bluuebunny/crossref_metadata_2025_split huggingface dataset:
(P1-31) The Determinants of Competency for Emergency Medical Technician-II in Taiwan
Authors: Jhang Y. , Luu S. , Yang Y. 
Published: May 2011

BackgroundThe formal training for Emergency Medical Technician (EMT) in Taiwan was legislated by Emergency Medical Care Services Act in 1995. Very little research discusses the competency of EMTs. The purpose of this study was to assess the determinants of competency for the EMT-II in Taiwan.MethodIn June 2005, a cross-sectional survey was targeted on firefighters with EMT-II certificate and having a minimum work experience of three months in central Taiwan. Kirkpatrick's (1994) four-level model guided the development of conceptual framework and questionnaire. Structural Equation Modeling (SEM) was adopted for the analysis.ResultsOne thousand and seventy-three EMT-IIs were included in the study. Majority of them were male (99.4%) with an average age of 34.46 years old. Among them, 96.5% were careered EMTs with 130.33 months of field experiences. The competency of EMT-II was measured by 4 indicators of error reduction, quality improvement, achievement orientation, and efficiency improvement. The construct of ‘Capability Enhancement’ dominated EMT-IIs' ‘Competency’, followed by ‘Length of Time for Field experience’, ‘Instructor Expertise’, ‘TA Expertise’, and ‘Willingness to Learn’. Both ‘Age’ and ‘Total Course Time’ had a negative effect on ‘Competency’. ‘Capability Enhancement’ was mainly influenced by ‘Practice Absorption’ and ‘Theory Absorption’, followed by “Willingness to Learn”, ‘Instructor Expertise’, ‘Total Course Time’, ‘TA Expertise’, ‘Self Confidence’ and ‘Practicum Time in Ambulance Station’. However, the construct of ‘Teaching Technique” imposed a negative effect on ‘Capability Enhancement’.ConclusionThe SEM model explains 75.7% of the variances in competency for EMT-IIs. The ‘Competency’ is dominated by ‘Capability Enhancement’. Improving the quality of course, instead of time, and recruiting younger EMT-IIs may advance the competency. Modification of ‘Teaching Technique’ may enhance the capability of EMT-IIs.
(P1-34) Chinese Undergraduate Nursing Student's Attitude and Understanding of Disaster
Authors: Yin H. , Wang L. , Lu H. , Yu X. , Arbon P. , Zhu J. 
Published: May 2011

ObjectiveTo identify attitudes and understanding of Chinese undergraduate nursing students towards disaster, therefore providing information for the development of a disaster nursing curriculum in the Chinese context.MethodsA total 214 undergraduate nursing students (Year 1 to 4) in one medical university in China were surveyed in 2010.ResultsThe majority of undergraduate nursing students (94.9%) were concerned about disaster, 46.7% of them thought they were very knowledgeable about disaster, while 39.3% of them stated they were moderately knowledgeable about disaster. The most popular way for the students to get information about disaster was television (88.3%), followed by internet (67.8%) and newspaper (45.8%). Only 33.6% of them said they gained information from the university. Earthquake (93.7% of students) and flood (36.1% of students) were mentioned by the students as examples of disasters that have occurred in China. The majority of students said the Wenchuan earthquake (2008) was the disaster that had the greatest impression on them. Five aspects were identified from their description of disaster, which included the cause, category, characteristic, impact and type of disaster. 36.4% of students were certain that disaster would happen again in China. A further 50.9% felt disaster was likely. Flood and earthquake were considered the most likely future disasters. 71% of nursing students strongly agreed that being prepared for disaster was important. The main reasons were better preparedness could decrease the damage to property and the incidence of death and injury. However, the level of understanding of the effects of disaster and the exposure of students to education about disaster health response was limited.ConclusionKnowledge and skills for disaster preparedness of nursing students should be strengthened in the medical university.
(P1-41) Utilization of a Cadaveric Model in Pericardiocentesis Training
Authors: Inboriboon P.C. , Lumlertgul S. 
Published: May 2011

BackgroundPericardiocentesis is rare but life saving procedure that all emergency physicians should be competent in performing. Improper technique can place patients at significant risk for iatrogenic injury. Proper training is needed to familiarize physicians with proper pericardiocentesis technique.Training ModelIn order to facilitate training of this relatively rare procedure, a cadaveric pericardiocentesis model was developed. Described is a step by step procedure for creating a cadaveric model that can be used to train and evaluate providers in pericardiocentesis competency.UtilizationThis unique teaching innovation can be utilized in a variety of settings to train providers, including those in resource limited environments. It has already been utilized in the training of emergency medicine residents in Thailand and in the United States.
(P1-44) Health Emergency and Disaster Management Training for Health Professionals
Authors: Godamunne A.U.K. , Fernando D.M.G. , Tennakoon S.U.B. 
Published: May 2011

BackgroundSri Lanka has learned, with contributions from a 30-year war and a tsunami, that disasters happen when and where least expected. Thus the Health Emergency and Disaster Management Training Centre (HEDMaTC) of the Faculty of Medicine, University of Peradeniya was established to prepare Sri Lankan healthcare workers for all forms of health disasters.DescriptionHEDMaTC conducts training programmes for health professionals, including medical doctors, nurses, emergency technical officers, ambulance drivers and porters. As these are adult training programmes practical methods of training such as drills, workstations, group work and hands on training have been used, in addition to lectures. Emergency care equipment, specific kits and techniques and desktop exercises are used to demonstrate protocols of emergency management and discuss principles of risk management, disaster management concepts, conceptual and technical challenges in measuring disasters and their impact on public health and its effective management. Participants prepare action plans for their individual institution based on the knowledge gained and are discussed in follow up programmes a month later.OutcomeHEDMaTC is the only institution in Sri Lanka that is accredited by the Ministry of Health, Sri Lanka to train their staff in disaster management. HEDMaTC has trained 200 personnel in Public Health Emergency and Disaster Management, 117 in Sexual and Reproductive Health Services in Crises and 1034 in pre-hospital emergency care. The trained personnel were mobilized to the North and East of the country to handle healthcare issues, ranging from administration to ground work, of almost 300,000 displaced civilians in 2009 with a very satisfactory outcome.RecommendationsThe training methods used in these programmes are especially beneficial in adult training and it is to be recommended. We also recommend that HEDMaTC to be developed as a regional training center for South Asia.
(P1-53) Effectiveness of “Understanding Disasters” Training Among Health Care Professionals and Responders in China
Authors: Lin C.L.Y. , Hung K. , Chan E.Y.Y. , Lee P.P.Y. 
Published: May 2011

BackgroundKnowledge about disasters plays an essential role in managing and responding to disasters and emergencies, especially among a group of health care professionals who are actively or will potentially be involved in disaster and emergency settings. A set of training materials that aims to enhance understanding of disasters and their impact of health has been developed. This project aims to examine the effectiveness of the disaster knowledge training to improve technical knowledge and perceptions of health impact of disasters in health care professionals and responders.Methods“Understanding Disasters” training was provided to 300 health care professionals during May to October. Each of the participated attendees filled a pre- and immediate post-training survey that contains socio-demographic information and 20 items measuring various knowledge of disasters.Results287 individuals completed the questionnaires (95% response rate). Findings demonstrated that training may effectively enhance one's knowledge about disasters, especially by clarifying the myths and misunderstandings towards disasters. Respondents demonstrated an enhancement of knowledge in 70% of the questions (14/20). Of note, while the whole sample exhibited an enhancement in knowledge, non-clinical staff appeared to have more statistical significant gained in knowledge than clinical based trainee.ImplicationAlthough disasters cannot be controlled, human impacts of disaster can be mitigated if appropriate training might be offer. This study demonstrates that training program might be useful to enhance better understanding of health impact of disasters.
(P1-57) Develop New Mechanism of Capacity Building of Disaster Preparedness in China
Authors: Zhang W. , Huang B. , Miao S. , Yao J. , Zhang B. , Li Q. 
Published: May 2011

BackgroundChina is one of the countries most affected by natural disasters, it is an important restricting factor for economic and social development. However, Disaster Medicine training is not included in medical education curriculum in China, continual training is separated among public health professionals and clinical personals.MethodsWHO provides technical and financial support for public health emergency preparedness through intensive training and workshop. We intended to develop a new working mechanism under the support of WHO and MOH, China for capacity building of disaster preparedness in China with the combination of public health professionals and clinical personals though TOT training.ResultsThrough the new mechanism, public health professionals from CDC system and clinical personals from hospitals could benefice mutually fro each side and strengthen the effectiveness for the disaster preparedness.ConclusionThe new mechanism increases the effectiveness of capacity building for disaster preparedness, TOT training should transit from national level to local level.
(P1-58) Frailty, Dementia and Disaster: An E-Learning Initiative for Health Care Providers
Authors: Maltais D. , Gibson M. , Hardy L. , Ruthe S. , Balazs M. 
Published: May 2011

Frailty, Dementia and Disaster: an e-learning initiative for Health care providers D. Maltais1, M. Gibson2, L. Hardy3, S. Ruthe4, 1University of Quebec, Chicoutimi 2St. Joseph's Health Care London, London 3Health and Social Services, Yukon Territory Government, Whitehorse 4Emergency Program, Corporation of the District of Oak Bay, Victoria, Canada.This poster describes the development, piloting, evaluation, and dissemination of the e-learning tool: “Frailty, Dementia and Disasters: What Health Care Providers Need to Know”. The purpose of the e-learning tool is to contribute to international efforts to reduce the disproportionate vulnerability of older adults in emergencies and disasters. Key literature on geriatric emergency preparedness and response issues, including the roles and responsibilities of health care providers, was identified and synthesized. Content was piloted in a facilitated workshop in Ontario. A Canada-wide health provider reference group provided feedback on the transition from a traditional powerpoint presentation to an e-learning format. The evaluation process included facilitated review of the tool by health care providers in two in-person workshops in each of Yukon and Quebec and in an independent review by health care providers in British Columbia (virtual). The learning objectives of the e-learning resource are to help health care providers, administrators and policy makers understand the: · disproportionate vulnerability of older adults who are frail and those who have dementia, in emergencies and disasters; · components of the emergency management cycle and how they apply to this target population; · best practice resources that can be used to improve emergency preparedness, response, recovery and mitigation; and · role of health care organizations and providers in emergency management for these older adults. The e-Learning tool is hosted with open access on www.dementiaknowledgebroker.ca (DKB), a platform facilitated by the CDRAKE - the knowledge exchange theme of the Canadian Dementia Knowledge TranslationNetwork (CDKTN).
(P1-69) Joint Military and NGO Vaccination Campaign in Remote Areas in Haiti
Authors: Paladino L. , Lucchesi M. 
Published: May 2011

IntroductionThe January 12 2010 7.0-magnitude earthquake's epicenter hit just 10 miles west of Porte-au-Prince and its 2 million inhabitants at 4:53 pm.ProblemAlthough assistance arrived to major ports and cities from all corners of the globe, access from rural and remote areas to centralized hospitals remained difficult. Many of the injured were without access to transportation even a month after the earthquake. Earthquake victims in remote areas have less access to wound care and running water, and therefore more pone to infection and tetanus.ResponseOur group was comprised of a civilian mobile medical team able to negotiate difficult terrain by foot with vehicle support provided by the 82nd Airborne military. The military support supplied vehicles and experience needed to tackle the difficult terrain. Because the vaccines are temperature sensitive, delivery of them to remote areas with long travel times in hot climates is logistically difficult and requires coordination. In order to assure vaccines would not be wasted, they were picked up from the WHO the morning of deployment and stored in coolers without direct contact with ice. An advance team would arrive to the target site first to coordinate with local community leaders and gather patients with tetanus prone wounds in a central area. A second team would transport the amount of vaccine needed as estimated by the advance team.ResultOur group vaccinated approximately 300 people without access to the centralized hospitals per day using this system, with no vials of vaccine wasted or spoiled.
(P1-72) Advanced Surgical Cooling Garment to Combat Heat Stress in CBW Ppe and Hot Surgical Environments
Authors: Mcisaac J. 
Published: May 2011

IntroductionHeat stress is an occupational hazard for all personnel requiring Personal Protective Equipment (PPE). Even “breathable PPE” increases measurable heat stress in active troops and surgical personnel. A novel negative-pressure, semipermeable surgical cooling vests for use in the operating theater was jointly developed by Mountain Laurel Biomedical, Hamilton Sundstrand, and Hartford Hospital.Materials and MethodsSurgical personnel alternated between wearing cooling garment vs no cooling under their surgical gowns (PPE) during surgical procedures lasting up to several hours. Tympanic temperatures were monitored for safety. A questionnaire was completed after the conclusion of surgery to assess perception of comfort. Trials began at ∼18 deg C, but ambient temperature was increased to 24 deg C (40–50% RH) for the third series of trials. Results: The study was terminated prematurely. After wearing the cooling vest, surgeons refused to complete additional control trials due to the heat. They demanded to use the cooling device for all surgery, even outside the protocol! Vest wearers remained dry and reported a statistically significant (p < 0.0001) greater level of comfort compared to control subjects. The weight, fit, and mobility restriction of the vest was not clinically significant.ConclusionActive cooling and drying using a negative pressure cooling vest improves subjective thermal comfort with minimal perceived impact on mobility during surgical procedures. This technology may have utility in other fields that utilize PPE. The Chemical Biological Warfare (CBW) ensemble, in particular, is a promising candidate. Heat stress from PPE ensemble even if “breathable” -Cooling at ∼100 watts with 18 deg C water -Semipermeable membrane allows condensation removal. Wearer stays cool and dry. -Negative pressure prevents coolant loss if punctured -Minimal perceived restriction of shoulder, neck, and waist range of motion - Light weight ∼1.5 lbs. (0.68 kg) - Quick disconnects allow options for cooling source.
(P1-89) Psychosocial Tsunami- Financial Crisis
Authors: Saenz M.C. 
Published: May 2011

Psychosocial Tsunami Financial Crisis Tragedies produced by nature have patterns similar to psychosocial emergencies. The disruptive effects impact on Public Health. Unemployment covers society and doesn't allow personal aptitudes to emerge and sinks people in hopelessness. There is a perception of constant risk. People are in alert with all the effects of sharp and chronic stress and in some occasions Post Traumatic Stress.ObjectiveTo get an efficient answer to reality from this impoverished group with severe effects facing working uncertainty and unsatisfied basic needs. To avoid the social tragedy to be a big wave that sinks a big part of the population very quickly. To train people on the importance of work to get a better quality life for each participant, the family and community.Methodology and Diagnosis6200 people were trained in twenty months and motivated to work in a population of 95000 citizens approximately. They got a salary and social security financed by the government and articulated with the NGO. They were organized according to working experience and abilities and a supervisor was elected every ten people. Each participant had been polled to reach these conclusions. Industrial security, health care, and group work abilities were some of the syllabus topics. Some of the tasks performed were: painting, gardening, public places embellishment and fixing, administrative duties, river cleaning, etc.Conclusion90% of labour inclusion among unemployed people. Acknowledge from the participants of their working abilities. To generate hope in uncertainty diminishing violence. Generate space to diminish stress with impact in cardiology matters, addictions and pathologies. The disruptive effects of financial crisis are diminished considerably in these groups.
(P1-103) Utilization of a Pediatric Disaster Coalition as a Model for Regional Pediatric Disaster Planning
Authors: Foltin G. , Flamm A. , Cooper A. , Sagy M. , Greenwald B.M. , Conway E. , Shah V. , Biagas K. , Abularrage J. , Uraneck K. , Gonzalez D. , Treiber M. , Goldfeder M. , Tunik M. , Frogel M. 
Published: May 2011

PurposeThere remains a lack of comprehensive pediatric emergency preparedness planning worldwide. A disaster or mass-casualty incident (MCI) involving pediatric patients could overwhelm existing pediatric resources within the New York City (NYC) metropolitan region. The NYC Department of Health and Mental Hygiene (DOHMH) recognizing the importance to plan for a MCI with a large number of pediatric victims, implemented a project (the Pediatric Disaster Coalition; PDC), to address gaps in the healthcare system to provide effective and timely pediatric care during a MCI.MethodsThe PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from the NYC pediatric/children's hospitals, DOHMH, Office of Emergency Management, and Fire Department (FDNY). Two committees addressed pediatric prehospital triage, transport, and pediatric critical care (PCC) surge capacities. They developed guidelines and recommendations for pediatric field triage and transport, matching patients' needs to resources, and increasing PCC Surge Capacities.ResultsSurge recommendations were formulated. The algorithm developed provides specific pediatric triage criteria that identify severity of illness using the traditional Red, Yellow, and Green categories plus an Orange designation for continual reassessments that has been adopted by FDNY that has trained > 3,000 FDNY EMS personnel in its use. Triaged patients can be transported to appropriate resources based on a tiered system that defines pediatric hospital capabilities. The Surge Committee has created PCC Surge Capacity Guideline that can be used by hospitals to create their individual PCC surge plans. 15 of 25 NYC hospitals with PCC capabilities are participating with PDC planning; 5 have completed surge plans, 3 are nea completion, and 7 are in development. The completed plans add 92 surge beds to 244 regularly available PICU beds. The goal is to increase the PCC surge bed capacity by 200 + beds.ConclusionsThe project is an effective, multidisciplinary group approach to planning for a regional, large-scale pediatric MCI. Regional lead agencies must emphasize pediatric emergency preparedness in their disaster plans.
(P1-105) The Surgical Care of Children with Gunshot Wounds in a Children's Field Hospital
Authors: Petlakh V.I. , Rozinov V.M. , Jandiev S.I. , Ivanov D.J. , Shabanov V.E. 
Published: May 2011

IntroductionThe treatment of victims with gunshot wounds has gained importance over the past 10–15 years due to continuous military conflicts and the increase in terrorist and criminal acts. Since 1992, a group of pediatric surgeons has been trained to treat gunshot wounds in both children and adults in field hospitals of the Russian Service of Disaster Medicine in Northern Caucasus.MethodsTwo working models of a Children's Field Hospital (ChFH) were reviewed. In the first model, a ChFH was implemented for 14 months (April 2001–July 2002) during a military conflict in the Chechen Republic. There were no other hospitals rendering medical aid to children in the area. In the second model, a field hospital was created for children following a terrorist act in Beslan, Northern Ossetia in 2004.ResultsOver the 14 month period, the Chechen Republic ChFH rendered medical aid to 102 adults and 20 (16.4%) children with gunshot wounds. Self-made explosives and unexpected munitions were blamed for explosive trauma in children. Two children died in the ChFH, and one child with amputated lower limbs was transported to Moscow for prosthetics placement. Three hundred eleven children presented to ChFH, including 55 children not requiring medical aid, and 256 wounded children, who were divided into 3 groups: 5 dying; 52 wounded and requiring emergency treatment; and 199 wounded who were transported to hospitals in Vladikavkaz after receiving initial medical aid at the ChFH. In total, 47 operations were performed, including seven abdominal and chest surgeries. Re-animation aid was provided at the Intensive Care Department of the ChFH for the stabilization of the critically wounded prior to their evacuation.ConclusionIn the situation of mass admissions of wounded patients, the most important considerations are triage and the arrangement of operations according to urgent indications.