bluuebunny/crossref_metadata_2025_split huggingface dataset:
(A197) Attitudes toward Public Assistance during a Disaster Among Patients with Rheumatoid Arthritis
Authors: Sato H. , Tomio J. , Mizumura H. 
Published: May 2011

BackgroundRecently, the local governments in Japan implemented the measures for people requiring assistance during a disaster (PRAD). These measures aim to provide public assistance during a disaster for the citizens who registered themselves to the PRAD list in advance, by sharing their personal information among relevant local authorities. However, the needs for such assistance were not clear among chronic disease patients, and there are some concerns about privacy protection in relation to the PRAD list.ObjectivesThe objective of this study is to describe the attitudes toward the registration to the PRAD list among rheumatoid arthritis (RA) patients.MethodsStudy subjects were the members of a nationwide RA patient group in Japan. Of about 20,000 members, 1,477 who lived in the municipalities affected by disasters from 2004 to 2006 were enrolled. Self-administered questionnaires were sent by mail. The subjects were asked their attitudes toward the registration to the PRAD list and categorized into three groups: (1) no need for assistance; (2) need assistance but will not register; and (3) need assistance and wish to register or already registered. Their concerns about privacy protection as well as socio-demographic and health status were also asked.ResultsOf 1,477, 664 (45%) responded validly, and 596 (40%) answered on their attitudes toward the PRAD list. Of these, 365 (61%) reported they need assistance, though 30% of them (108) did not wish to register. A majority of the subjects concerned about privacy protection among those did not wish to register (65%) as well as among those wished to register (55%). Patients who lived alone, and those with low income were more likely to wish to register.ConclusionsThere are substantial needs for public assistance during a disaster among RA patients although the privacy protection issue would be a barrier to be overcome for successful utilization of the list.
(A212) The 2008 Mumbai Terrorist Attacks and the Changing Pattern of Violent Injuries
Authors: Tanwar Y. , Kaushik V. , Roy N. , Sinha S. , Guru B. 
Published: May 2011

IntroductionThe 26–29 November 2008, terrorist attacks in Mumbai, have been referred to as “India's 9/11”. Violent events in Mumbai over the past six decades were researched to understand the changing pattern of violent injuries.MethodsA complex, retrospective, descriptive study on terrorist events was performed, using event reports, legal reports, newspaper reports, and police and hospital lists. The distribution of victims to various city hospitals, the critical radius, surge capacity, and nature of interventions required were assessed. The profile of those killed in the attacks was noted by sex, nationality, and occupation. Besides the overall mortality and case-fatality ratio, the critical mortality was calculated based on the death rates among the critically injured.ResultsIn 51 violent events in Mumbai over a 60-year period (1950–2009), 1,582 people were killed and 4,145 were injured. In the Mumbai terrorist attacks of 2008, the financial loss due to direct physical damage was INR 847,612,971 (US$18.5 million). Among those killed, the average age was 33.4 years, 80% were male, and 12% were foreign nationals. The case-fatality ratio for this event was 36.2% and the mortality among the critically injured (critical mortality rate) was 11%. Among the injured, 79% were male and the average age was 33.21 years (three months–85 years); 38.5% of patients arriving at the hospitals required major surgical intervention.ConclusionsThe injuries of violent events in Mumbai have been changing due to the use of heavy firepower and explosives. Strengthening the public hospitals for trauma care is a medical counter-terrorism response for future terrorist attacks. These attacks have affected the lives of the common person in Mumbai, in terms of increased security checks, alerts, and fear of further attacks. These are areas of further research.
(A221) Medical Preparedness for Expo 2010 Shanghai China
Authors: Liu Z. 
Published: May 2011

ObjectiveEXPO 2010 Shanghai China attracted about 246 nations and international organizations as well as 73 million visitors from home and abroad. To provide good medical services to is a challenge.MethodsEight Level A hospitals are designated as EXPO Hospitals to provide advanced medical services to those who need critical care. There are five first aid stations in the EXPO park to provide first aid to EXPO visitors and staff. First aid at scene and emergency response are the emphasis. Practical, realistic, and systematic and forewarning emergency plans are made. An agile and efficient structure is organized. All EXPO staff members underwent first aid training, especially the CPR training and the use of AED. The public are trained for self rescue skills via different approaches and provided with first-aid kits. A medical rescue team is recruited; the team consists of Critical Care physicians, surgeons, anesthetists and nurses. The team is able to deal with different situations under all conditions. The team is a standing army, after the EXPO, the team will be responsible for providing medical services in the regional disaster rescue. Drills are performed periodically to practice the rescue skills, enhance the communication and cooperation among different government departments.ResultsBy joint efforts, a safe, wonderful and unforgettable EXPO was presented to the world. During the 184 days, medical personnel provided medical services to the 73 million visitors.ConclusionsThe medical preparedness for World EXPO should be practical, realistic, and systematic and forewarning. The public should have the easy access to the information and resources. Develop the contingency plans according to the real situation, ensure its timely updating and deliver training to every one involved. Drills should be performed periodically to practice the rescue skills, enhance the communication and cooperation among different government departments.
(A248) Médecin En Zone D'exclusion Lors D'un Accident Chimique
Authors: Ronchi L.A. , Decanlers C. 
Published: May 2011

La doctrine classique, en cas d'accident catastrophique en contexte chimique, consiste á confier aux sauveteurs (porteurs d'une tenue d'isolation leur permettant de ne pas Être eux-mêmes contamines) l'extraction et la décontamination d'urgence des victimes. Le médecin n'intervient alors qu'après passage des victimes dans la chaine de décontamination. Ce concept est actuellement remis en cause au vu des retours d'expérience. La plupart des accidents catastrophiques référencés sont constitués d'accidents Á effet limité, et se situent dans une dimension d'espace et de temps réduite. La présence médicale en zone d'exclusion apportera au moins les Eléments favorables suivants: •Caractérisation plus rapide du toxique sur une analyse séméiologique fine
•Pratique de gestes de survie (exsufflation d'un pneumothorax suffocant, intubation d'un trauma crânien inconscient, remplissage d'une hypo volhémie aiguë administration précoce d'un antidote)•Soutien des Équipes de sauvetage•Anticipation Évolutive au vu de la nature du toxique en cause (décision d'administration de l'antidote, méta-triage des victimes)
Il existe néanmoins certains inconvénients potentiels:
•Une présence médicale en zone d'exclusion devra Être précoce et donc susceptible d'amputer les effectifs médicaux initialement présents sur le terrain•La présence d'un médecin implique de sa part une discipline et une intégration parfaites au sein des Équipes de secours, soulignant la nécessité d'un entrainement régulier•Le travail en tenue de décontamination comporte des conséquences ergonomiques certaines, ralentissant la pratique des gestes techniques, et imposant des relèves•Une présence médicale implique un renfort logistique (réapprovisionnement en drogues et matériel)•Le médecin devra constamment garder Á l'esprit le contexte d'accident catastrophique pour ne pas ralentir le processus d'Évacuation de la zone contaminéeL'analyse du rapport favorable/défavorable concernant la présence médicale en zone d'exclusion lors d'un accident catastrophique en contexte chimique incite Á recommander cette présence, recommandation reprise dans les textes officiels récents.
(A264) Does the Implementation of Start Triage Criteria in the Emergency Department Reduce Over- and under-Triage of Patients?
Authors: Kumar R. , Bhoi S. , Chauhan S. , Sinha T.P. , Adhikari G. , Sharma G. , Shyamla K. 
Published: May 2011

BackgroundAppropriate triage shortens the delay in definitive care. this study examined whether the implementation of START triage criteria in emergency departments (ED) reduces over- and under-triage of patients. The purpose of this study was to examine the impact of START triage criteria on over and under-triage subjects.MethodsThe study was performed between 01 January to 15 September 2008. All patients presenting to the ED were recruited. A triage nurse tagged the patients with a red, yellow, and or green wristband, as per START triage protocol. Over-triage was defined as patients who were re-triaged from red (R) to yellow (Y) or Y to green (G) within 30 minutes of arrival. Under-triage was defined as patients re-triaged from Y to R or G to Y within 30 minutes of arrival.ResultsOf 25,928 patients, triage was performed for 25,468 (98.2%) subjects. A total of 8,303 were triaged during the morning shift, 6,994 during the evening shift, and 9,978 during the night shift. A total of 1,431 (5.6%) subjects were tagged as R, 10,634 (41.7%) with Y, and 13,424 (52.7%) were tagged as G. Four hundred seventy-four (1.9%) patients were over-triaged. Two hundred twenty (0.9%) were under-triaged.ConclusionsThe START triage criteria reduce over- and under-triage of patients.
(A269) Lightning Injuries: A Case Series
Authors: Yih Chong Michael C. , Russelle B. , Hsin Kai G. 
Published: May 2011

BackgroundSingapore, albeit a small country, has one of the highest lightning activities in the world. However, injuries related to this spectacular weather phenomenon are under-reported and rarely a subject of study. Most reported cases dealt with lightning-caused fatalities but lightning-caused accidents are not always fatal. Actual reported international data showed that about 80% of lightning victims survived, with or without after effects. This study reviewed the cases of lightning-related injuries who presented to Tan Tock Seng Hospital, Emergency department.MethodsThis is a case series of 5 patients. All 5 patients presented to Tan Tock Seng Hospital, Emergency Department after a thunderstorm. All were undergoing military training when the incident happened. The circumstances surrounding their injury and their presentation and symptomatology were reviewed.ResultsIn our study, three possible mechanisms of injury were identified through a side flash which occurred when the lightning hit the tree and traveled partly down that tree before a portion jumped to the nearby victims; through the concussive effect of the shock waves produced by the lightning; and through step voltage mechanism wherein the lightning after hitting the tree traveled into the ground where victims were standing. Two patients were diagnosed with rhabdomyolysis, one suffered from sensory-neural hearing loss, and one patient had a mild conjunctivitis as a result of tissue inflammation. Other symptoms included retrograde amnesia, parasthesia, tinnitus, and a single episode of seizure which resolved spontaneously. All our patients survived the ordeal and were discharged well back to their premorbid states.ConclusionThis paper supports existing evidence that lightning-caused accidents are not always fatal and that victims may survive with no or little side effects given proper medical treatment.
(A275) Experimental Crowd Packing Analysis in Mass Gathering
Authors: Wang S.J. , Choi H.Y. 
Published: May 2011

IntroductionMedical assistance for mass gathering can be classified based on the characteristics of mass gathering into primary or emergency health care for individual patient vs. medical assistance for public in case of disastrous mass gathering. It is necessary to prepare primary and emergency health care in case of routine mass gathering, but when an accident or event occurs, different medical approach will be necessary. One of the representative types of accident or event is crowd packing which can make high pressure among mass gathering participants usually from crowd rush or surge. This study was performed for identifying the characteristics of crowd packing in mass gathering.MethodsThe literature survey was performed on mass gathering and crowd packing. Human model simulation was done as a pilot study and 2-dimensional pedestrian pressure experiment was performed with volunteer students and pressure sensing device by video recording and analysis. Lateral shoulder loading and frontal chest loading were analyzed per load cell and per packed condition.ResultsAs pushing pressure increased, the body was rotated to 90 degree after some threshold pressure point. The maximal and average pressures among volunteers were extracted. Pedestrian injury criteria(PIC) curve was generated.ConclusionsWhen crowd packing occurs, the body will be rotated about 90 degree after some threshold pressure point. And then interpersonal pressure will be increased to crush injury as crowd packing proceed. For defining the interpersonal pressure to mortality and critical injury, further research will be needed reflecting real human physiology and anatomy.
(A283) Hospital Security Planning for Patient Surge Incidents: A Comparison of Three National Systems in China, India, and Japan
Authors: Downey E. , Hebert, Chpa A. , Kim D. 
Published: May 2011

IntroductionAs the number of disasters caused by natural and non-natural hazards increase, so does the emphasis placed on healthcare security planning for the influx of patients that often accompany such events. This presentation expands on a previously published examination of national healthcare security systems and emphasizes the role of security in the hospital environment during disasters in China, India, and Japan. National emergency preparedness planning systems and disaster type are examined. Elements of planning for a mass-casualty incident (MCI) that most directly impact security planning include mass-notification alert systems, patient routing processes to hospitals (from an MCI scene) and within hospitals (emergency department flow), staffing, disaster triage, patient identification, tracking and discharge, volunteer tracking, and the adaptability and flexibility of space and processes.MethodsResearchers conducted extensive literature reviews of country-specific health care and physical security elements of patient surge. The comparative analysis was augmented by communication with national healthcare security experts.ConclusionsPositive associations exist between increased disasters and the level of priority and funding given to healthcare security measures in disaster planning. National characteristics of governance, landmass, disaster history, and population influenced the development of healthcare security systems and planning for patient surge incidents. Planning for the mental health impact of terrorism victims, and its subsequent impact to patient surge into hospitals was more relevant in the literature for both India and Japan.
(A285) Hospital Preparation for Mass Casualty Events
Authors: Margalit G. 
Published: May 2011

BackgroundHospitals handle numerous tasks whose fundamental purpose is to provide medical treatment. Amongst these, the hospital prepares for the treatment of trauma patients who have been involved in car accidents, injuries at work and industrial accidents. These preparations, although part of the operative conventions of the hospital, do not guarantee the ability to handle Mass Casualty Events which require unique and dedicated preparation and a different operational approach. This paper presents the hospital approach of handling Emergency Mass Casualty Events.The ApproachThe preparations require involvement of a national level that must participate in the definition of the activities, task assignment and preparation of an annual plan. The peak of the preparations is a multidisciplinary drill, implemented as part of the annual activity of the hospital.The ImplementationIn an emergency situation, the aim is for the hospital staff to be capable of providing its patients (and family members) the best professional care in any given scenario. To achieve the above, the hospital is required to perform the following tasks: Defining procedures, personnel training, logistics infrastructure, control, drills and lesson learned implementation. The tasks should be performed under a multi-annual plan that covers various Mass Casualties Events scenarios including: a train accident, an event involving dangerous industrial materials (e.g. ammonia spill), biological scenarios (e.g. bird-flu) and radiation events (e.g. nuclear reaction).ConclusionsOnly precise preparations, disconnected completely from the on-going hospital routine can answer the need to handle Mass Casualties Events.
(A307) Disaster Task Force's Management Support at Emergency Response Phase in the Merapi Eruption November 2010
Authors: Wartatmo H. 
Published: May 2011

BackgroundMerapi, the most active volcano in the world, erupted on the 26th October 2010 at 17.02, and followed by several eruptions. The biggest eruption was on the 5th of November 2010. Damages were catastrophic: 386 people killed, and more than $400 million lost. A wide area of fertile lands and settlements were destroyed which resulted in more than 200.000 refugees. This disaster had impact to 2 provinces and 6 districts. At the emergency phase, a special task force was established by central government of Indonesia. This paper aims to evaluate the task force and the role of its management support during the acute phase in the disaster.Methodan input and process evaluation of task force work was implemented.ResultsThe input evaluation shows that the task force members for emergency response came from central, provincial, district government employees, universities and non government organisation members. The financial sources are from public and private funding. The activities process of task force in forms of health response command system, temporary information system, communication and telecommunication system, supporting the volunteer groups, managing the refugees camps, implementing surveillance system, and backed up the local district health officers. There were problems of programs coordination and channelling the budget from national treasury due to the multiple eruptions. Most of these problems were solved by a management support team for the task force.ConclusionThe multiple strikes of Merapi eruption needs better human resources management and financial support. During Merapi eruption, it is proved that a management support for emergency response task force is important. This management support allowed better control and coordination of available resources.
(A310) Academic Training for Paramedics - A Unique University Based Model
Authors: Schwartz D. , Aronson L. , Adini B. , Nesher L. 
Published: May 2011

IntroductionThe paramedic profession is relatively new, dating to the 1970's. In Israel, it was introduced in 1980 and paralleled the introduction of advanced life support units (ALS) to Israel's national emergency medical services (EMS), Magen David Adom (MDA).The curriculum and assigned roles were adopted with minor changes from Anglo-American systems. Initially, paramedics were assigned alongside physicians, but in recent years a growing percentage of units operate without an on-board physician. Despite the increasing complexity of required tasks and the move toward paramedic-led crews, paramedic training has changed little. Most are trained through a non-academic, certificate granting tracts. In 1998, a fully academic bachelor's degree program was launched at the Ben-Gurion University (BGU).MethodsThe programs aims, curriculum, and experience are described, based on past and current curriculum and on interviews with past and current staff and students.ResultsThe BGU program is a three year program that grants its graduates both a University BA and professional paramedic certification. The program is housed as a university department within the Faculty of Health Sciences. First year courses center on basic sciences. The second year centers on classroom and simulation-based learning of the clinical topics. The third is devoted mostly to clinical clerkships, in hospital wards in the first semester and on MDA ALS units in the second. To date, the program boasts more than 300 graduates, many attaining higher academic degrees in healthcare sciences and many who work in Israel's national EMS.DiscussionThe BGU academic paramedic training program is the only such program in Israel and one of a few worldwide. Questions regarding the increasing responsibility and task complexity require a move from certificate training to University degree granting learning and the possible contribution of such
(A315) Improvement of the Prehospital Healthcare System in Iran
Authors: Khankeh H.R. , Jallali A.R. , Masoomi G.R. 
Published: May 2011

BackgroundThe prehospital time delay in acute health problem still is a problem in most low- and middle-income countries, like Iran. It often is possible to minimize adverse consequences by promptly providing effective prehospital servicesAimThis study was designed to compare the response time interval occurring during the prehospital care process in Tehran during the last decade.MethodsA retrospective, comparative study was designed, and the mean response time intervals in relation to prehospital care were identified from September 1999 until September 2000 were compared with data from September 2009 until September 2010. Data were collected from Tehran emergency medical services (EMS) center registries.ResultsThe EMS center of Tehran dispatched 213 ambulances every day in 1999–2000 compared with 1,200 in 2009–2010. During the 2009–2010 period, the mean response time for city locations was 14.18(+ /−4) minutes, compared with 1999–2000 the mean response time for city location was 16(+ /− 8). The mean response time from the time period of 1999–2000 also was longer than for 2009–2010 (14.18 vs. 16.58 minutes).ConclusionsDespite the prominent increase in the number of ambulance dispatching everyday, the mean response time in Tehran decreased during last decade. This improvement can be due to the improvement of the prehospital system in Tehran, including the number of: ambulances, trained staff, EMS stations, etc. However, it still is far from a national standard (eight minutes for city).