bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protecting New Health Facilities from Natural Hazards: Guidelines for the Promotion of Disaster Mitigation
Authors:   Area on Emergency Preparedness and Disaster Relief, Pan-American Health Organization (PAHO)/World Health Organization (WHO)
Published: August 2016

El conocimiento técnico y la experiencia acumulada en la reducción de los efectos de los desastres nos han enseñado que es posible reducir al mínimo los riesgos y los daños si se adoptan las medidas preventivas necesarias en el diseño, construcción y mantenimiento de las nuevas instalaciones de salud. Sin embargo, es un tema complejo que aún no tiene la presencia necesaria en las agendas políticas y de desarrollo de los países de América Latina y el Caribe.La Organización Panamericana de la Salud, en colaboración con el Centro Colaborador de la OMS en Mitigación de Desastres de la Universidad de Chile y con el apoyo del Banco Mundial y el Consorcio ProVention, ha publicado lasGuías de reducción de vulnerabilidad en el diseño de nuevos establecimientos de salud, con el objetivo de orientar a los administradores, profesionales y asesores técnicos del área de la salud que tienen por misión la gestión, diseño, construcción e inspección de proyectos de construcción de nuevos establecimientos de salud.Esta publicación presenta un resumen de esas Guías, enfatizando cómo pueden utilizarse, por quién y con que propósito. Asimismo, incluye algunas recomendaciones para promover su uso en la Región entre autoridades nacionales, planificadores y financiadores involucrados en el desarrollo de estos proyectos. Se trata de un instrumento de introducción al tema, que permite un acercamiento rápido y directo para comprender los beneficios sociales y económicos de la aplicación de medidas de mitigación en los procesos de diseño, planificación y construcción de instalaciones de salud y sobre todo, para saber cómo aplicarlas con el objetivo de alcanzar niveles de protección capaces, no solo de garantizar la seguridad de las personas, sino la seguridad de la infraestructura y de la operación de los servicios.
Out-of-Hospital Cardiac Arrest Locations in a Rural Community: Where Should We Place AEDs?
Authors: Portner Marc E. , Pollack Marc L. , Schirk Steven K. , Schlenker Melissa K. 
Published: August 2016

AbstractEarly defibrillation improves survival for patients suffering cardiac arrest from ventricular fibrillation (VF) or ventricular tachycardia (VT). Automated external defibrillators (AEDs) should be placed in locations in which there is a high incidence of out-of-hospital cardiac arrest (OOHCA). The study objective was to identify high-risk, rural locations that might benefit from AED placement. A retrospective review of OOHCA in a rural community during the past 5.5 years was conducted. The OOHCAs that occurred in non-residential areas were categorized based on location. Nine hundred, forty OOHCAs occurred during the study period of which 265 (28.2%) happened in non-residential areas. Of these, 127 (47.9%) occurred in healthcare-related locations, including 104 (39.2%) in extended care facilities. No location used in this study had more than two OOHCAs. Most (52.1%) non-residential OOHCAs occurred as isolated events in 146 different locations. Almost half of the OOHCAs that occurred in non-residential areas took place in healthcare-related facilities suggesting that patients at these locations may benefit from AED placement. First responders with AEDs are likely to have the greatest impact in a rural community.
OP or Not OP: The Medical Challenge at the Chemical Terrorism Scene
Authors: Krivoy Amir , Layish Ido , Rotman Eran , Goldberg Avi , Yehezkelli Yoav 
Published: August 2016

AbstractSince the 1995 Tokyo subway sarin attack, terrorist attacks involving weapons of mass destruction or other industrial chemicals present worldwide security and health concerns. On-scene medical triage and treatment in such events is crucial to save as many lives as possible and minimize the deleterious effects of the toxic agent involved. Since there are many chemicals that can be used as potential terrorist weapons, the medical challenge for the emergency medical services (EMS) is a combination of: (1) recognizing that a chemical terrorist attack (non-conventional) has occurred; and (2) identifying the toxic agent followed by proper antidotal treatment. The latter must be done as quickly as possible, preferably on-scene. The most valuable decision at this stage should be whether the agent is organophosphate (OP) or not OP, based on clinical findings observed by pre-trained, first responders. This decision is crucial, since only OP intoxication has readily available, rapidly acting, onscene, specific agents such as atropine and one of the oximes, preferably administered using autoinjectors. Due to the lack of a specific antidote, exposure to other agents (such as industrial chemicals, e.g., chlorine, bromide, or ammonia) should be treated on-scene symptomatically with non-specific measures, such as decontamination and supportive treatment. This paper proposes an algorithm as a cognitive framework for the medical teams on-scene. This algorithm should be part of the medical team's training for preparedness for chemical terrorist attacks, and the team should be trained to use it in drills. Implementing this path of thinking should improve the medical outcome of such an event.
Survey of EMTs' Attitudes towards Death
Authors: Smith-Cumberland Tracy L. , Feldman Robert H. 
Published: August 2016

AbstractIntroduction:The purpose of this study was to ascertain information about emergency medical technicians' (EMTs') attitudes towards their training, comfort, and roles when a patient dies on-scene.Methods:A sample of 136 EMTs (all levels) from 14 different states participated in a survey prior to completing a continuing education program. About 40% (n = 54) of the EMTs were attending a training program related to death based on the Emergency Death Education and Crisis Training Curriculum,1 while 60% (n = 82) were attending an EMT training program not related to death. Each participant answered questions about their attitudestowards a death on-scene using a five-point Likert scale. The EMTs were compared by level of training (EMT-B/EMT-I and EMT-P), and by type of educational program attended (death-related education and nondeath-related education).Results:Most (82%) participants reported that an EMT's actions impact the grief process of a bereaved family. About half (54%) reported that an EMT's role should include notifying the family of the death. However, three-quarters (76%) reported that they had not been trained adequately to make a death notification or help the family with their grief. Many (40%) felt uncomfortable making a death notification. Differences were present in EMTs enrolled in the death education courses as compared to those attending an educational program not related to death. Differences also were found in the levels of EMTs (EMT-B/EMT-I versus EMT-Paramedics).Conclusion:This study provides new insights about EMTs' attitudes towards death and the death-related training they receive.
Disaster Modeling: Medication Resources Required for Disaster Team Response
Authors: Rosenthal Marc S. , Klein Kelly , Cowling Kathleen , Grzybowski Mary , Dunne Robert 
Published: August 2016

AbstractIntroduction:Responses to disasters involve many factors beyond personnel, such as medical andnon-medical equipment and supplies. When disaster teams respond, they must do so with sufficient amounts of medicine and supplies to manage all of the patients expected for several days before re-supply. In order for this process to be efficient and expedient, accurate and advanced planning for supplies needed by disaster workers is necessary. These supplies must provide for general medical care and for hazard-specific problems.Objective:To develop a model that provides the framework for determining supply requirements for the National Disaster Medical System, Disaster Medical Assistance Teams, or other responding disaster teams in a civilian environment.Methods:A community hospital was modeled to determine patient characteristics when presenting to an emergency department (ED), including patient demographics and chief complaint, medications administered during the emergency department visit and prescribed at discharge, and laboratory tests ordered to assess disaster team supply requirements. Data were downloaded from a patient tracking software package and abstracted from various hospital data information systems. Data from the community hospital were compared with data published from two hurricane disasters by members of the National Disaster Medical System.Results:To the extent possible, the model predicted the proportion of patient complaints and, therefore, the medicine and supplies needed for the management of these patients.Conclusion:This model offers a first step in preparing disaster medical teams for deployment.
Thiopental vs. Etomidate for Rapid Sequence Intubation in Aeromedicine
Authors: Sonday Charles J. , Higgins Robert , Axelband Jennifer , Jacoby Jeanne , Crider Duane 
Published: August 2016

AbstractIntroduction:Although there is a general agreement that rapid sequence intubation (RSI) is thepreferred technique for intubation in aeromedical care, several pharamacological regimens have been employed without clear evidence of which is superior.Hypothesis:This study was designed to compare the use of etomidate (ETOM) with that of thiopental (THIO)as an adjunctive agent used with succinylcholine (SCh) for rapid sequence intubation in an urban, aeromedicalsystem.Methods:This was a retrospective, before-and-after study utilizing computer-assisted chart review. Adultpatients who received thiopental for rapid sequence intubation over a two-year period were compared to adult patients who received etomidate for rapid sequence intubation over a similar period, after a change in protocol, which mandated etomidate rather than thiopental for all intubations.Results:No difference was found in any of the primary endpoints. Stabilization time (13.1 vs. 12.9 minutes), number of intubation attempts (1.1 vs. 1.2), successful first intubation attempts (90% vs. 82%), overallsuccessful intubations (100% vs. 96%), and intubation time (18.4 vs. 21.7 seconds) were similar for all comparisons of thiopental vs. etomidate (allp>0.05).Conclusion:This study found no clinically relevant differences between the use of etomidate or thiopental as adjuncts with succinylcholine for rapid sequence intubation in the aeromedical setting.
Overview of the Tsunami Disaster
Authors: Wahlstrom Margareta 
Published: August 2016

AbstractThis is the text for the Opening Address for the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The frightening reality of the costs (human and material) must be balanced by what has been and can be learned that, if applied, can make the world more resilient for the next event. At the time of this Conference, we are moving from response to recovery. The immediate conclusion relates to the consequences of the realization of a truly interdependent world. Given the huge resourcesmade available, there is an increased need for accountability. Several factors will bear heavily on the outcomes: (1) risk of loss of momentum; (2) ensuring that no gaps in services occur; (3) ensuring that already marginalized communities do not become forgotten or even more marginalized; (4) support and respect of national leadership; (5) commit to enhanced coordination; and (6) develop mechanisms for joint and shared assessments. The available resources must be used to stablize the livelihoods of people for years. Lastly, the reliability and sustainability of the important contributions of the military and the commercial private sectors for future events must be established
Panel 2.11: Food Security and Nutrition
Authors: Yoosuf Abdul Azeez , Prinzo Zita Weise , Atwood Stephen J. , Webb Patrick , Untoro Rachmi , Haider Rukhsana 
Published: August 2016

AbstractThis is a summary of the presentations and discussion of Panel 2.11, Food Security and Nutrition of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04–06 May 2005. The topics discussed included issues related to food security and nutrition as pertain to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) findings; (2) key questions; (3) discussion; and (4) recommendations.
Knowledge of Severe Acute Respiratory Syndrome among Community Physicians, Nurses, and Emergency Medical Responders
Authors: Tice Alan Douglas , Kishimoto Mitsumasa , Dinh Chuong Hoang , Tak-Kin Lam Geoffrey , Marineau Michelle 
Published: August 2016

AbstractIntroduction:The preparedness levels of front-line clinicians including physicians, nurses, emergency medical responders (EMRs), and other medical staff working in clinics, offices and ambulatory care centers must be assessed, so these personnel are able to deal with communicable and potentially lethal diseases, such as severe acute respiratory syndrome (SARS). In order to determine the knowledge of these clinicians, a survey of their understanding of SARS and their use of educational resources was administered.Methods:A questionnaire was distributed to physicians, nurses, and EMRs attending conferences on SARS in the summer of 2003. Questions related to information sources, knowledge of SARS, and plans implemented in their workplace to deal with it. Statistical analysis was performed using the Statistical Package for the Social Sciences (10.1 Program, SPSS Inc., Chicago, Illinois).Results:A total of 201 community healthcare providers (HCPs) participated in the study. A total of 51% of the participants correctly identified the incubation period of SARS; 48% correctly identified the symptoms of SARS; and 60% knew the recommended infection control precautions to take for families. There was little difference in knowledge among the physicians, nurses, and EMRs evaluated. Media outlets such as newspapers, journals, television, and radio were reported as the main sources of information on SARS. However, there appears to be a growing use of the Internet, which correlated best with the correct answers on symptoms of SARS. Fewer than one-third of respondents were aware of a protocol for SARS in their workplace. A total of 60% reported that N-95 masks were available in their workplace.Conclusion:These findings suggest the need for more effective means of education and training for front-line clinicians, as well as the institution of policies and procedures in medical offices, clinics, and emergency services in the community.
Pattern of Drug Prescription and Utilization among Bam Residents during the First Six Months after the 2003 Bam Earthquake
Authors: Sepehri Gholamreza , Meimandi Manzumeh-Shamsi 
Published: August 2016

AbstractIntroduction:It is important to identify what kinds of drugs are required by disaster-affected populations so that appropriate donations are allocated. On 26 December 2003, an earthquake with an amplitude of 6.3 on the Richter scale struck southeastern Iran, decimating the city of Bam. In this study, the most frequently utilized and prescribed drugs for Bam outpatients during the first six months after the Bam Earthquake were investigated.Methods:In this descriptive, cross-sectional study, the data were collected randomly from 3,000 prescriptions of Bam outpatients who were examined by general practitioners from Emergency Medical Assistance Teams in 12 healthcare centers during the first six months after the Bam Earthquake. The data were analyzed for: (1) patient sex; (2) number of drugs/prescriptions; (3) drug category; (4) drug name (generic or brand); (5) route of administration; (6) percent of visits where the most frequent drug categories were prescribed; and (7) the 25 most frequently prescribed drugs, using World Health Organization (WHO) indicators of drug use in health facilities.Results:Male patients represented 47.4% and females 52.6% of the total number of outpatients. The mean number of drugs/prescriptions was 3.5 per outpatient. Oral administration was the most frequent method of administration (81.7%), followed by injections (10.9%). Respiratory drugs were the most frequently used drugs (14.2%), followed by analgesics/non-steroidal anti-inflammatory drugs (non-steroidal anti-inflammatory drugs) (11.3%), antibacterials (11.2%), gastroinestinal (GI) drugs (9.6%), and central nervous system drugs (7%). Penicillins (6.8%), cold preparations (8%), and systemic anti-acids (ranitidine and omeprazole) were among the 25 most frequently used drugs by outpatients and inhabitants of Bam during the first six months after the Bam Earthquake.Conclusion:Respiratory, analgesic, antibacterial, gastrointestinal, and psychiatric medications were among the most commonly prescribed pharmaceuticals after the catastrophic Bam Earthquake.The results of this study may help to predict the needs of patients during future disasters and prevent unnecessary donations of medicine.
The 2003 Bam Earthquake: Overview of First Aid and Transport of Victims
Authors: Mirhashemi Sedighe , Ghanjal Ali , Mohebbi Hassan Ali , Moharamzad Yashar 
Published: August 2016

AbstractIntroduction:In December 2003, the residents of Bam, Iran experienced an earthquake that measured 6.6 on the Richter scale and destroyed more than 90% of the city.Problem:The purpose of this study was to assess the status of the rescue, evacuation, and transportation of the casualties during the early stages following the earthquake.Methods:A cross-sectional study of 185 casualties who were transferred to and hospitalized in the university hospital during the first week period following the earthquake was conducted. Information regarding different places of settlement after being removed from the rubble, initial medical care, and the means of transportation was obtained by reviewing medical records and interviewing the victims.Results:The mean value of the duration of times taken for the first rescuers to reach the scene and remove the casualties from the rubble was 1.7 ±2.7 and 0.9 ±1.1 hours, respectively. Sixty-nine (37.7%) of the patients stayed within the area immediately surrounding their home for average times of 8 ±10 hours. The majority of casualties (57.6%) were transferred manually to a first place of settlement; 45.8% were taken to a second place of settlement using blankets. Of the patients studied, 159 (85.9%) did not receive any basic medical care at the first place and intravenous fluid therapy was the most common treatment provided for 24 (13%) patients at the second place of settlement. Patients received medical care at the first place of settlement for a mean time of 16.8 ±13.5 hours after escaping the rubble.Conclusions:These findings indicate that the emergency medical service system in Bam was destroyed and not able to respond adequately. In order to reduce the negative effects of such disasters in the future, there is an essential need for a comprehensive disaster management plan and improvement of hospital structures, healthcare facilities, and communication between the different governmental departments for better coordination and planning.
Integrated Plan to Augment Surge Capacity
Authors: Dayton Christopher , Ibrahim Jamil , Augenbraun Michael , Brooks Steven , Mody Kiaran , Holford Donald , Roblin Patricia , Arquilla Bonnie 
Published: August 2016

AbstractIntroduction:Surge capacity is defined as a healthcare system's ability to rapidly expand beyond normal services to meet the increased demand for appropriate space, qualified personnel, medical care, and public health in the event of bioterrorism, disaster, or other large-scale, public health emergencies. There are many individuals and agencies, including policy makers, planners, administrators, and staff at the federal, state, and local level, involved in the process of planning for and executing policy in respect to a surge in the medical requirements of a population. They are responsible to ensure there is sufficient surge capacity within their own jurisdiction.Problem:The [US] federal government has required New York State to create a system of hospital bed surge capacity that provides for 500 adult and pediatric patients per 1 million population, which has been estimated to be an increase of 15–20% in bed availability. In response, the New York City Department of Health and Mental Hygiene (NYC DOH) has requested that area hospitals take an inventory of available beds and set a goal to provide for a 20% surge capacity to be available during a mass-casualty event or other conditions calling for increased inpatient bed availability.Methods:In 2003, under the auspices of the NYC DOH, the New York Institute of All Hazard Preparedness (NYIHP) was formed from four unaffiliated, healthcare facilities in Central Brooklyn to address this and other goals.Results:The NYIHP hospitals have developed a surge capacity plan to provide necessary space and utilities. As these plans have been applied, a bed surge capacity of approximately 25% was identified and created for Central Brooklyn to provide for the increased demand on the medical care system that may accompany a disaster. Through the process of developing an integrated plan that would engage a public health incident, the facilities of NYIHP demonstrate that a model of cooperation may be applied to an inherently fractioned medical system.
Accuracy of Computer Simulation to Predict Patient Flow during Mass-Casualty Incidents
Authors: Franc-Law Jeffrey M. , Bullard Micheal J. , Corte F. Della 
Published: August 2016

AbstractIntroduction:Although most hospitals have an emergency department disas- ter plan, most never have been implemented in a true disaster or been tested objectively. Computer simulation may be a useful tool to predict emergency department patient flow during a disaster.Purpose:The aim of this study was to compare the accuracy of a computer simulation in predicting emergency department patient flow during a masscasualty incident with that of a real-time, virtual, live exercise.Methods:History, physical examination findings, and laboratory results for 136 simulated patients were extracted from the disastermed.ca patient database as used as input into a computer simulation designed to represent the emergency department at the University of Alberta Hospital.The computer simulation was developed using a commercially available simulation software platform (2005, SimProcess, CACI Products, San Diego CA). Patient flow parameters were compared to a previous virtual, live exercise using the same data set.Results:Although results between the computer simulation and the live exercise appear similar, they differ statistically with respect to many patient benchmarks. There was a marked difference between the triage codes assigned during the live exercise and those from the patient database; however, this alone did not account for the differences between the patient groups. It is likely that novel approaches to patient care developed by the live exercise group, which are difficult to model by computer software, contributed to differences between the groups. Computer simulation was useful, however, in predicting how small changes to emergency department structure, such as adding staff or patient care areas, can influence patient flow.Conclusions:Computer simulation is helpful in defining the effects of changes to a hospital disaster plan. However, it cannot fully replace participant exercises. Rather, computer simulation and live exercises are complementary, and both may be useful for disaster plan evaluation.