bluuebunny/crossref_metadata_2025_split huggingface dataset:
(P1-105) Osteosynthesis of Children with Femur Fractures from Traffic Accidents
Authors: Rozinov V.M. , Jandiev S.I. , Petlakh V.I. 
Published: May 2011

IntroductionThe growing number of children suffering polytrauma from traffic accidents dictates the expansion of the indications for osteosynthesis. Elastic-stable intramedullary osteosynthesis (ESIN) is the optimum treatment of fractures of long bones in children.MethodsClosed intramedullary osteosynthesis of diaphyseal femur fractures with flexible nails was performed in 74 patients (76 fractures) during 2006–2010. The patients were children ages 1–8 years. Titanium elastic nails (TEN) (Synthesis, Switzerland) were used in the procedures. AO Foundation recommendations were adhered to when selecting the size of the implant (i.e., diameter approximately 1/3 the diameter of the femur medullar canal at its narrowest part).ResultsThere was a prevalence (n = 53) of simple fractures (Ð3 by AO classification) in this group of patients. Sixteen children had Ð2-type fractures, five with spiral (Ð1), and two with slanting (Ð2) fractures. There were no type Ð1 or Ð3 complex fractures in this group. Good functional results of closed intramedullary osteosynthesis with TEN at diaphyseal fractures of the femur in children with isolated and associated damages were achieved. There were no post-operative complications. This method provided stability of osteosynthesis, which allows activating patients in the short- term, i.e., during the post-operative period.ConclusionTreating femur fractures in children with ESIN provides optimum treatment of polytrauma. Osteosynthesis without exposure to the area of damage, and the early activation of children can prevent infectious complications and contractures.
(P2-3) Analysis of Chest Compression Rate and Its Affect on the Quality of Chest Compressions
Authors: Emberts Z.T. , Schwab J.H. , Williams A.L. , Birnbaum M.L. , Padjen P.D. , Bhattacharya A. , Olson S.K. 
Published: May 2011

BackgroundIn the last 50 years of modern-era cardiopulmonary resuscitation (CPR), survival rates remain dismal, worldwide. International CPR guidelines recommended a compression rate of at least 100 per minute. There is little evidence documenting if and to what extent high compression rates affect the quality of chest compressions.ObjectivesAn objective of this study was to evaluate the effect mean compression rate (MCR) had on the overall quality of chest compressions. Investigators hypothesized that MCRs > 110 would result in a smaller percentage of adequate: compressions (PAC); depth (PAD); and recoil (PAR).MethodsIn this observational pilot study, basic life support providers were recruited from prehospital and in-hospital settings to provide 10 minutes of continuous chest compressions, based on the 2005 American Heart Association guidelines. An adequate compression was defined as a compression that was > 35 mm, had full recoil, and correct hand position. Data were recorded using the Laerdal PC Skill reporting System.ResultsNinety four (91.3%) of 103 participants completed 10 minutes of compressions. Rescuers represented a variety of backgrounds, average age of 35.5 ± 11.0 years. Fifty eight (56.2%) rescuers had performed CPR in the last two years, and 54 (52.4%) practiced prehospital EMS. Providers that did not complete the entire 10 minutes tended to have a higher MCR than those completing 10 minutes, 114.2 ± 19.3 vs. 105.8 ± 15.4 respectively. Within the first two minutes, rescuers with a MCR > 110 delivered 45% of their compressions adequately, compared to 60% when a rescuer's MCR was < 110. This initial disparity was primarily due to decreased PAR, not decreased PAD. After 2 minutes, higher MCRs correlated with decreased PAC, due to decreased PAD.ConclusionsData indicates a higher MCR results in decreased PAC, PAD, and PAR, likely attributed to increased rescuer fatigue.
(P2-8) Analysis of the Performance of Emergency Medical Services Management of 51 Mass-Casualty Incidents in Israel
Authors: Jaffe E. 
Published: May 2011

IntroductionBetween February 2002 and January 2004, a total of 51 terrorism-related mass-casualty incidents (MCIs) occurred in Israel.ObjectiveThe objective of this study was to analyze data provided in After Action Reports (AAR) held by Magen David Adom (MDA), after each MCI.MethodsInformation relating to the type of MCI, location, number of ambulances dispatched in five-minute intervals from time of notification, and number of casualties evacuated by urgency in five-minute intervals from the start of the incident was analyzed.ResultsThere were 34 MCIs in 2002, 15 in 2003, and two in 2004. More MCIs (24%) occurred on Wednesdays, and more MCIs occurred during the 05:30–08:59 (18%), 12:00–14:59 (20%), and 17.00–19.59 (24%) time slots. More MCIs occurred in the Jerusalem (24%) area, followed by Tel Aviv (16%). Twenty-six percent of the MCIs resulted from explosions in open areas, 22% in buses, 20% from shootings, and 28% from explosions in semi-closed and closed areas. The mean dispatch time of the first ambulance after notification was 48 seconds. An average of 14.25 ambulances were dispatched in the first five minutes, followed by eight, three, and three in the five-minute slots following. An ANOVA indicated a significant difference in dispatch times by towns/cities (p = 0.05). The average arrival of the first ambulance was 6.4 minutes, and evacuation of the first urgent casualty was 13.6 minutes, the last evacuation was 26.5 minutes after arrival. More urgent casualties (45%) compared to 20% non-urgent were evacuated in first 15 minutes; the majority of non-urgent victims (79%) were evacuated after 16 minutes. The mean number of dispatched ambulances ranged from 37.9 to 26 in urban versus rural areas, respectively. The number of ambulances actually used for evacuation in urban and rural areas was 55% and 44%, respectively.ConclusionsInformation analyzed from AAR is useful for improving Standard Operating Procedures and structuring continuing education interventions for MCIs.
(P2-15) Problems of Permanent Threat of Impact on Persons Authorized as Drivers
Authors: Umyerov R.A. , Rossodivita A. , Trufanov A. , Memetov R.N. 
Published: May 2011

IntroductionPeople using public transportation have to put their health and even their lives in the hands of personnel authorized to drive the vehicles. But, organizers are taking unprecedented measures to protect transportation from diverse threats. However, there is often overwhelming evidence of the weak effectiveness of pertinent measures.MethodThere is a permanent threat of possible physical and/or psychological impact on persons authorized as drivers, which leads to a possible threat to the health and lives of others. Such events can be divided into two groups: (1) pre-driving; and (2) in-driving. Anthropogenic impacts while pre-driving and in-driving periods stimulate feelings of fear, which comprises different components.ResultsIn the pre-driving group, drivers face overwhelming mental health impacts. This includes fear for their lives and health, fear of responsibility for family, friends, and passengers. In the in-driving group, the variation of physical and mental impacts determines the addition of fears of other categories.ConclusionIntegrated sensors for measuring levels of blood pressure, sweating, heart rate, respiratory rate, and changes in the retina of the eye should be implemented. This hardware and software should process information about drivers. They would provide instant alerts on changes in the indicators.
(P2-20) Explosion At A Steelwork Plant
Authors: Bortolin M. , Raviolo M. , Vacca R. , Bono D. 
Published: May 2011

IntroductionOn the night of 06 December 2007, an explosion occurred at a steelworks plant in the city of Turin. The incident involved 10 people. The emergency medical services (EMS 118 Turin) declared a mass-casualty incident (MCI).ObjectivesThe aim of this case report is to analyze the response of the EMS 118 Turin to the MCI in order to identify problems or short-comings and improve the service for future responses.MethodsInformation from the dispatch center, medical report of the EMS, and hospitals that received the patients were analyzed.ResultsThe emergency call was placed at 01:04 hours, and the MCI was declared closed at 04:40 hours. The disaster, in according to Disaster Severity Scale (DSS), was classified 3. The METHANE message was sent to the dispatch center by the first ambulance 4 minutes after the call. There were 10 patients: seven T1; one T2; and two T3. The dispatch center deployed nine teams, which consisted of five advanced life support (ALS) teams and four basic life support (BLS) teams. All of the casualties were able to walk when they arrived to the medical care. The T1 casualties had burns to > 80% of their body surface area (BSA), the T2 and T1 casualties suffered inhalation of smoke gas. The first casualties were evacuated to the hospital 28 minutes after the call. Four casualties (three T1 and one T3) were transported to the nearest hospital. the other four T1 casualties were transported to four different hospitals of the city. All the T1 casualties died in the next 24 days.ConclusionsThe management of resources during this MCI was suboptimal. The number of ALS teams that responded to the MCI was high considering the number of casualties and the time taken to resolve the incident. The lessons learned from this incident and other cases have permitted the EMS Turin to improve their response plan concerning the use of resources and surge capacity.
(P2-21) Differences in Self-Protective Behavior between Hospital Workers and Community Care Workers in Israel during the Peak of A/H1N1 Pandemic
Authors: Rofe Y. , Bar-Dayan Y. 
Published: May 2011

BackgroundEffective function of the community care system is important during a pandemic. Self-protective behavior might help stop the spread of the disease during a pandemic and prevent system dysfunction because of personnel morbidity.ObjectiveTo compare the immunization rate and reported self-protective behavior of healthcare workers between hospitals and community care clinics during the peak of the winter A/H1N1 pandemic in Israel.MethodsA questionnaire was completed by 1,147 healthcare workers in 21 hospitals and 40 primary care clinics in Israel between 26 November 2009 and 10 December 2009 (the peak of the winter A/H1N1 flu outbreak).ResultsThe rate of vaccination against A/H1N1 among hospital workers (27.9%) was significantly higher compared with primary care clinics workers (19.3%) (OR = 0.691 (0.821–0.582)).
(P2-23) Attempted and Completed Suicides: A Two-Year Analysis from a German Helicopter Base
Authors: Frank M.D. , Hencke A. , Braun J. , Pyrc J. 
Published: May 2011

IntroductionIn Germany, emergency physicians in the prehospital rescue system ensure primary care. The rescue helicopter in Dresden covers the city of Dresden (population 517,000), surrounding areas with distances up to 70 km. Typical reasons for alerting the rescue helicopter are heart diseases or injuries during accidents. There also is a high number of patients with attempted or completed suicides. The goal of the study was to analyze cases associated with suicide.MethodsData of all emergency transports from the German Air Rescue (DRF-Luftrettung) Helicopter Base Dresden between January 2008 and December 2009 were recorded on a standardized protocol and transferred to a central computer database. Subsequently, all cases were analyzed with special regard to suicides.ResultsThere were a total of 3,051 cases during the study period. Fifty-nine cases (1.9%) were related to suicide. The helicopter was on the scene within 10.9 minutes. The mean NACA Score was 4.9. The mean age was 51.6. A total of 52.5% of patients were male. In 15.2% of the cases, the patient called for emergency help; in 37.3%, bystanders contacted authorities. The reason for attempted suicide was unknown in 57.6% of the cases. In 16.9%, it was related to partnership, in 20.3% to health problems, in 5.1% to financial problems. The main method of attempt was the use of medical pills (47.4%). Other frequent methods were strangulation (18.6%), stab wounds and gunshots (8.5%), intoxication (3.4%), or unknown (16.9%). Six patients received cardiopulmonary resuscitation, four reached a Return of Spontaneous Circulation, and 10 patients died.DiscussionHelicopters often transport suicide victims. This study demonstrates the need for better prevention as well as an improvement of education for emergency physicians working in the prehospital setting.
(P2-26) EMS-Assessed Mass Casualty Incident: A Pilot Surveillance
Authors: Park C.B. , Shin S.D. , Suh G.J. , Park J.O. , Kim C.H. 
Published: May 2011

Background Recently the number of disaster and mass casualty incident (MCI) is increasing in Korea, but there have been few administrative reports or technical reports for disaster and MCI. An ad hoc basis data collection method is usually incomplete and outdated. This study was conducted to investigate the new surveillance system composed of EMS based real time survey and medical records based in-depth survey.MethodsA retrospective review was conducted of the 119 fire department call center database and ambulance running sheets in one metropolitan city. The data on all transported patients with non-medical reasons (fire, rescue and others) between May 2006 and December 2008 was reviewed. We selected all data from the accidents which had more than 2 casualties to exam the feasibility and conducted in-depth surveillance based on medical records.ResultsThe total number of accidents was 2,027 with 2,625 patients. The number of accidents which had more than 2 patients was 307 (total 898 patients) and more than 6 patients was 19 (total 176 patients). Among the “MCI” events, 15 cases were traffic accidents (125 patients, 71.0%), 4 cases were fire (51 patients, 29%). Total 142 medical records (80.7%) were reviewed. Admission rate was 32.4% (46 patients) and overall mortality was 3.5% (5 patients).ConclusionThis nationwide public EMS system could contribute to the establishment of the systematic disaster database.
(P2-29) Educational Model for Pre-Hospital Disaster Management in Haiti and Beyond
Authors: Gore R. , Bloem C. , Elbashir K. , Roblin P. , Ostrovskiy G. , Daphnis J. , Arquilla B. 
Published: May 2011

IntroductionThere has been increased international awareness and a need to provide accessible and essential emergency preparedness training in developing countries that has resulted in the recognition of new teaching needs and number of new initiatives to meet these needs.MethodsThese teaching methods have been applied in Haiti before and after the 2010 earthquake. They include: - Established a “Train the trainer” model - Established civilian first responder training - Basic Life Support (BLS) and First Aid - Implemented medical training using the Meti Simulator models - Conducted post-training Disaster drill - Conduction of post training assessment - Succession model of training.ResultsA total of 54 people completed a BLS course and 67 completed a First Aid course. 12 participants completed the First Aid and BLS Instructors course. 95 program participants completed an end of course survey. 41 participants had no prior BLS/First Aid training or exposure. The course participants included 2 physicians, 22 students, 8 nursing students, 7 nurses, 20 teachers, 12 health workers, 5 drivers, and 14 laborers. 92 of those surveyed stated they would recommend this course to a friend. 88 participants stated that hands on learning helped them better learn the course material.ConclusionThis training model has been well received in rural Haiti and can be applied in other developing countries. We would like to standardize training protocols that will serve as a foundation for self-sustaining higher-level emergency, pre-hospital, disaster training and management. This will improve the general quality of health care delivery. Our next pilot of this program will be in other parts of Haiti and in Khartoum, Sudan.
(P2-37) The Triage and Medical Management of Alcoholized/Intoxicated Patients at the Zurich “Street Parade”, One of the Biggest “Techno Dance Parades” of Europe
Authors: Mueller S.M. 
Published: May 2011

BackgroundEvery year, the City of Zurich hosts the “Street Parade”. This is one of the biggest European “techno parade” dance parties attracting way over a half a million mostly young people who party on a 2 km route along the lakeside of the City. Many of these guests drink alcohol and some eventually consume other drugs (e.g., GHB, Ecstasy, LSD). Combinations of these drugs may affect conscience eventually leading to a critical medical condition. Until recently the emergency-posts at the scene, as well as the emergency rooms of the local hospitals have been “flooded” with such patients, leading to obvious logistical problems.Discussion of InterventionOver the last years the Ambulance Service of the City of Zurich utilized an unused shelter close to the event scene, where these “intoxicated” mostly young patients were medically supervised and taken care of. The shelter has room for 108 patients. Every patient is first triaged; if a patient suffers from something else than just “intoxication” (e.g., cuts from broken glass) he is sent directly to the hospital for adequate treatment. The patients are then numbered, if needed showered, and receive a bed where they are regularly assessed for pulse, oxygen saturation, blood pressure and GCS by professional personnel. In parallel, if their clothes are dirty, they are washed and dried so the patient will have something clean to dress at the moment of dismissal. The average time of the patients in this shelter is 3 hours 7 minute and the charge is 600 CHF (approx 620 USD). This system has been so helpful for the hospitals, they now supply medical personnel for no cost.ConclusionThis system of triage and separate medical supervision of “simply” intoxicated patients has been successful in the management of a large number these kind of patients.
(P2-43) Utilizing a Unified Health Command Structure for Mass Gathering Preparedness and Response: Lessons Learned from the 2008 Pacific Arts Festival
Authors: Bouslough D.B. , Lemusu S. , Avegalio F. 
Published: May 2011

BackgroundThe Pacific Arts Festival is a mass-gathering event occurring every four years in Oceania. The 10th festival in American Samoa, July 20 to August 2, 2008, brought 2200 performers and 2500 tourists (a 15% population increase) from 27 Pacific nations to the island. Anticipated healthcare concerns included hospital surge (175% in 2004), HIV/STI transmission, imported/communicable diseases, food/water/sanitation-borne illness, interpersonal violence, and healthcare resource utilization.ObjectiveTo describe the preparedness and response efforts for this mass gathering event by emergency medical services, the hospital, and the department of health.MethodsA retrospective review of after-action reports, public health and emergency department surveillance records, and key-informant interviews was conducted. Descriptive statistics were used to evaluate data.ResultsA Unified Command structure was utilized for pre-/post-event response. Patient surveillance data was collected daily. During the festival 217 participants (42% female, 58% male, Average age 36) sought medical care. Acute illness (n = 166), injury (n = 39), other (n = 15), routine follow up (n = 9), chronic conditions (n = 6), mental health (n = 1), OB/GYN (n = 1) were complaints addressed. Predominant acute illnesses included headache (n = 49, 23%), respiratory illness (n = 30, 14%), musculoskeletal pain (n = 26, 12%), and gastroenteritis (n = 17, 8%). One fatality occurred among delegates. No public health outbreaks were reported. Visits per healthcare venue demonstrated a decentralization of patient surge from the hospital setting (37.4% venue aid stations, 28.1% delegation medical staff, 24% DOH clinic, 10.6% hospital).ConclusionA unified health command structure was effective in responding to this mass gathering event. Surveillance data was rapidly gathered and utilized to direct healthcare resources. Efforts to decentralize healthcare from the hospital were successful. Public health emergencies were avoided.
(P2-45) Impact of Educational Intervention on Knowledge Regarding Disaster Management Among Nurses Working in Nepal
Authors: Mandal G.N. 
Published: May 2011

ObjectivesThe purpose of this study was to find the change in knowledge regarding disaster management among nurses after educational intervention.MethodsOne group pretest and post test design was adopted for the study. The study was carried out in B.P. Koirala Institute of Health Sciences, Nepal. Forty Nurses were selected from emergency, orthopedics, medicine, and surgical ward by using non-probability convenience sampling technique. A self-administered semi-structured questionnaire was used to collect the data. Data was collected before and after the educational intervention. The collected data were analyzed using descriptive statistics (frequency, percentage, mean, standard deviation) and inferential statistics (Chi-square and Z test) were used to identify the difference in knowledge between pre-test and post-test, at 0.05 level of significance.ResultsStudy findings revealed that in the pre-test, grand mean of the means of the nurses' knowledge on different aspects of disaster management as a whole was 2.39 with the standard deviation of 0.87. Similarly the grand mean of means of knowledge on different aspects of disaster management was 3.2 with the standard deviation of 0.47 in the post-test. The difference between pre-test and post-test in respondents' knowledge in different aspects of disaster management as a whole was calculated by using “Z” test (p < 0.05) The result showed that the educational intervention was effective in bringing changes in knowledge in all aspects of disaster management.ConclusionsStudy findings revealed that there was significant increase in knowledge in the post-test after the educational intervention. Therefore, it can be concluded that education plays an important role in increasing awareness. It is recommended that awareness programs on disaster management should be carried out periodically as in-service education.
(P2-46) Understanding the Willingness of Australian Emergency Nurses to Respond to a Health Care Disaster
Authors: Ranse J. , Arbon P. , Cusack L. , Shaban R. , Considine J. , Mitchell B. , Woodman R. , Hammad K. , Kako M. , Bahnisch L. 
Published: May 2011

BackgroundDisaster response is an emergency nursing responsibility. Responding to disasters, however, is hazardous as terrorism, pandemics and chemical industrial accidents challenge the safety of nurses and their families. International experience has shown that nurses can become victims of disasters and that fear of contaminating family and friends may prevent nurses from attending work or returning home during a disaster response. An understanding of the factors that enable or disable their disaster preparedness will underpin future disaster policy and planning for Australian and international health care organizations.MethodsThis study examines the willingness of Australian emergency nurses to attend work to respond to a health care disaster, using a 3-phase mixed-method design. Phase 1 was a national online survey, with 451 responses. Phase 2 involved 6 focus groups at 4 hospital sites, with 41 participants and Phase 3 involved in-depth interviews with emergency nurses at different sites, with 11 participants. This presentation will highlight results from the study on the willingness of Australian emergency nurses to respond to a health care disaster.ResultsPreliminary findings indicate that emergency nurses' willingness to respond to health care disasters was dependent on a number of factors, including their out-of-work responsibilities, the changes to their roles and responsibilities at work, their confidence in management and their work team, the information they are given about the disaster, the type of disaster and the degree of risk involved.ConclusionsThe contribution the findings this study will make to disaster planning and preparedness for nursing staff, health planners and administrators will be outlined.