bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revisiting Blood Transfusion Preparedness: Experience from the Bam Earthquake Response
Authors: Abolghasemi Hassan , Radfar Mohammad H. , Tabatabaee Morteza , Hosseini-Divkolayee Nasim S. , Burkle Frederick M. 
Published: August 2016

AbstractBlood transfusion plays a critical role in the provision of medical care for disasters due to man-made and natural hazards. Although the short-term increase in blood donations following national disasters is well-documented, some aspects of blood transfusion during disasters remain under study. The 2003 earthquake in Bam, Iran resulted in the death of >29,000 people and injured 23,000. In total, 108,985 blood units were donated, but only 21,347 units (23%) actually were distributed to hospitals around the country. Kerman Province, the site of the disaster, received 1,231 (1.3%) of the donated units in the first four days after the disaster.The Bam experience revealed crucial missteps in the development of a post-event strategy for blood product management, and led to the development of a detailed disaster preparedness and response plan that addresses issues of donation, distribution, communication, transportation, and coordination. The current plan requires the Iranian Blood Transfusion Organization to convene a disaster task force immediately as the main coordinator of all disaster preparedness and response activities.
KAMEDO Report No. 91 2004 Tsunami Disaster in Asia—Home Transport and Emergency Care in Sweden
Authors: Brokopp Tom , Brändström Helge , Edsander-Nord Åsa , Hedelin Annika , Johansen Lars , Lundin Tom , Nyström Robert , Riddez Louis , Örtenwall Per 
Published: August 2016

AbstractThis is a descriptive report of the Swedish authorities' responses to the tsunami that affected Southeast Asia in December 2004. The main focus is the care of survivors and the injured during their transportation from Thailand and their return to Sweden. The psychological and physical after-effects also are presented based on a poll conducted one year after the tsunami.
KAMEDO Report No. 92 Evacuation of Swedes from Lebanon—Observational Studies in Connection with the War in Lebanon in Summer 2006
Authors: Kulling Per , Sigurdsson Susannah , Hamberger Bertil 
Published: August 2016

AbstractA large-scale armed conflict between Hezbollah and Israel in July 2006 caused the evacuation of a large number of Swedish residents from Lebanon. This report describes the evacuation throughout its various stages. Swedish authorities were prepared for an event of this type from the experience of the 2004 Asian tsunami disaster. Lessons learned from the management and medical care during the evacuations are presented in this report.
Non-Doctors as Trauma Surgeons? A Controlled Study of Trauma Training for Non-Graduate Surgeons in Rural Cambodia
Authors: Van Heng Yang , Davoung Chan , Husum Hans 
Published: August 2016

AbstractIntroduction:Due to the accelerating global epidemic of trauma, efficient and sustainable models of trauma care that fit low-resource settings must be developed. In most low-income countries, the burden of surgical trauma is managed by non-doctors at local district hospitals.Objective:This study examined whether it is possible to establish primary trauma surgical services of acceptable quality at rural district hospitals by systematically training local, non-graduate, care providers.Methods:Seven district hospitals in the most landmine-infested provinces of Northwestern Cambodia were selected for the study. The hospitals were referral points in an established prehospital trauma system. During a four-year training period, 21 surgical care providers underwent five courses (150 hours total) focusing on surgical skills training. In-hospital trauma deaths and postoperative infections were used as quality-of care indicators. Outcome indicators during the training period were compared against pre-intervention data.Results:Both the control and treatment populations had long prehospital transport times (three hours) and were severely injured (median Injury Severity Scale Score = 9). The in-hospital trauma fatality rate was low in both populations and not significantly affected by the intervention. The level of post-operative infections was reduced from 22% to 10.3% during the intervention (95% confidence interval for difference 2.8–20.2%). The trainees' selfrating of skills (Visual Analogue Scale) before and after the training indicated a significantly better coping capacity.Conclusions:Where the rural hospital is an integral part of a prehospital trauma system, systematic training of non-doctors improves the quality of trauma surgery. Initial efforts to improve trauma management in low-income countries should focus on the district hospital.
Non-Doctors as Trauma Surgeons?
Authors: Sundnes Knut Ole 
Published: August 2016

Some papers send more than just one message. And sometimes, the number of messages is unintentional or at least not explicitly debated in the article. Such papers have been produced before, but perhaps we should elaborate on these imbedded signals.The primary messages brought forward by this paper include:1. Non-doctors, if properly trained, but lacking pathophysiological insight, can provide acceptable surgical care and raise the standard of health care;2. Training in science can be and should be dovetailed into capacity building as an integral part of quality control;3. Scientific work can be performed outside the laboratory and the established, high-tech hospitals. Science/evidence can be produced where everyday activities occur; and4. Large Level-1 Trauma Centers probably are cost-ineffective in most low-resource regions as they consume too many resources and most people do not have access to them.
Injury Perceptions of Bombing Survivors—Interviews from the Oklahoma City Bombing
Authors: Glenshaw Mary T. , Vernick Jon S. , Frattaroli Shannon , Brown Sheryll , Mallonee Sue 
Published: August 2016

AbstractIntroduction:Bombings, including the 1995 Oklahoma City bombing, remain an important public health threat. However, there has been little investigation into the impressions of injury risk or protective factors of bombing survivors.Objective:This study analyzes Oklahoma City bombing survivors' impressions of factors that influenced their risk of injury, and validates a hazard timeline outlining phases of injury risk in a building bombing.Methods:In-depth, semi-structured interviews were conducted within a sample of Oklahoma City bombing survivors. Participants included 15 injured and uninjured survivors, who were located in three buildings surrounding the detonation site during the attack.Results:Risk factor themes included environmental glass, debris, and entrapment. Protective factors included knowledge of egress routes, shielding behaviors to deflect debris, and survival training. Building design and health status were reported as risk and protective factors. The hazard timeline was a useful tool, but should be modified to include a lay rescue phase. The combination of a narrative approach and direct questioning is an effective method of gathering the perceptions of survivors.Conclusions:Investigating survivors' impressions of building bombing hazards is critical to capture injury exposures, behavior patterns, and decision-making processes during actual events, and to identify interventions that will be supported by survivors.
Seatbelt Use in Qatar in Association with Severe Injuries and Death in the Prehospital Setting
Authors: Munk Marc-David , Carboneau Dora M. , Hardan Muhammed , Ali Faleh Mohamed 
Published: August 2016

AbstractIntroduction:Road traffic crashes (RTCs) are common in Qatar, and are now considered the third leading cause of mortality. In this study, the safety devices used by the Qatari public at the time of RTCs were assessed and the association between seatbelt use by vehicle occupants involved in RTCs and severe injury/death in the prehospital setting was determined.Methods:This study was a retrospective case-control investigation. A Hamad Medical Corporation Emergency Medical Services (EMS) database of RTCs occurring from January 2006 to April 2007 was utilized for this study, providing a total of 5,267 patient records (83.5 % male, 16.5% female, median age = 28 years). Patient demographics, crash characteristics, prehospital assessments, and interventions were identified, and use of safety devices was determined. Univariate analysis including chi-square, Student's t-test, and analysis of variance (ANOVA) was performed as appropriate. “Case” patients are defined as those who had specific, critical prehospital assessments, or who received advanced cardio-respiratory life support measures in the field. Logistic regression modeling was used to predict the probability of a case being unbelted, controlling for confounders.Results:Seatbelt use in Qatar was low: 33.9% of males and 32.6% of females wore seatbelts at the time of the RTC. Victims involved in a vehicle rollover crash were less likely to be belted than were those involved in a non-rollover incident (26.2% belted vs. 37.8%; OR = 0.59; 95%CI = 0.50–0.68). Case patients—those with defined critical assessment findings or resuscitation in the field—and control patients were similar in age (30 years vs. 28 years median). Case patients were disproportionately male (89.1% vs. 83.2%; OR = 1.65; 95%CI = 1.01–2.83) and were more likely to be victims of a vehicle rollover crash (44.7% vs. 23.8%; OR = 2.57; 95%CI = 1.84–3.59). Seatbelt use was significantly lower among cases than controls: 19.7% of cases were reported to have worn seatbelts compared to 34.2% of controls (OR = 0.47; 95%CI = 0.31–0.69). This relationship also persisted (OR = 0.51; 95%CI = 0.33–0.76) after controlling for confounders.Conclusions:Seatbelt use in Qatar is low. Seatbelts are protective: in the pre-hospital setting unbelted vehicle occupants involved in RTCs were nearly twice as likely to suffer severe injury or death compared to belted patients. Prehospital morbidity and mortality appears to be reduced significantly by the consistent use of seatbelts by the motoring population in Qatar.
Needle Thoracostomy by Non-Medical Law Enforcement Personnel: Preliminary Data on Knowledge Retention
Authors: Sztajnkrycer Matthew D. 
Published: August 2016

AbstractIntroduction:Tension pneumothorax is the second leading cause of preventable combat death. Although relatively simple, the management of tension pneumothorax is considered an advanced life support skill set. The purpose of this study was to assess the ability of non-medical law enforcement personnel to learn this skill set and to determine long-term knowledge and skill retention.Methods:After completing a pre-intervention questionnaire, a total of 22 tactical team operators completed a 90-minute-long training session in recognition and management of tension pneumothorax. Post-intervention testing was performed immediately post-training, and at one- and six-months post-training.Results:Initial training resulted in a significant increase in knowledge (pre: 1.3 ±1.35, max score 7; post: 6.8 ±0.62, p < 0.0001). Knowledge retention persisted at one- and six-months post-training, without significant decrement.Conclusions:Non-medical law enforcement personnel are capable of learning needle decompression, and retain this knowledge without significant deterioration for at least six months.
Mississippi's Infectious Disease Hotline: A Surveillance and Education Model for Future Disasters
Authors: Cavey Andrew M. J. , Spector Jonathan M. , Ehrhardt Derek , Kittle Theresa , McNeill Mills , Greenough P. Gregg , Kirsch Thomas D. 
Published: August 2016

AbstractIntroduction:The potential for outbreaks of epidemic disease among displaced residents was a significant public health concern in the aftermath of Hurricane Katrina. In response, the Mississippi Department of Health (MDH) and the American Red Cross (ARC) implemented a novel infectious disease surveillance system, in the form of a telephone “hotline”, to detect and rapidly respond to health threats in shelters.Methods:All ARC-managed shelters in Mississippi were included in the surveillance system. A symptom-based, case reporting method was developed and distributed to shelter staff, who were linked with MDH and ARC professionals by a toll-free telephone service. Hotline staff investigated potential infectious disease outbreaks, provided assistance to shelter staff regarding optimal patient care, and helped facilitate the evaluation of ill evacuees by local medical personnel.Results:Forty-three shelters sheltering 3,520 evacuees participated in the program. Seventeen shelters made 29 calls notifying the hotline of the following cases: (1) fever (6 cases); (2) respiratory infections (37 cases); (3) bloody diarrhea (2 cases); (4) watery diarrhea (15 cases); and (5) other, including rashes (33 cases). Thirty-four of these patients were referred to a local physician or hospital for further diagnosis and disease management. Three cases of chickenpox were identified. No significant infectious disease outbreaks occurred and no deaths were reported.Conclusions:The surveillance system used direct verbal communication between shelter staff and hotline managers to enable more rapid reporting, mapping, investigation, and intervention, far beyond the capabilities of a more passive or paper-based system. It also allowed for immediate feedback and education for staff unfamiliar with the diseases and reporting process. Replication of this program should be considered during future disasters when health surveillance of a large, disseminated shelter population is necessary.
Poison Control Centers' Role in Glow Product-Related Outbreak Detection: Implications for Comprehensive Surveillance System
Authors: Chu Alvin F. , Marcus Steven M. , Ruck Bruce 
Published: August 2016

AbstractIntroduction:The development of syndromic surveillance systems to detect bioterrorist attacks and emerging infectious diseases has become an important and challenging goal to many governmental agencies and healthcare authorities. This study utilized the sharp increase of glow product-related calls to demonstrate the utility of poison ontrol data for early detection of potential outbreaks during the week of Halloween in 2007.Methods:A review was conducted of the electronic records of exposures reported to the New Jersey Poison Information and Education System NJPIES) Poison Control Hotline from 2002 through 2007 with generic code number 0201027 (glow products) set by the American Association of Poison Control Centers (AAPCC). Key information such as age, gender, time of the call, exposure reason, clinical effects, and medical outcomes along with telephone number, zip code, and county location were used in the analyses to determine the extent of the outbreak.Results:Analyses included a total of 139 glow product-related calls during the week of Halloween in 2007 with a single-day high of 59 calls on Halloween Day. More than 90% of the glow product exposures were in children 1–10 years of age. The glow product-related calls on Halloween Day increased from 14 calls in 2002 to 59 calls in 2007, a 321% increase during a six-year period.Conclusions:Poison control centers in the United States are equipped with a unique and uniform input data collection system—the National Poison Data System—that provides an important data source in the development of a comprehensive surveillance system for early outbreak detection.
Experience of Health-Related Problems during House Parties in the Netherlands: Nine Years of Experience and Three Million Visitors
Authors: Krul Jan , Girbes Armand R. J. 
Published: August 2016

AbstractObjective:The objective of this study was to report on a nine years of experience of providing medical support during house parties (raves) in the Netherlands, where they can be organized legally.Design:This was a prospective, observational study of self-referred patients from 1997 to 2005. During raves, first aid stations are staffed with specifically trained medical and paramedical personnel. Self-referred patients were diagnosed, treated, and recorded using standardized methods.Results:During a nine-year period with 219 raves occurred, involving approximately three million participants, 23,581 patients visited the first aid stations. The medical usage rate (MUR) varied from 59–170 patients per 10,000 rave participants. The mean age increased from 1997 to 2005 from 18.7 ±2.7 to 23.3 ±5.7 years. The mean stay at the first aid station was 18 ±46 minutes. Most health problems were mild. Fifteen cases of severe incidents were observed with one death.Conclusions:Unique data from the Netherlands demonstrate a low number of serious, health-related, short-term problems during raves.
Transport and Use of Point-of-Care Ultrasound by a Disaster Medical Assistance Team
Authors: Mazur Stefan M. , Rippey James 
Published: August 2016

AbstractThe role of ultrasound in disaster medicine has not been not well established. This report describes the transport and use of point-of-care ultrasound by Disaster Medical Assistance Team (DMAT) responding to a mass-casualty incident due to a cyclone. Ultrasound-competent physicians on the team were able to use portable ultrasound on cyclone casualties to exclude intra-abdominal hemorrhage, peri cardial fluid, pneumothoraces, and hemothoraces Information obtained using ultrasound made initial patient management, and subsequent decisions regarding triage for transport safer and based on more detailed clinical information.
Maintaining Health Sector Collaborations between United States Non-Governmental Organizations and North Korea through Innovation and Planning
Authors: Yim Eugene S. , Choi Ricky Y. , VanRooyen Michael J. 
Published: August 2016

AbstractIntroduction:Humanitarian agencies in North Korea operate within a complex sociopolitical environment historically characterized by a baseline of mistrust. As a result of operating within such a heated environment, health sector collaborations between such agencies and the North Korean government have followed unpredictable courses.Problem:The factors that have contributed to successful programmatic collaborations, as perceived by United States non-governmental organizations (NGOs) and North Korean officials were investigated.Methods:A qualitative, multi-case, comparative, research design using semistructured interviews was used. Expert North Korean informants were interviewed to generate a list of factors contributing to programmatic success, defined as fulfilling mutually established objectives through collaboration. The North Korean informants were asked to identify US NGOs that fulfill these criteria (“mission-compatible NGOs”). Representatives from all of the missioncompatible NGOs were interviewed. All informants provided their perspectives on the factors that contributed to successful programmatic collaborations. The interviews were recorded, transcribed, and analyzed for thematic content.Results:North Korean informants identified six mission-compatible US NGOs. The North Korean and US NGO informants provided a number of factors that contributed to successful programs.These factors were grouped into the following themes: (1) responsiveness to North Korean requests; (2) resident status; (3) program monitoring; (4) sincerity (apolitical objectives); (5) information gathering; and (6) interagency collaboration.Conclusions:Some US NGOs have devised innovative measures to work within a unique set of parameters in North Korea. Both US NGOs and North Korean authorities have made significant concessions to maintain their programmatic partnerships. In this manner, seasoned collaborators have employed creative strategies and a form of health diplomacy to facilitate programmatic success in North Korea by building trust within a complex sociopolitical space.
Safe Management of Mass Fatalities following Chemical, Biological, and Radiological Incidents
Authors: Baker David J. , Jones Kelly A. , Mobbs Shelly F. , Sepai Ovnair , Morgan Dilys , Murray Virginia S.G. 
Published: August 2016

AbstractContaminated mass fatalities following the release of chemical, biological, or radiological agents pose a potential major health hazard. A United Kingdom government investigation has identified a number of areas of risk. This paper presents an outline of the findings of the study and describes specific pathways for the management of contaminated and non-contaminated fatalities. Factors determining the choice between cremation and burial are discussed. Effective decontamination remains a neglected area of study for both fatalities and casualties.
Smallpox, Risks of Terrorist Attacks, and the Nash Equilibrium: An Introduction to Game Theory and an Examination of the Smallpox Vaccination Program
Authors: Hamilton Richard , McCain Roger 
Published: August 2016

AbstractIntroduction:The smallpox vaccination emergency preparedness program has been unsuccessful in enrolling sufficient numbers of healthcare workers.Objective:The objective of this study was to use game theory to analyze a pre-event vaccination versus post-event vaccination program using the example of a terrorist considering an attack with smallpox or a hoax.Methods:A three-person game (normal and extensive form), and an in-person game are played for pre-event and post-event vaccinations of healthcare workers facing the possibility of a smallpox attack or hoax.Results:Full pre-event vaccinations of all targeted healthcare workers are not necessary to deter a terrorist attack. In addition, coordinating vaccinations among healthcare workers, individual healthcare worker risk aversion, and the degree to which terrorists make the last move based on specific information on the status of pre-event vaccination all greatly impact strategy selection for both sides. A Nash Equilibrium of pre- and post-event vaccination strategies among a large number of healthcare professionals will tend to eliminate the advantage (of the terrorists) of a smallpox attack over a hoax, but may not eliminate some probability of a smallpox attack.Conclusions:Emergency preparedness would benefit from game theory analysis of the costs and payoffs of specific terrorism/counter-terrorism strategies.
Video Laryngoscopy in the Prehospital Setting
Authors: Bjoernsen Lars P. , Lindsay Bruce 
Published: August 2016

AbstractIn the prehospital setting, the emergency care provider must anticipate that some patients will manifest with difficult airways. The use of video laryngoscopy to secure an airway in the prehospital setting has not been explored widely, but has the potential to be a useful tool. This article briefly reviews some of the major video laryngoscopes on the market and their usefulness in the prehospital setting. Studies and case reports indicate that the video laryngoscope is a promising device for emergency intubation, and it has been predicted that, in the future, video laryngoscopy will dominate the field of emergency airway management.Direct laryngoscopy always should be retained as a primary skill; however, the video laryngoscope has the potential to be a good primary choice for the patient with potential cervical spine injuries or limited jaw or spine mobility, and in the difficult-to-access patient.The role of video laryngoscopes in securing an airway in head and neck trauma victims in the prehospital setting has yet to be determined, but offers interesting possibilities. Further clinical studies are necessary to evaluate its role in airway management by prehospital emergency medical services.