMS does not carry any weapons. The Police provide the teams with the same protective equipment that the SWAT/CTU has. After some years, there is a three-day refresher course for active TEMS service. In this course, the main training points are working in austere environments, such as helicopters, boats, and in urban environments wearing civilian clothing. Police pay for the usage of TEMS in missions, but they do not pay for training days.Results:TEMS has good national coverage. In 2017, there were 131 TEMS activations. The normal response to a mission is a team of one or two TEMS operators.Discussion:TEMS has achieved good national coverage and is deployed often. TEMS has also channeled information and training, such as TECC, to normal EMS personnel and raised their preparedness as well.
In What Ways Does Australian Emergency Management Reflect the Criteria of a Profession?
Authors: Mcardle Dudley , Archer Francis , Spencer Caroline 
Published: May 2019

Introduction:The term “profession” to describe the people who carry out emergency management (EM) in Australia continues to gain momentum. Many emergency managers see themselves and are seen by others as professionals, yet little evidence exists to confirm this proposition. Unlike other professions, there is no peak body or overarching organization in Australia to help the diverse group of emergency managers to identify standards of performance and to lobby decision-makers on their behalf.Aim:This study identifies criteria that define a profession and considers how the emergency management sector in Australia reflects them.Methods:A literature review and review of established professions informed criteria of what constitutes a profession. Using these criteria, a survey was conducted to identify the demographic profiles of Australian emergency managers, their perception of the criteria of a profession, and their attitudes towards professionalization of their sector. Semi-structured interviews were conducted with a representative sample. Ethics approval was obtained.Results:A set of criteria for an EM context in Australia was created. 859 emergency managers in Australia were surveyed using an online questionnaire. No common profile emerged from the survey in terms of age, gender, background, expertise, skills, or experience. Likewise, no clear career path, no clearly defined standard training, no universal standards of performance, and no statutory certification to qualify an emergency manager as a professional were revealed. Participants variously identified some of the necessary criteria of a profession, but no uniformity emerged.Discussion:This unique study concludes that the sector is not yet in a position to regard emergency management as a profession. Recommendations suggest steps be taken in the short- and long-term to facilitate the establishment of EM as a profession and identifies further research to inform the journey towards professionalizing the emergency management sector.
Long-Term Disaster Resilience: A Research Gap
Authors: Spencer Caroline , Majeed Saadia , McArdle Dudley , Parkinson Deb , Archer Frank 
Published: May 2019

Introduction:This research identified a gap in understanding the lived experience of long-term disaster resilience (LTDR). Increasing disasters could influence more people. Therefore, understanding LTDR becomes imperative. Little research documents men and women’s reflections following disasters. Current research highlights survivors’ mental health, particularly clinical diagnoses like PTSD. Research remains limited on the social impacts long after disasters.Aim:Research aimed to identify a gendered perspective of the lived experience about what contributes to LTDR three years after Ash Wednesday in 1983, the Victorian floods in 1993 and 2010-11, and the 2009 Black Saturday fires.Methods:A comprehensive, systematized search was conducted of peer-reviewed, grey, and secondary literature for a narrative review and thematic analysis.Results:106 references were identified. After removing duplicates and papers not fitting the inclusion criteria, two papers met the criteria. However, two borderline papers were included due to the closeness of the timeframe and brevity of research available.Discussion:Most research is related to the immediate aftermath or short-term resilience. Papers provided no specific attributes to enhance the lived experience of LTDR as it related to gender. However, factors that could enhance the lived experience of LTDR were drawn from six themes in sociological studies. Presumptive interpretations were made about what factors may provide insight into the social and contextual issues of LTDR. The literature dearth identified the need for long-term disaster resilience research. The most striking conclusion drawn from themes tells how people perceived the way a disaster and the ensuing period affected their personal relationships and circumstances. Overall, positive experiences strengthened their resilience while negative experiences hindered their resilience. While the review resulted in a disappointing outcome, the dearth of LTDR research lacked any reference to gender but confirmed research opportunities for innovative research that could influence policy and practice.
Emergency Medical Teams in ASEAN Region - Challenges for Global EMT Classification
Authors: Kai Soichiro 
Published: May 2019

Introduction:Quality assurance of Emergency Medical Teams (EMTs) is a world concern. The World Health Organization (WHO) published an international guideline for EMTs in 2013 and started the global EMT classification, a quality assurance program for EMTs, in 2015. There are 16 classified EMTs in the world as of October 2018. The Association of Southeast Asian Nations (ASEAN) region is a disaster-prone area. Therefore, the need for EMTs is relatively high. However, there is no classified EMT in the ASEAN region. Factors that prevent the global classification of EMTs in the ASEAN region are unknown.Aim:The objective of this study was to analyze the inhibitory factors of the global EMT classification in the ASEAN region.Methods:A questionnaire survey was taken to the 10 national groups of ASEAN countries. Each group consisted of EMT-related personnel. They were 39 participants for the third AMS Training of the ARCH Project held in May 2018. 10 national groups were asked to answer whether governmental EMT of their country is able to meet the criteria for the EMT global classification. The criteria were written in the WHO-provided minimum standard self-assessment checklist for the Type 1 fixed EMT.Results:Among 39 categories in the self-assessment checklist, 5 were the most difficult categories to meet the criteria: [Core Standards] Self-sufficiency, Sanitation, and Waste Management; Indemnity and Malpractice; [Technical Standards] Logistics; EMT Capacity.Discussion:There are some limitations to the study. Non-governmental EMTs were not covered. Participants of the training were not at the official EMT focal point for the global EMT classification. Logistical requirements may be inhibitory factors of the global EMT classification in the ASEAN region.
International Disaster Medical Relief of China: Lessons and Practices
Authors: Bibo Peng 
Published: May 2019

Aim:This descriptive study explored barriers and difficulties faced by an international disaster relief team from China, which took part in two types of international disaster relief missions.Methods:Data was collected since the founding of the Chinese international disaster relief team, including information on team composition, operational hours, and average number of patients rescued and treated by staff per day, etc.Results:Overall, thirteen disaster relief missions utilizing the Chinese disaster relief team occurred in eight countries. All the operations were divided into two kinds of models: Urban Search and Rescue mission, and Emergency Medical service. The first model consisted of search, rescue, and emergency medical services on site. The ratio of medical staff on the team accounted for 18.8%. According to the six international health-based operations, the team was deployed ten days following the disaster, with an average working time of 17.8 days, and benefiting around 6,812 wounded and sick persons per operation. Compared with these two models, medical-based operations deployed more staff after the disaster and had a longer window of operation. The beneficiaries of medical-based operations are ten times greater than those of rescue-based operations. The differences are distinct.Discussion:Missions will better meet the needs of international relief by enhancing organizational coordination among medical teams around the world, and by contributing to the communication between teams. They will further benefit from technical capacity building, regional coordination trainings, formatting the standard of teaming building, and evaluation of the work.
Research on the Design of a Training Course for an International Emergency Medical Team
Authors: Hu Hai 
Published: May 2019

Introduction:Currently, Technical Advisors of the World Health Organization’s (WHO) Emergency Medical Teams (EMT) Secretariat are conducting standardized verification work for international emergency medical teams in various countries and organizations. However, a uniform and standard training course for an International EMT is lacking.Aim:To design a training course model based on knowledge structure, teaching, and evaluation methods for an International EMT.Methods:The first and second level catalogue defined as chapters and sections for the International EMT training curriculum were drafted based on literature and summaries of fragmentary experience. The teaching syllabus with the method of teaching and evaluation was initially outlined. The expert consultation form was designed and validated. Experts from International EMTs from various countries were consulted and investigated. The Delphi method 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.Results:A total of 25 experts were consulted. By 2 rounds of consultation with a Kendall coordination coefficient W value of 0.210 and chi-square value of 78.61 (p<0.05), consensus about the knowledge structure for the curriculum was achieved, which consisted of 6 chapters: (1) introduction of International EMT, (2) Disaster medicine, (3) Global health, (4) Care in austere condition, (5) Medical technology, (6) Field training, with the weights of 0.1415, 0.1584, 0.1536, 0.1827, 0.1728, and 0.1909, respectively, and 32 sections. Teaching methods for different knowledge modules were determined, which included lecture, demonstration, discussion, drills, and tabletop simulation. The evaluation methods were affirmed via a quiz, written examination, skill test, and teamwork test assessed by intra-group and inter-group evaluation.Discussions:Through scientific investigation of experts from International EMTs, a training course model for International EMT was established.
What About Us? Addressing the Needs of First Responders in Behavioral Health Disaster Planning in Chicago
Authors: Hebert Charles 
Published: May 2019

Introduction:Behavioral health needs of first responders often receive less attention than those of survivors. Fire, police, medical, and other personnel frequently witness direct loss of life, assaultive violence, and other stressors during disasters. Evidence indicates a greater incidence of psychiatric sequelae among disaster workers. What role do emergency management authorities have in addressing the needs of such personnel?Aim:To evaluate integration of first responder behavioral health needs among a metropolitan healthcare coalition, the Chicago Healthcare System Coalition for Preparedness and Response (CHSCPR).Methods:CHSCPR developed a Behavioral Health Annex providing uniform guidance on behavioral health integration into emergency operations with attention to first responders. An electronic Behavioral Health Capability Survey of coalition members was performed in March 2017 to assess implementation of these recommendations. Qualitative and quantitative responses were recorded.Results:Fifteen of thirty-five institutions responded, including academic and private community hospitals. Many reported no services. Where services existed, most facilities endorsed use of employee assistance programs or external vendors for staff support. 4/15 (26.7%) reported proactive strategies to mitigate stress such as information sheets on healthy coping. Measures for family support of affected emergency personnel were varied and typically outsourced to online resources, or reported as “in development.”Discussion:Findings suggest that recognition of emergency personnel behavioral health needs is lacking in city-wide disaster planning with greater emphasis on post-disaster needs than preventative efforts. Increased awareness of risk for psychological decompensation among first responders, and inclusive efforts to mitigate this risk, are warranted in future disaster planning.
Surveillance and Control of Threats in the Public Health System in Brazil: Mapping Managers’ Competencies
Authors: Silva Marcio Haubert Da , Albini Alessandro , Witt Regina Rigatto 
Published: May 2019

Introduction:With the increase in the number and intensity of disasters, integrated risk management has been a subject of discussion in Brazilian health system, in which the local level plays an important role. Competency Mapping of Managers working at a Municipal Health Office from a Metropolitan Area of Curitiba, Southern Brazil was developed.Aim:To describe gaps in core competencies identified for Surveillance and Control of Risks and Threats.Methods:The Public Health Core Competencies contained in the booklet: A Regional Framework for the Americas, of the Pan American Health Organization, originated a semi-structured self-assessment questionnaire. A Likert scale with levels of proficiency (from one to five) was aggregated to the 56 specific core competencies. It was applied to a sample of 78 managers between the months of October 2017 and January 2018. The data obtained were submitted to quantitative analysis. Gaps (Training Priority Degree) were defined according to the grade of importance and expression by means of a arithmetic mean and standard deviation.Results:Gaps were identified for the competencies: Design disaster risk management plans for natural, technological and biological threats so as to mitigate their impact on health (2.82 ± 1.16); Design investment projects for reducing the health risks of disasters (2.8 ±1.07); Provide an immediate response to threats, risks and damage from disasters based on the risk assessment, in order to protect health (2.89 ± 1.13); Plan and execute post-disaster reconstruction, based on the damage identified for the immediate restoration and protection of the population’s health (2.81 ± 1.11).Discussion:The degree of expression for these competencies indicate the need of preparing public health managers for surveillance, by monitoring the exposure of people or population groups to environmental agents, or their effects with an integrated approach to injuries and the etiology of emergencies and disasters.