bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the Preparedness of Student Paramedics for the Mental Health Challenges of the Paramedic Profession
Authors: Holmes Lisa 
Published: May 2019

Introduction:The mental health challenges encountered by paramedics have received much attention in recent years. This attention has particularly focused on high rates of stress, depression, anxiety, and post-traumatic stress disorder. This heightened awareness of the high incidence of mental illness, which has at times tragically resulted in the suicide of serving and former paramedics, is stimulating the address of mental health within the paramedic profession. It is now time to call on paramedic educators to prepare student paramedics for the mental health challenges associated with a career in the emergency medical services.Aim:To explore the preparedness of student paramedics for the mental health challenges of the paramedic profession and identify the coping strategies used by veteran paramedics to successfully meet these challenges.Methods:Twenty semi-structured interviews with veteran paramedics from Australia and New Zealand were conducted.Results:Advice from veteran paramedics was comprised of three key themes: support, health, and the profession.Discussion:The findings of the study indicate that the preparation of student paramedics for the mental health challenges of the paramedic profession throughout the undergraduate curriculum could be advantageous. The advice offered by veteran paramedics can be included within undergraduate paramedic curricula and delivered by sharing the personal experiences of the veteran paramedics. These experiences are highly credible and sharing them offers an opportunity for veterans to contribute positively to the future of paramedicine. Guidelines for their inclusion in the undergraduate paramedic curriculum should be prepared to facilitate knowledge translation and to encourage the development of conscious coping strategies by student paramedics during their learning phase. Further research is needed to raise awareness in this area, with a specific focus on preparing paramedic students to cope with mental health challenges related to undergraduate degree programs, and how they feel about commencing their career as a paramedic.
Stroke Prehospital Informed Decision-Making Using EEG Recordings (SPIDER)
Authors: Loudon Wayne , Wong Andrew , Finnigan Simon , Tippett Vivienne 
Published: May 2019

Introduction:The acute care of stroke involves the administration of a clot-dissolving drug (thrombolysis) and/or its removal using endovascular clot retrieval. Earlier intervention results in significantly improved patient outcomes. Clinical assessment scores have limitations, and studies have shown that even the most robust scores have a reported false-negative rate of >20% for large vessel occlusive strokes that may be eligible for clot retrieval, while inappropriate bypass may delay delivery of thrombolysis.1 Quantitative Electroencephalography (QEEG) has been shown to have a very high sensitivity and specificity in the identification of acute stroke versus matched controls in an in-hospital setting.(2,3)Aim:The SPIDER study commenced in Brisbane, Queensland on September 3, 2018, and is investigating the use of an EEG recorder to gather data on acute stroke patients presenting to a metropolitan ambulance service.Discussion:The data collected will guide the development of a simple numerical output reference to guide decision making. The data may aid in identifying large vessel occlusive stroke and patients eligible for endovascular intervention. The QEEG will provide a more accurate and cost-effective tool for the prehospital clinician over other imaging technologies and can guide early destination decisions. This presentation discusses the implementation of a pre-hospital research platform, integration with the clinical dispatch matrix, staff engagement, patient recruitment, and the success of the project so far.
Discovering Best Practice for Establishing Evacuation Centers for Vulnerable Populations: Findings from an Australian Pilot Study
Authors: Kako Mayumi , Steenkamp Malinda , Ryan Benjamin , Arbon Paul , Takada Yosuke 
Published: May 2019

Introduction:Potentially vulnerable population groups in disasters include the elderly and frail, people who are isolated, and those with chronic diseases, including mental health conditions or mobility issues. The 2011 Queensland flood disaster affected central and southeast Queensland, resulting in 2.5 million people being adversely affected. Seventy-two local government areas disaster were activated under the Natural Disaster Relief and Recovery Arrangements, which was more than 99 percent of Queensland. The issues regarding the role and responsibility across governments relating to planning, setup, and management of evacuation centers will be discussed.Aim:This paper will report the preliminary findings of a pilot study undertaken with local government officials and humanitarian agencies in Australia concerning their involvement in planning for, setting up, and managing evacuation centers for vulnerable populations in Australia during the Queensland floods in 2011. The objective is to illuminate the challenges officials faced, and the resolutions and lessons learned in the preparation of evacuation centers through this event.Methods:The study involved interviews with local government and relevant agencies’ officials who have been involved in establishing evacuation centers for vulnerable populations during the 2011 floods. Six officials were recruited from local government areas affected by the disaster in Queensland, Australia. Semi-structured phone interviews were audio-recorded and thematic analysis was conducted using NVivo software.Results:Three core themes emerged: 1) understanding of the importance of preparation, 2) challenging evacuation center environments, and 3) awareness of good governance principles.Discussion:This pilot study demonstrated that communication with stakeholders during the preparation period prior to a disaster is essential to best practice for evacuation center management. Understanding and being aware of good governance is also an important element to establish evacuation centers effectively.
Measuring the Health Impact of Natural Disasters – The Attribution Challenge Facing the Medical Community
Authors: Finnigan Gerard A 
Published: May 2019

Introduction:Published reports on health impacts from natural disasters causing injuries, poisonings, infectious disease, chronic illness, and NCDs continue to grow exponentially. Simultaneously, calls for the improvement in scientific rigor to improve causal links, strength of association, and efficacy of interventions are increasing. At the heart of this challenge is demonstrating mortality and morbidity risk across a time continuum, where the health effect is not detected for weeks, months, or years after the disaster event. In some circumstances, the presence and acuity of illness are not apparent until after an insidious or cumulative point has been reached. Notwithstanding medical observations or disaster-attributed morality classification matrices being available for 20 years, natural disaster mortality continues to be measured narrowly, on those confirmed dead (acute physical trauma, drowning, poisoning, or missing). There has been little effort to expand mortality assessment beyond this historical lens. For example, it fails to consider suicide in drought and was not redefined when the Indonesian fires caused the highest mortality in 2015. Tens of thousands of lives were lost from smoke exposure.Aim:This study sought to test the progress of two decades of published medical and scientific literature on natural disaster mortality reporting.Methods:A retrospective analysis of natural disaster impact reports for the past ten years was performed on three of the world’s largest disaster databases, including CRED, Sigma, and ADRC.Discussion:WADEM members must commence a strategic process to expand the recognition of health impacts from natural disasters. Global and domestic advocacy is required for building evidence through improved systematic collection of data and especially reporting patient continuum of care as a minimum standard. Without this leadership, disaster health impacts will continue to be underestimated and emergency health program responses and financial resources will fall short in protecting those most at risk.
Use of Solar Power Production for Point-of-Care Ultrasound: A Comparative Analysis
Authors: Gallien John , Sullivan Ashley 
Published: May 2019

Introduction:Use of Point-of-Care Ultrasound (US) has grown considerably in resource-limited and wilderness environments because of a combination of features, including portability, durability, and safety. However, the optimal method of powering US devices in such environments is not well established.Aim:This project has the following aims:
1.Develop a solar power generation and storage system that maximizes power capacity and minimizes weight while being easily transportable by a single person.2.Test the system in a real-world environment to evaluate actual performance relative to stated performance.3.Determine the approximate US scan-time where solar systems would outperform pre-charged batteries with respect to weight.Methods:We developed multiple solar collecting systems using a combination of polycrystalline, monocrystalline, and thin-film solar arrays paired with different powerbanks and tested them using a variety of US systems. From this, the duration of usage was calculated, which makes the solar power generation system a superior option to pre-charged batteries.Results:Lithium-ion energy storage was found to be superior to lead-acid batteries for multiple reasons, most prominently, weight. Several models of US systems were tested revealing that portable US systems consume between 30 to 50 watts. Tri-fold monocrystalline solar panels coupled with lithium-ion powerbanks provided the best combination of weight and transportability. Total weight of the combined solar array, powerbank, and US system is 10 kilograms and easily packs into a backpack carrier. It was found that systems using solar generating capacity become superior to pre-charged powerbanks in regard to weight at approximately 14 hours of scanning time.Discussion:While these results are not fully generalizable due to seasonal and geographic variability as well as the type of US system used, use of solar generating capacity to power US systems is optimal for extended durations of use in resource-limited environments.
The 25 Years of Experience Since Inauguration of All-Russian Center for Disaster Medicine “Zaschia” (Protection)
Authors: Kipor Gennady , Baranova N. , Pichugina N. , Goncharov S. 
Published: May 2019

Introduction:Main functions of the Russian Federation in disasters and emergencies are loaded on All-Russian Center for Disaster Medicine of Ministry Health (ARCDM). The principal strategies of the staff are to play leading roles in preparedness, emergency response, evacuation, recovery of health systems, and education.Methods:Our presentation includes selection, classification, analysis, and statistics. There about 80 territorial Disaster Medicine Centers working under the leadership of ARCDM. One experience from the Moscow Territory Disaster Medicine Center will be presented.Results:At the operational and informational department, there are nine special medical emergency teams (three with helicopters). Time of arrival takes between seven and ten minutes, and transport to the hospital takes about five to seven minutes with 33 landing places for helicopters. The operational and control department uses an early warning system. About 1,300 exercises were organized in these centers and hospitals. We will discuss the examples of medical care delivery to the injured in metro Slaviynskie, Basar park Pobedi, Narofominskay, two major fires, and hurricanes. The mobile field hospital worked in more than 12 countries and in many territories in the Russian Federation over 25 years.Discussion:The last year was very difficult due to the Football World Cup, working hard as a collaborating center in emergencies, and working in the framework of a memorandum with China. Preparedness for an international event next May, which includes a field drill with participants from emergency medical teams of Health Ministries of CIS Countries and from State Health of China. We invite others to observe or join this event. Thus, we have some difficulties and problems, but we must increase solidarity and collaboration due to the scale, frequency, and number of losses in emergencies and disasters. Humanity could be able to cope with emergencies if we take into account these issues.
The Advanced Practice Provider in Federal Disaster Medical Response: An American Experience
Authors: Lennon Erin 
Published: May 2019

Introduction:Advanced Practice Providers (APP) are utilized in the United States National Disaster Medical System (NDMS) and consist of Certified Registered Nurse Anesthetists (CRNA), Nurse Practitioners (NP), and Physician Assistants (PA). They fill a critical role as Medical Officers in the Federal Disaster Medical Response on both Disaster Medical Assistance Teams (DMAT), Trauma & Critical Care Teams (TCCT), and United States Public Health Service (USPHS). DMAT teams and components of TCCT and USPHS responded to National Security Special Events, multiple natural disasters over the past two years including prolonged hurricane response in 2017 and 2018. The APPs were heavily utilized in key roles throughout the responses with much success.Aim:To explain how APPs are a vital component to US Federal Disaster Medical Response and are able to fill a multitude of roles as Medical Officers.Method:We used qualitative data from APPs in the US NDMS system illustrating what roles they filled during recent disaster responses.Results:The APPs were key components to the US NDMS response to disasters in the US and US territories by providing direct medical care as APPs, aid in medical evacuation, triage, healthcare administration, and medical infrastructure evaluations.Discussion:The APP is essential in the US Federal Disaster Medical Response and future research would be to obtain quantitative data on APPs in the U.S. NDMS. With increasing natural and man-made disasters affecting more people across the world annually, the increasing global population, and expected international health care worker shortages, APPs can be part of the overall solution to Medical Officer shortfalls and other key components in future disaster responses throughout the world. As APPs are not widely utilized worldwide, there will need to be education on what APP training is and how they can be utilized in areas not familiar with their abilities.
Assessing the Impact of a New Emergency Triage System on Head Injury Mortality: Tikur Anbessa Specialized Hospital Emergency Department in Addis Ababa, Ethiopia
Authors: Fantaye helena , Lomencho Amanuel , de vos Pol 
Published: May 2019

Introduction:One of the improvements in Ethiopia’s emergency medical system was the introduction of a five-level Emergency Triage System (ETS) in January 2015 that was piloted in selected Addis Ababa hospitals.Aim:To assess the effect of this intervention on the head injury mortality in Tikur Anbessa Specialized Hospital (TASH) Emergency Department (ED).Methods:Data were retrospectively collected from all medical records of head injury patients seen in Adult TASH- ED over two 6 months periods, before and after the new Emergency Triage System implementation: 01/04/2014 – 30/09/2014 versus 01/04/2016 – 30/09/2016. An inclusion criterion was age above 13 for the records that could be retrieved. Exclusion criterion was “patient declared dead on arrival.” Mortality and patterns of head injury were compared pre- and post-intervention. Chi-square was used for the analysis using STATA 14.Results:A total of 522 Head injury patients were analyzed in the ED in both the pre- 258 and post-264 intervention study periods. Among head injury admission in the ED in both study periods, the highest number of patients were Road Traffic Accident/RTA/ victims, males and young age (<30). Mortality rate among head injury patients decreased from a pre-intervention 44 (17.05%) to post-intervention 27 (10.2%) (OR=0.55 9. 5% CI (0.32, 0.95), p=0.02). The median age of death was 45 years in pre- and 40 years in the post-intervention period, with ages ranging from 13 to 85 and 13 to 96 years, respectively. The proportion of deaths from moderate head injury decreased significantly from 14.0% in pre-intervention to 6.3% in the post-intervention period, respectively (p<0.001).Discussion:The Emergency Triage System at TASH-ED has decreased mortality caused by head injury. This could increase life years saved and productivity in a cost-effective and easily achievable way in resource-poor settings.
Assessment of Emergency Medical Rescue Ability of Secondary and Tertiary Hospitals in One City Responding to the Risk of Production and Storage of Hazardous Chemicals
Authors: Hu Xu 
Published: May 2019

Introduction:With the development of the economy and the expansion of the hazardous chemicals industry in one city, it is necessary for the city to establish an evaluation model of emergency medical rescue capability for hazardous chemicals production, storage, and exposure risk.Aim:Establish an emergency medical rescue capacity evaluation model for secondary and higher hospitals in a city to deal with exposure risks of hazardous chemicals.Methods:1.Develop an expert consultation form2.Develop a survey on the status quo of emergency medical rescue capacity of hospitals in secondary and above hospitals in response to exposure and risk of hazardous chemicals production and storage.3.Calculate the weights of the first, second, and third-grade indicators, and establish a comprehensive evaluation model for the rescue capacity assessment of Chengdu hospitals.Results:Five levels of first-level indicators were obtained, namely, the weights of the five indicators of “centralized admission ability,” “hospital comprehensive ability,” “emergency management ability,” “material equipment capability,” and “health emergency team” were 0.2884, 0.2219, 0.1938, 0.1507, and 0.1453, respectively.Discussion:The establishment of an emergency medical rescue capacity evaluation model for the risk of exposure and storage of hazardous chemicals in secondary and higher hospitals in a city is related to five capabilities, the most important of which is the ability to focus on admission.
Back to the Future: Portable Word Processors and the Electronic Health Record
Authors: Mori Alfredo 
Published: May 2019

Introduction:The Electronic Health Record (EHR) is now the standard means for recording and maintaining medical notes in most emergency departments. The EHR is an independent cause of physician burnout, and maintenance of the EHR may occupy 30 to 50% of clinical time. There are software solutions available, but they are connected to fixed, expensive, distracting, and bright electronically powered computers. Scribes have been successfully trialed, but are also expensive and attached to computers on wheels. Portable digital word processors in the form of the AlphaSmart Neo is a redundant technology designed primarily for children with typing difficulties. It has recently enjoyed a resurgence in popularity among professional writers, journalists, and field researchers for the ultimate distraction-free writing experience. The Alphasmart Neo is cheap, nearly indestructible, intuitive, and requires almost no recharging. It is compatible with all software across Mac OS, Windows, and Linux. Notes are entered by the clinician or scribe, independently of computers, at the bedside, and uploaded to any software via USB cable.Aim:To describe the introduction and impact of the AlphaSmart Neo on the EHR in emergency departments across Australia.Methods:We will examine the role of the Alphasmart Neo in austere, low power, extreme environments with a demonstration on how to enter, maintain, and transfer an electronic health record independent of any computer or power source.Discussion:We believe the AlphaSmart Neo is an ideal, personalized, cheap, effective, and efficient hardware solution to entering notes independent of other software and hardware. It is distraction free at the patient’s bedside, resulting in better notes that the clinician enjoys writing.
Caring for the Vulnerable Geriatric Individual in a Disaster
Authors: Mace Sharon , Doyle Connie 
Published: May 2019

Introduction:The elderly have the highest rates of morbidity/mortality in a disaster and are therefore the most vulnerable. 50% of deaths in Hurricane Katrina were ≥75 years old. In the California wildfires, most deaths were people in their 70s and 80s living in areas with unreliable communication services (without cell phone service, etc.), and were uninformed of the disaster or unable and/or unwilling to evacuate. Issues include social isolation and limited technology skills (may not receive messages).Methods:A review of the literature and after action reports from multiple disasters.Results:Augmented services are needed for persons with decreased mobility (impaired access to transportation and shelters); impaired senses; dependence on devices/technology, comorbidities requiring medications/equipment/oxygen, special feedings, sanitary/hygiene needs increased susceptibility to environmental extremes (heat, cold), inability to do ADLs (need for caregivers), increased susceptibility and increased morbidity/mortality with infections, illnesses, trauma; exacerbation of underlying conditions/illnesses when in crowded transportation vehicles and shelters. Additional stress may precipitate or exacerbate coping skills especially in those with dementia, delirium, or mental health illnesses.Discussion:Recommendations include the following:
1.Communications: messages in various forms: closed captioning, TTY deaf phones, use of family, friends, neighbors, officials for notification in addition to mass communication notices, house-to-house notification.2.Medical: Medical/Special Needs Shelters to provide medical care (dialysis, etc.), cache of common medications (diabetic and BP medications) and devices (BP monitoring, glucometers), oxygen, wound care supplies, potable and non-potable water, special diets/formulas, feeding tubes, catheter care, diapers and other hygiene supplies.3.Independence: Health care professionals to assist with medical and psychiatric needs. Caregivers to assist with ADLs.4. Supervision: Those with dementia, delirium, mental health conditions may need supervision.5. Transportation: Need for ambulances, wheelchair vans, specially equipped buses/vans in addition to “usual” school buses/vans with access to water, food, and sanitation if traveling long distances.