bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toward More Efficient Multinational Work on Rescue and Aid for Disasters: Lessons Learned during the Aceh Tsunami and Yogya Earthquake
Authors: Rahardjo Eddy , Wiroatmodjo Karijadi , Koeshartono  
Published: August 2016

Introduction:In the aftermath of the magnitude 9 Sumatra-Andaman earthquake and Indian Ocean tsunami of 2004, a huge number of international responders launched rescue and relief missions in Aceh Province of Indonesia. Thousands of voluntary personnel came to help the wounded, assist with recovery, and rebuild damaged communities. As is often the case with disasters, the necessary disaster management manpower was not immediately athand. Consequently, rescue and relief missions did not coordinate with one another, and chaotic inefficiency prevailed.Just a little over a year after the 2004 earthquake and tsunami, a second disaster occurred in Indonesia following a major earthquake that occurred in May 2006 on Indonesia's most populous island. The May 2006 earthquake killed 5,000 people in Yogyakarta Province, located in the central region of Java Island.
Building Integrated Mental Health and Medical Programs for Vulnerable Populations Post-Disaster: Connecting Children and Families to a Medical Home
Authors: Madrid Paula A. , Sinclair Heidi , Bankston Antoinette Q. , Overholt Sarah , Brito Arturo , Domnitz Rita , Grant Roy 
Published: August 2016

AbstractIntroduction:Hurricane Katrina, a Category 3 hurricane, made landfall in August 2005. Approximately 1,500 deaths have been directly attributed to the hurricane, primarily in Louisiana and Mississippi. In New Orleans, Louisiana, most of the healthcare infrastructure was destroyed by flooding, and >200,000 residents became homeless. Many of these internally displaced persons received transitional housing in trailer parks (“villages”) under the auspices of the [US] Federal Emergency Management Agency (FEMA).Problem:The FEMA villages are isolated from residential communities, lack access to healthcare services, and have become unsafe environments. The trailers that house families have been found to be contaminated with formaldehyde.Methods:The Children's Health Fund, in partnership with the Mailman School of Public Health at Columbia University, began a program (“Operation Assist”) to provide health and mental health services within a medical home model. This program includes the Baton Rouge Children's Health Project (BRCHP), which consists of two mobile medical units (one medical and one mental health). Licensed professionals at the FEMA villages and other isolated communities provide care on these mobile units. Medical and psychiatric diagnoses from the BRCHP are summarized and case vignettes presented.Results:Immediately after the hurricane, prescription medications were difficult to obtain. Complaints of headache, nosebleeds, and stomachache were observed at an unusually frequent degree for young children, and were potentially attributable to formaldehyde exposure. Dermatological conditions included eczema, impetigo, methicillin-resistant staphylococcus aureus (MRSA) abscesses, and tinea corporis and capitis. These were especially difficult to treat because of unhygienic conditions in the trailers and ongoing formaldehyde exposure. Signs of pediatric under-nutrition included anemia, failure to thrive, and obesity. Utilization of initial mental health services was low due to pressing survival needs and concern about stigma. Once the mental health service became trusted in the community, frequent diagnoses for school-age children included disruptive behavior disorders and learning problems, with underlying depression, anxiety, and stress disorders. Mood and anxiety disorders and substance abuse were prevalent among the adolescents and adults, including parents.Conclusions:There is a critical and long-term need for medical and mental health services among affected populations following a disaster due to natural hazards. Most patients required both medical and mental health care, which underscores the value of co-locating these services.
Primary Triage, Evacuation Priorities, and Rapid Primary Distribution between Adjacent Hospitals—Lessons Learned from a Suicide Bomber Attack in Downtown Tel-Aviv
Authors: Pinkert Moshe , Lehavi Ofer , Goren Odeda Benin , Raiter Yaron , Shamis Ari , Priel Zvi , Schwartz Dagan , Goldberg Avishay , Levi Yehezkel , Bar-Dayan Yaron 
Published: August 2016

AbstractIntroduction:Terrorist attacks have occurred in Tel-Aviv that have caused mass-casualties.The objective of this study was to draw lessons from the medical response to an event that occurred on 19 January 2006, near the central bus station, Tel-Aviv, Israel. The lessons pertain to the management of primary triage, evacuation priorities, and rapid primary distribution between adjacent hospitals and the operational mode of the participating hospitals during the event.Methods:Data were collected in formal debriefings both during and after the event. Data were analyzed to learn about medical response components, interactions, and main outcomes. The event is described according to Disastrous Incidents Systematic AnalysiS Through—Components, Interactions and Results (DISAST-CIR) methodology.Results:A total of 38 wounded were evacuated from the scene, including one severely injured, two moderately injured, and 35 mildly injured. The severe casualty was the first to be evacuated 14 minutes after the explosion. All of the casualties were evacuated from the scene within 29 minutes. Patients were distributed between three adjacent hospitals including one non-Level-1 Trauma Center that received mild casualties. Twenty were evacuated to the nearby, Level-1 Sourasky Medical Center, including the only severely injured patient. Nine mildly injured patients were evacuated to the Sheba Medical Center and nine to Wolfson Hospital, a non-Level-1 Trauma Center hospital. All the receiving hospitals were operated according to the mass-casualty incident doctrine.Conclusions:When a mass-casualty incident occurs in the vicinity of more than one hospital, primary triage, evacuation priority decision-making, and rapid distribution of casualties between all of the adjacent hospitals enables efficient and effective containment of the event.
Effects of Simulation on Emergency Vehicle Drivers' Competency in Training
Authors: Lindsey Jeffrey T. , Barron Ann E. 
Published: August 2016

AbstractIntroduction:The number of accidents involving emergency vehicles is a major concern for emergency service providers.Objectives:This study assessed the effectiveness of adding a driving simulator to a traditional training program.Methods:The sample consisted of students attending the National Emergency Medical Services Academy in Lafayette, Louisiana. Each participant self-scheduled two days in which he or she would attend the driving portion of the training class. A total of 52 participants were in the control group and 50 participants were in the treatment group. In addition to the classroom training, the treatment group used a driving simulator prior to driving on the competency course.Results:The treatment group took significantly less time to drive through the competency course on the first run than did the control group. It also acquired significantly fewer penalty points on the first run and required significantly fewer runs to complete the course.Conclusions:Simulators can be effective training tools for teaching emergency vehicle drivers.
Knowledge and Attitudes of the Out-Of-Hospital Emergency Care Consumers in Santo Domingo, Dominican Republic
Authors: Báez Amado Alejandro , Giraldez Ediza , Lane Peter L. , Pozner Charles , Rodriguez Juan , Rogers Selwyn 
Published: August 2016

AbstractIntroduction:Prehospital emergency services are a vital public service, and consumer access to the system is an important factor in their use. The Dominican Republic recently experienced “the epidemiological transition” leading to increased morbidity and mortality secondary to traumatic and cardiac conditions—thus, increasing the need for prompt and adequate delivery of emergency medical care.Methods:A survey was administered to 90 subjects from diverse backgrounds, all living in Santo Domingo. Survey items included questions on emergency medical services (EMS) systems knowledge (i.e., access numbers), confidence in the system, first-aid education and prior experience with the EMS system. Chi-square was used to measure statistical significance for categorical variables and Student's t-test for continuous variables (JMP 2.0 software was used for statistical processing).Results:A total of 90 subjects were surveyed. The average age of respondents was 36 ± 12 years SD. More than one-fifth (22.2%) of respondents did not know the established universal emergency number (9-1-1), and 37.8% responded that they would access a different telephone number in case of a medical emergency.Conclusions:Important deficiencies and access-to-care concerns were interpreted from the results. An adequate understanding of the current state of prehospital care could lead to creation of policies by system administrators to further improve the delivery of emergency medical care. This study will assist system administrators in future design and policy issues.
Characteristics of Emergency Medical Technicians Involved in Ambulance Crashes
Authors: Studnek Jonathan R. , Fernandez Antonio R. 
Published: August 2016

AbstractObjectives:This study utilizes a [US] national sample of emergency medical services (EMS) professionals to explore the hypothesis that demographic and work-related characteristics are associated with involvement in ambulance crashes.Methods:In 2004, a cohort of nationally registered EMS professionals was surveyed to determine ambulance crash involvement during a 12-month period. Involvement in an ambulance crash was the outcome variable of interest. Demographics such as age, community size, service type, call volume, time spent in an ambulance, and current sleep problems were analyzed as independent variables. A multivariate logistic regression model identified variables associated with involvement in an ambulance crash within the past year.Results:Surveys were received from 1,775/5,565 (32.0%) participants; 1,297 (73.1%) met the inclusion criteria. A total of 111 (8.6%) of participants reported being involved in an ambulance crash within the past 12 months. When controlling for call volume and time in an ambulance, the odds of involvement in an ambulance crash within the past year were significantly higher for younger EMS professionals and those reporting sleep problems.Conclusions:Results from this analysis suggest age and sleep problems are associated with involvement in an ambulance crash. Future studies should investigate interventions to minimize the effects of these associations.
Acute Stress Symptoms, Dissociation, and Depression Among Rescue Personnel 24 Hours after the Bet-Yehoshua Train Crash: The Effects of Exposure to Dead Bodies
Authors: Ben-Ezra Menachem , Palgi Yuval , Essar Nir , Sofer Hilik , Haber Yeela 
Published: August 2016

AbstractIntroduction:The immediate impact of exposure to severe wounds, dead bodies, and immediate threat to life has been understudied. Most studies focus on the acute stress disorder and/or post-traumatic stress disorder phases in order to assess rescue personnel's symptomatology, and tend to neglect the immediate exposure to elements of the disaster.Hypothesis:Rescue personnel who had a history of previous exposure to dead bodies would exhibit higher levels of acute stress symptoms, dissociation, and depressive symptoms within the 24 hours following a traumatic event.Methods:Twenty-three rescue personnel participated in the search and excavation of dead and mutilated bodies following the Bet-Yehoshua train crash in Israel.The rescue personnel group was divided based on previous exposure to dead bodies. Each participant completed a demographic questionnaire, which included a question on perceived threat to life, the impact of event scale revised, the dissociative experience scale, and the center of epidemiologic studies depression questionnaire. Student'st-tests, along with multivariate analysis of covariance (MANCOVA) were conducted in order to learn which factors are related to psychiatric symptomatology following the immediate exposure to such stressors.Results:Among rescue personnel, those with previous exposure to dead bodies did not differ in their levels of acute stress symptoms, dissociation, and depressive symptoms from those who were not previously exposed to dead bodies.Conclusions:These results may suggest the possibility that the impact of exposure to dead bodies does not emerge in the acute stress reactions (ASR) phase (up to 24 hours after the event), but later when people have time to process the trauma. Another possibility is that the rescue coping mechanisms of detachment may serve as a buffer for the horrific sights encountered during the ASR period.
Hospital Preparedness in Earthquake Zones: A Must
Authors: Ammar Ahmed 
Published: August 2016

It is important that medical and paramedical teams responding to earthquakes and treating victims understand the following: (1) the definition of an earthquake; (2) the consequences of an earthquake; and (3) the common international terms used.Earthquake An earthquake is the shaking or trembling of the earth, which may be natural or man-made (e.g., due to atomic explosion) in origin. An earthquake is a sudden, strong movement or slipping of the earth's crust that result in a sudden release of energy. Earthquakes occur at certain locations where the tectonic plates which form the earth's crust, coincide. Populations that live near these zones or on these plates always must be prepared for earthquakes and their consequences. The direct impacts of earthquakes may be seen in several forms, such as shaking, ground ruptures, landslides, avalanches, fires, soil liquefaction, tsunamis, and/or flooding.
Near-Infrared Laser Spectroscopy as a Screening Tool for Detecting Hematoma in Patients with Head Trauma
Authors: Ghalenoui Hossein , Saidi Hossein , Azar Mazyar , Yahyavi Seyyed Taha , Razavi Hamid Borghei , Khalatbari Mahmoudreza 
Published: August 2016

AbstractIntroduction:Among imaging techniques, computed tomography (CT) is a reliable method for detecting intracranial hematomas in patients with head trauma, but it is not generally available in special circumstances like prehospital situations and harsh conditions such as those following an earthquake.Objective:The objective of this study is to determine if near-infrared spectroscopy (NIRS) is useful for performing CT scans on patients with closed head trauma that present to medical centers that do not have the ability to perform a CT scan or in prehospital or harsh situations. Near-infrared spectroscopy and CT scan were compared according to sensitivity and specificity.Methods:This was an observational, prospective study. One hundred forty-eight patients admitted to Rasool Akram General Hospital in Tehran, Iran with head injuries during a one-month period were studied using NIRS and CT. The observational, prospective study was conducted and sensitivity, specificity, positive and negative predictive values of NIRS were calculated. Chi-square and Kappa analysis was performed, and ap-value <0.05 was considered significant.Results:According to the CT scan findings, 54 (36.5%) of the patients developed intracranial hematoma. The NIRS examination showed that 69 patients (46.6%) might have intracranial hematoma. The number of true negatives was 73 and the number of false negatives was six patients. The sensitivity and specificity of NIRS examination was 88.9% and 77.7%, respectively.Conclusions:This study speculates that NIRS may be a useful screening tool to detect intracranial hematoma. This capability could be useful in special situations like in a deprived area, medical centers without CT scan capabilities, prehospital situations, and in harsh conditions like those after an earthquake or other disasters that causes increased numbers of victims with closed head trauma.
Potential Roles of Military-Specific Response to Natural Disasters—Analysis of the Rapid Deployment of a Mobile Surgical Team to the 2007 Peruvian Earthquake
Authors: Malish Richard , Oliver David E. , Rush Robert M. , Zarzabal Esmeraldo , Sigmon Michael J. , Burkle Frederick M. 
Published: August 2016

AbstractThe August 2007 earthquake in Peru resulted in the loss of critical health infrastructure and resource capacity. A regionally located United States Military Mobile Surgical Team was deployed and operational within 48 hours. However, a post-mission analysis confirmed a low yield from the military surgical resource. The experience of the team suggests that non-surgical medical, transportation, and logistical resources filled essential gaps in health assessment, evacuation, and essential primary care in an otherwise resource-poor surge response capability. Due to an absence of outcomes data, the true effect of the mission on population health remains unknown. Militaries should focus their disaster response efforts on employment of logistics, primary medical care, and transportation/evacuation. Future response strategies should be evidence-based and incorporate a means of quantifying outcomes.
Mustard Gas or Sulfur Mustard: An Old Chemical Agent as a New Terrorist Threat
Authors: Wattana Monica , Bey Tareg 
Published: August 2016

AbstractSulfur mustard is a member of the vesicant class of chemical warfare agents that causes blistering to the skin and mucous membranes. There is no specific antidote, and treatment consists of systematically alleviating symptoms. Historically, sulfur mustard was used extensively in inter-governmental conflicts within the trenches of Belgium and France during World War I and during the Iran-Iraq conflict. Longitudinal studies of exposed victims show that sulfur mustard causes long-term effects leading to high morbidity. Given that only a small amount of sulfur mustard is necessary to potentially cause an enormous number of casualties, disaster-planning protocol necessitates the education and training of first-line healthcare responders in the recognition, decontamination, triage, and treatment of sulfur mustard-exposed victims in a large-scale scenario.
Application of Outcome Measures in International Humanitarian Aid: Comparing Indices through Retrospective Analysis of Corrective Surgical Care Cases
Authors: McQueen K.A. Kelly , Magee William , Crabtree Thomas , Romano Christopher , Burkle Frederick M. 
Published: August 2016

AbstractIt is common for international organizations to provide surgical corrective care to vulnerable populations in developing countries. However, a current worsening of the overall surgical burden of disease in developing countries reflects an increasing lack of sufficient numbers of trained healthcare personnel, and renders outside volunteer assistance more desirable and crucial than ever. Unfortunately, program evaluation and monitoring, including outcome indices and measures of effectiveness, is not measured commonly. In 2005, Operation Smile International implemented an electronic medical record system that helps monitor a number of critical indices during surgical missions that are essential for quality assurance reviews. This record system also provided an opportunity to retrospectively evaluate cases from previous missions. Review of data sets from >8,000 cases in 2005 and 2006 has provided crucial information regarding the priority of surgery, perioperative and operative complications, and surgical program development.The most common procedure provided was unilateral cleft lip repair, followed closely by cleft palate. A majority of these interventions occurred for patients who were older than routinely provided for in the western world. The average child treated had an age:weight ratio at or below the [US] Centers for Disease Control and Prevention (CDC) 50th percentile, with a small percentage falling below the CDC 20th percentile. A majority of children had acceptable levels of hemoglobin, but the relative decreased age:weight ratio nonetheless can reflect mild malnutrition. Complications requiring medical intervention were seen in 1.2% of cases in 2005 and 1.0% in 2006. Thirty percent were reported as anesthesia complications, and 61% reported as surgical complications. One death was reported, but occurred after discharge outside the perioperative period. Complication rates are similar to rates reported in the US and UK and emphasizes the importance of standardization with uniform indices to compare quality performance and equity of care. This study offers an important example of the importance of collecting, analyzing, and reporting measures of effectiveness in all surgical settings.
Laryngeal Tube and Intubating Laryngeal Mask Insertion in a Manikin by First-Responder Trainees after a Short Video-Clip Demonstration
Authors: Jokela Jorma , Nurmi Jouni , Genzwuerker Harald V. , Castrén Maaret 
Published: August 2016

AbstractIntroduction:This study was performed in the Finnish Defense Forces to assess the potential applicability and value of short video clips as educational material to teach advanced airway management and as the first means of introducing the use of a laryngeal tube (LT) or an intubating laryngeal mask (ILMA) to inexperienced, military, first-responder trainees with no prior hands-on experience.Methods:The 60 non-commissioned medical officers participating in this study were randomly assigned into one of two groups: the LT- and the ILMA-group. After viewing the video clips, the trainees were required to perform 10 consecutive, successful insertions of the given instrument into a manikin. The number and duration of the attempts required prior to the 10 consecutive successful insertions were measured.Results:The goal of 10 consecutive successful insertions was attained by all 30 subjects in the LT-group, and by 27 of 29 subjects in the ILMA-group with a maximum of 30 attempts. Improvement in the ease and speed of insertion was evident between the first and last consecutive insertions in both groups.Conclusions:“Satisfactory” to “good” skill levels are achieved with the applied video-clip demonstration method, even in inexperienced first-responder trainees lacking previous hands on experience.
Ethical Considerations for Emergency Care Providers during Pandemic Influenza–Ready or Not…
Authors: Pena Margarita E. , Irvin Charlene B. , Takla Robert B. 
Published: August 2016

AbstractWhen an infectious pandemic occurs in the United States, emergency care providers (ECPs) will be on the frontlines caring for infected, potentially infected, and non-infected patients. Logistically, the current emergency care system is not ready for a pandemic, but are the providers ethically ready? Some of the most difficult and challenging issues that will be raised during a pandemic will be ethical in nature. An ECP likely will be confronted with ethical values and value conflicts underlying restriction of liberty, duty to care, and resource allocation.This report summarizes the ethical concerns and challenges that ECPs face during an infectious pandemic, and raises ethical questions that may arise related to the role of an ECP as a healthcare provider and stakeholder.