bluuebunny/crossref_metadata_2025_split huggingface dataset:
(P1-92) Safety Function Action: Current and Future Directions
Authors: Allen A. , Shultz J.M. 
Published: May 2011

IntroductionSAFETY FUNCTION ACTION for Disaster Responders (SFA) trains a framework for achieving and maintaining a high level of disaster health. Within SFA, disaster health is defined as, “maximal safety, optimal function, and effective action in preparedness for, and response to, emergencies, disasters, and extreme events.” A set of six strategies forms the backbone of the framework with two strategies each for SAFETY (safeguard and sustain), FUNCTION (comfort and connect), and ACTION (advise and activate).MethodsDuring 2008, a total of 2,553 participants were trained throughout the State of Florida. Participants were drawn from public health, healthcare, mental health, and professional/volunteer emergency responder workforces. During 2009, an additional 861 participants were trained as “SFA facilitators.” Facilitators were provided with guidance and training materials to return to their worksites and train peers on the SFA modules. Facilitators were in direct contact with a team of 5 DEEP Center “coaches” who supported their training efforts. To assess the training's effectiveness, pre/post-assessment data on the 2,533 SFA participants and 861 SFA facilitators were collected.ResultsLive-training evaluation data showed highly favorable quality ratings for the course, materials, presenters, and all individual course components. Pre/post comparisons of the data indicated consistent gains in self-reported confidence ratings for all 7 “facilitator skills” (recruiting, motivating, training colleagues; teaching SFA skills, working with coaches) and 15 SFA “strategies and response skills” (applying the six SFA strategies to responders (self, family, team) and disaster survivors). Consistent gains were evident for 12 scales asking facilitators to self-report their comfort in dealing with disaster survivors exhibiting distress or suffering trauma and loss.Future DirectionsSFA has been launched as an online training course and a cell phone “app” is in progress. SFA has recently been trained in South America and Europe. Experiential components of SFA are being refined and expanded.
(P1-100) Monitoring the Mental Well-Being of B-Fast Caregivers during Disaster Relief after the 2010 Haïti – Earthquake
Authors: Van Der Auwera M. , Debacker M. , Danschutter D. , Gijs G. , Hubloue I. 
Published: May 2011

IntroductionDuring disaster relief, personnel's safety is very important. Mental well-being is a part of this safety issue. There is however a lack of objective mental well being monitoring tools, usable on scene, during disaster relief. This study covers the use of validated tools towards detection of psychological distress and monitoring of mental well being of disaster relief workers, during the Belgian First Aid and Support Team deployment after the Haiti earthquake in 2010.MethodologyThe study was conducted using a demographic questionnaire combined with validated measuring instruments: Belbin Team Role, Compassion Fatigue and Satisfaction Self-Test for Helpers, DMAT PsySTART, K6 + Self Report. A baseline measurement was performed before departure on mission, and measurements were repeated at day 1 and day 7 of the mission, at the end of mission, and 7 days, 30 days and 90 days post mission.ConclusionsThe study proved the ability to monitor mental well being and detect psychological distress, by self administered validated tools, during a real disaster relief mission. For practical reasons however some tools should be adapted to the specific use in the field. This study opens a whole new research area within the mental well-being and monitoring field.
(P1-102) Developing Methodologies to Assess Resource Needs and Ability to Provide Interventions and Care for Children in Disasters, Terrorism and Public Health Emergencies
Authors: Markenson D. , Reilly M. 
Published: May 2011

IntroductionIn emergency preparedness there is the need to prospectively develop an approach to which interventions can be provided with available resources and the maximal amount of clinical effectiveness which can be attained by staff.MethodsA panel of pediatric emergency preparedness experts employed our previously validated evidence based consensus process with a modified Delphi process for topic selection and approval. Interventions were chosen such that resources and staff efficiency would not exceed previously published data for non-disaster emergency care but allowing for standard emergency preparedness planning alterations in standards of care such as the assumption that usual numbers of staff would care for a disaster surge of four times the usual number of patients.ResultsUsing standard emergency preparedness assumptions of limited resources and staff efficiency, the panel agreed upon both methodologies for resource allocation and feasible interventions. A number of standard interventions would not be feasible and included detailed recording of vital signs, administration of vasoactive agents, prolonged resuscitation and central venous access.ConclusionBy employing this approach to resource utilization described combined with the unique aspects of pediatric care, we can improve our planning and responses. This can be accomplished by understanding the needs of the population being served, learning how to focus on both pediatric needs and the expectations of the community with regard to care of children, adopting what has been learned in prior events in the United States and abroad, and developing prospective recommendations regarding essential interventions which can be performed in a disaster.
(P1-110) Key Elements of Successful Disaster Health Management Policy
Authors: Du W. , Fitzgerald G. , Clark M. , Hou X. 
Published: May 2011

IntroductionDisaster health management policies are being developed and implemented by various government and non-governmental organizations. However, there has been a lack of studies to comprehensively identify the key elements in the successful disaster health management policies.MethodsA survey of experts was used to identify key elements of successful disaster health management policy arrangements. This research conducted 10 face-to-face interviews, together with 22 e-mail surveys to identify the key elements. The experts were selected based on the person's background and expertise in disaster health management and policy analysis.ResultsKey elements of disaster health management policies were identified and introduced in four parts, including the characteristics of conceptual policy framework of disaster health management (risk assessment and recognition, strategic view, resilience community, inclusive and accountable, good structure with clear authority, fault tolerant, good communication, rigidity and flexibility, education and training, mutual understanding, effective funding), elements of policy development (adequate leadership, extensive consultation, clear goals and terms, easy to access and implement, locally owned and accepted, standard and flexibility, linkage with other policies, keep updated, involve all the stakeholders, regular drills as part of the policy), elements of policy implementation (well defined structure and agencies, professional disaster management body, delegate the power and coordination, maintain interests and involvement, communication, recognition of disaster risks, policy familiarity, full participation of health elements, financial support, specific measurement), and elements of policy effectiveness evaluation (advisory committee, evaluate true disasters, evaluate policies in exercises and drills, test people's knowledge, evidence of stakeholders contributing, practice and procedural change, evaluate operating procedural, scientific evidence).ConclusionsKey elements must be considered in developing, implementing, and evaluating of disaster health management policies to ensure the success of these policies.
(P2-1) Large Civilian Jets Configured for Aeromedical Use: Implications for Disaster Health
Authors: Curnin S. 
Published: May 2011

BackgroundAustralia is a vast and isolated country and often the only viable option of transporting multiple casualties is using fixed wing aircraft. A number of civilian aeromedical services and the military are responsible for the evacuation of casualties, both nationally and internationally. Due to Australia's increased operational commitments, the military can no longer be expected to provide a rapid aeromedical deployment. This situation, coupled with the limited surge capacity of Australia's civilian fixed wing aeromedical services, highlights the need for Australia to improve preparation and readiness for a large scale civilian aeromedical response.Discussion and ObservationsHistorically, the use of large jets configured for aeromedical use has been exclusively the domain of the military. Yet in recent years the use of large civilian jets configured for aeromedical capability has been suggested as a solution. The purpose of this paper is to explore the role of large civilian jets configured for aeromedical use in the event of a disaster with multiple casualties. This study involved an extensive literature review and an international study tour of aeromedical services that are at the forefront of using large jets in aeromedical evacuation. The findings identified that standard civilian jets can easily be reconfigured for transporting multiple casualties. It is argued that this strategy can be an inexpensive and effective option and should be included in emergency preparedness arrangements. The aim of this paper is to prompt disaster health agencies in Australia to consider the use of a civilian jet system that can be used for a disaster requiring a large scale aeromedical response.
(P2-7) Patient Distribution during a Mass-Casualty Incident: The 25 February 2009 Turkish Airlines Crash in Amsterdam
Authors: Postma I.L.E. , Weel H. , Heetveld M. , Bloemers F. , Bijlsma T. , Goslings J.C. 
Published: May 2011

BackgroundDifficulties have been reported in patient distribution during mass-casualty incidents (MCIs). In this retrospective, descriptive study, the regional Patient Distribution Protocol (PDP) and the management of the patient distribution after the Turkish Airlines airplane crash on 25 February 2009 near Schiphol Airport in Amsterdam were analyzed.MethodsAnalysis of the of PDP involving the 126 surviving victims of the crash, by collecting data on Medical Treatment Capacity (MTC), number of patients received per hospital, triage classification, Injury Severity Scale (ISS) score, secondary transfers, distance from the crash site, and critical mortality rate.ResultsThe PDP holds two inconsistent definitions of MTC. The PDP was not followed. Four hospitals received 133–213% of their MTC, and five hospitals received one patient. There were 14 receiving hospitals (distance from crash: 5.8–53.5 km); thre hospitals within 20 km of the crash did not receive any patients. Major trauma centers received 89% of the “critical” casualties and 92% of the casualties with ISS score ≥ 16. They also received 10% of “minor” casualties and 29% of casualties with ISS score < 8. Only three patients were secondarily transferred, and no casualties died in, or on the way to, the hospital (critical mortality rate = 0%).ConclusionsPatient distribution was effective, as secondary transfers were low, and the critical mortality rate was zero. The regional PDP could not be followed during this MCI. Uneven casualty distribution was seen in the hospitals. The regional PDP is inconsistent, and should be updated in a new cooperation between Emergency Services, surrounding hospitals and vSchiphol Airport, a high risk area, for which area-specific PDPs must be designed.
(P2-35) Loose Livestock in Disaster and Emergency Situations, Risks to the Public and Emergency Responders
Authors: Herthel W.F. , Madigan J. , Graham T.W. 
Published: May 2011

IntroductionThe general public's association with livestock (cattle, sheep and horses) raises a need for public safety. During emergency/disasters, animals are accidentally/intentionally released from containment structures. Loose livestock become agitated with unpredictable behavior which is a risk to both humans and animals. Specific training/protocols for responders are necessary for dealing with livestock.ProblemLivestock running loose in populated areas raises risks to people, especially during capture attempts. Untrained personnel subject themselves to undue danger when assisting with livestock capture. Capture plans should be in place in advance and training should be provided to first responders on safety issues regarding animals.MethodsA review of a loose livestock event brought forth the following considerations: (1) Evaluate the risks of a loose livestock/public event; (2) Inspect containment facility and identify secondary containment barriers, including fencing, buildings, rivers, etc.; (3) Develop plan for capture and containment within the immediate facility and surrounding area; (4) Provide training: training exercises, animal capture, basic animal behavior, and Incident Command System for first responders; (5) Arrange for emergency care or humane euthanasia for injured animals; (6) Coordinate capture and transport activities with local livestock experts.ResultsProduction of a comprehensive loose livestock plan can prevent injury and/or death to both people/animals. Agencies involved in safety and emergency response should have a well written plan that can be used by all appropriate local agencies involved in loose livestock response. The utilization of a loose livestock worksheet (template) with professional training is essential for emergency response agencies.ConclusionDisaster managers should develop a comprehensive plan and training program with other local agencies in advance of an event to respond effectively to capture loose livestock.
(P2-39) Public Health Safety for Traditional Mass Gatherings in India: A 10-Year Analysis
Authors: Sanyal S. , Madan A. 
Published: May 2011

IntroductionIn the past decade, India has witnessed many lapses in crowd safety during mass gatherings. The high casualty rate in stampedes during traditional mass gatherings has prompted the study of these events. Wide variations exist in casualty rates for similar events, and key issues in healthcare services in these special situations were addressed in the Indian context.MethodsFrom 2001–2010, Mass gathering data were collected from news items reported in the archives of newspapers, “The Times of India”, “The Hindu” and “The Indian Express”. The keywords used were: “stampede”, “mass gathering”, “mass-gathering events”, “mass-gathering incidents”, “crowd”, and “crowd management”. The study included triggers for the incident and the number of casualties (dead and injured) in each incident.ResultsIn 27 separate mass gatherings in India, there were 936 dead and 540 injured casualties. The unique characteristics of mass gatherings in India included a predominance of old and vulnerable people in traditional mass gatherings, in contrast to the young and middle-aged groups who gather for music and sporting events elsewhere. Further, alcohol/substance abuse, brawls, and violent behavior were absent at traditional Indian mass gatherings. Non-traditional mass gatherings accounted for a lesser number of incidents in India, and were located in movie theatres and railway stations.ConclusionsIn a populous country like India, traditional mass gatherings predominate, and ensuring the health, safety, and security of the public at such events will require an understanding of crowd behavior, critical crowd densities, and crowd capacities in the Indian context. However, planning for mass gatherings can be developed using the existing body of knowledge of mass-casualty preparedness, food safety, and health promotion.
(P2-41) Emergency Medical Response Systems in a University Athletic Program: A Descriptive Analysis
Authors: Wendell J.C. , Bitner M.D. , Ossmann E.W. , Greenwald I.B. 
Published: May 2011

IntroductionUnpredictable environmental conditions, crowd dynamics, and a variety of medical emergencies create logistical and clinical obstacles when planning emergency medical response coverage for mass-gathering events. In a collaborative endeavor between a university athletics program and an academic division of Emergency Medicine, a stadium emergency medical response system was created consisting of hospital-based healthcare providers and pre-hospital healthcare providers.ObjectivesProvide descriptive statistics relevant to the nature and frequency of injury/illness, location of treatment within stadium confines, and resources used in the care of students, event staff, and spectators during collegiate football operations, to assist in future planning of mass-gathering events.MethodsA continuously updated, quality assurance database of de-identified, aggregate statistics was utilized to analyze trends regarding aspects of medical operations.ResultsDuring a 7-game home football season, there were a total of 399 patients encounters, including 1 cardiac arrest (0.25%), 12 “life-threatening” (3.01%), 121 urgent (30.33%), and 266 routine (66.67%). Total season attendance was 201,248 attendees (28,749/game and 19.83 patients encounters per 10,000 in attendance). Twenty-eight patients were transported (1.39 per 10,000), with eight resultant hospital admissions. Encounters varied by complaint, with skin (42%) comprising the largest number of encounters. Other categories included: (1) heat-related (23.5%); (2) allergic (15%); (3) neurologic (10.3%); (4) cardiopulmonary (3.5%); (5) gastrointestinal (3.6%); (6) musculoskeletal (5%); and (7) other (5%). Encounters increased noticeably when the heat index was greater than 80 °F– (29.4 vs. 10.5 per 10,000 attendees).ConclusionsThe collaborative effort by a multi-level provider model adequately covered presenting medical conditions. Consistent with previously literature, a strong correlation existed between heat index and number of patient encounters deemed urgent and routine. Interestingly, the number of “life-threatening” encounters did not appear to vary much with the heat index. Further studies of medical presentations and provider/resource utilization could provide for predictive modeling of future staffing and supply models.
(P2-49) Longitudinal Study of Health Conditions After the Sichuan Earthquake in China - The First and Second Year's Results
Authors: Yamamoto A. , Hu X.Y. , Cheng Y. , Li J. , Luo Y. 
Published: May 2011

ObjectiveThe objective of this study was to identify the daily lives and health conditions of survivors of the Sichuan Earthquake after two years.MethodsThe study was conducted for the survivors ≥ 18 years of age who experienced the earthquake. The questionnaire included the survivors' socio-demographics, impact of the disaster, and their health status after the disaster.ResultsApproximately 65% of respondents said that their conditions were healthy in the second year after the earthquake. The changes of daily lives among the survivors were increased from 1st year to 2nd year, as follows: diet (1st year; 24.5%–2nd year; 14.1%), sleep (29.4%–23.6%), entertainments (9.6%–15.1%). As health conditions, the following symptoms were increased; diabetes (2.8%–3.5%), cardiac disease (2.9%–5.0%), functional disturbances of body's joints and muscles (18%–21%). In contrast, the following symptoms were decreased; obesity/skinny (5%–3.5%), kidney disease (4.4%–1.6%), asthma and allergy (7.2%–5.6%). The current health conditions of the survivors included: headache, eyestrain, hand, foot, and/or joint's ache, sleep disorder. With regard to the psychological condition, the mean value of IES-R score was 22.2 ± 11.8. Compared with the 1st year results, the mean value IES-R score significantly decreased (1st year; 30.8 ± 16.8, p < 0.001, by paired t-test).ConclusionsThe survivors' physical and psychological conditions have improved compared to 1st year results. However most of the survivors still had some health problems in their health.
(P2-63) An Evaluation of 57 Tick Bite Cases
Authors: Ortatatli M. , Gumral R. , Uckardes H. , Eroglu M. , Kenar L. , Eyi Y.E. , Arziman I. , Durusu M. 
Published: May 2011

Crimean-Congo Hemorrhagic Fever (CCHF) is a fatal zoonotic viral infection. The agent belongs to the Nairovirus of the Bunyaviridae species. The virus naturally recycles in vector-vertebrate-vector. This study aimed to evaluate cases of tick bites admitted to Infectious Diseases and Emergency Departments in 2008, and to develop management recommendations of such cases. Fifty-seven patients who admitted to a hospital due to tick bites in 2008 were included in the study. A 10-day clinical follow-up was performed to assess for symptoms including fever, fatigue, abdominal pain, headache, nausea/vomiting, diarrhea, disseminated somatic pain, and other hemorrhagic signs. During this period, laboratory analyzes, including white blood cells, thrombocytes, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, lactate dehydrogenase, creatinine phosphokinase (CK), and pentylenetetrazol were performed. Personal data of the patients, location of the bite, and the removal of the tick were recorded.ResultsOf the 57 patients, 37% were from the city, and 63% were from rural areas. The tick was removed by health staff in 25 (44%) of the cases. The bites occurred on body areas including the head/neck, trunk, upper extremities, and lower extremities in 14%, 24%, 27%, and 13% of the cases, respectively. During the follow-up period, none of the patients exhibited any of the signs or symptoms listed above. Laboratory tests did not reveal any abnormalities, except for high levels of CK in 15 patients. Thus, 57 cases did not develop CCHF.Discussion and ConclusionSince 2002, CCHF has caused an increased mortality in Turkey, and has resulted in high anxiety and concern among the Turkish public regarding tick bites. This has resulted in a rise in the number of patients admitting to emergency departments with tick bites. Due to CCHF's incubation period, patients with tick bites should be evaluated for 10 days using a multidisciplinary approach involving both clinical and laboratory evaluations in order to prevent the unnecessary administration of ribavirine.
(P2-73) Ocular Nerve Sheath Diameter for Evaluation of Raised Intracranial Pressure in Patients Presenting to the Emergency Department - A Prospective, Observational Study
Authors: Sinha T.P. , Bhoi S. , Rodha M. , Bhasin A. , Kumar S. 
Published: May 2011

BackgroundUltrasonography of optic nerve sheath diameter (ONSD) may be useful in detecting raised intracranial pressure (ICP) in head injury (HI). There is limited data from India.ObjectiveThe objective of this study was to evaluate the utility of measuring ONSD for diagnosis of raised intracranial pressure in HI victims in the emergency department.MethodsFifty-two HI patients presenting between February to August 2009 were included, A CT head scan was performed and simultaneous ocular ultrasound was done by an emergency physician who had underwent goal-directed training in ophthalmic sonography by a linear probe of 10 MHz. An ONSD greater than > 5 mm for patients > 15 years of age, 4.5 mm for 1–15 years of age, and 4 mm for infants were considered abnormal. The two modalities of diagnosis were compared.ResultsThe median age was 30 years (Range = 0.25–72 years). A total of 90.4% were male and 9.6% were female. A total of 71.2% had severe HI, 19.2% had moderate HI, and 9.6% had mild HI. A raised ICP based on CT findings was present in 42 (80.8%) patients. Mean optic nerve diameter in patients with raised ICP was 5.11 + 1.56 mm compared to 5.04 + 1.6 mm in patients with no features of raised ICP. Sensitivity and specificity of ONSD as a screening test for detection of raised intracranial pressure were 57.1% and 40%, respectively with a positive predictive value and negative predictive value of 80% and 18.1%, respectively.ConclusionsThe evaluation of the ONSD diameter is a simple and non-invasive potential tool in initial assessment of raised intracranial pressure.