bluuebunny/crossref_metadata_2025_split huggingface dataset:
(A214) Road War: A 200-Vehicle Crash, Special Report
Authors: Khalifa G.E.A. 
Published: May 2011

The last thing the world needs is another war.1 Everyday about 3000 people die and 30,000 people are seriously injured on the world's roads.2 Furthermore, for people who survive the crash, additional suffering and frustration occur because of administrative, legal, and social barriers.3 Since transport to hospital usually takes 30–45 minutes, the ‘golden hour’ in which 48% of deaths occur is spent mainly in the prehospital environment.4 On March 11, 2008 at 7:30 AM a very foggy morning, a major car crash occurred on the high way from Abu Dhabi to Dubai. Initial scene response was conducted by Abu Dhabi traffic police Abu Dhabi Police Ambulance and Rescue Sections helped by Dubai. Casualities were transported to 2 hospitals in Abu Dhabi; Al Mafraq and Al Rahba. The Authors describes Al Rahba hospital response that received 159 causalities (almost half of the causalities).ResultsThree victims died immediately on scene. Most of the causalities were triaged and re triaged as Priority 3 (green), suffered from extremity trauma, were treated and discharged. Twenty patients were triaged as Priority 2 (yellow) and were admitted to the hospital, Three patients were priority one (red) were admitted to the ICU, one of them died 10 days later due to severe head and chest injuries.
(A226) Establishing a Framework for Synchronizing Critical Decision Making with Information Analysis during a Health/Medical Emergency
Authors: Paturas J. , Pelazza J. , Smith R. 
Published: May 2011

BackgroundThe Yale New Haven Center for Emergency Preparedness and Disaster Response (YNH-CEPDR) has worked in the United States with state and local health and medical organizations to evaluate critical decision making activities and to develop decision making tools and protocols to enhance decision making in a time sensitive environment. YNH-CEPDR has also worked with international organizations and US federal agencies to support situational awareness activities in simulated and real world events.ObjectivesDuring this session YNH-CEPDR will share the best practices from recent events such as the H1N1 response and the Haiti Earthquake. Participants will be engaged in discussions regarding overall framework for successful information collection, analysis and dissemination to support decision making based on these experiences. This session will also incorporate concepts provided by the US National Incident Management System (NIMS) and the Incident Command System (ICS), specifically through the development of Situational Reports (SitReps), Incident Action Plans (IAP) and Job Action Sheets as methods to implement the framework and concepts discussed. Participants will be led through a series of scenario-based discussions to allow application of critical decision making factors to their organization. At the conclusion of the session, participants will be able to identify next steps for enhancing the synchronization of critical decision making and information analysis within their organizations.
(A240) Preparación De Hospitales De Alta Complejidad Ante Un Saldo Masivo De Victimas
Authors: Ruiz R.B. , Ramírez G.P. , Reyes F.R. 
Published: May 2011

ObjetivoPreparativos de los “Hospitales de Alta Complejidad” ante la presencia de un evento con un saldo masivo de víctimas, dando una respuesta oportuna, eficiente y eficaz de los recursos, salvando al mayor número de víctimas y disminuyendo las secuelas.MétodoSe relata la experiencia de la Unidad Hospitalaria La Paz, (de Alta Complejidad) que atiende frecuentemente a saldo masivo de víctimas en la Ciudad de Puebla, Pue., México.DesarrolloLa presencia de 2 o más pacientes críticos en una sala de urgencia normalmente ocasiona caos, disminuyendo la eficacia de sus recursos, aumentado la mortalidad y/o las incapacidades. Los hospitales que son clasificados por su mayor capacidad resolutiva como “Alta Complejidad”, que deben de recibir a las víctimas de prioridad I, (lesiones que ponen en peligro su vida de manera inmediata) destinando recursos mediante la preparación de un “Plan en caso de Desastre Externo” que contempla las acciones a desarrollar el antes, durante, y después del ingreso al hospital, cubriendo los criterios internacionales para dar atención a 100 víctimas de diferentes prioridades, iniciando con la realización del 1er. TRIAGE afuera de la sala de urgencias, arriba de la ambulancia, para corroborar o ratificar la clasificación prehospitalaria e ingresar o referir a las víctimas con prioridad I al área de reanimación inmediata en donde son atendidos por 5 a 6 médicos y enfermeras por cada 2 pacientes, resolviendo sus prioridades, posteriormente el jefe de cirugía realiza un 2do. TRIAGE para distribuir a las víctimas en las áreas de Cuidados Intensivos, Cirugía u Hospitalización con base a sus prioridades.ConclusionesEl propósito es salvar al mayor número de víctimas en la atención de un saldo masivo de víctimas, realizando un “Plan en caso de Desastre Externo” mediante la organización del personal Médico, de Enfermería y Administrativo.
(A244) El Riesgo De La Interrupcion
Authors: Saenz M.C. 
Published: May 2011

Justificació nEl desastre deja de ser un momento de disrupció n en la cotidianeidad y quienes está n ante la coordinació n de gestió n de estrategias de respuesta son responsables de generar efectos no iatrogé nicos en la salud pú blica. La mayorí a de las catá strofes no son sorpresivas ni inmanejables. Observamos que la discontinuidad en las acciones genera desorden y mayor sufrimiento humano. Los costos de estas situaciones no son solamente econó mico- financieros, sino que generan pé rdida de vidas, bienes, desequilibrios psico-sociales, deterioro del medio ambiente y profundas crisis polí ticas y econó micas-financieras.Metodologí aMejoramos en cada evento en el que se trabajo, la eficiencia y la capacidad de planificació n operativa con base en datos “ cientí ficos en el manejo de instrumentos especí ficos y evaluaciones rá pidas de dañ os.Evaluamosseis eventos trá gicos en el paí s, incendio, atentado, inundació n, guerra, en 10 añ os y el efecto de la evolució n de las acciones normatizadas y no interrumpidas para evaluar la eficiencia y la eficacia de las acciones no interrumpidas en estrategias de respuesta logí stica.ConclusióLa contenció n psicosocial y evaluació n de los Recursos Humanos se impone como una tarea ineludible en la logí El rol del á mbito de la Salud y de la comunicació n es de fundamental importancia ante los impactos psicosociales previstos tragedia. Amenazas, riesgos y vulnerabilidades, recursos de acrecentamiento de la resiliencia deben estar contemplados en todo trabajo que busque disminuir el sufrimiento humano Gestionar la crisis era resolver lo caó tico, gestionar los riesgos es evitar lo caó tico. Programas “ help to help” la, consideració n de la Resiliencia, burn-out y stress se incluye en situaciones de emergencia y desastres. La discontinuidad del aprendizaje de estrategias de respuesta es iatrogé nica.
(A255) Medication Preparedness during Wildfire Evacuations
Authors: Mayner L. , Stratton S.J. 
Published: May 2011

IntroductionDuring wildfires, many are evacuated with little time to collect personal items. Evacuees who depend on daily medication for ongoing medical conditions often arrive to evacuation shelters without medication and with little knowledge of what they require. This problem is reported for evacuees in the 2008 Orange County California (USA) Freeway Triangle Wildfires.MethodsData was obtained retrospectively from Orange County Health Care Agency records regarding people who required medication while housed in evacuation shelters. Descriptive data was analysed using SPSS 17 and STATA 11.01.Results40,000 persons were evacuated during the wildfires. Sixty of the evacuees aged from 6 to 82 years were without necessary medications. Of the sixty, there were 26 females and 34 males. People requiring medication would present to a public health nurse in the shelter whom would contact the Disaster Health Officer to arrange scripts for medication. Of the 60 people, 67% were unable to contact a primary physician and 75% were able to be issued a script for needed medication. The most common prescribed medication was albuterol for asthma and lung disease, then narcotic pain relief medication and next medication for cardiovascular / hypertension conditions.ConclusionsResults show that life sustaining medication was required by people housed in an evacuation shelter. These people may not have had time to retrieve necessary medication if they had to evacuate quickly or may not have had an adequate supply of medication at the time of evacuation. Thus far there has been very little published on this issue however, our results show there is a need for pre-planning on behalf of people living in wildfire prone areas who require daily medication and are at risk for sudden evacuation. Our findings also highlight the important role provided by health workers in evacuation shelters in providing assistance for medication purposes.
(A259) Objective Triage in the Disaster Setting: Will Children and Expecting Mothers be Triaged Like Others?
Authors: Kouliev T. 
Published: May 2011

IntroductionThe study of disaster triage is made difficult by the complex emotional response of potentially lifesaving intervention that a triage officer must make decisions based on a succinct and efficient algorithm.MethodsWe designed a survey of triage professionals in Chicago, Philadelphia, and Beijing to identify sources of emotional bias that lead to failure of the START triage protocol that result in a lack of correlation between triage priority and clinical outcomes.Results and ConclusionsAmong our subjects, we observed that a pediatric victim is uniformly overtriaged when compared to less injured victims. We examine the possible reasons behind the consistency of this selection, explain the means we used to minimise bias, and propose avenues for further research and clinical implementation of better triage systems and guidelines.
(A274) Mass-Gathering Event Risk Scoring Model: A Score to Predict Risk Level and Medical Usage Rate during Metropolitan Mass Gatherings
Authors: Revello A. , Marzio A. 
Published: May 2011

BackgroundDuring the planning phase of a mass gathering, it is important to organize the most suitable healthcare responses to assure primary, emergency, and major accident care, with the best balance between available resources and costs.ObjectivesThis study tries to develop a Mass-Gathering Event Risk Scoring Model (MGE-RS) to predict Medical Usage Rate (MUR) that can assist emergency medical services providers in planning for mass gatherings across a variety of events and venue types in a metropolitan area.Methods and ResultsThis study includes 48 mass gatherings in Rome (35 mass gatherings; 2005–2006) and Milan (13 mass gatherings; 2009–2010). All 35 mass gatherings in Rome had > 100,000 attendees (100,000 to 5,000,000), while the 13 mass gatherings in Milan had a median of 100,000 attendees (50,000–200,000). The median patient presentation rate (PPR) was 0.5 patients/1,000 persons: this rate is close to PPRs for mass gatherings reported in the literature (0.5–2.0 patients/1,000 attendees). For each event, the predicted MURs, calculated using the Arbon Model and the MGE-RS Model, were compared with the actual MUR. The MGE-RS scoring model uses a formula that assigns points based on known information (type of event, place, duration, crowd, health system facilities) to predict the risk. The MGE-RS score ranged from 16 to 77. There are five risk levels, each one corresponds to an expected MUR from 1.5 to 45. In the events studied, the predicted MUR calculated with the Arbon model corresponded in 60% of cases (20% under/overestimation); the MGE-RS was in range in 88% of cases (0% underestimated; 12% overestimation).ConclusionsThe MGE-RS seems to be a provider-friendly tool to be used in planning phase, and is able to give an acceptable estimation of the risk level and expected MUR for a mass gathering, without underestimating the estimated MUR during the planning phase.
(A280) Safety of Rural Hospitals during Flood: A Case Study on Begusarai District of Bihar, India
Authors: Chatterjee R. , Nisha D. 
Published: May 2011

IntroductionIndia is one of the most flood prone countries in the world, flooding annually about 9 million hectares and accounting for one-fifth of global flood deaths. Approximately 56.5 % of flood-affected Indians live in Bihar. Out of 38 districts in Bihar, 22 are flood prone, including Begusarai. The life line to the community is the Primary Health Center (PHC) which is at stake during a disaster such as floods.MethodsTo study the status of primary health care in rural parts of Begusarai during recurring floods, a survey was undertaken to analyze the preparedness and response mechanism at various hospital levels. The status of rural hospitals during a flood was represented by a case study on the PHC of Bakhri block of Begusarai district. To determine the prevailing situation during floods, the chief medical officers of each level of health care centers were interviewed.ResultsThe PHC of Bakhri caters to a population of about 408,896, which is four times the normal load for a PHC. In 2007, it was affected severely by flooding from the Baghmati River. The PHCs that were studied perennially face a shortage of human resource and infrastructural support. This is compounded by unsafe locations and structural hazards associated with the hospital building, rendering the working conditions unsafe for the medical team during disasters.ConclusionThis paper envisages the functionality and challenges of healthcare providers during floods despite their limited available resources. The prevailing case scenario demonstrates the challenges in rural India, and the best practices for safe rural hospitals in coping with disasters in a resource-poor setting will be discussed.
(A287) Who Regional Office for Europe - Health Systems Crisis Preparedness Assessment Tool
Authors: Bayer C.P. , Rockenschaub G. 
Published: May 2011

WHO Regional Office for Europe - Health Systems Crisis Preparedness Assessment Tool Bayer CP, Rockenschaub G.ObjectivesHealth crises are often unpredictable and may occur at any place or time. Communities are particularly vulnerable when local and national systems, specifically health systems, are unable to cope with the consequences of a crisis, usually because they are overwhelmed by a sudden increase in demand or because the institutions that underpin them are fragile and cannot deliver what is required. The World Health Organization (WHO) Europe Health System Crisis Preparedness Assessment Tool aims to provide guidance to ministries of health and other relevant authorities on evaluation and strengthening of their health system's capacities for crisis management.MethodsBased on an all hazard approach, an assessment tool was developed which comprises essential attributes considered vital for countries to meet the challenges of future health crises. The foundation of the tool derived from expert consultation workshops and pilot testing in eight countries in the WHO European Region.ResultsThe tool lists essential attributes with respective indicators crucial for evaluating and identifying gaps in health system crisis preparedness. The assessment tool is structured according to the six building blocks of the WHO health system framework and is complemented by a user manual, allowing countries to apply a self–assessment approach. The tool is intended for use by ministries of health or other relevant institutions.ConclusionsThe tool may help determine the current status of health system crisis preparedness and facilitate the development of a prioritized plan of action that addresses any gaps identified. When used regularly the tool will help monitor progress.
(A295) Post Disaster Mental Health among Ethnic Minorities in Rural China: Results from Qualitative Studies
Authors: Cheung E.Y.L. , Chan E.Y.Y. , Lam H.P. , Lin C.L.Y. , Lee P.P.Y. 
Published: May 2011

BackgroundChina has one of the countries with highest occurrence of disasters and disasters are disproportionately affecting rural area of China where ethnic minorities are inhibiting. Limited studies have been conducted to examine how mental health of ethnic minorities in China might be affected by disasters. Through qualitative focus group study methods, this multi-site project examines the mental health impact of disasters in ethnic minority groups in rural China.Methods20 focus groups were conducted in rural Sichuan, Yunnan, Gansu and Hainan province of China to understand the mental health impact and coping of disasters during 2008–2010. Ethnic minority groups including Tai, Naxi, Li, Jiang and Hui affected by earthquake, flooding, mudslide, storm and snow storm were included for the focus group interviews. Guided questions were used and male and female participants participated separately in different groups. Focus groups were held at common area within the village and were all type recorded and transcribed for analyses. Saturation of data was reached and thematic analyses were conducted.ResultsWhilst distress, including mood disturbance, sleep problems and heightened arousal after disaster occurrences, were reported among respondents, when compared with Han Chinese affected in disasters, ethnic minority respondents reported more resilience and coping capacity post disaster. Gender impact and gaps in mental health service were identified.ConclusionStudy results disparities in resilience and coping behavior among different ethnic groups in China. More in-depth studies should be conducted to understand post disaster mental health needs and service utilization of ethnic minorities in China.
(A299) Comparison of Imbalance in Psyche as Sequel in Amputations and Salvage in Trauma of Extremities
Authors: Raju V. 
Published: May 2011

AimComparative analysis of under considered psychological implications in earning members of family who happen to be victims of trauma and end up in early or delayed amputations to those in whom salvage to acceptable or useful function was possible.MaterialWorking and ably earning members who sustained traumatic wounds in industry, domestic, traffic, calamity, war, homicide, suicide, etc. Age groups from 1 to 75 years studied. Grade I,II,III A and III B compound wounds included. Psychological evaluation in early and delayed amputations compared with those salvaged to partial / useful function.MethodsPeriodic and frequent counseling as integral part of treatment regime to victims of trauma and their peers, family members, employers, police and lawyers.DiscussionClassification, incidence and outcome of post traumatic psychosis. Need of effective counseling to reduce post traumatic psychological imbalance and improve quality of life.ObservationsBehavioral changes and suicidal tendency are profound and pronounced in traumatic and early amputees compared to subjects of delayed and revision amputations. Acceptance and adaptability with limb / extremity salvage is encouraging with minimal post traumatic psychosis.ConclusionFrequent and repetitive counseling aids reduce post traumatic psychosis. Depressive psychosis is much less prevalent even in partially functionally acceptable traumatic limb salvage than in early or delayed amputations, though salvage takes a long course in management, rehabilitation and changed occupation by relocation.
(A319) Using a Computer Simulation (CS) to Improve Training and Event Management of Paramedics for Mass Casualty Incidents (MCI)
Authors: Jaffe E. , Dagan A. , Zahavi E. 
Published: May 2011

Using a Computer Simulation (CS) to improve training and event management of paramedics for Mass Casualty Incidents (MCI). Eli Jaffe, Avi Dagan, Eyal Zahavi, Einat Aviel, Bruria Adini. The Department of Emergency Medicine, Ben-Gurion University of the Negev Magen David Adom (MDA) is the national emergency organization in Israel. Over the past few decades MDA personnel have been required to deal with MCIs involving large numbers of casualties. Recently, there have been fewer terrorist related MCIs, however, there is a continuing need for to maintain the knowledge and skills of paramedics to manage MCIs.ObjectiveTo examine performance of paramedics exposed to a CS compared to a control group exposed to a traditional lecture based learning experience.MethodAn interactive CS based on the MDA standard operating procedure for managing MCIs was developed. The participants were randomly divided into two groups. Group 1 received the lecture format, and Group 2 the CS. Both groups were given a pre-test (Group 1 average score 56.3, Group 2 average score 53.1), and two post-tests. One immediately following completion of the intervention, and a second a month after completion of the course.ResultsAverage scores for the CS Group (n = 15) was significantly different on the first post-test (Group 1 average score 53.2, Group 2 average score 68.7), by 30% and on the second (Group 1 average score 71.9, Group 2 average score 80.8) by 12% compared to the Lecture Group (N = 17) (P = < 0.00).ConclusionCS allow for the use of multiple media formats based on real events, and are able to replicate reality using real media material. MDA has recommended that continuing education interventions for emergency medical personnel for maintaining knowledge and skills required for the management of MCIs utilize a CS based training methods.
(A324) Emergency Management Preparedness and Response Planning in the US: Aphis Foreign Animal Disease Preparedness and Response Plan (FAD PREP)
Authors: Myers L.M. , Fromberg L. 
Published: May 2011

BackgroundPreparing for and responding to foreign animal diseases are critical missions to safeguard any nation's animal health and food supply. A specific challenge of foreign animal disease preparedness and response is the ability to rapidly incorporate and scale-up veterinary functions and countermeasures into emergency management operations during a disease outbreak. The United States Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services has established a Foreign Animal Disease Preparedness and Response Plan (FAD PReP) which provides a framework for FAD preparedness and response. The FAD PReP goal is to integrate, synchronize, and de-conflict preparedness and response capabilities, as much as possible, before an outbreak by providing goals, guidelines, strategies, and procedures that are clear, comprehensive, easily readable, easily updated, and that comply with the National Incident Management System (NIMS). An overview of FAD PReP will be presented.BodyThe APHIS FAD PReP incorporates and synchronizes the principles of the National Response Framework (NRF), the National Incident Management System (NIMS), and the National Animal Health Emergency Management System (NAHEMS). The FAD PReP contains general plans and disease specific plans that include incident goals, guidelines, strategies, procedures and timelines for local, State, Tribal and Federal responders. The FAD PReP helps raise awareness of the required veterinary functions and countermeasures, helps identify gaps or shortcomings in current response preparedness and planning, and helps to provide a framework to the States, Tribes, and Industry sectors in developing their individual response plans for specific diseases such as HPAI and FMD. The FAD PReP will also identify resources and personnel for potential zoonotic disease outbreaks and large-scale outbreaks, define stakeholder expectations for successful and timely outcomes, identify and resolve issues that may become competing interests during an outbreak and provide a systems approach to preparedness issues that need additional time, attention and collaboration.