bluuebunny/crossref_metadata_2025_split huggingface dataset:
The 14th Asia Pacific Conference on Disaster Medicine in Kobe, Japan: A Brief Overview and a Proposal
Authors: Nakayama Shinichi , Ukai Takashi , Kozawa Shuichi , Kawase Tetsunori , Ishihara Satoshi , Kai Kai Soichiro , Kayano Ryoma , Kai Tatsuro 
Published: May 2019

Introduction:The Asia Pacific Conference on Disaster Medicine (APCDM) started in 1988 in Osaka, Japan, and the 14th conference was held from October 16-182, 2018, in Kobe.Aim:To give a rundown of the 14th APCDM and a proposal for WADEM.Methods:Retrospective analysis of participants, the category of presentations, and deliverables.Results:With “Building Bridges for Disaster Preparedness and Response” as its main theme, the 14th APCDM was held near the epicenter of the 1995 Great Hanshin Earthquake in Kobe. The total number of participants was 524 from 35 countries, not only from Asia and the Pacific but also Europe and the Americas. Its program had 10 lectures by distinguished speakers such as WADEM Board members and WHO (World Health Organization), four symposia, two panel, oral and 99 poster presentations. “Preparedness” and “Education and Training” were the categories with the largest number of presentations. The presidential lecture outlined improvements made in Japan since the Great Hanshin Earthquake (disaster base hospitals, disaster medical assistance teams, emergency medical information system, and disaster medical coordinators) and emphasized the importance of standardizing components for better disaster management. This idea was echoed in symposia and round-table discussions, where experts from WHO, JICA (Japan International Cooperation Agency), and ASEAN (The Association of Southeast Asian Nations) countries discussed other components such as SPEED (Surveillance in Post Extreme Emergency and Disasters) and standardization of Emergency Medical Teams.Discussion:Each country in the disaster-prone Asia-Pacific region has a different disaster management system. However, participants agreed in this conference that we can cope with disasters more efficiently by sharing the standardized components, from both academic and practical points of view. APCDM must provide these deliverables to WADEM, so both conferences can cooperate and contribute to disaster preparedness and prevention in the new era.
Analysis of Emergency Situations in the Russian Federation
Authors: Aleksanin Sergei , Evdokimov Vladimir 
Published: May 2019

Introduction:Emergency situations (ES) are situations within a certain territory, which have arisen because of an accident, a dangerous natural phenomenon, natural disaster, or other that may cause or have caused human casualties, damage to human health or the environment, significant material losses, and unbalance of living conditions of people. Important characteristics of ES are suddenness and involvement of a significant number of victims who need first aid and emergency medical care. These characteristics determined the organization of the Unified State System for Emergency Prevention and Elimination of the Russian Federation.Aim:To study the structure of ES in Russia. By the scale of spread and damage caused, ES can be local, municipal, inter-municipal, regional, interregional, or federal, by the source of origin – technogenic, natural, biological, or social. The terrorist acts are usually allocated in a separate group of ES. The structure of ES, according to the EMERCOM of Russia in 2005-2017, is as follows:
1.Technogenic (59.61%)2.Natural (29.42%)3.Biological and social (9.91%)4.Major terrorist acts (1.06%)Methods:Statistical analysis was conducted. According to the EMERCOM of Russia, every year in 2005-2017 there were 422.5 ± 46.5 ES, resulting in the death of 796 ± 56 people. Polynomial trends in the number of ES and deaths, according to the EMERCOM of Russia, (with significant coefficients of determination R2 = 0.85 and R2 = 0.64, respectively) show a decrease in the number of ES and deaths.Discussion:The resulting analysis of the structure and number of ES, the number of deaths, the risk of being in an emergency, and the individual risk of death in an emergency can predict the forces and means necessary for the elimination of the consequences of ES.
Are We Ready for Bioterrorism? Health Personnel were Affected by Contaminated Meat Cooked at a Daily Routine Hospital Kitchen
Authors: Ülker Volkan , Erdoğan Özcan 
Published: May 2019

Introduction:Salmonellae are gram-negative motile bacilli. The transmission of salmonellae to a susceptible host usually occurs from the consumption of contaminated foods. Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, but can be severe enough to require hospitalization.Aim:Describe a hospital kitchen based mass foodborne infection.Methods:Descriptive analysis of the foodborne infection event.Results:310 health personnel were contaminated from lunch that was cooked at our hospital kitchen. On that day 70 patients came to the emergency department for complaints of vomiting, fever, and diarrhea. During the next two days, we canceled all planned surgical operations. At the second day, we followed 80 patients and third day 150 patients came to our emergency services. Our emergency services and ıntensive care units were blocked because of personnel illness. We examined all patients, got blood tests and stool stains and cultures. Because of this mass casualty contamination, our infection control committee gave formal information that suspicious of Salmonellosis. 13 of 310 infected health personnel were hospitalized. They got intravenous saline and electrolytes support like calcium and potassium. After two days we got Results of stool cultures, there was inoculation of Salmonella types. None of them died.Discussion:We realized that we are not ready for mass casualty incidents like this contamination. Because our patient flow was really blocked. We had to call in new doctors and nurses from different hospital staffs. The event was similar to bioterrorism conditions and we suddenly have to put in place hospital disaster plans at the beginning of decontamination. This situation made us to recognize bioterrorism agents like Salmonella types. We have to raise awareness of the community about chemical, biological, radiological and nuclear agents attacks.
Availability of Essential Medical Equipment for Prehospital Trauma Care on Public Ambulances in Ukraine
Authors: Gaievskyi Stanislav , Meghoo Colin 
Published: May 2019

Introduction:The public ambulance system in Ukraine is the primary deliverer of prehospital care for trauma patients in this Eastern European country, but no national assessment has previously been made to ensure the presence of essential medical equipment on these ambulances.Aim:Working with the Ukraine Ministry of Health, our aim was to assess the availability of public ambulances of medical equipment essential for managing traumatic injury using an internationally recognized standard for prehospital care.Methods:We identified 53 Advanced Life Support (ALS) ambulances from randomly selected cities for evaluation. We performed an inventory of available medical equipment and supplies on these ambulances against a matrix of essential equipment for prehospital providers developed by the World Health Organization (WHO).Results:Essential medical equipment in the categories of personal protection, patient monitoring, hemorrhage control, and immobilization were generally available in the ALS public ambulances surveyed. Deficiencies were noted in equipment and supplies for basic and advanced airway monitoring and management.Discussion:Public ALS ambulances across Ukraine are adequately equipped with many essential medical supplies to manage traumatic injury, but have deficiencies in both basic and advanced airway management. Correcting these deficiencies may improve prehospital survival of the traumatically injured patient. The results of this study will enable the Ukraine Ministry of Health to develop requirements of essential medical equipment for all public ALS ambulances in the country, to inform resource allocation decisions, and to guide public health policy regarding prehospital trauma care.
Behavioral Health Resource Utilization of Emergency Department Patients Presenting from Mass Gathering Events
Authors: Hebert Charles , Peksa Gary , DeMott Joshua 
Published: May 2019

Introduction:Behavioral health needs of attendees at mass gathering events who require emergency department (ED) evaluation are poorly understood. Appropriate resource allocation of mental health staff and other behavioral interventions necessary to support this patient population are also unclear.Aim:To describe behavioral characteristics and psychiatric resource utilization of patients presenting to a tertiary academic medical center emergency department from mass gathering events.Methods:Single-center retrospective study evaluating attendees at mass gathering events who presented to a Chicago ED. Electronic medical records for patients presenting between October 13, 2013, and December 31, 2015, were reviewed and descriptive analyses performed.Results:209 distinct records were reviewed. Most patients presented from large outdoor concerts (n = 186, 89%). Forty-two (20.1%) reported a mental health complaint at presentation, including concerns related to pre-existing psychiatric disturbances or onset of new symptoms. Twenty-seven of the total cohort (12.9%) endorsed a prior psychiatric history. Thirty-five (16.7%) reported use of prescribed psychotropic medications, including antidepressants, stimulants, mood stabilizers, and others. Diagnostic testing among the total sample included serum ethanol measurement (31.1%), urinary toxicology (25.4%), acetaminophen (6.2%), aspirin (5.3%), and creatine kinase measurements (11%). Computed brain tomography was ordered for 20 patients (9.6%). Twelve patients (5.7%) received an anxiolytic (lorazepam) and 113 (54.1%) received intravenous fluids. An antipsychotic (olanzapine) was administered to one patient (0.5%). There were no reports of suicidal ideation, but physical restraints for agitation were employed in 13 patients (6.2%). Police consultation occurred in 10 cases (4.8%). No formal psychiatric consultations were requested by ED providers.Discussion:Patients presenting to the emergency department from mass gathering events frequently endorse behavioral complaints requiring directed use of diagnostic and other emergency department resources for their ailments. The need for physical restraints and limited use of anxiolytics and antipsychotics in our sample suggest that psychiatric consultation is underutilized.
The Birth and Growth of the National Ambulance Service in Ghana
Authors: Kingsley Mawuli 
Published: May 2019

Introduction:This study aimed to document the growth and challenges encountered in the decade since inception of the National Ambulance Service (NAS) in Ghana, West Africa. By doing so, potentially instructive examples for other low- and middle-income countries (LMICs) planning a formal prehospital care system or attempting to identify ways to improve existing emergency services could be identified.Methods:Data routinely collected by the Ghana NAS from 2004–2014 were described, including: patient demographics, reason for the call, response location, target destination, and types of service. Additionally, the organizational structure and challenges encountered during the development and maturation of the NAS were reported.Results:In 2004, the NAS piloted operations with 69 newly trained emergency medical technicians (EMTs), nine ambulances, and seven stations. The NAS expanded service delivery with 199 ambulances at 128 stations operated by 1,651 EMTs and 47 administrative and maintenance staff in 2014. In 2004, nine percent of the country was covered by NAS services; in 2014, 81% of Ghana was covered. Health care transfers and roadside responses comprised the majority of services (43%–80% and 10%–57% by year, respectively). Increased mean response time, stable case holding time, and shorter vehicle engaged time reflect greater response ranges due to increased service uptake and improved efficiency of ambulance usage. Specific internal and external challenges with regard to NAS operations also were described.Discussion:The steady growth of the NAS is evidence of the need for Emergency Medical Services and the effects of sound planning and timely responses to changes in program indicators. The way forward includes further capacity building to increase the number of scene responses, strengthening ties with local health facilities to ensure timely emergency medical care and appropriateness of transfers, assuring a more stable funding stream, and improving public awareness of NAS services.
Collaboration between a Hospital and the Surrounding Communities in an Emergency and Disaster
Authors: Alim Ahmad , Santosa Budi , Setiawan Budi , Husein Rahmawati , Nurkholis Arif , Nihayati Zuhdiyah , Rintawan Corona , Inayah Iin , Afik Al , Arliono Tri , Haedar Ali , Alim Syahirul , Samsu Danang , Supartiny Eny , Nurjuman Husnan 
Published: May 2019

Introduction:Muhammadiyah, the Indonesia non-governmental organization (NGO), has more than 300 hospitals. It is one of the forerunners of the Safe Hospital Initiative in Indonesia beginning in 2008. Muhammadiyah realized that hospital strengthening must be done in collaboration with community strengthening. From 2016 to 2018, Muhammadiyah ran a program named Hospital Preparedness and Community Readiness for Emergency and Disaster (HPCRED) that was carried out through strengthening two hospitals and their surrounding communities in Palangka Raya, Central Kalimantan, and Bima, West Nusa Tenggara (NTB). This program was funded by the Australian Government and is in line with the Safe Hospital Comprehensive Framework of the World Health Organization (WHO).Aim:To strengthen hospitals and the surrounding communities to prepare for emergencies and disasters.Methods:HPCRED completed 92 activities in two areas consisting of the following: 10 training, 26 workshops, 12 exercises, four monitoring and evaluation meetings, and seven technical sessions/seminars. The exercises consisted of tabletop exercises, skill drills, command post exercise, and full-scale exercise.Results:There were positive changes in the hospitals and communities particularly on disaster management, policy, procedures, staff and community skills, knowledge, and behavior. The integration and collaboration between the hospital surrounding communities were established and can be examined by documents, agreements, and activities done together between the hospital and community during and after the program.Discussion:Before the program, hospitals were not ready to face disasters. PKU Bima Hospital collapsed during a flash flood in December 2016. The community, to save housing from water, hollowed the hospital wall out causing water entrance into the hospital. It meant there were no communication and coordination between the hospital and its community. HPCRED not only made them communicate and coordinate but also collaborate and cooperate to reduce risks and response disasters such as responding Lombok Earthquake in July 2018.
Comparison of the Effects of Sacco and START Triage Methods in the Death Risk Assessment of Mass Trauma Patients after Earthquake
Authors: Aoyu Wang , Run Lin , Yaqi Chen , Mengjiao Tao , Hai Hu 
Published: May 2019

Introduction:Compared with traditional START Triage Method, the Sacco Triage Method is a new way to access death risk in disaster scenes. However, due to the difficulties in disaster medical research, there is still no evidence to prove which one is more effective.Aim:To assess and compare the value of START Triage Method and Sacco Triage Method in the death risk assessment of transport and the one-month death risk assessment of the earthquake mass trauma patients.Methods:A retrospective analysis was conducted on 1,612 patients who were transferred to the West China Hospital by assigning to different triage levels by Sacco Triage Method and START Triage Method respectively. Both of the triage methods were evaluated based on death cases on either during transport or in the emergency department, using the area under the receiver-operator curve.Results:For death during the transport and in the emergency department, the receiver-operator curve of two groups reflected as 0.721 and 0.649. For death in a consequence, the receiver-operator curve of the two groups was revealed as 0.667 and 0.519.Discussion:As an accurate triage method, the Sacco Triage Method may be used in a mass casualty incident. It is a more effective way than the START Triage Method for the evaluation of death risk assessment of the mass trauma patients.
Critical Concepts in Disaster Medicine for Saudi Arabian Emergency Residency Programs: A Delphi Study
Authors: Alossaimi Bader , Molloy Michael , Hart Alexander , Voskanyan Amalia , Sarin Ritu , Ciottone Gregory 
Published: May 2019

Introduction:Saudi Arabia, the largest country in the Middle East, has suffered numerous terrorist attacks and is the location of Hajj, one of the world’s largest annual mass gatherings. Healthcare providers’ pre-incident knowledge and understanding of basic disaster medicine (DM) concepts are crucial for a unified and effective health-system response. Introducing healthcare providers to best practices is a stated vision of the Saudi Commission for Health Specialties. Standardizing DM curriculum taught to physicians during their residency training will assist this goal.Aim:To produce expert consensus on the most critical DM topics for the residency curriculum in emergency medicine (EM) in the Kingdom of Saudi Arabia.Methods:Utilizing a Delphi approach, a panel of Saudi Arabian experts in DM and EM residency directors were surveyed regarding potential DM topics for EM residency curricula. The first round comprised of open-ended questions seeking lists of suggested DM curriculum topics. In subsequent rounds, each participant received a questionnaire asking them to review the items contributed in the first round, summarized by the investigation team. The participants rated each item on a five-point Likert Scale to establish preliminary priorities and added their comments. In further rounds, participants reviewed and prioritized subjects until they reached a consensus of >=80%.Results:The study is ongoing and full data will be available in the new year.Discussion:This expert consensus from major stakeholders can be used to improve the foundation of the DM curriculum. The Delphi Method gives an evidence-based approach to identification and prioritization of subjects, which should be integrated within the Saudi Arabian Emergency Medicine Residency Curriculum. It also can be used as a cornerstone for implementation in other medical education programs across the Kingdom in the future.
Developing a Knowledge Program for Large Scale Prehospital Assistance During Disasters and Big Incidents
Authors: Van Roessel Will , Cools Carian 
Published: May 2019

Introduction:In the Netherlands, we started in 2016 with a new procedure for large scale medical assistance during a crisis. The normal daily assistance in the Netherlands is organized on a regional level, and we have 25 regions. These regions are far too small to handle big incidents, and cooperation is needed on a higher level to generate enough capacity. However, the Aim is that most emergency workers continue to do their own work in standard procedures, we also need more coordination, information management, transition of “stay and play” to “scoop and run” and deploying volunteers and citizens.Aim:We developed the model practice-based, however, we have little big incidents. We feel the urgency to compare this practice to international knowledge.Methods:The goal is twofold: validation of the starting points of our model, but also further improvement: speeding up the transport and treatment of patients, improvement of capacity, safety of the ambulance staff – especially with terrorist attacks or contamination, civil participation. We held the first survey on scientific literature in English, related to items in our prehospital assistance model. (the article is not yet published).Results:The conclusion was, that scientific articles are rare, however, a lot of information is given about the practical course of incidents. Scientific research to explore these experiences is rare, partly due to a missing universal terminology on disaster medicine.Discussion:We want to contribute to enlarging the scientific knowledge on large scale prehospital assistance. We expect that a lot of practical experience can be unlocked by bringing together experts in this field. We want to present the Dutch model, with a focus and invitation to compare this with the models in other countries, to compare experiences, to deepen them and to stimulate international research. We want to commit ourselves to facilitate this.
Development and Effect of a Pandemic Disaster Training Program for Healthcare Providers from Designated Hospitals for Infectious Patient
Authors: Noh Jiyoung , Chung Hyun Soo , Jin Hye Mi , Hur Jayoung , Kim Min Ji , Kang Chan Mi , Lee Ga Hyun 
Published: May 2019

Introduction:South Korea experienced Middle East Respiratory Syndrome (MERS) outbreak in 2015. To mitigate the threat posed by MERS, the Ministry of Health and Center for Disease Control designated hospitals to be responsible for managing any suspected or confirmed infectious patient. These hospitals receive mandatory training in managing infectious patients, but many of the trainings lack practical skills practice and pandemic preparedness exercise.Aim:To develop and evaluate a training course designed to train healthcare providers from designated hospitals to enhance their competencies in managing emerging infectious diseases and potential outbreaks.Methods:A two-day course was developed by the Center for Disaster Relief, Training, and Research in collaboration with the Korea Health Promotion Institute using Kern’s 6-step approach. The course consisted of didactic lectures, technical skills training, tabletop simulation, and scenario-based simulation. Table-top simulation exercises consisted of cases involving a single infectious patient detected in the outpatient clinic and outbreak in the emergency department. Scenario-based simulation exercises involved managing a critically ill infectious patient in an isolated ward. A post-survey questionnaire was used to evaluate the course and assess the perception changes of the participants. All pre-to-post differences within subjects were analyzed with paired t-tests.Results:A total of 121 healthcare providers participated in three separate courses. The competencies for pandemic preparedness knowledge, skills, and attitude improved from pre- to post-course. The differences were all statistically significant (p<0.05). Overall course satisfaction in average for expectation, time, delivery method, and contents were 9.5, 9.2, 9.4, and 9.2, respectively.Discussion:There needs to be tests and exercises to recognize gaps of systems in place for pandemic preparedness. Simulation exercises are ideal tools for this purpose. Although this was only a two-day intensive course, this increased familiarity with workflows, tested the coordination of workflows between different disciplines and allowed the identification of gaps.