bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison Overview of Prehospital Errors Involving Road Traffic Fatalities in Victoria, Australia
Authors: Boyle Malcolm J. 
Published: August 2016

AbstractIntroduction:Until early 2003, the Consultative Committee on Road Traffic Fatalities (CCRTF) in Victoria, Australia was the main body investigating and publishing data about prehospital errors resulting from road traffic fatalities. The objective of this study was to identify and interpret prehospital error rate trends associated with road traffic fatalities during a 10-year period of the CCRTF reports.Methods:This study is a review of the prehospital errors defined in Victorian CCRTF reports of preventable deaths of road traffic fatalities over a 10-year period.Results:Six CCRTF reports contained prehospital data for errors associated with road traffic fatalities. From 1992 to 1998, system errors decreased.However, over the same timeframe, management, technical, and diagnostic errors increased. There was a marked jump in system, technique, and diagnosis errors from 1998 to 2001–2003. However, management errors declined over the same timeframe. The jump in errors in the 1998 to 2001–2003 timeframe coincided with the introduction of advanced life support (ALS) for Victorian paramedics in 2000.The number of preventable deaths decreased from 1992 to 1998, however, there was an increase from 1999 onwards, coinciding with the introduction of the state trauma system and ALS for paramedics.Conclusions:This study demonstrates that there has been an increase in prehospital error rates, especially from 2000, which coincided with the introduction of ALS for paramedics and the state trauma system in Victoria, even though the state trauma system had an overall decrease in error rates.
Role of Air-Medical Evacuation in Mass-Casualty Incidents—A Train Collision Experience
Authors: Assa Amit , Landau Dan-Avi , Barenboim Erez , Goldstein Liav 
Published: August 2016

AbstractBackground:On 21 June 2005, a passenger train collided with a truck near Revadim, Israel.The collision resulted in a multiple-scene mass-casualty incident in an area characterized by difficult access and a relatively long distance from trauma centers. A major disaster response was initiated by civilian and military medical forces including the Israeli Air Force (IAF) Search and Rescue teams. The air-medical evacuation from the accident site to the trauma centers, the activities of the airborne medical teams, and the lessons learned from this event are described in this report.Methods:A retrospective analysis of data gathered from relevant elements that participated in management, treatment, and evacuation from the accident site was conducted.Results:The accident resulted in 289 injured passengers and seven of the injured were killed. Six helicopters (performing nine sorties) participated. Helicopters evacuated trauma victims and aided in transporting air-medical teams to the site of the collision.Overall, 35 trauma victims (10 urgent) were evacuated by air to trauma centers. The length of time between the first helicopter landing and completion of the air evacuation was 83 minutes. The airmedical evacuation operation was controlled by the commander of the IAF Search and Rescue. Different crew compositions were set in real time.Conclusions:Air-medical evacuation during this unique event enabled prompt transportation of casualties from the scene to trauma centers and provided reasonable distribution of patients between various centers in the region.This operation highlighted the necessity for flexibility in medical decision-making and the need for non-conventional solutions regarding crew compositions during management of an airborne evacuation in similar settings. Air-medical evacuation should be considered as a part of responses to mass-casualty incidents, especially when the site is remote or characterized by accessibility difficulties.
Impact of the 2007 Ica Earthquake on Health Facilities and Health Service Provision in Southern Peru
Authors: Chapin Erica , Daniels Amy , Elias Rosa , Aspilcueta Daniel , Doocy Shannon 
Published: August 2016

AbstractIntroduction:Few studies have examined post-disaster coping abilities of health facilities and hospitals. On 15 August 2007, a 7.9 (Richter) earthquake struck off the western coast of Peru near the Department of Ica that devastated the healthcare infrastructure. The impact of the earthquake on the health facilities in the four most affected provinces (Cañete, Chincha, Ica, and Pisco), the risk factors associated with the damages incurred, ability to provide services, and humanitarian assistance received were assessed.Methods:A stratified, systematic sampling design was used to interview a sample of 40 health facilities. The most senior healthcare provider at each facility was interviewed about the facility's experience with service provision following the earthquake.Results:Sixty percent of the facilities reported some damage due to the earthquake; four (10%) were completely destroyed. A total of 78% of the facilities reported providing medical care within the first 48 hours after the earthquake and public facilities were more likely to remain open than were private facilities (p = 0.030). Facilities with an emergency response plan were more likely to provide services than were those without a plan (p = 0.043). Six months after the earthquake, similar numbers of HIV and tuberculosis (TB) patients were receiving treatment at the sampled facilities as prior to the earthquake, and no difficulties were reported in obtaining medications. Some form of assistance, most commonly medications, was received by 60% of the facilities; receipt of assistance was not associated with the facility type, location, damage incurred, or post-disaster service provision.Conclusions:Response plans were an important factor in the ability to provide services immediately following an earthquake. While a facility's ability to provide services can be determined by structural impacts of the precipitating event, response plans help the staff to continue to provide services and care for affected populations, and appropriately arrange referrals when care cannot be provided at the facility. The findings suggest that health facilities in disasterprone areas should invest in developing and implementing disaster response plans in order to improve health service provision capacity during disasters.
Driver-Related Risk Factors in Commercial Motorcycle (Okada) Crashes in Benin City, Nigeria
Authors: Iribhogbe Pius Ehiawaguan , Odai Emeka Danielson 
Published: August 2016

AbstractIntroduction:There has been global concern regarding road traffic injuries. Motorcyclists constitute a high proportion of fatalities in road traffic crashes. Commercial motorcyclists (Okadas) constitute a unique group in this regard. The purpose of this study was to evaluate driver-related risk factors in Okada accidents in Benin City, Nigeria.Methods:This was a prospective study. Interviewers administered questionnaires that were used to assess Okada drivers during a two-month period (November–December 2006).Results:A total of 996 Okada drivers were interviewed, 995 males and one female. Their ages ranged from 16–80 years with a mean age of 36.4 ±2.4 years. In the majority of cases, the maximum educational level achieved was primary or secondary. The majority of Okada drivers (82.8%) took to the Okada business as a last resort. Driver's licenses for Okada operation were possessed by 73.5% of drivers, but only 27.2% had taken a road test before being given a license. No form of training on the use of Okadas was received by 45% of drivers before they commenced operations. Crash helmets were owned by 56.4%, but they did not use them on a regular basis. Inconvenience was the reason provided for poor compliance by 52.7% of drivers. Regular intake of alcohol was present in 39.8% of drivers.Conclusions:Okada drivers are mainly young males with a low level of education who are ill-prepared and ill-equipped for the road. This is a recipe for traffic crash-related injuries and fatal motorcycle crashes. There is an urgent need for job creation, better licensing procedures, road safety education, national legislation, and enforcement of crash helmet laws as well as alcohol breath tests for Okada drivers in Nigeria.
Inter-Agency Communication and Operations Capabilities during a Hospital Functional Exercise: Reliability and Validity of a Measurement Tool
Authors: Savoia Elena , Biddinger Paul D. , Burstein Jon , Stoto Michael A. 
Published: August 2016

AbstractIntroduction:As proxies for actual emergencies, drills and exercises can raise awareness, stimulate improvements in planning and training, and provide an opportunity to examine how different components of the public health system would combine to respond to a challenge. Despite these benefits, there remains a substantial need for widely accepted and prospectively validated tools to evaluate agencies' and hospitals' performance during such events. Unfortunately, to date, few studies have focused on addressing this need. The purpose of this study was to assess the validity and reliability of a qualitative performance assessment tool designed to measure hospitals' communication and operational capabilities during a functional exercise.Methods:The study population included 154 hospital personnel representing nine hospitals that participated in a functional exercise in Massachusetts in June 2008. A 25-item questionnaire was developed to assess the following three hospital functional capabilities: (1) inter-agency communication; (2) communication with the public; and (3) disaster operations. Analyses were conducted to examine internal consistency, associations among scales, the empirical structure of the items, and inter-rater agreement.Results:Twenty-two questions were retained in the final instrument, which demonstrated reliability with alpha coefficients of 0.83 or higher for all scales. A three-factor solution from the principal components analysis accounted for 57% of the total variance, and the factor structure was consistent with the original hypothesized domains. Inter-rater agreement between participants' self-reported scores and external evaluators' scores ranged from moderate to good.Conclusions:The resulting 22-item performance measurement tool reliably measured hospital capabilities in a functional exercise setting, with preliminary evidence of concurrent and criterion-related validity.
Differences in the Sources of Information and Acquaintance with Instructions between Dimona and the General Population after a Suicide Bomber Event
Authors: Richman Aaron , Shohat Galit , Soffer Yechiel , Bar-Dayan Yaron 
Published: August 2016

AbstractA telephone survey among two randomly selected, representative samples of adults was conducted two days after a suicide bomber event in Dimona, Israel. Television, radio, Internet, and newspapers were more common sources of information in the general population, whereas friends, family, and the local authorities were the more common sources of information in Dimona. Higher acquaintance with police instructions and higher knowledge of the exact location of the event were found in the population of Dimona. Authorities must pay attention to this phenomenon and use the correct sources of information in each area in order to achieve better exposure of the target population to the police instructions after a terrorist event.
Emergency Airway Placement by EMS Providers: Comparison between the King LT Supralaryngeal Airway and Endotracheal Intubation
Authors: Burns J. Bracken , Branson Richard , Barnes Stephen L. , Tsuei Betty J. 
Published: August 2016

AbstractIntroduction:The ever-present risk of mass casualties and disaster situations may result in airway management situations that overwhelm local emergency medical services (EMS) resources. Endotracheal intubation requires significant user education/training and carries the risk of malposition. Furthermore, personal protective equipment (PPE) required in hazardous environments may decrease dexterity and hinder timely airway placement. Alternative airway devices may be beneficial in these situations.Objective:The objective of this study was to evaluate the time needed to place the King LT Supralaryngeal Airway compared to endotracheal intubation when performed by community EMS personnel with and without PPE.Methods:Following training, 47 EMS personnel were timed placing both endotracheal tubes and the King LT supralaryngeal airway in a simulator mannikin. The study participants then repeated this exercise wearing PPE.Results:The EMS personnel wearing PPE took significantly longer to place an endotracheal tube than they did without protective equipment (53.4 seconds and 39.5 seconds, p <0.002). The time to place the King LT was significantly faster than the placement of the endotracheal tube without protective equipment (18.4 seconds and 39.5 seconds, respectively, p<0.00003). There also were statistically significant differences between the time required to place the King LT and endotracheal tube in EMS personnel wearing protective equipment (19.7 seconds and 53.4 seconds, p <0.000007).Conclusions:The King LT Supralaryngeal Airway device may be advantageous in prehospital airway management situations involving multiple patients or hazardous environments. In this study, its insertion was faster than endotracheal intubation when performed by community EMS providers.
Lessons Learned at World Youth Day: Collecting Data and Using Postcards at Mass Gatherings
Authors: Hutton Alison , Roderick Allison , Munt Rebecca 
Published: August 2016

AbstractIntroduction:World Youth Day (WYD) and its associated activities were held in Sydney, Australia from 15–20 July 2008. The aims of this research were to pilot the use of postcards at mass gatherings and to collect baseline data of how young people (age 16–25 years) identify factors that may affect their health and safety when attending mass gatherings.Hypothesis:The concerns of young people in relation to their health and safety at mass gatherings are poorly understood. It was decided that postcards would be an effective method of data collection in the mobile mass gathering environment.Methods:The research setting was the Pilgrim Walk at WYD. Participants on this walk were young people. To measure their health and safety concerns, a postcard was developed using a Likert scale to rank their attitudes on a continuum.Results:Young people stated that staying hydrated, having enough to eat, and being safe in a crowd were important to them. They also indicated that they perceived, overcrowding, getting to and from an event, and violent behavior as the greatest risks to their health and safety at a mass gathering.Conclusions:The problems with postcard distribution at a “mobile” mass gathering have been identified. Even so, results gathered showed that young people were focused on “in the moment” aspects of their health; such as access to food and water. They also had concerns for their safety due to potential overcrowding and/or violent behavior.
H1N1: Communication Patterns among Emergency Department Staff during the H1N1 Outbreak, April 2009
Authors: Klein Kelly R. , Cohen Hillary , Baseluos Cindy , Marshall John , Likourezos Antonios , Jain Ashika , Davidson Steven 
Published: August 2016

AbstractIntroduction:The H1N1 influenza virus has been described by the World Health Organization (WHO) and the media as a disease that could rival the 1918 Spanish Influenza epidemic in deaths. During the spring of 2009, emergency departments across the world saw a spike in the number of influenza cases and by June 2009, the WHO had declared H1N1 a pandemic. In order to prevent emergency department staff from becoming ill and to provide upto-date medical care to patients, information had to be disseminated quickly to emergency department staff.Methods:An anonymous Internet survey was utilized to query emergency department staff regarding communication methods and overall attitudes regarding safety and treatment during the spring of 2009.Results:The majority of emergency department staff (263; 88.3%) used multiple sources to obtain information about the H1N1 virus. There were 258 respondents (88.9%) that felt that the hospital was supplying them with the necessary information to protect themselves and their families and 280 (98.5%) felt confident that their emergency department was treating patients by the government-recommended guidelines. Statistically significant differences were noted in communication patterns between direct and indirect patient care providers.Conclusions:In general, H1N1 communication to emergency department staff was perceived as good during the initial H1N1 outbreak. However, because of the limitations associated with an online survey, these results do not allow for generalization to the total emergency department staff population. Hospital administrators may need to consider the differences in communication preferences of direct patient care providers and indirect patient care providers when distributing important information to emergency department staff during crisis and emergency situations.
Collaboration between Civilian and Military Healthcare Professionals: A Better Way for Planning, Preparing, and Responding to All Hazard Domestic Events
Authors: Marklund LeRoy A. , Graham Adrienne M. , Morton Patricia G. , Hurst Charles G. , Motola Ivette , Robinson Donald W. , Kelley Vivian A. , Elenberg Kimberly J. , Russler Michael F. , Boehm Daniel E. , Higgins Dawn M. , McAndrew Patrick E. , Williamson Hope M. , Atwood Rodney D. , Huebner Kermit D. , Brotons Angel A. , Miller Geoffrey T. , Rimpel Laukton Y. , Harris Larry L. , Santiago Manuel , Cantrell LeRoy 
Published: August 2016

AbstractCollaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial.This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.
Estimation of Healthcare Resources at Sporting Events
Authors: Khorram-Manesh Amir , Berner A. , Hedelin A. , Örtenwall P. 
Published: August 2016

AbstractBackground:The consequences of a major incident at a sporting event could be catastrophic. Therefore, there should be an estimation of the healthcare resources at such events as part of the planning. Although there are National guidelines (e.g., Planning Safe Public Events: Practical Guidelines in Australia) defining the role of the healthcare system at sporting events, these guidelines either lack a simple calculating method to estimate the need for healthcare resources or the methods are complex and impractical to use. The objective of this study was to find a safe and easy method for the estimation of healthcare resources at sporting events.Methods:A model for the estimation of healthcare resources at music events recently has been approved in Sweden. After minor adjustments, this model was used at sport events by a number of planning officers. The models' accuracy and usability was evaluated by analyzing its outcome in a pilot and a controlled study using different sporting and non-sporting scenarios.Results:The pilot study showed that the model was valid and easily could be used for various sporting events. The obtained estimations were consistent with the methods used by experienced planning officers in 97% of cases. The results of the controlled study showed that by using this model, the minimum amount of resources required easily could be calculated at sporting events and by people with different backgrounds.Conclusions:This model safely can be used at sporting events.
Chain of Survival at Mass Gatherings: A Case Series of Resuscitation Events
Authors: Ranse Jamie , Zeitz Kathryn 
Published: August 2016

AbstractBackground:At a large public event, or mass gathering, various factors influence patient presentations that brings challenges to patient care. The chain of survival has been investigated in the prehospital setting. However, this has not explicitly included the mass-gathering environment.Objective:This study sought to determine the facilitators and barriers to the chain of survival at mass gatherings.Methods:This case-series research was exploratory and descriptive, using the analysis of personal experiences of resuscitation. Participants were members of St John Ambulance Australia who had participated actively in a resuscitation event in 2007. Telephone interviews were used as a means of data collection. Participant narrative was recorded electronically, transcribed verbatim, and analyzed thematically using a well established human science approach.Results:The thematic analysis revealed five main themes and a number of sub-themes. Four of the main themes were aligned easily with the four chain of survival links. The remaining main theme outlined a new link in the chain of survival of specific importance to mass gatherings, ‘early planning’. Additionally, a number of sub-themes were identified, which exemplified various facilitators and barriers to the chain of survival in this environment.Conclusions:This research highlights various barriers and facilitators to the chain of survival in the mass-gathering environment. Additionally, the unique “early planning” link in the chain of survival as described in this research highlights the importance of a preparatory phase for responders at mass gatherings.
Integrated Response to the Dynamic Threat of School Violence
Authors: Callaway David W. , Westmoreland Ted C. , Baez Alejandro A. , McKay Sean A. , Raja Ali S. 
Published: August 2016

AbstractA terrorist attack on US schools no longer can be considered a Black Swan event. Mounting evidence suggests that extremist organizations actively are targeting US schools. Equally disturbing are data suggesting that schools, universities, and communities are unprepared for large-scale violence. The Operational Medicine Institute Conference on an Integrated Response to the Modern Urban Terrorist Threat revealed significant variations in the perceived threats and critical response gaps among emergency medical providers, law enforcement personnel, politicians, and security specialists. The participants recommended several steps to address these gaps in preparedness, training, responses, and recovery.
Chinese Disasters and Just-in-Time Education
Authors: Yang Yingyun , Chen Yanwen , Chotani Rashid A. , LaPorte Ronald E. , Ardalan Ali , Shubnikov Eugene , Linkov Faina , Huang Jesse 
Published: August 2016

AbstractJust-in-time ( JIT) Educational Strategy has been applied successfully to share scientific knowledge about disasters in several countries. This strategy was introduced to China in 2008 with the hopes to quickly disseminate accurate scientific data to the population, and it was applied during the Sichuan Earthquake and Influenza A (H1N1) outbreak. Implementation of this strategy likely educated between 10,000 and 20,000,000 people. The efforts demonstrated that an effective JIT strategy impacted millions of people in China after a disaster occurs as a disaster mitigation education method. This paper describes the Chinese JIT approach, and discusses methodologies for implementing JIT lectures in the context of China's medical and public health system.