bluuebunny/crossref_metadata_2025_split huggingface dataset:
(A288) World Health Organization Regional Office for Europe All-Hazard Hospital Emergency Preparedness Checklist
Authors: Sorensen B. , Bayer C.P. , Zane R. , Wante B. , Rockenschaub G. 
Published: May 2011

ObjectivesHospitals play a critical role in communities to provide essential medical care during all types of disaster. Depending on their scope and nature, disasters can lead to rapidly increasing service demand that can overwhelm the functional capacity and safety of hospitals and the health care system at large. The World Health Organization (WHO) Regional Office for Europe All-Hazard Hospital Emergency Preparedness Checklist aims to assist hospital administrators and disaster managers in preparing health facilities to respond effectively to the most likely disaster scenarios.MethodsA checklist tool was developed that comprises current hospital-based emergency management principles and techniques, and integrates applications specific to hospital preparedness needs in the WHO European Region.ResultsA list of recommended actions within critical service categories is provided in a step-wise, all-hazard form for rapid implementation by hospital administrators and disaster managers in response to the most likely types of disaster.ConclusionsThe principles and recommendations provided in this tool may be used by hospitals at any level of emergency preparedness. The checklist is not intended to replace standards and protocols already defined in hospital emergency management plans. Rather, it provides recommendations to enhance existing plans in concert with national guidelines.
(A290) Coordinated Hospital Disaster Response: A Detailed Assessment of Leadership
Authors: Downey E. , Andress K. 
Published: May 2011

IntroductionThe Hospital Preparedness Program, prompted by the 9/11 terrorist attacks, emphasizes the value of developing coordinated response capabilities by community leaders. Immediately following Hurricanes Katrina and Rita, this study examined the hospital emergency preparedness coordinators' leadership style and applied leadership theory to Louisiana planners as an integral part of a complex National Response Framework. This regionally coordinated system remains in place today and has been tested a minimum of 15 times in hurricane activations and state-wide exercises and drills.MethodsThree hospital groups participated: (1) regional coordinators representing nine geographic areas; (2) coordinators at acute care facilities; and (3) coordinators at non-acute care facilities. A total of 744 study participants represented over 150 hospitals. The Multifactor Leadership Questionnaire (Bass, 1995) assessed three dimensions of leadership style and the Emergency Preparedness Indicator assessed planning priorities, performance ratings, demographic variables of gender, education, and Healthcare Performance Partners (HPP) planning experience and disaster declarations.ResultsTransformational leadership was highest among all three groups and included characteristic of: idealized influence, idealized behaviors, inspirational motivation, intellectual stimulation, and individual consideration. Transactional leadership was highest (but still lower than transformational) among the non-acute care group and included characteristics of: contingent reward and management by exception (both active and passive). Gender and education were not significant predictors of leadership style but positive associations of time spent on emergency preparedness activities were found.ConclusionsPrevious studies reported the relationship of transformational leadership style to cohesion scores of 2.1. This study expands those results by further detailing leadership styles to the hospital emergency preparedness coordinator. It builds on a standardized approach to assess coordinator leadership style and effectiveness measures.
(A292) Disaster Assessment and Gathering Medical Intelligence Following a Major Public Health or Complex Humanitarian Emergency
Authors: Reilly M. 
Published: May 2011

IntroductionImmediately following a major public health emergency or complex humanitarian emergency such as the South East Asian Tsunami in 2004, the Haitian Earthquake in 2010 or Hurricane Katrina in 2005, there is a critical need to rapidly and as accurately as possible gather information not limited to morbidity and mortality, but necessary to assess the stability and existence of a public health or medical infrastructure, logistic supply chain, condition of food, water and shelter for victims and rescue workers, and particularly the security and stability of the region following the incident. With this information, only then can an effective humanitarian response be planned and executed that meets the actual versus perceived needs of an affected population.MethodsSpecific disaster risk assessment and medical intelligence techniques will be presented that are currently used by a variety of relief organizations. Specific topics of discussion include: Disaster epidemiology; Indicators of health in populations; Systems of surveillance; Impact of weather and climate; Displaced populations and refugee health; Tactical and combat medical intelligence; Zoonotic diseases; Agricultural trends and food security; Public health and health system infrastructure assessment; and Personal and physical security concerns.ConclusionsUtilizing case reports, best-practices and lessons learned from numerous international humanitarian responses, this session will guide participants though the performance of a rapid disaster assessment and the gathering of critical medical intelligence to determine the kinds and types of resources needed in an affected area. And the process of utilizing limited information to plan humanitarian relief efforts.
(A293) Critical Incident Stress Management and Mental Health Strategies after the 2009 American Samoan Tsunami
Authors: Bouslough D.B. , Biukoto P. , Stracensky S. 
Published: May 2011

BackgroundTsunamis are infrequent but devastating natural disasters. Loss of life, livelihood, and property contribute psychological stresses to an affected population, resulting in new psychiatric illness.ObjectiveTo describe post-disaster hospital, Department of Human Services (DHS), and Department of Education (DOE) methods of mental health resource dissemination, and their effectiveness.MethodsA retrospective review of after-action reports, psychiatric clinic charts, and key-informant interviews over a 4 month period was employed. Descriptive statistics were used to evaluate data.ResultsThe September 29, 2009 tsunami claimed 33 American Samoan lives. Hospital Family Assistance Center counselors aided families in the identification of 12 corpses, 9 missing persons, and providing psychiatric referral. Fifty-four hospital staff suffered loss. (Loss of: transportation, n = 13; utilities, n = 15; homes/shelter, n = 2). Coupled with the stresses of providing post-event medical care, the hospital staff was at high risk for psychiatric sequelae. Debriefing sessions for hospital staff were poorly attended due to conflicting work responsibilities, and an unfamiliar discussion format. DHS assembled four teams, each composed of one psychiatrist/psychologist leader and 6 crisis counselors. DOE school counselors utilized DHS mental health teams to screen all school aged children. The hospital psychiatry clinic remained the definitive referral destination. Federal mitigation grants provided funding for two psychiatrists, and two psychologists (including pediatric specialists) to augment hospital mental health capacity. Screening statistics and prevalence of psychiatric disease are further reported. Six month post-event rates of persistent psychiatric disease reflect that reported in recent literature (1-2%).ConclusionHospital critical incident stress management requires culturally acceptable counseling methods and administrative support. Family assistance counselors are key players in identifying the needs of families of the deceased. Student counseling services and collaborative mental health teams provide a novel approach to the dissemination of mental health services within a community.
(A317) Evaluation Outcomes - Capacity Building for Emergency Medical Services along National Highway No. 5 in Hai Duong Province, Vietnam – October 2009
Authors: Bollinger P. , Baird S. 
Published: May 2011

BackgroundThis project was designed to reduce secondary injury of road traffic accidents (RTA) victims in Hai Duong (HDRC) province in Vietnam in collaboration with the Red Cross with funding from Medical Teams International (MTI). The approximate number of beneficiaries was 601,820, including the 1,820 direct beneficiaries who received first responder training and emergency treatment. The 600,000 indirect beneficiaries is the population along a 45km corridor of National Highway #5 crossing Hai Duong province.MethodsIn late October 2009 an evaluation team from MTI reviewed the training of Vietnam Red Cross volunteers in Hai Duong province. The pre-evaluation activities (review of patient contact log books and patient interviews) were conducted by the MTI-Vietnam staff. 58 trained lead volunteers and 20 community members participated in this evaluation. Additionally 92 patients who had been treated by the volunteers were also interviewed.ResultsFindings included: a) the volunteers who received training stated an increase in their confidence to respond to emergencies, b) a 65% increase of Red Cross volunteers, c) a increased awareness of EMS within the province, d) greater community engagement at emergency scenes, and e) broad respect from the community towards the HDRC volunteers.DiscussionConsiderations for the future include: a) development of a continuing education program, b) increase of supplies to volunteers, c) more training involving multi casualty incidents, d) development of a communications protocol between volunteers and other healthcare providers and e) limit CPR training to drowning related events.ConclusionThe outcomes exceeded the planned goals: knowledge and retention of course materials and skills is good, confidence levels of volunteers increased and those that are involved in emergency events in Hai Duong province are safer. The profile of EMS and first responders as a critical component of community health has been measurably raised among key stakeholders and the community.
(A323) Wildfire Associated Burn Injury of 1400 Sheep in Northern California: A Coordinated Mass Casualty Veterinary Response
Authors: Madigan J. , Rowe J. , Angelos J. , Herthel W.F. , Matz D. , Dinucci M. , Fletcher V. 
Published: May 2011

IntroductionWildfires can injure animals both from burns and inhalation of smoke and particulates. In 2006 a rapidly moving grass wildfire burned 12 square miles in Yolo County. Approximately 1400 sheep on the range suffered variable degrees of burns. A coordinated effort of triage and individual treatment or humane euthanasia was performed by the UC Davis Veterinary Emergency Response Team.MethodsAnimals: Two sheep ranches with 1100 (ranch A) and 300 (ranch b) adult sheep of different breeds, ranging in age from 1-6 years of age. Initial owner evaluation: Both ranchers considered humane destruction of all sheep showing evidence of burned discoloration, estimated to be over 95% of 1400 sheep. Ranch B attempted shooting comprised sheep but stopped and requested aid from UC Davis as did ranch A. Veterinary initial evaluation and communications: Several burned sheep were visible from the roadway. Many sheep were standing with limited movement and some were recumbent. Triage was performed by bringing food and water sources to the sheep and those not eating and drinking were evaluated first. Gunshot euthanasia following AVMA guidelines based on veterinary determination of hopeless prognosis was used. Veterinary team members (N = 25) coordinated treatments, communications with public health, animal control, and press media, carcass disposal, volunteer management, and acquisition of office of emergency services resources.TreatmentTopical treatment of eyes and skin burns with silver sulfadiazine ointment, administration of systemic antibiotics (LA 200), pain relief (flunixine meglumine), wound debridement, and cesarean section of late term terminal sheep were performed.ResultsOver 500 sheep were euthanized by gunshot and the remainder (approximately 900) recovered lasting from 1-42 days. Progression of burn injury to skin, udder, face, and hoofs persisted for 42 days.ConclusionA coordinated veterinary response provided humane care and triage of this mass casualty animal emergency.
(A337) State Failure as a Factor in International Global Medical Operations: Network Modeling
Authors: Trufanov A. , Rossodivita A. , Aminova M. , Tikhomirov A. , Caruso A. , Umerov R. 
Published: May 2011

IntroductionIn order to counteract disasters and emergencies, it is necessary to build cooperation and collaboration among all entities and actors. Field teams of rescuers require support from the State experiencing a disaster. The responses to the earthquake in Haiti demonstrated a lack of cooperation and collaboration and the rescuers encountered concomitant difficulties. Thus, the problems in the field are not only related to natural and technological aspects, but also social and political contexts. It is time to explore the role of the impact of State power on national and international disasters and emergencies. One modern and fruitful instrument for analysis of these complicated social and group processes is Complex Network modeling. Complex Network tools have been applied successfully to understanding and counteracting such threats as they relate to the spread of infectious diseases and/or to terrorist activities. Another significant utilization of the Complex Network approach is to develop good governance, management, and organizational processes in national and corporate landscapes.MethodsBased on a Complex Network Scope, a novel, three-layer network model of public connections for diverse State regimes for further simulation is proposed. Quantitative assessments and practical processes should be implemented for countering global disasters using international and interdisciplinary teams. Contrary to the known hierarchical layer approach for knowledge acquisition, this new model describes an overall national Society Network by dividing the approach into the three layers: (1) Formal (State), as hierarchical governments structures; (2) Informal (presented by different long-term sustainable link groups); and (3) Informal (aquatinters with short term links (“weak ties”).ResultsAccording to each of these layers, one of three types of network topologies exist: (1) hierarchical; (2) scale-free; and (3) random, respectively.
(A340) The Role of Field Hospitals in Severe Environments — Guidelines to Prepare and Build a Field Hospital during a Disaster
Authors: Rossodivita A. 
Published: May 2011

IntroductionFacing the threats of disasters due to natural hazards and terrorist attacks, communities and nations are strategically preparing to respond rapidly to such incidents with the appropriate medical services. Both natural and complex disasters may produce a massive number of casualties that outstrip the ability of the local healthcare system to provide the required care. Damage to the healthcare infrastructure will further compromise the delivery of health services. Field hospitals (FHs) may provide care for the injured and act as a substitute for destroyed hospitals in the aftermath of sudden-onset disasters. A FH is a large mobile medical unit that temporarily provides care to casualties on-site before they can be transported safely to more permanent hospital facilities. The concept was inherited from the battlefield (such as the mobile army surgical hospital (MASH)). A FH is defined as a mobile, self-contained, self-sufficient healthcare facility capable of rapid deployment and expansion or contraction to meet immediate emergency requirements for a specified period of time. The FH may be dispatched temporarily with personnel or donated without personnel.MethodsField hospitals have been focused on providing emergency trauma care for the initial 48 hours following the sudden-onset disasters, but they tend to continue operations much longer after the on-set. The aim of this study was to assess the timing, activities, and capacities of the FHs deployed after a disaster, especially in severe environments, and provide guidelines on the implementation and deployment of a FH during a disaster. In particular, the activity of Italian Field Hospitals utilized during disasters, humanitarian emergencies, and mass-gatherings events will be described.ConclusionsField hospitals have been used successfully during disasters, and now have a crucial role in supporting affected populations and damaged healthcare infrastructures. Field hospitals also play a role in the international community response.
(P1-1) The Daily Risk
Authors: Saenz M.C. , Cappo Lertora C. 
Published: May 2011

BackgroundCan Health Professionals do something to diminish the risks in big cities? Civilian society is in need of protection and training when emergencies occur. The objective is to develop the capacity to feel competent when daily violence occurs and to diminish the risks of possible tragic, daily and unexpected events. Inexperience and lack of knowledge has a direct impact on Public Health. Through orientation and training with appropriate tools we prevent and diminish the effects on daily catastrophes: insecurity, violence, loss of material things, mourning to elaborate for loss after tragedies, car accidents, effects on financial emergencies, social alert states, etc.Methodology and ObjectiveThrough questionnaires and observation directed to city residents data was generated for evaluation. We reached the conclusion that non-government organizations (NGO) and government organizations (GO) together can diminish the effects of daily tragedies. Approximately 4500 citizens were trained directly and indirectly to give them the tools and techniques to support groups in communities in order to diminish the risk among high impact psychosocial events and abrupt events produced by nature or men that expose persons to disruptive situations that need to be solved. The modules include First Aid, Psychological Support, Debriefing and Stress.ConclusionDiminishing the risks depends on the people's vulnerability, resilience, social, institutional and family support groups and training. The use of participative techniques allows participants to assimilate the content of the course directed to men and women from different ages. It is necessary to generate an emergency culture for a society at risk.
(P1-14) Incident Command and Rescue during a Building Collapse
Authors: Arikan R. , Durusu M. , Arziman I. , Kandis H. , Erdogan N. , Eryilmaz M. , Erdil A. 
Published: May 2011

On 11 December 2006, at 8:20h, five flats of a building containing 10 apartments collapsed due to a heater explosion. Four injured patients were transferred to a military hospital with the help of bystanders. Approximately 200 people gathered at the scene. People who were trapped in the building were rescued. The building was surrounded by safety tape. The first injured patient was discovered 4 hours after the collapse. The patinet was transferred by the National Medical Rescue Team. Rescue activities were terminated after 36 hours. A total of eight dead, including five children, and five injured people were recovered from the building. Six of the eight injured patients had superficial wounds. Two patients were monitored: one with head trauma and another with liver contusion and costa fracture.DiscussionThe explosion occurred during working hours, which contributed to the low number of injuries and deaths. The top floor of the building had the highest survival rate. Bystanders entered the scene through the safety tape, and complicated the rescue efforts.ConclusionsRescue efforts during disasters require a high level of education. Otherwise, it becomes impossible to control the crowd and prevent chaos. Also, considering the direction of the building collapse during the rescue activities might enable reaching more people in a shorter time period. Coordination by the departments taking part in the rescue efforts is just one of the key issues affecting a successful response.
(P1-21) Medical Disaster Relief after the 2009 American Samoan Tsunami: Lessons Learned
Authors: Partridge R. , Bouslough D.B. , Proano L. , Soliai-lemusu S. , Avegalio F. , Anesi A. 
Published: May 2011

BackgroundTsunamis most commonly occur in the “Ring of fire” in the Pacific due to frequency of earthquakes and volcanic activity. Damaging tsunamis occur 1–2 times yearly. On September 29, 2009, an earthquake on the Pacific floor caused a tsunami that struck American Samoa, Samoa and Tonga, with only 20 minutes warning.ObjectiveTo evaluate the disaster response in American Samoa by emergency medical services (EMS), the territorial hospital, and the Department of Health.MethodsA retrospective review of EMS logs, public health records, hospital emergency department charts, and key-informant interviews over a 2-week period. Descriptive statistics were used to evaluate data.ResultsThree 5-meter waves struck the American Samoan islands, with land inundation as far as 700 meters. Many low- lying villages, including the capital city Pago Pago were affected. A total of 33 people (8 male, 23 female, including 3 children) were killed by the water, with approximately 150 significantly injured. EMS runs increased 250% from normal daily averages, with island-wide responses significantly delayed by flood damage. The hospital in Pago Pago, situated near the shore and only 10 meters above sea level, utilized 75 staff to evacuate 68 in-patients to high ground as soon as tremors were felt. This process was completed in 20 minutes with no associated morbidity or mortality. Patient injury patterns for the event are similar to recent literature reports. Mobile clinics and alternate care sites established at outlying dispensaries were used to decentralize healthcare from the hospital. DMAT/DMORT teams from Oregon and Hawaii supported local healthcare initiatives. Post-disaster public health surveillance focused on identifying and limiting food/water-borne illnesses, dengue fever, and influenza-like-illness outbreaks, as well as disaster related PTSD.ConclusionThe disaster response to the tsunami in American Samoa was effective. Disaster planning was appropriate and rapidly implemented. Post-disaster public health emergencies were minimized.
(P1-23) The Potential Terrorist Possession of Weaponized Plague in North Africa: A Forensic Epidemiology Case Study and Discussion of Principles in Tizi Ouzou, Algeria
Authors: Allswede M.P. , Binyamin T. 
Published: May 2011

BackgroundA report of black death, presumably pneumonic plague (Yersinia Pestis) occurred in the terrorist group Al Qaeda in the Land of Islamic Maghreb (AQLIM) in 2009. Up to 40 members of AQLIM are reported to have perished rapidly.DiscussionThe event was managed by Algeria, but questions remain as to the nature of this event and the level of investigation that was applied. This paper is a discussion of the principle elements of a forensic epidemiology investigation that should have, but did not take place in Algeria. The need for improved forensic epidemiology investigation capability is illustrated in this event due the unique problems inherent in the investigation of intentional outbreaks.