bluuebunny/crossref_metadata_2025_split huggingface dataset:
(P1-74) Introduction of the Portable Decontamination Unit of Gulhane Military Medical Academy
Authors: Bayir A. , Eyi Y.E. , Durusu M. , Oztuna A. , Eryilmaz M. 
Published: May 2011

IntroductionChemical, biological, radiological and nuclear (CBRN) cases are seen as an increasing risk because of the increasing threat of international terrorism. Decontamination is one of the basic components of the intervention for CBRN exposure. The introduction portable decontamination unit in the hospital setting is described in this presentation.MethodThe general properties, facilities, and capabilities of the portable decontamination unit, which is present in the GATA CBRN Department of the Turkish Armed Force's Health Command, were evaluated.ResultsThe portable decontamination unit in the hospital has a metal frame that is 54 m2 wide. It is composed of two tents that weigh about 300 kg. The metal frame, metal legs, and tent cloth are stored in carrying bags. Four people can construct the tents in 10 minutes. An educated squad of four people can prepare the decontamination system and instructions in 25–30 minutes. The unit consists of two lines: one for outpatients and another for inpatient decontamination, which includes a rail system. Each decontamination line contains an undressing, shower, and dressing section.DiscussionAlong with metal-framed decontamination tents, there also are inflatable tents. The inflatable decontamination units can be pitched in 5–7 minutes by an electrical air compressor. Metal-framed tents are easy to carry, as the frame, metal legs, and tent cloth are stored in carrying bags. By pitching the decontamination tent on a smooth ground in front of the hospital entrance, decontamination of patients can be completed before they reach the hospital. Another decontamination unit is in place next to the emergency department.ConclusionTerrorist attacks that result in mass casualties demonstrate the importance of CBRN preparedness. A decontamination unit and an appropriate CBRN preparedness plan should be constituted into the basic treatment system.
(P1-81) Differences between Radiation Dosages to Which the Radiology Department Staff and the Public were Exposed
Authors: Ortatatli M. , Kenar L. , Gumral R. , Bayir A. , Arziman I. , Durusu M. 
Published: May 2011

IntroductionIn this study, the mean daily and annual radiation exposure of the radiology department staff, other hospital health staff, and public volunteers was compared at Maresal Cakmak Military Hospital in Erzurum, Turkey.MethodsThe NEB.211 Dose–Rate Meter with a Gaiger–Müller counter was used to measure the amount of radiation. Six radiology department health staff carried the NEB.211 device during seven working hours. At the end of the day, total absorbed dosages were noted. The same measurements were also done for the six health staff of the other departments and six non-hospital volunteers. Seventeen additional hours were noted for the non-hospital volunteers. The mean value of 17 hours of daily measurements (3.31 mSv) was added to the both group's working hours measurements and the total daily radiation amounts were calculated.ResultsThere was no statistical difference between each three groups in working hours (p = 0.087), daily and annual equivalent dosages (for both p = 0.099).DiscussionThe radiology department health staff was exposed to radiation under the border of equivalent dosage which is determined by Turkish Automic Energy Authority. Public volunteers were seen as they were exposed the radiation over the determined border of equivalent dosage. Nonetheless, with changes depending on living standards, the physical properties of living spaces and geographical circumstances per capita exposed annual dosage is about 2.4–2.8 mSv throughout the world. There was no significant statistical difference between the amounts of equivalent dosage which were exposed to the radiology department health staff, the other hospital staff and public members.
(P1-85) Health Seeking Behavior Post-Unintentional Household Injury in Hong Kong
Authors: Chan E.Y.Y. , Lee P.P.Y. , Leung J.M.S. 
Published: May 2011

BackgroundUnintentional household injuries are a major public health problem that affects large numbers of people. Various population-based surveys from the literature showed > 40% of households reporting an injury that required medical attention. However, there is a general lack in comprehensive population surveys to highlight the risk of post-injury, help-seeking behavior and its associated financial cost. This study is part of the urban, home-based injury epidemiological study series (2007–2010) in Hong Kong.MethodsA population-based, cross-sectional, random telephone survey was conducted using the last birthday method in 2009. A study instrument was developed and validated based on the modified Chinese World Health Organization guidelines for injury and violence surveys.ResultsThe study population comprised of non-institutionalized, Cantonese-speaking Hong Kong residents (n = 6,570). Among the 39.4% self-reported injuries within the past 12 months, only 8.6% of injured people had sought medical care. Respondents tended to seek medical care from the private setting in the first episode of post-injury treatment. Among health seekers, 70% of the injured participants reported having to seek a second treatment and the care-seeking pattern shifted from private to public medical service delivery setting. Predictors of service preferences were identified and discussed.ConclusionsMedical care seeking patterns post-unintentional household injury was identified. Medical and emergency services providers may wish to consider health service implications.
(P1-86) Socioeconomic Impact of Natural Disasters in China
Authors: Zhang W. 
Published: May 2011

IntroductionChina is one of the countries most affected by disasters caused by natural hazards. Disasters comprise an important restricting factor for economic and social development.MethodsRetrospective analysis was performed based on the epidemiological data of disasters caused by natural hazards in recent two decades.ResultsThe deadliest disaster that was reviewed was the Sichuan, Wenchuan earthquake on 12 May 2008 with a death toll of 88,928. Floods were the the primary natural hazard resulting in disaster in China. The economic loss caused by natural disasters was huge, the Sichuan earthquake alone resulted in an economic loss of 845.1 billion Chinese Yuan. However, psychosocial factors did not receive attention by Chinese Government and academics.ConclusionsThe characteristics and impact of disasters should be analyzed to scientifically provide useful information for natural disaster mitigation in China.
(P1-95) Clinical Effectiveness of Psychological First Aid Training among Emergency Responders in Chinese Population: Preliminary Results of 3-Month Follow-Up
Authors: Cheung E.Y.L. , Chan E.Y.Y. , Lin C.L.Y. , Lee P.P.Y. 
Published: May 2011

BackgroundPsychological First Aid (PFA) has become the choice of mental health intervention and integration with the current disaster relief protocols during emergencies by the Institute of Medicine, NIMH and the WHO. It can be used during or immediately after disaster. People without mental health specialized training, including public health practitioners and emergency responders can learn and apply to everyone in need. Whilst being used extensively, few studies have evaluated the effectiveness of PFA and its field applicability.MethodsA prospective randomized controlled study. 800 emergency medical responders were recruited. Participants were randomly assigned to the control/intervention arms to receive a one-day training of PFA based on the protocol developed by the National Child Traumatic Stress Network (2006). A pilot study was conducted to evaluate the screening tools and training material and all training was provided by trained clinical psychologist. Repeated measures analysis of covariance was used to evaluate the efficacy of PFA program in changes in various outcome measures between PFA intervention and control group. All analyses were conducted on the intent-to-treat and completer groups. Ethical approval was approved by the CUHK-NTEC Clinical Research Ethics Committee.ResultsPreliminary results from the post-training and 3 month follow-up data indicated participants in the training group have reported a significantly more substantial knowledge in disaster mental health, improve self-efficacy in delivering help in times of emergencies, high frequency of actual helping behavior as well as better self-reported psychological well-being when compared with waitlist control group.ConclusionThis study examines and reports findings of clinical effectiveness of PFA 3 months post training in Chinese emergency responders. Preliminary results provided empirical evidences on the effectiveness of the approach.
(P2-11) Teletransmission of 12-Lead ECG in Warsaw Ambulance Service — Analysis of the First Months of the Operation
Authors: Michalak G. , Zając D. , Pilip S. 
Published: May 2011

BackgroundSince September 2009, the Warsaw Ambulance Service (WAS) has enabled 23 ambulances to carry out a 12-lead electrocardiograph (ECG) transmission to the specialist in the ECG transmission center, and in return received an interpretation of sent data along with guidelines concerning further treatment and transportation. This would allow patients with myocardial infarction (MI) eligible for PCI to be transported directly to the catheterization laboratory. The aim of this study was to present the results of the first four months of operation of the ECG transmission system in WAS, and assess the frequency of its use and the amount of MI it covered. Furthermore this study, attended to the main issues that might have had a negative impact on the surveyed system.MethodsSince September 2009, each attempt of transmission was described by a number of factors by the staff attending to ECG transmission center. Documentation created from September to December 2009 was subjected to a thorough analysis.ResultsFrom September to December 2009, there was a total of 1,650 attempts of transmission, 292 (18%) of them were unsuccessful. Of 1,358 successfully transmitted ECGs, 39 (3%) suggested a ST-Segment Elevation Myocardial Infarction (STEMI) and 149 (11%) suggested a Non-ST-Elevation Myocardial Infarction (NSTEMI). The number of attempted ECG transmission carried out by individual ambulance teams per intervention was significantly different (p < 0.001) and showed a relation with a place of stationing. The proportion of unsuccessful attempts was significantly different for individual ambulance teams (p < 0.001) and was higher for ambulance teams with lower amount of attempts (p < 0.0001).ConclusionsPrehospital 12-Lead ECGs help to reduce emergency medical services-to-Balloon times. It often was used as a support in case of patients without symptoms typical for MI. Motivation and personal opinion of individual ambulance teams about the system affected frequency of its use. More frequent use of the system by ambulance teams resulted in a lower percentage of unsuccessful attempts of ECG transmission.
(P2-14) Support System for Medical Command and Control at Major Incidents
Authors: Nilsson H. , Lundin R. , Bengtsson E. , Gustafsson L. , Jonsson C. , Vikström T. 
Published: May 2011

IntroductionCommunication and information are cornerstones of management during major incidents and disasters. To support medical command and control, the Web-based support system called Paratus Major Incident can be used. The Paratus Major Incident system can provide management staff with online information from the incident area, and support management and patient handling at both single and mass-casualty incidents. The purpose of the Web-based information technology (IT) system is to ensure communication and information between the medical management at the scene, hospital management, and regional medical command and control (gold level).ExperiencesIn the region of Östergötland, Sweden, Paratus Major Incident system is used in operating topics such as: (1) information dissemination from the incident area; (2) communication between prehospital, regional, and hospital management; (3) continuous updates between the dispatch centre and medical commanders at all levels; (4) digital log-files for medical management and patient records; (4) database used for follow-up studies and quality control.ResultsDuring 2,161 incidents, 746 “first incident reports” from ambulance on scene were sent to regional medical command and control within 2 minutes. Four hundred and fifty-six “verification reports” were sent within 10 minutes. During 15 incidents, the designated duty officer on regional level confirmed “major incident” directly via the digital system, thereby notifying all arriving ambulance resources and involved medical managements.ConclusionThis Web-based IT system successfully has been used daily within prehospital management since 2005. The system includes medical command and control at the regional level and all involved hospitals in a major incident.
(P2-16) Study to Assess the Cost Effectiveness of Re- Use of Expensive Disposable Items in a Neurosurgery Intensive Care Unit
Authors: Cj M. , Agarwal D. 
Published: May 2011

BackgroundCertain disposable items such as Percutaneous Tracheostomy (PT) sets and intracranial pressure (ICP) monitoring sets are expensive and a major drain on resources of public funded hospitals.AimsTo assess the use and cost-effectiveness of reusing expensive disposables (PT& ICP sensor) in a neurosurgery intensive care unit (ICU). Another objective was to assess the importance of bedside Tracheostomy and ICP insertion in an ICU rather than in OT.MethodsAn observational, retro-prospective study was done from January 2008 to November 2010 in the neurosurgical department of JPN Apex Trauma Center. Retrospective data on surgeries performed in Neurosurgery OT were taken for the year 2008 and following introduction of PT and bedside ICP monitoring sets in ICU, prospective data were collected from November 2009 in the neurosurgery ICU. Each set was tagged according to number of times used. A procedure book was maintained, in which each case along with the set used was mentioned.ResultsOf the 1209 surgeries performed in the neurosurgical OT in 2008–2009, 257 were minor procedures (238 open tracheostomy and 19 ICP transducer placements). In 2009–10, 236 percutaneous tracheostomies were performed in the ICU. Of these, 79 (33.4%) were new and 157 (66.5%) were re-used sets. The cost of a new PT set is Rs 15,000. With re-use, the average price per set came down to Rs 5,033. In the same period, 231 disposable ICP transducers were placed with an average of 19 cases per month (range 5–28). Of these, 142 (61%) were new ICP sets and 97 (42%) were ethylene oxide (ETO) sterilized. The cost of new ICP set is Rs 35,000. With re-use, the average price per set came down to Rs 21,515.ConclusionNearly 40% of minor procedures are now excluded from the Neurosurgery OT statistics, as they are being performed in the ICU. This study shows that expensive disposable items can be re-used effectively, bringing immense cost savings to hospitals.
(P2-28) Collaboration Between Nurses and Physicians in the Emergency Department: An Indonesian Study
Authors: Suryanto S. 
Published: May 2011

BackgroundPositive collaboration between nurses and physicians is essential in all areas of care especially in emergency practice. This is because it has a significant relationship with the quality, safety, accountability, and responsibility of care. Three areas are positively related to collaborative interaction between nurses and physicians: provider outcomes, patient outcomes, and organizational outcomes.AimTo examine nurses' and physicians' attitudes towards nurse-physician collaboration in the Emergency Department of Dr Saiful Anwar General Hospital, Malang, Indonesia.MethodsThe study was a comparative descriptive quantitative study using a modified Jefferson Scale of Attitude towards Physician-Nurse Collaboration. Data were collected from 47 nurses and 24 physicians who participated in the study. Descriptive statistics, parametric and non-parametric inferential statistics were used to determine group scores and to examine differences between groups, as well as to determine the relationship between demographic characteristics and participants attitudes.ResultsEmergency nurses had significantly more positive attitudes toward collaboration than emergency physicians (p < 0.001). Emergency nurses had significantly higher scores in three of four underlying factors of the instrument: “physician dominance”, “nurse autonomy”, and “caring as opposed to curing”. The effects of gender, age, education, and experience in other hospitals on nurses' and physicians' attitude towards collaboration were not statistically significant. However, experience in the Emergency Department of Dr Saiful Anwar General Hospital was significantly related to participants' attitudes towards collaboration (p = 0.023).ConclusionsThe findings of this study indicate that both organizational and individual strategies should be developed to enhance the nurse-physician collaborative relationship. Inter-professional education may enhance health care professionals' attitudes towards collaboration. A larger and more representative sample is needed for future research, especially examining relationships such as between collaboration of these health professionals and patient outcomes and work place satisfaction.
(P2-30) Development of Disaster and Emergency Medicine in Nepal
Authors: Maharjan R.K. 
Published: May 2011

Nepal, a landlocked country between China and India, is developing disaster and emergency medicine. In 2007, the Nepal Disaster and Emergency Medicine (NADEM) Center was formed with the aim of developing this specialty in Nepal. The first hospital was built in July 1889. It wasn't until 1988 that a Disaster Response Team was organized following a stampede incident in the national stadium in Kathmandu. The country often experiences disaster and emergency situations due to geographic and natural hazards and political tensions.In 1984, the Institute of Medicine, Tribhuvan University Teaching Hospital created emergency services with general practitioners (GPs) directing and providing services. Since then, almost all emergency services of different hospitals are run by GPs with house officers, nurses, and paramedics. There still is a lack of training and proper management, and limited equipment and infrastructure to provide needed disaster and emergency services to the people. The NADEM Center is developing coordination objectives between different emergency service providers to organize ways of service providing. This will be done through NADEM's continuing medical education and publication of Journal of Nepal Disaster and Emergency Medicine (J-NADEM) and NewsHealth; coordination among emergency medical services (prehospital), in-hospital services, and disaster and critical care medicine; and planning and implementation of different research, training, workshops, seminars, and conferences in disaster and emergency medicine with cooperation from the world. The NADEM Center will develop International Institute of Disaster and Emergency Medicine.
(P2-42) Mass-Gathering Risks in the Beijing Subway System
Authors: Du W. , Fitzgerald G. 
Published: May 2011

IntroductionMass gatherings pose a significant risk on health and safety. The mass gathering in the subway systems in Beijing represents a daily risk. An average of 4.52 million passengers rode the subway each day between 15 November and 30 November 2010, with the highest daily passenger number totaling 5.14 million. The purpose of this study is to identify the health and safety aspects of mass gatherings in Beijing subways, and proposes strategies that may mitigate these risks.MethodsThe methods included a literature review, field visitation of the subway systems, and interviews of 20 passengers and 10 management personnel from the subway system.ResultsMany safety and health measures has been taken by the Beijing Subway System, including emergency exit signs and other safety signs, prohibition of smoking, firefighting equipment and explosion-proof tanks, safety inspection of bags, and safety education in the subways. However, additional key health and safety aspects were indentified, including: (1) lack of strict flow control of passengers in interchange subway stations; (2) lack of platform safety gates in Line 1, Line 2, Line 13; (3) lack of passenger control during peak hours; (4) lack of biomedical monitoring systems in the subways; and (5) lack of health facilities and rescue equipments in the subways.ConclusionsMass gatherings pose great risks on subway passengers in Beijing, including psychosocial risks, biomedical risks, and environmental risks. Additional safety measures need to be taken to ensure the safety and health of passengers in subways in Beijing.
(P2-48) Improve Nursing Disaster Preparedness by Education and Maneuver
Authors: Khankeh H.R. , Masoomi G.R. , Jallali A.R. , Ghanbari V. , Madah S. , Nakhaee M. , Ranjbar M. 
Published: May 2011

IntroductionNurses have pivotal roles before, during, and after disasters. Enhancing their professional skills to help the injured is one the basic principles in health management in disasters. The aim of this study is to investigate the effectiveness of training disaster nursing preparedness on improving the preparedness of nurses.MethodUsing a quasi-experimental method, 113 nurses were selected randomly. The preparedness program, which consisted of a one-day workshop on disaster management, a tabletop exercise, and an operational maneuver, was executed for the participants. The preparedness of all participating nurses was measured by disaster preparedness questionnaire, one week and also one month after the program. Data analysis was performed by using the ANOVA test.ResultsThe mean scores of knowledge, attitude, and performance improved from 5.55 to 19.88, from 66.18 to 72.41, and from 3.36 to 12.48, respectively (p < 0.001). In addition, the mean of total preparedness score was increased from 75.14 in pretest to 104.77 in the follow up (p < 0.001).ConclusionsPreparedness plan training improves participants' preparedness for responding disasters, because preparedness and reliability for responding to disasters is influenced directly by the training courses and previous experiments. Therefore, based on the results obtained in this project, in order to improve the preparedness of nursing staff, including a disaster preparedness plan in academic, educational curriculum and as a continuing educational program is recommended.