bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expand the Understanding of Response Roles: Who Really is First on Scene
Authors: Klein Kelly , Harris Curtis , McCarthy Kelli , Waltz Tawny , Prins Parker , Liu E. Liang , Swienton Raymond 
Published: May 2019

Introduction:The US, as well as many countries, are being beseeched by more natural and man-made events; both small (e.g., shootings) and geographically vast (e.g., floods). Due to a myriad of issues, traditional first responders i.e., EMS, fire department, and police cannot be expected to be the only trained lifesavers on the scene. In the US (as in many countries), it is imperative to begin the discussion to better understand the role of the “injured” and “immediate” responders and how they interact with the “first” responders.Aim:To open a discussion amongst disaster experts about the merits of training and subsequent promotion of a curriculum for “immediate” responders.Methods:Literature review.Discussion:After recent evaluations of events, it is postulated that there are three categories of responders: the injured, the immediate, and the first (EMS, fire department, police). The premise upon which disaster risk reduction and building community resilience are achieved begin with strengthening, empowering, and equipping local populations with the appropriate tools. This would involve education, skills, and training. With the average general public trained, and if they are one of the first two categories, then the community would not only be better able to assist themselves, but also be able to integrate into the recovery process much more quickly and fully. By doing this, they will be empowered to take care of themselves, neighbors, and community, which in turn increases local resilience.
Exploring the Utilization of Small Unmanned Aerial Vehicles (UAV) Known as Drones in Early Phase Disaster Response
Authors: Luman Jenifer , Luman Benjamin 
Published: May 2019

Introduction:Disaster Medical Response is a challenging field where opportunities for advancement are welcomed. Small Unmanned Aerial Vehicle (sUAV) technology (i.e., drones) has made enormous strides in the past few years and is poised for utilization in the early disaster response phase.Aim:To discuss current uses of UAVs, proposed utilization and logistical details, technological advancements, current deficits, and training.Methods:Our Foundation, Luman Medical, is working in the field of UAV integration for small to large scale disaster response. The concept is to equip first responders with small, relatively inexpensive, programmable drones that come equipped with hardware and software that are easy to use for inexperienced as well as skilled sUAV pilots.Discussion:These UAVs could increase ease and speed of deployment for early assessments of disaster area mapping, thermal imaging, ingress and egress routes, the discovery of survivors, communications, and delivery of supplies. Drone technology offers a new and growing type of tool in the disaster response arena. It is our hope to explore an integration that is easy, safe, and affordable to augment and enhance existing disaster response planning.
Identification of Preventable Death and Severe Complications in Train Crashes in Rural and Cold Environment Using a Simulation-Based Model
Authors: Aléx Jonas , Forsberg Rebecca , Nilsson Heléne 
Published: May 2019

Introduction:The use of rail transport is increasing in Sweden, as well as within Europe, and train speeds are escalating. These factors contribute to an increasing frequency of train crashes and major crashes so severe that they can be classified as disasters. There is a lack of knowledge concerning factors of importance related to the rescue operation that can influence survival rate at train crashes, especially in cold environments.Aim:The aim was to identify preventable death and severe complications among passengers in a train crash in rural and cold environments using a simulation-based model.Methods:A train crash scenario was developed based on scientific research, crash reports, and lessons observed in incidents. The scenario was set to a train with seven carriages consisting of 150 passengers that derailed in a curve in 160km/h, 10km from the hospital. In Umeå in the north of Sweden, 12 participants from seven emergency/disaster organizations joined in two preparing workshops and a real-time simulation-based train crash. The Emergo Train System (ETS) was chosen as a simulation tool. Data collection such as rescue capacities, response time, and patient surge were collected and transferred into the ETS.Results:The results show 17 preventable death and 9 preventable severe complications since the actions were not implemented in the recommended time.Discussion:The results show that an extended rescue operation can have devastating consequences especially in cold environments. Further experimental simulations are needed with defined interventions to find out how preventable deaths and severe complications can be reduced.
Improving Emergency Preparedness among Children with Special Health Care Needs in a Pediatric Infant Disease Clinic
Authors: Atti Sukhshant , Persaud Eric , Salway James , Gist Ramon , Roblin Patricia , Kohlhoff Stephen , Arquilla Bonnie 
Published: May 2019

Introduction:Children with Special Health Care Needs (CSHCNs) are at an increased risk for physical, developmental, or emotional conditions, and require special services beyond what is typically required by children. Improving emergency preparedness amongst families with CSHCNs has been advocated by the Centers for Disease Control (CDC), Federal Emergency Management Agency (FEMA), and The American Academy of Pediatrics (AAP).Aim:We evaluated the preparedness of children and family members, who are infected, or affected, by HIV illness and require daily medications.Methods:A convenience sample was used to enroll patients and their parents at a pediatric infectious disease clinic. Surveys were used to assess baseline emergency preparedness. Patients were then given an educational intervention on improving personal preparedness. Participants were provided with emergency go-kit and educational materials. Follow up was completed in 30 days to re-assess preparedness by re-administering the initial survey with additional questions.Results:Thirty-eight patients were enrolled and 10 were lost to follow up. Data from a total of 28 patients were used for study results analyses. Chi-squared testing was used for non-parametric variable analyses for an N < 30. Participants who designated an emergency meeting place outside of their home, post-intervention, were statistically significant-X2 (1) = 29.20, p-value <0.0001. Participants who completed an emergency information form, post-intervention, were statistically significant-X2 (1) = 13.69, p-value <0.0002. Participants who obtained an emergency kit of supplies for 3 days, post-intervention, were statistically significant-X2(1) = 8.92, p-value <0.0028. Participants who obtained a home first aid kit, post-intervention, were statistically significant-X2(1) = 12.16, p-value <0.0005. Five families obtained an emergency supply of medications, post-intervention-X2 (1) = 1.99, p-value = 0.1582. This result was not statistically significant.Discussion:This study demonstrates that brief educational intervention has potential to improve the preparedness of CSHCNs, including those living with HIV illness.
An Integral Hospital Response Protocol for Emergencies and Disasters from the Emergency Department
Authors: Saleme Elisa N. , De la Sierra Luz A. , Kramis Jose L. , Arguelles Pedro , Montiel Hector 
Published: May 2019

Introduction:Mexico has suffered multiple social and natural events that tested its response capacity. Hospital units of the third level of care are an axis of response and a central reference. Guaranteeing their integral and organized response promotes risk prevention and mitigation strategy in emergencies and disasters.Aim:To analyze the national and international regulations and the existing documents about emergency and disasters related to a hospital with the identification of the critical actors in the response.Methods:This research consists of a cross-sectional and descriptive study with a mixed methodology (qualitative and quantitative), that generates a protocol for response in a third level care hospital. Quantitative analysis was carried out using central tendency measurements based on a surveys (training, knowledge) performed in the hospital services that provide a critical response with the ED in emergencies or disasters (ED, ICU, Supplies, Nursing, Operating Room, Security, Hospital Admission, Crisis Committee). In the quantitative analysis, the staff were interviewed about their experience in responding to previous events (to the same critical services), recognizing importance and points of improvement with a discourse analysis methodology.Results:With the information collected and based on the protocols of Safe Hospital program (PAHO/WHO) we generated a protocol organized by the ED that involves massive victims.Discussion:Regulations oblige hospital units to have protocols of action in critical situations linked to Safe Hospital program, so it is a great tool for planning. All the surveyed personnel consider that it is important to have a plan that allows for immediate steps to ensure quality and timely patient care, considering it an ethical and social obligation. Analysis suggests that continuous training and the contribution of an operational plan per service provide security and better prognosis to the victims. The protocol includes all critical response services with a clinical practice guide.
Investigation on Level of First Aid Knowledge among Undergraduates
Authors: Run Lin , AoYu Wang , Yaqi Chen , Enjiang Lai , Hai Hu 
Published: May 2019

Introduction:First aid in a short time is the key to saving lives. As undergraduates step into society, they should have enough ability to save others. As a result, first aid knowledge and training are essential for them.Aim:To investigate the cognition level of the first aid knowledge among undergraduates, and to improve the training for undergraduates.Methods:A questionnaire was designed for this study. It includes the basic information of the test subjects, attitude towards first aid, level of first aid knowledge, etc. The subjects of the questionnaire were mainly undergraduates in Sichuan province.Results:There were 302 valid questionnaires. The percent correct of the first aid basic knowledge quiz was only 47.62%. Using Chi-Square tests to analyze, medical education can make a significant difference in the level of first aid knowledge. (Chi-Square=251.004, P<0.01) Additionally, 78.81% of undergraduates thought it was significant to learn and master first aid knowledge, and the most common way to learn first aid knowledge was through university (81.46%).Discussion:Universities should strengthen the training for undergraduates to improve their first aid skills. This is a feasible approach to promote a public level of first aid knowledge.
Issues of Which Organization is Responsible for Hospital Evacuation in Nuclear Disasters
Authors: Ogasawara Masaru , Sato Yuta , Ito Katsunori , Saito Kyoji , Ito Katsuhiro , Hanada Hiroyuki 
Published: May 2019

Introduction:At the time of a nuclear disaster, residents should evacuate from areas with high air dose rate. In the Great East Japan Earthquake, about 10% of patients died in a hospital evacuation in which medical teams were not involved in transportation.Aim:To determine if hospital evacuation improved after the Fukushima nuclear accident.Methods:This research investigates how the medical system of a nuclear disaster in Japan changed.Results:There are 41 hospitals designated as Nuclear Emergency Core Hospitals, and they have 53 Nuclear Emergency Medical Assistance Teams (NEMAT; disaster medical dispatching team specialized in nuclear disasters consisting of medical doctors, nurses, and radiological technologists) that can support hospitals and information in the acute phase.Discussion:At the time of a nuclear disaster, NEMAT is supposed to evacuate residents from the Urgent Protective Action Planning Zone (UPZ; within about 30 km radius). Tens of thousands to one million people live in this area. Hospital evacuation of more than several thousand patients is necessary. The entry of workers for transportation vehicles and lifeline restoration is limited within UPZ, so staying in a hospital is virtually impossible. There are over 2000 Disaster Medical Assistance Teams (DMAT), and many Red Cross Relief Teams; both of which are stipulated not to conduct clinical treatment in high dose areas and are not educated on nuclear disasters. Although there are Radiation Emergency Medical Assistance Teams (REMAT) consisting of doctors and technicians specializing in radiation medicine, they are few in number. They can perform dose assessment, but general medical care cannot be performed because an emergency physician is not included. Therefore, although NEMATs will conduct emergency and hospital evacuation in the affected area, the number of teams is too small to respond. The issue of which organization is responsible for massive hospital evacuation remains unsolved.
Leadership and Factors Enabled the “Group Allocation” which Preserved Pre-existing Local Social Ties in Prefabricated Temporary Housing After Great East Japan Earthquake (GEJE)
Authors: Masuno Kanako , Osaka Ken , Aida Jun , Uchiumi Yuichi , Iguchi Tsuneaki , Hirono Yoshiyuki 
Published: May 2019

Introduction:Social isolation and death alone in the prefabricated temporary housing after a disaster has been a social concern. The importance of social ties among the community has been suggested and several reports pointed out the positive effect of “group allocation” which preserves pre-existing local social ties compared to the “lottery allocation”.Japan Red Cross Society recommended “group allocation” as a better option than “lottery allocation” on their guidelines. However, many municipalities carried out “lottery allocation” for temporary housing arrangement after the Great East Japan Earthquake (GEJE).Aim:To collect the information about the accelerating factors and bottlenecks when practicing the “group allocation”.Method:In-depth interview was conducted between August and November 2013. Interviewees were the professionals of disaster management, individuals who were involved in arranging the prefabricated housing and the residents. This research was supported by the Ministry of Education, Culture, Sports, Science, and Technology in Japan.Results:This study found the municipality which carried out “group allocation” had characteristics such as: (1.) the staff in charge of housing arrangement had the information about the positive effect of “group allocation”, and (2.) pre-existing community leaders were able to gather residents’ opinions, and citizens were involved in the decision making to some content.Discussion:Although this study is based on the experience of a limited number of key persons, it would be useful to give the insight about the possible bottleneck for the practitioners who will be in charge of housing arrangement under the disaster setting in future. Also, the relevancy and evidence about “group allocation” should be carefully examined in the context of preventing social isolation as well as various long-term effects. It would be essential that the knowledge and experience will be accumulated and shared between municipalities in a usable and comparable format.
Learning from Disasters: How Do We Share the Knowledge and Experience?
Authors: Richardson Sandra 
Published: May 2019

Introduction:Understanding the difficulties of sharing knowledge generated from disaster situations is essential to allow for a better process of disseminating the “lessons learned” from the ongoing natural and man-made situations which result in healthcare crises.Aim:To explore nurses ways of gaining knowledge from previous experiences, with a particular focus on earthquakes and natural disasters in the New Zealand (NZ) setting.Methods:Initial analysis of a series of individual, semi-structured interviews with a small group (n=10) of emergency department registered nurses from a range of geographical areas in NZ.Results:While familiar with the major earthquake events that have recently affected different areas of NZ (most notably Canterbury, Kaikoura, and Wellington), few could recall detailed information or lessons generated from these events. When asked about the most effective means of learning about and from disasters, the direct experience was identified as the most effective, followed by narrative retelling and vicarious experience.Discussion:Recognition of the value of “story-telling” in sharing information, and of the importance of offering experiences in a way that allows colleagues to experience or place themselves in the situation in a “virtual” sense is necessary for learning to occur. This involves an emotional as well as an intellectual connection to occur. There is a risk for knowledge to be lost, and lessons to be constantly “re-learned,” as each succeeding generation needs direct involvement to retain the information and insight generated. We need to tailor the medium by which this information is shared, for maximum effect.
Measuring Student Nurses’ Preparedness and Resilience for a Disaster Setting
Authors: Grimes Andrea , Rouen Christopher , West Caryn 
Published: May 2019

Introduction:Nurses have long been utilized in disaster response and recovery and they possess broad skill sets, which are critical in times of crisis. However, studies show that more than 80% of nurses who volunteered in disasters settings have no disaster education.Aim:This project explored the disaster knowledge, preparedness, and resilience of 2nd and 3rd-year undergraduate student nurses in a Bachelor of Nursing Science program in a regional university to garner support for the introduction of dedicated disaster nursing education, which is currently absent from Australian undergraduate nursing curricula. Whilst disaster management processes in Australia are robust and Australian health care systems have explicit plans in place, the same cannot be said for all countries and health care systems. Australian trained nurses are highly valued and actively sought in the global health workforce market. In a world marked by increasing change and instability, the lack of dedicated disaster education and skills in the largest health workforce increases the overall vulnerability.Methods:Data were collected using the Disaster Preparedness Evaluation Tool, the Connor-Davidson Resilience Scale, simple demographics, and a previous disaster experience questionnaire.Results:The results highlight important gaps in current practice and vulnerabilities in the current disaster management framework. Local students scored higher results in preparedness and resilience.Discussion:Student nurses are an underutilized resource in disaster preparation and by response teams around the world. With a global intent of shared responsibility and increased resilience in individuals and communities before, during, and after disaster events, dedicated capacity building of nursing staff has the potential to address key factors and simultaneously utilize an underappreciated demographic of student nurses. To the best of the author’s knowledge, this project is the first to explore disaster knowledge, preparedness, and resilience in undergraduate student nurses using validated disaster preparedness and resilience tools in Australia.
Needs of Family Survivors of Floods in Molepolole, Botswana
Authors: Maripe-perera Dorcas Basetsana 
Published: May 2019

Introduction:Floods are common worldwide and are the leading cause of fatalities. They are destructive to property, crops, and livestock, and leave survivors homeless or displaced to evacuation camps.Aim:To explore the needs of family survivors of floods in Molepolole, determine assistance received and needed, and identify coping strategies used to deal with the impact and effects of floods.Methods:Jordan (2015) model of disaster survivors’ hierarchy of needs guided the study. Purposive sampling selected six families, and seven participants from these families enrolled in the study. A pilot-tested semi-structured interview guide collected data. Data were analyzed using the content style.Results:The study findings confirmed that survivors of floods had immediate and long-term needs, and these were classified into basic, safety, recovery, stress reaction, grief and loss, and growth. Not all survivors were grateful for the assistance they received following floods. Survivors used varied coping strategies to deal with their stressors. The study was conducted in Molepolole, hence, the findings may not be applicable in other settings. Individuals were interviewed on behalf of the entire family.Discussion:There is a need for a multidisciplinary team which will keep the community at the forefront in tackling flood mitigation and developing policies specific to floods. Policies will include indigenous flood mitigation practices and will strengthen awareness of communities to improve knowledge, skills, and attitude. More research is needed on the needs of each survivor.
Needs of Patients in the Triage Category “Expectant” in Prehospital Disaster Settings: A Survey Among German Medical Incident Commanders and Palliative Care Physicians
Authors: Ripberger Gerald , Oppert Michael , Bickelmayer Jens Werner 
Published: May 2019

Introduction:The treatment of patients in the triage category “expectant” is not in the focus of the prehospital disaster medicine. The aim is to save as many lives as possible in situations with very limited resources. It is necessary to allocate the life-saving interventions to those who have the chance to survive, but there is a human right of best assistance even for those who are expected to die.Aim:In Germany, it is possible to use the triage category “expectant” in overwhelming disasters, so there should be preparedness for those patients, who receive this categorization. A survey was conducted to find out what the needs are of those patients.Methods:An online-survey was submitted to German medical incident commanders and palliative care physician in function of expert groups via their national associations.Results:219 physicians participated. The majority confirmed a necessity to treat those patients and to be prepared. Currently, in most of the areas, there is no preparation. The main needs are the treatment of pain, dyspnoea, fear, and loneliness. Following the “Dying person’s bill of rights” (1), the most relevant rights are:
To be treated as living human being until I dieTo be free from painTo express the feelings and emotionsTo die in peace and dignityDiscussion:Palliative care should be part of disaster medicine planning. It is not too difficult to prepare a special group of helper for the care of dying patients. Medical incident commanders and palliative care physicians agree in the majority about the necessity, so SOPs can be implemented to teach non-medics. The medics will be needed for the first aim of disaster medicine.