bluuebunny/crossref_metadata_2025_split huggingface dataset:
(A98) Animal Relief Coalition of Haiti (ARCH): A Collaborative Approach to Animal Relief and Recovery
Authors: Green D. 
Published: May 2011

BackgroundFollowing the devastating earthquake in Haiti last January, the International Fund for Animal Welfare (IFAW) and the World Society for the Protection of Animals (WSPA) developed the Animal Relief Coalition of Haiti (ARCH). 19 animal welfare agencies from around the world joined IFAW and WSPA to provide a $1.04M managed fund to the Minstery of Agriculture, Natural Rescources, and Rural Development (MARNDR).Discussion and ObservationsThe relief and recovery efforts were based around six objectives: 1. Mobile veterinary clinic 2. Public Outreach emphasizing disaster preparedness, disease prevention, and animal welfare 3. Educational outreach to include an animal welfare curriculum for school-aged children 4. Cold-chain: to provide solar-powered refer/freezer units in remote sections of Haiti to keep vaccines cold 5. Dog and cat survey in Port-au-Prince 6. Rebuilding of the National Laboratory The purpose of this presentation will be to discuss how ARCH was developed and Best Practices and Lessons Learned from a collaborative approach to animal relief and recovery.
(A113) Ethics in the Delivery of Humanitarian Health Response: Learning from the Narratives of Health Care Workers
Authors: Redwood-Campbell L. , Hunt M. , Schwartz L. , Sinding C. , Elit L. , De Laat S. , Ranford J. 
Published: May 2011

Aims1. To hear the types of ethical challenges foreign health care workers (HCWs) experience while providing health care in conditions of disaster and deprivation. 2. To hear how they responded 3. To understand the kinds of resources that may have been helpful to support HCWs in these ethical dilemmas.MethodsQualitative study, loosely grounded theory. Canadian trained HCWs (n = 20, mean age 39) who have worked in disaster response, conflict, post disaster.ResultsEthical dilemmas emerged from 4 main sources: resource scarcity, historical/political/social structures, aid agency policies/agendas, HCWs norms roles/interactions. Participants described little preparation to deal with ethical dilemmas, and the value in pre-departure training. Clinicians are nurtured in western ethics- mostly formed on autonomy, beneficence, non-maleficence and justice. New realities for many were related to community oriented Public Health Ethics. Early discussion has emerged about the possibility of developing a simple, practical, hand held decision-making model (toolkit) to be used in the field to help guide reflection about ethical dilemmas for HCWs in disaster settings.
(A151) Non-Traumatic Out-of-Hospital Arrests: Initial Cardiac Arrhythmia, Circadian Differences and Cause of Death
Authors: Alicia V. , Yih Chong Michael C. , Eillyne S. 
Published: May 2011

BackgroundOut-of-hospital cardiopulmonary arrest (OHA) is an international health issue. There is an urgent need to better understand the key factors that affect OHA survival. Epidemiological surveillance is the first step towards scientific understanding of the problem. This study looks at the profiles of patients who suffered an OHA.MethodologyIn this retrospective study, the medical records of all patients who died upon arrival at Tan Tock Seng Hospital, Emergency Department (TTSH ED) between 1st January 2009 and 31st December 2009 were reviewed. The outcomes include patient demographics, pre-hospital management and the cause of death.ResultsWithin the study period, there were a total of 275 OHA, 5 (1.8%) traumatic and 270 (98.2%) non-traumatic cases. Emergency Medical Service (EMS) conveyed 247 (91.5%) of OHA and 23 (8.5%) arrived by self-transport. The incidence of non-traumatic OHA was 14 per 10,000 ED attendees, predominantly male (72.2%). Male were significantly younger than female (63 vs 70 years, p = 0.002). The commonest initial cardiac arrhythmia recorded on scene by paramedics was asystole (54.1%), pulseless electrical activity (34.8%) and ventricular fibrillation (11.1%). One hundred sixty-one (59.6%) patients collapsed during the day (0600 – 1759 hours). Patients found in ventricular fibrillation on scene peaked in the morning (1020hours). All OHA were started on cardiopulmonary resuscitation, intubated with laryngeal airway mask, given intravenous adrenaline, and all ventricular fibrillation was electrically defibrillated en-route by the paramedics. Despite continued resuscitative efforts in the ED, all remained in asystole. The State Coroner reviewed 266 (96.7%) OHAs, of which, 96 (36%) were subjected to post mortem. Among patients with asystole at scene, acute coronary syndrome (55.2%), hypertensive heart disease (13%) and bronchopneumonia (5.2%) were the three commonest cause of death. The commonest cause of death for ventricular fibrillation at scene was acute coronary syndrome (76.7%), of which 10 (43.5%) had no pre-existing medical conditions.ConclusionIn our study population, majority of patients had asystole as their presenting arrhythmia at scene. OHA with ventricular fibrillation demonstrated significant circadian differences and the underlying cause of death was acute coronary syndrome. This knowledge will allow EMS to devise future strategies that have the greatest potential to improve survival outcomes.
(A185) Did the Ministry of Health's Intervention Increase Compliance of Medical Teams to be Vaccinated against H1N1?
Authors: Adini B. , Laor D. , Hornik-Luria T. , Goldberg A. , Aharonson-Daniel L. 
Published: May 2011

BackgroundPandemic influenza poses a great challenge to healthcare systems. Vaccinating medical teams and the population against pandemic influenza is the global recommended strategy to contain spread of the disease. As part of the efforts made to overcome the H1N1 pandemic, the Israeli Ministry of Health (MOH) initiated a general vaccination program for medical teams and the total country population. Due to low compliance rates of the medical staff, the MOH conducted regional conferences aimed at providing knowledge and encouraging staff to be vaccinated.ObjectivesTo evaluate the effect of the regional conferences on the compliance rates amongst medical providers to be vaccinated against H1N1.MethodsMedical providers from the primary health care services were invited to conferences that were conducted in 3 regions. Attitudes of the teams regarding compliance to be vaccinated were assessed pre and post the conferences. Additionally, the actual rates of vaccinations were recorded over the period of vaccination program. Actual compliance rates before and after the conferences were compared to detect differences as well as the relationship between teams' attitudes and actual vaccinations.ResultsVaccination rates of medical providers remained low during the full vaccination period. Among the non-vaccinated, 24% to 29% reported before the conference that they agree to be vaccinated versus 57% to 62% following the conference. Analysis of the actual vaccination data among the medical providers did not demonstrate a change in compliance following the conferences and an overall decrease was noted after the first two weeks of the vaccinated project.ConclusionsA statistically significant relationship was not found between reported attitudes of medical providers regarding readiness to be vaccinated and their actual vaccination. The MOH intervention did not achieve the expected result and did not raise compliance to be vaccinated.
(A276) Improving Emergency Medical Care in Nigeria - The Ubth Emt-Paramedic Training Programme
Authors: Iribhogbe P.E. 
Published: May 2011

BackgroundTrauma is the leading cause of death in the age group 15–44 years in Nigeria. The burden of trauma has continued to increase in the subregion. It is estimated that a significant proportion of trauma deaths occur prehospital. The role of the EMT-Paramedics in trauma and emergency care is well established. However the profession has been absent in the West African subregion. There was no training centre for EMT Paramedic professionals until the UBTH established one in 2008.ObjectiveTo review the UBTH EMT-Paramedic training programme and the implications for trauma and emergency care.MethodThe programme onset, implementation and challenges so far is reviewed in detail with illustrations.ConclusionThe injection of the EMT-Paramedic professionals into our health system will surely improve our emergency care. The support of the Government at all levels as well support for the training from all Medical professionals is urgently neede.
(P1-8) The Port-Au-Prince 2010 Earthquake - Unique Lessons Learned by Florida One Disaster Medical Assistance Team (FL1 DMAT) in the First International Dmat Deployment
Authors: Mccann D.G. 
Published: May 2011

IntroductionThe devastating Haiti earthquake of January 10, 2010 resulted in 250,000 dead, more than 300,000 wounded and at least 1.3 million displaced. As the poorest nation in the Western Hemisphere, life in Haiti was already fraught with poverty and one of the highest HIV rates in the world. After the earthquake, life in Haiti became intolerable. As Chief Medical Officer of Florida One DMAT, the author helped to coordinate medical relief operations at the US Embassy in Port-au-Prince beginning within 60 hours of the earthquake. The author and his FL1 DMAT team supported medical relief operations not only at the US Embassy but also at the Toussaint L'Ouverture International Airport for air evacuation of survivors to Miami and at Terminal Varreux for coordination of ingress/egress casualty operations for the USNS Comfort hospital ship.ResultsUnique lessons were learned in this first ever deployment of US DMATs on foreign soil. The presentation will describe the medical operations, the triage process, the challenges of operating on foreign soil, and the results of the relief efforts. Recommendations will be offered to facilitate future international DMAT deployments including development of Standard Operating Procedures (SOPs) for DMAT international deployments and increased coordination between the US Department of State (who have jurisdiction over US assets on foreign soil) and the US Department of Health & Human Services (who are the coordinating governmental department for DMAT operations).
(P1-54) Healthcare Worker's Perception towards Individual and Institution Disaster Preparedness
Authors: Lim G.H. 
Published: May 2011

Background and AimDisaster and MCI events are occurrences that healthcare institutions must be prepared to respond to at all times. The events of September 11 2001 have rekindled our attention to this aspect of preparedness amongst our healthcare institutions. In Singapore, the SARS experience in 2003 and the recent H1N1 outbreak have thrust emergency preparedness further into the limelight. While priorities had been re-calibrated, we feel that we still lack far behind in our level of preparedness. This study is conducted to understand the perception of our healthcare workers towards their individual and the institution preparedness towards a disaster incident.MethodA questionnaire survey was done for this study for the doctors, nurses and allied health workers in our hospital. Questions measuring perception of disaster preparedness for themselves, their colleagues and that of the institution were asked. This was done using a 5-point likert scale.ResultsThe study was conducted over a 2-month period from 1st August 2010 till 30th September 2010. 1534 healthcare workers participated in the study. 75.3% felt that the institution is ready to respond to a disaster incident; but only 36.4% felt that they were ready. 12.6% had previous experience in disaster response. They were more likely to be ready to respond to future incidents (p = 0.00). Factors that influenced perception of readiness included leadership (p = 0.00), disaster drills (p = 0.02), access to disaster plans (p = 0.04), family support. 80.7% were willing to participate in future disaster incident response training. 74.5% felt that being able to respond to a disaster incident constitute part of their professional competency. However, only 31% of the respondents agreed that disaster response training was readily available and only 27.8% knew where to go to look for these training opportunities.ConclusionThere is an urgent need to train the healthcare workers to enhance their capability to respond to a disaster incident. While they have confidence in the institutions capability they were not sure of their own capability. Training opportunities should be made more accessible. We should also do more to harvest the family support that these worker value in order for them to be able to perform their roles in a disaster incident.
(P1-64) E-Learning for Staff Education on Managing Catastrophe Plan – Hospital in Sao Paulo – Brazil
Authors: Mizoi C. , Sousa E. , Kina S.O. , Vaidotas M. , Sako Y.K. , Tucherman M. , Barros C.G. 
Published: May 2011

IntroductionStaff education and qualification is a safety issue to maintain employees ready to act whenever the catastrophe plan is deflagrated especially since it only happens once in a while. Considering that catastrophe is an unexpected event and most of the time an unusual scenario, the risk of inefficient patient care and unsafe situations for employees and for the environment is high.ObjectiveTo describe the e-learning as a continuous training methodology to keep staff prepared to manage victims from a catastrophic situation whenever it happens.MethodologyE-learning is a methodology for distance learning with focused content, pedagogy, technology and instructional system design aimed to deliver education. E-learning has advantages such as: a rapid update, customization of content, access flexibility, continued availability, reduced time for learning, training of a large number of employees with access control and release reporting. The development of e-learning is based on the following phases: analysis of topic relevance, evaluation by expert professional, relevance and applicability as educational strategy, planning and content construction with related areas, development of the storyboard and formatting with an instructional designer. The content of the e-learning Catastrophe Plan include definition of catastrophe, STAR screening method, roles and responsibilities, attendance flows, tests. Its duration was 30 minutes.ResultsDuring 03 months the e-learning of Catastrophe Plan was available in the intranet to Albert Einstein employees. A total of 3104 employees were trained representing 56% of target public (n = 5541). After this period, the e-learning became constantly available and part of the new employees admission process.ConclusionE-learning is an innovative educational methodology that contributes to the retention and generation of knowledge. The care and support team during the simulations in 2010 showed better performance when compared to 2009 due to the capability of this tool to spread the knowledge.
(P1-73) Medical CBRN Training for Military Health Staff and Its Benefits
Authors: Kenar L. , Ortatatli M. , Kunak Z.I. , Oztuna A. , Arziman I. 
Published: May 2011

ObjectiveThe increasing threat of the use of chemical, biological, radiological, and nuclear (CBRN) agents requires significant military medical preparedness and response, including training. The initiatives for CBRN training by Gulhane Military Medical Academy, which is under the Health Command of the Turkish Armed Forces, will be discussed, and the training program and educational model for medical CBRN defense will be highlighted.MethodThe training is given to military hospital staff once or twice a year. Hospital staff is trained over a period of five days, with practical issues regarding medical CBRN defense covered during the last two days. A questionnaire is given to trainees at the beginning and at the end to ascertain the adequacy of the course.ResultsSo far, this medical CBRN training has been given to 150 military health staff including physicians, nurses, and medical non-commissioned officers. According to the survey, they benefited greatly from this training, and there was a statistically significant increase in CBRN knowledge when the initial and final scores of the survey were compared (x2 = 3.089; p = 0.002).ConclusionThrough this planned trainings, staff are trying to become well-trained in detection, personal protection, decontamination, and the organization aspects of CBRN defense to apply the proper prophylactic measures, diagnosis, and treatment. Feedback suggests this program also helped “train the trainers”, providing extensive information to other staff working in military hospitals.
(P1-101) Salvage of Traumatized Extremities Restores Morale in Working Class of Society
Authors: Raju V. 
Published: May 2011

IntroductionTo improve quality of life among subjects with crush injuries of extremities as an outcome of traumata of various aetiology by salvage procedures. To prevent or minimize psycho-social derangement or implications by minimizing partial or total loss of traumatized body parts and restore useful function.Material20 year study/observation in trauma of limbs, hands, feet, fingers, toes with partial to near total vascular compromise sustained in road traffic, industrial, domestic, suicidal, homicidal, war wounds, fire work blasts, etc. accidents.MethodPre-operative/follow-up counselling of every patient, attendants and employer are of utmost importance. Primary debridement, stabilization, skin cover and serial paraffin-gauge dressings are followed with straps/splints, passive/active range of movement exercises and delayed suture removal. Antibiotic cover with sequential cultures are mandatory.Facts / FiguresSepsis is a challenge. Males, youth, hands, Grade II wounds and RTAs dominate incidence. Contamination, delayed presentation, poor compliance and follow-up, poor nutritional status, anaemia, etc., dread salvage. Initial poor tissue perfusion is no indication for early decision to amputate/terminalize.ResultsCompromised vascular crushes in which primary closure was achieved, salvage of limb and appendages was surprisingly possible. Cosmesis in working class is never the priority, but restoration of function and more so the chance of livelihood are. Dexterity and confidence come with practice. Richer the patient, difficult to convince. Psycho-social depression is more with early amputations than in revisions and much less in salvaged groups, commoner in men and unmarried illiterate women. Women adapt better to salvaged parts.ConclusionEven a nail lost with its bed is lost for ever, leaving a painful defunct stump. No riches can truly compensate. If soft tissue cover on bony elements and neuro-vascular bundles is achievable, an entire limb may survive and regain near normal function. When crush wounds remain aseptic a decision to amputate can wait.
(P2-4) Prehospital System Development in Jaffna, Sri Lanka
Authors: Bollinger P. , Zimmerman J. , Bertermann K. , Nominathan R. , Woodyard D.R. 
Published: May 2011

IntroductionThis case study presents the development of a prehospital system in Jaffna, Sri Lanka. The case then outlines the development of the system, examines its first year of operations, and investigates possible reasons for the results of the development of the prehospital system in Jaffna. Finally, the case discusses the continued operations of the system.MethodsThis case study qualitatively researches the development of the Jaffna prehospital care system by looking at indicators of success in human resources, technical knowledge and community awareness. The case study also quantitatively examines the utilization and financial performance of the system during its first year of operation.ResultsAccording to indicators, the implementation of the model and its functioning can arguably be considered successful in terms of utility, and in many regards financial stability. The system has already responded to over 2,000 emergency calls in its first eleven months of operation. The main ambulance and call center has managed to operate at only a $13.50 USD loss during its first twelve months of operation. It has established quality standards by utilizing trained Emergency Medical Technicians (EMT) and ambulances featuring basic life saving equipment. The system has also integrated itself as a part of the overall health system of the community it is serving.ConclusionsThe system's success in development should be examined as a potential model for implementing prehospital care in a developing and middle-income country setting, while keeping in mind factors outside of the system that were integral to its developmental success.
(P2-6) Evaluation of Air Rescue Missions Using a Helicopter — Analysis from a German Helicopter Base
Authors: Frank M.D. , Aschenbrenner U. , Nitschke G. , Braun J. 
Published: May 2011

IntroductionIn Germany, emergency medical care is provided by ambulances. Emergency physicians also are used in the German rescue system to ensure primary care. Additionally, rescue helicopters are insertable. The rescue helicopter in Dresden covers the city of Dresden and its surrounding areas, with 517,000 inhabitants and distances up to 70 km. The goal of this study was to evaluate emergency cases in helicopter rescue missions according to primary diagnoses and severity of the mission on the basis of NACA Score.MethodsData from all emergencies using the German Air Rescue (DRF-Luftrettung) Helicopter Base Dresden were recorded on a standardized protocol and transferred to a central computer database (MEDAT®). Data from all emergency cases between January 2006 and July 2010 were analyzed.ResultsThere was a total of 6,310 emergencies during the study period, with a significant increase over time. The helicopter was on-scene within 10.9 minutes. In total, 54% of the patients were male. The rate of female patients > 80 years of age was 64.5%. A total of 63.4% of patients suffered life-threatening injuries or dysfunctions and a NACA score ≥ 4. A total of 7.6% of patients were classified in NACA 6 or 7. The most common cause for rescue missions was an acute coronary syndrome (20.4%). Other frequent diagnoses included brain injury (13.3%), unconsciousness (12.5%), stroke (12.9%), general cerebral convulsion (7.9%), polytrauma (6.4%), and cardiac arrest (5.0%). The rate of prehospital endotracheal intubation was 15.1%. In 1.1% of patients, a thoracic drainage was established.ConclusionsIn recent years the number of helicopter rescue missions increased, along with injury severity. The total number of patients with NACA 6 and 7 was extremely high, and demonstrates the need for an efficient emergency medical rescue system that includes helicopters.