bluuebunny/crossref_metadata_2025_split huggingface dataset:
(A316) Pre-Hospital Emergency Care in Sudan - Current Practices in Disaster Management (DM)
Authors: Elbashir K. , Gore R. , Bloem C. , Roblin P. , Ostrovskiy G. , Abuaaraki T. , Yousif M. , Arquilla B. 
Published: May 2011

IntroductionThe problems of pre-hospital care and training in the developing world are very similar – resource limitations and training deficiencies. Humanitarian conditions in the Sudan have been among the worst in the world including both man-made and natural disasters. Effectively responding to emergencies is of paramount importance.MethodsThe information was collected by a group of Sudanese physicians working in the emergency department at a large urban public hospital in Khartoum, Sudan and in the U.S. for the purpose of establishing structured training programs for pre-hospital responders.ResultsThere are currently 37 registered state operated mini-van ambulances serving ∼8 million people in the capital city of Khartoum. There is 1 central dispatching command center operated by the state Ministry of Health (MOH) that serves 29 hospitals. Services are available by calling a central “999” emergency response number. There are no private ambulances in Khartoum; however, most patients are transported by private or public transportation. Ambulance transport teams consist of ∼2 ambulance emergency assistants with limited medical training. Ambulance transport costs are covered either by insurance for the insured; however, the majority of patients are self paid. Emergencies are also managed by the Department of Civil Defense, which is a branch of the Sudanese MOH that responds to natural and man-made disasters. There are 2 layers of this team; 420 physician with masters degrees in DM and emergency rescue workers. These emergency rescue workers do not have formalized training. Other important findings are: lack of training centers for first emergency responders, no standardized practice guide lines among pre-hospital care personnel.ConclusionEmergency response in the Sudan is a relatively new practice but has shown a promising trend for the continued development of a highly advanced and functional pre-hospital/emergency response system. More structured training through collaborative efforts and substantial resources are needed.
(A345) The Longitudinal Study of Survivors' Daily Lives and Health Conditions after Sichuan Earthquake in China — The Result of the 3rd Year Compared with the 1st Year and 2nd Year Study
Authors: Hu X.Y. , Cheng Y.J. , Chen Q. , Long N. , Li J.P. , Luo Y.L. , Yamamoto A. 
Published: May 2011

ObjectiveTo longitudinally investigates the Survivors' daily lives and healthy condition after Sichuan earthquake in China. This study identifies Survivors' daily lives and health conditions for 3-years.Ethical ConsiderationThe study was conducted after obtaining approval in Ethical Review Board of Sichuan University.MethodThe study was conducted for the survivors who experienced the earthquake and aged 18 years and over, and joined the 1st year and 2nd year study. Questionnaire included the survivors' socio-demographics, impact of disaster and the health status after disaster. The date was analyzed using SPSS 13.0 software.ResultsResults showed the follow-up date which was results of 3-years. The changes of daily lives of survivors for 3-years were fluctuations. As their health conditions in the 3rd year, the following symptoms were decreased: locomotors system disease, respiratory disease, Autoimmunity and endocrine diseases, asthma and allergy, Gout, Irregular menstruation/dysmenorrheal, kidney disease and the others. In contrast, the following symptoms were increased: cardiac disease, weight gain/less, hypertension, diabetes, and liver disease. About their self-rated health, “Not healthy” at 3rd year was 26.4%. Compared with the 1st year and 2nd year results, it has taken a turn for the significantly better (1st year 49.9%; 2nd year 35.1%). With regard to the psychological condition, the Positive response of IES-R at 3rd year was 11.6%. Compared with the 1st year and 2nd year results, the Positive response of IES-R significantly decrease (1st year 49.8; 2nd year 31.8%. p < 0.001, by Pearson Chi-square).ConclusionAfter 3rd year of the Sichuan earthquake disaster, the survivors' physical and psychological conditions have improved compared to 1st year and 2nd year results. However most of the survivors still had some health problems in their health. Our local nursing authorities still need to go on their health promotion, which can further improve the survivors' health status.
(P1-3) Frequency of Cerebrovascular Diseases and Risk Factors in Emergency Department in Banja Luka
Authors: Banjac N. , Kezic S. , Maravic-oplakan G. , Vukadinovic S. , Janjic N. , Vulic V. , Kovacevic D. 
Published: May 2011

IntroductionCerebrovascular disease include all disorders in which a part of brain is transiently or persistently damaged by ischemia or bleeding and/or where one or more blood vessels of brain are primarily damaged by pathological processes. The research confirmed the influence of risk factors.ObjectiveThe primary objective was to measure frequency of patients with cerebrovascular diseases in the Emergency Service during the period from September 1, 2008 to March 1, 2009. The secondary objective was to prove co-morbidity between the risk factors and cerebrovascular diseases.MethodNumerical indicators for patients with cerebrovascular diseases are extracted retrospectively by statistical work-up for the six-month period. The data indicating the risk factors predisposing cerebrovascular diseases are obtained through the (hetero)anamnesis.ResultsFrom the overall number of 24,600 patients, 127 patients had a diagnosis of cerebrovascular diseases. The frequency of cerebrovascular diseases is linearly increasing with age; after the age of 50, frequency is doubled. The frequency of cerebrovascular diseases is higher in women than in men, the role of heredity is significant, and risk factors influenced development of cerebrovascular diseases as follows: 50.40% of patients had hypertension, 16.54% diabetes mellitus, 48.82% smoking cigarettes, 40.94% obesity, 20.47% alcohol abuse, 11.02% migraine-like headaches, 30.71% cardiovascular diseases and 22.05% hyperlipidemias.ConclusionCerebrovascular diseases are increasing in developing countries. The main reason is poor control of risk factors. In the majority of cases it is possible to produce decrease of frequency of cerebrovascular diseases by elimination and reduction of risk factors through the change of life style. Pre-hospital urgent concept of therapy and improving of organization of emergency service will contribute to decreasing mortality and morbidity of cerebrovascular diseases.
(P1-9) Multinational Disaster Response Exercise: Critical Look and Lessons Learned
Authors: Norii T. , Terasaka Y. , Miura M. , Nishinaka T. , Lueken R. , Sasaki H. , Alseidi A. 
Published: May 2011

IntroductionInternational collaboration for disaster response is an increasing phenomenon. Japan-United States joint field exercises have been conducted annually since 2004, triggered by an incident in which a US helicopter crashed into a university campus in Okinawa, Japan. The fifth Japan-US disaster field exercise was conducted testing the disaster response of the Okinawa government and US military.MethodsThe simulated exercise involved a US Navy aircraft that crashed into a city center in Okinawa, Japan. There were 16 simulated casualties that included US military members and Japanese citizens. The participants in this exercise were US military members, including the Disaster Assistance Response Team (DART) and local rescue and medical teams including the Okinawa Disaster Medical Assistance Team (DMAT). Data were gathered from the joint debriefing session held by both medical teams. Furthermore, interviews with team leaders from both nations were conducted and feedback obtained.ResultsLack of communication and inaccurate communication remained the root of most problems encountered. There were several miscommunications at the scene due to the language barrier and ignorance of different medical teams' capability and method of practice. Due to the unclear signage of the initial triage zone, another triage zone was developed later by a second medical team. Confusion regarding gathering information and order of transport also was witnessed. The capabilities of team members were not well known between teams, resulting in inappropriate expectations and difficulty in effective cooperation.ConclusionsUnderstanding the systems and backgrounds of each medical team is essential. Signs or symbols of key elements including triage areas should be clear, universal, and multilingual. Communication remains the Achilles' heel of multi-national disaster response activities.
(P1-10) Post-Deployment Survey of Korean Disaster Relief Team Medical Team Members after the Earthquake in Haiti
Authors: Kim H. , Ahn M.E. , Oh B.J. , Kim K.H. , Shin D.W. , Hong E. 
Published: May 2011

IntroductionThe Korean Disaster Relief Team (KDRT) medical team, mainly composed of graduates from first government certified international disaster support education course, deployed to Haiti after the earthquake in January 2010, and operated a medical relief mission. The present study was designed to evaluate the KDRT medical team mission in Haiti.MethodsData were collected via an anonymous questionnaire that was distributed one day after the completion of the mission in Haiti. Questionnaires were composed of four categories.ResultsThe response rate for this survey was 72% (18/25). The KDRT members were relatively young, with 72% of personnel.
(P1-12) Had the Times Square Bomb Exploded: What about the Injured Children?
Authors: Conway E. , Flamm A. , Foltin G. , Cooper A. , Greenwald B.M. , Biagas K. , Sagy M. , Hojsak J. , Abularrage J. , Shah V. , Ushay M. , Uraneck K. , Gonzalez D. , Treiber M. , Goldfeder M. , Tunik M. , Frogel M. 
Published: May 2011

IntroductionChildren frequently are the victims of disasters due to natural hazards or terrorist attacks. However, there is a lack of specific pediatric emergency preparedness planning worldwide. To address these gaps, the federal grant-funded New York City Pediatric Disaster Coalition (PDC) established guidelines for creating Pediatric Critical care (PCC) surge plans and assisted hospitals in creating their plans. To date, five hospitals completed plans, thereby adding 92 beds to surge capacity. On 01 May 2010, 18:00h, there was an attempt to detonate a car bomb in Times Square, a large urban attraction in the heart of New York City. The perpetrator was later convicted of the attempted use of a weapon of mass destruction. Had the bomb exploded, given the location and time of day, it is possible that many critically injured victims would have been children.MethodsThe unit director or a senior attending of nine major hospitals in the NYC area (five in close proximity and four at secondary sites) were surveyed for the number of their vacant pediatric critical care beds at the time of the event before activation of surge plans.ResultsAt the time the car bomb was discovered, the nine hospitals, which have a total of 141 PCC beds, had only 29 vacant approved pediatric critical care beds.ConclusionsHad the event resulted in many pediatric casualties, the existing PCC vacant beds at these hospitals may not have satisfied the need. Activating surge plans at five of these hospitals would have added 92 to the 29 available PCC beds for a total of 121. In order to provide PCC to a large number of victims, it is crucial that hospitals prepare PCC surge plans.
(P1-24) Future Weapons of Mass Destruction: Preparing For Emerging Threats
Authors: Mcisaac J. 
Published: May 2011

IntroductionCivilian Weapons of Mass Destruction (WMD) training involves preparing for threats well-known to the military since World War II. Present and future developments in Chemical-Biological (CB) research have resulted in new potential agents, modes of action, and methods of delivery. Chemical-Biological defense training should include these new agents and anticipate contact with previously unknown ones. The natural response to an unknown threat is fear and panic, out of proportion to the actual threat. Specific training in management of new pathogens and toxidromes should be incorporated into existing preparedness regimes. Leadership skills that address uncertainty and inspire constructive responses will increase resiliency.MethodsLiterature ReviewResultsRecent and Future CB Agents: (1) 4th Generation AchE inhibitors: Novichoks, Substance 33, etc.; (2) Genetically enhanced bacteria and engineered chimeric diseases; (3) Modified viral diseases: Variola, Influenza, filoviruses, flaviviruses, arenaviruses; (4) Bacteriophage induced diseases; (5) Agents targeting specific racial or genetic groups; (6) Mid-spectrum agents; (6) Bioregulators: Substance P, vasopressin, enkephalin, etc.; (7) Novel toxins: tetrodotoxin, SEB, saxitoxin, etc.; (8) Hallucinogens and incapacitants (LSD, DMT, carfentanyl, cis-fluoro-ohmefentanyl); (9) Prions and infectious nucleic acids Delivery: (1) New delivery methods: micro- and nano-robots modeled on insects (MEMS systems), microencapsulation; (2) Directed Energy Weapons Mitigation: (1) Development of systems for identifying and dealing with unknown agents and symptoms; (2) Hazard Identification, Risk Estimation, Risk Reduction Strategies, Residual Risk Evaluation and Monitoring, Mitigation and Recovery Leadership skills needed during uncertainty: Sense making, Visioning, Relating, Inventing.ConclusionsPreparing for events without training for new and novel CB agents leaves us unprepared. Incorporating modern science with leadership skills will lessen the impact of future CB release and improve organizational resiliency. The main mistake people make is that they fear current problems more than future ones. Carl von Clausewitz Chance favors the prepared mind. Louis Pasteur.
(P1-30) Natural Disasters Challenge for Emergency and Rescue Services - Lessons Learned
Authors: Gula P.W. , Szafran E.M. 
Published: May 2011

Natural disasters challenge for Emergency and Rescue Services- lessons learned Przemyslaw Gula MD PhD, Edyta Szafran Institute for Emergency Medicine. Krakow, Poland.In the period 2008–2010 Poland experienced series of natural disasters including 3 large scales flooding, 2 periods of extremely high snowfalls followed by low temperature periods and finally local flush flooding in different locations. The time of each disaster elapsed from several days up to 6 weeks. All of them had severe impact on local infrastructure by destroying road systems, communication as well as healthcare and fire brigade facilities. The rescue efforts required evacuation, Search and Rescue operations, providing medical care and shelter. The most problems occurred in following areas: - large scale evacuation - collapse of communication systems (including 112 dispatch) - inadequate number of specialized rescue equipment (helicopters, vehicles, boats, snowmobiles, etc.) - providing EMS in affected areas - necessity of evacuating hospitals. The lessons learned showed the need for following changes: - strong trans regional coordination in means of facilitation of utilizing civil protection and military recourses - unification of operative procedures for all actors of the response operation - improvement of communication systems and reducing their vulnerability on environmental factors - establishing regional crisis management and control centers, covering the emergency response activities in affected areas - need of large-scale use of HEMS as well as Police and military helicopters in natural disasters - need for better supply in specialized rescue equipment including recue motorboats, 4 wheels drive recue vehicles and ambulances, snowmobiles, quads in local response units. The main rule of commanding the entire operation is subsidiary. Local coordinating structures should be supported by regional and central governments by supplying necessary recourses. However the operational command should be unified and include all participating units and organizations.
(P1-33) Psychological Stress and Effect of War on Education and Educator
Authors: Reha A. 
Published: May 2011

BackgroundA well sounded education in a peaceful environment is a stepping stone to a good future of a society. Therefore, we can say the foundation and potentiality of economic and socioeconomic of any country is well defined by this.DiscussionNot everyone receives the reward of education that plays a vital part in their lives. The main reasons as to why this is the case, Is due to the environment the person/individual lives in. For example, when a child is living in conflict and poverty as a major crisis the need for education will be ignored. Children in war torn countries such as Afghanistan where children are constantly under physical and psychological stress due to their schools being destroyed by bombardment and also the killing of their educators. Furthermore, children in war torn countries have a high risk of concern for a pointless education as they don't get a chance to attend school regularly, but they will dapper with educational stress. In this situation all the educators and their students will be whirling in the storms and floods of psychological stress. Education is very emotional and traumatic as it is in Afghanistan, where they suffered through the unfair interference of outsiders in their home country as the Russian did by the name of democracy in 1979–1998. Unfortunately, following 09/11 a new time has set with a new kind of invasion which is going on. We now observe more tragic situation which again external powers are injecting their culture and foreign bodies in Afghanistan. It's obviously drying out the water of our culture.ConclusionsWhere the Culture itself is one of the most important and valuable aspect of life it is a tower of education. Without culture, education would never have been built and so never could be improved.
(P1-35) Adapting a Humanitarian Organization for Disaster Response, Operation Smile in Haiti, 2010
Authors: Zoraster R. , Beers M. , Crabtree T. 
Published: May 2011

BackgroundOperation Smile International (OSI) is a Non-Government Organization (NGO) with experience providing surgical care throughout the world. OSI has vast logistical capacity, skilled and credential providers, and international relationships. Disaster response had been considered by OSI in the past, but never initiated. However, the magnitude of the Haiti disaster, coupled with request from Haitian OS Partners led to the initial disaster response of the OSI organization.Discussion and ObservationsThis presentation will: (1) Describe the considerations and rationale that led OSI to this intervention. (2) Discuss the process of developing a disaster response within a relatively short period of time. (3) The response itself, and (4) Present how the lessons learned will be adapted to future OSI capacity and planning.
(P1-37) Over and Undertriage in Simulation Exercises
Authors: Styrwoldt E. 
Published: May 2011

Over and undertriage in simulation exercises Introduction The first healthcare personnel arriving at the scene of an accident or major incident is often an ambulance crew. It is therefore of importance that they are familiar with, and can practice triage during situations were there is a lack of resources. Overtriage, when a casualty is given a priority higher than motivated, may lead to inadequate use of resources, while undertriage can be seen as a risk for medical errors. There is a consensus that up to 50% overtriage is accepted in order to have an undertriage, which is less than 5%. The aim of this study was to increase knowledge regarding prehospital personnel's triage during standardized simulation exercises.Material and Method76 standardized simulation exercises where the triage of casualties was evaluated. The exercises were part of a training program for medical command and control at scene. The students trained were all professional ambulance crew. The scenario was a fire at a football stand with 50 causalities. All in all 3800 (76 x 50) triages were performed. The simulation system used was Emergo Train System. Prior to the exercises an expert group had triaged the causalities according to the MIMMS system (sieve). Of the 50 patients 15 were triaged as T1 by the expert group and the rest were not.ResultsOf the 3800 triages 37% (n = 410) were classified as undertriage and 13% (n = 134) as overtriage. The most frequently undertriage casualties had an airway and/or breathing problem that were not observed. The most frequently overtriage casualties had a burn injury involving 30% of body surface area or unconscious casualties.ConclusionsTriage in this simulation setting did not meet acceptable standards. More triage training for ambulance crew may improve outcome. More studies are needed regarding simulation exercises as a tool for evaluating results of triage.
(P1-46) A Model of Mass Casualty Management Education: The Prehospital Mass Casualty Exercise and Trauma Management Course
Authors: Eryilmaz M. , Durusu M. , Tuncer S.K. , Bayir A. , Arziman I. , Eyi Y.E. 
Published: May 2011

IntroductionIn this article, we aimed to share “the prehospital mass casualty exercise and trauma management course” which is performed at the 10th European Congress of Trauma & Emergency Surgery as a model.Methods and MaterialsThe preparation, format, participant properties and the discussion of the course were evaluated.ResultsThe course performed in 4 parts. On the first part, a panel discussion including opening, targets of course and a conference was performed. On the second part, the prehospital mass casualty exercise was performed. On the third part, the participants discussed in different 4 workshops. On the last part, basic discussion results were declared. At the mass casualty exercise, the scenario was adapted from bus bombing which was in Diyarbakir on 03.01.2010, 6 deaths, 96 wounded. Field and injury simulations were performed. We trained 15 paramedic volunteers to act as wounded patients. Moulage and make-ups were made due to previously defined injuries as in Diyarbakir. The victims were placed in simulated maneuvers field. Participants were accepted in five each groups to the maneuvers field and they were requested to manage the scene, triage, first aid. After the exercise, 4 workshops themed as Scene Medical Management, Ground and Air Evacuations, Preparedness of the E D's and Preparedness of the OR's, and ICU's were performed. The results of the workshops were presented at the last part.Discussion and ConclusionThe participants expressed that observing and experiencing the chaos circumstances during the maneuvers are the most important things in scene management and these must be considered in preparedness and planning phases.