bluuebunny/crossref_metadata_2025_split huggingface dataset:
(A42) Developement of Slovene Military Medical Unit
Authors: Strahovnik A. 
Published: May 2011

DiscussionDuring the past 12 years we have been developing our military medical unit through collaboration between the public health system and military system. We found that one system could not work separate without another. Experts from public health system are incorporated into the military structure which provides efficient technical support and logistics. Through such a system we can cooperate in international projects.
(A43) Are Injuries due to Terrorism and War Similar? A Comparison of Civilians and Soldiers
Authors: Peleg K. 
Published: May 2011

ObjectiveThe objective of this study was to compare injuries and hospital utilization and outcomes from terror and war for civilians and soldiers.BackgroundInjuries from terrorism and war are not necessarily comparable, especially among civilians and soldiers. For example, civilians have less direct exposure to conflict and are unprepared for injury, whereas soldiers are psychologically and physically prepared for combat on battlefields that often are far from trauma centers. Evidence-based studies distinguishing and characterizing differences in injuries according to conflict type and population group are lacking.MethodsA retrospective study was performed using hospitalization data from the Israel National Trauma Registry (10/2000–12/2006).ResultsTerrorism and war accounted for trauma hospitalizations among 1,784 civilians and 802 soldiers. Most civilians (93%) were injured in terrorism and transferred to trauma centers by land, whereas soldiers were transferred by land and air. Critical injuries and injuries to multiple body regions were more likely due to terrorism than war. Soldiers tended to present with less severe injuries from war than from terrorism. Rates of first admission to orthopedic surgery were greater for all casualties with the exception of civilians injured in terrorism who were equally likely to be admitted to the intensive care unit. In-hospital mortality was higher among terrorism (7%) than war (2%) casualties, and particularly among civilians.ConclusionsThis study provides evidence that substantial differences exist in injury characteristics and hospital resources required to treat civilians and soldiers injured in terrorism and war.
(A46) Health Volunteers during the MT. MERAPI ERUPTION: What did Nursing Students Learn?
Authors: Rochmawati E. 
Published: May 2011

BackgroundUndergraduate nursing students are expected to be responsive and competency, particularly during a disaster. Working as health volunteers is one strategy to develop these skills. However, little research has investigated the experiences of nursing students working as health volunteers during a disaster.ObjectivesThis study aimed to investigate undergraduate nursing student perceptions and experiences of being health volunteer during the Mt. Merapi eruption.Methods: A non-experimental, descriptive design was used. A sampling of 25 undergraduate nurse students who worked as health volunteers during the Mt. Merapi eruption completed a self-administered questionnaire. The questionnaire consisted open- and closed-ended questions, and was used to measure students' self awareness and what they have learned. Additional questions were asked to prioritize attributes required to be health volunteers. Data were aggregated and analyzed using a simple, descriptive analysis.ResultsUndergraduate nursing students had internal motivation of being health volunteers during disaster. Findings of this study illustrated benefits, future impact of being health volunteer, and required attributes of being good health volunteers.ConclusionsStudents' perceptions and experiences during disasters underscores important factors in the promotion of disaster management competency in nursing education.
(A60) Collection of Disaster Information in the Emergency Phase: An NGO View
Authors: Takada Y. , Ukai T. 
Published: May 2011

BackgroundIn a disaster, the most important information for those in the international disaster response community is that about the exact place and scale. However, problems with communication networks and the complexity of the disaster information can make collection difficult. The United Nations Office for the Coordination of Humanitarian Affairs provides information about the situation in the affected country on its websites; Virtual On-Site Operations Coordination Center (V-OSOCC), One Response (OR) and Relief Web (RW). The positive and negative characteristics of these websites are discussed from the viewpoint of a medical non-governmental organization (NGO).ResultsV-OSOCC is a platform for disaster response personnel in around the world. Disaster coordination information is shared interactively on a mimic board. This information is sent in E-mails and SMS in real time. OR is a collaborative interagency website, designed to enhance coordination of humanitarian responses within the cluster approach. Public documents such as situation and assessment reports, maps, meeting schedules, and contact lists can be viewed. RW provides a wide range of information, not only about disasters but also about humanitarian emergencies. However, this website does not provide information such as contact lists for direct use in relief work.DiscussionThese websites are considered from the viewpoint of a medical NGO. V-OSOCC can share information related to urban search and rescue in real time, but there is no coordination of medical teams. Thus, each medical team has to participate in health cluster meetings on site. OR is more convenient than V-OSOCC for health cluster members because it provides more detail, with updated situation and assessment reports and meeting schedules. However, such reports do not show needs at the community level. RW is suitable for institutions such as libraries, which generally collect academic information.ConclusionThe websites discussed here are useful for collecting disaster information; however, they do not have information about community-level needs. Therefore, needs assessment has to be undertaken within affected communities.
(A68) 7 Options for Evolving the Concept of Disaster Health
Authors: Allen A. , Shultz J.M. , Espinel Z. 
Published: May 2011

IntroductionThe World Association for Disaster and Emergency Medicine (WADEM) has been the primary innovator and incubator for the concept of disaster health. This presentation puts forth 7 options for consideration for evolving the concept of disaster health.Discussion(1) Promote disaster health from an adjective to a noun phrase. Disaster health has been a modifier for too long, tucked into expressions such as disaster health management or disaster health education. It is time for disaster health to emerge in its own right. (2) Elevate disaster health from a discipline to an endpoint, a defined and desired outcome. (3) Liberate disaster health from the confines of medicine and health care. Disaster health originated there, but is much more expansive. One of the distinctions of disaster health is its multidisciplinary nature. (4) Fully integrate the mental health and psychological dimension of disaster health. WADEM has been at the forefront, championing psychosocial issues in disasters, yet to date, this dimension of disaster health has been underdeveloped and underappreciated. (5) Consider the parallels inherent in optimizing disaster health for both disaster responders and disaster survivors. Also consider using plain language to create a common set of strategies for achieving disaster health that is equally applicable for responders and survivors. (6) Consider disaster health applied at the community level in a manner that subsumes community health, resilience, and disaster resistance. (7) Give disaster health its own framework. Clear and comprehensive WADEM-driven frameworks now exist for disaster health education, for example. Disaster health needs a framework that is simple, supple, and explanatory.ConclusionWADEM has promulgated disaster health as a vital, pivotal concept. The 7 options presented here have come from our own engagement with this concept. They are, in fact, defining features of our SAFETY FUNCTION ACTION framework for disaster health.
(A84) Video Documentation as a Supplemental Teaching Tool for Multi-Focused Emergency Management Exercises
Authors: Tedeschi C. , Hilmi L.M. 
Published: May 2011

IntroductionEmergency management education and large-scale disaster drills help to increase local capacity for dealing with a multitude of hazards. Video recordings of disaster drills offer participants with little exposure to fundamental emergency management principles an introduction to important topics and scenarios. Such resources allow ongoing training and education, thus maximizing the investment required to mount a large-scale exercise.MethodsDuring emergency management exercises in Mumbai, India between 2008 and 2010, video recordings of prior exercises were used to augment training for clinicians, administrators and public health practitioners. During the exercises, videos depicting scenario-based disaster drills were produced for use as teaching and evaluation tools focused on pre-hospital care, trauma life support, and hospital operations. Videos are distributed digitally and online, extending the teaching impact of multi-day courses and serving as a benchmark for future exercises.ResultsDuring the 2010 exercise in Mumbai, approximately eight hours of video footage were recorded by professional producers, and by participants in the evaluation and monitoring track of the course. That footage was added to a library from exercises in Ahmedabad and Mumbai, India, in 2007 and 2008. Video was used as a tool for immediate feedback on participant performance as well as the foundation for ongoing instruction. Videos allowed students to be sensitized to important issues prior to taking part in a drill, and to participate in the post-drill evaluation process.ConclusionVideo documents of disaster management exercises serve as a valuable addition to an ongoing program of emergency management education and preparedness. Short video pieces increase the effectiveness of a teaching program by providing re-usable, easily accessible, and setting-specific teaching tools.
(A104) Simulation in Disaster and Emergency Medicine
Authors: Khalifa G.E.A. 
Published: May 2011

SimulationAn activity or situation that produces conditions which are not real, but have the appearance of being real, used especially for testing something. Longman Dictionary of Contemporary English. Simulation has evolved over the centuries but has not been applied to medicine until the 20th century with the introduction of virtual reality and computers. Prior to the 20th century simulation took the forms of physical models and cadavers. With the introduction of flight simulation there was an effort to move similar approaches into medicine. This was pushed by the demands of minimally invasive surgery and the introduction of robotics in surgery. In the 21st century in addition to cognitive task analysis tools we are beginning to see the migration of advanced intelligence tools to simulation. We are just at the beginning of how we will use adversarial reasoning in the medical environment and in high risk time constrained situations like Emergency Medicine. The practitioner of emergency medicine is at high risk for errors because of multiple factors including high decision density, high levels of diagnostic uncertainty, high patient acuity, and frequent distractions. Some authors have suggested that instructing physicians in “cognitive forcing strategies” or “metacognition” will help reduce the amount of cognitive error in medical practice. It has been said ‘‘[There is an] ethical obligation to make all efforts to expose health professionals to clinical challenges that can be reasonably well simulated prior to allowing them to encounter and be responsible for similar real-life challenges.’' TYPES OF SIMULATION • Verbal • Tactile • Visual • Situational • Environmental TYPES OF SIMULATION TRAINING • Standardized patients (role play) • Basic models (partial task trainers) • Simple level • Higher level • Mannequins • Low fidelity • High fidelity • Virtual patients • Screen-based; computer-based • COMBINATIONS • Augmented sp encounters with technology • Crises management HUMAN PATIENT SIMULATION • Realistic • Suitable for all levels • Safe • Wide variety of training programs • Expensive ADVANTAGES OF SIMULATION • Patients are never at risk • Serious but infrequent events, in predictable times and places • Errors can be allowed to occur, and play-out • Rehearsal, repetition, mastery • Crisis management simulation, planning • Reduces institutional liability • Increases operational confidence • Produces rapid results • Allows team training • Increases institutional prestige The use of high fidelity simulations to train multidisciplinary teams in critical environments is well established.
(A114) Disaster Medical Services System in Hyogo Prefecture from the Lessons of the Great Hanshin-Awaji Earthquake
Authors: Nakayama S. , Kozawa S. , Ukai T. 
Published: May 2011

PurposeTo examine how did Hyogo prefecture renovate disaster medical services system from the lessons of the Great Hanshin -Awaji Earthquake.MethodCountermeasures after the experience of the Earthquake were 1. Establishment of disaster-related medical information network which was introduced to each of various institutions to collect and disseminate medical information at the time of disaster. 2. Designation of sixteen hospitals as Disaster Medical Centers, which were expected to play leading role in disaster management,and to receive many patients at a time of disasters. 3. Construction of Hyogo Emergency Medical Center which was designated as a main Disaster Medical Center to train medical staffs, to operate the Emergency Medical Information Control Center.ResultsWe have several training courses for medical staffs. The most important training course is the DMAT (Disaster Medical Assistant Team)training course. DMAT trainigs held at two main Disaster Medical Centers, east National Disaster Medical Center, west Hyogo Emergency Medical Center. More than three hundreds teams have been cultivated now. We experienced five disasters in Hyogo prefecture in these seven years. 2 were natural disasters by the typhoon. 3 were a collision of the ship, the collision of the truck, train derailments each. A big JR train accident occurred in Amagasaki city of Hyogo on April 25,2005. Hyogo Emergency Medical Center worked as the emergency information control center, dispatched doctor attended ambulance, performed on-site triage and first aid, dispatched second team by helicopter, received four severe cases by helicopters, dispatched third team in the evening and provided confined space medicine, and took initiative of surveillance study of the casualties.ConclusionDisaster medical services system from the lessons of the Earthqukake functioned at the time of the JR Train accident.
(A121) Relation of Dopamine Dependent Hypotension with Outcome in Cervical Spine Injury Patients
Authors: T. D. Agarwal A. 
Published: May 2011

BackgroundIt is believed that dopamine resistance sets in within 72–92 hours following therapy. However, in the authors' experience, spinal cord injury patients may require dopamine to maintain blood pressure over several weeks.ObjectivesThis study aims to: (1) assess the incidence and duration of of dopamine dependence in cervical cord injury patients; and (2) find the relation (if any) of dopamine dependent hypotension with outcome of spinal cord injured patients.MethodsThis was a prospective, observational study carried out over 2-month period in the neurosurgery intensive care unit (ICU) at JPN Apex Trauma Centre, AIIMS. All cervical spine injury patients who had hypotension during the hospital stay were included in the study. History, clinical findings, requirement of ionotropic support, management, and outcome were recorded for all enrolled subjects.ResultsDuring the study period 48 patients were admitted with cervical spine injury in the ICU. Of these, 26 patients (54%) had hypotension and were constituted the study group. Eleven patients had complete spinal cord injury (power 0/5) and 15 patients had incomplete spinal cord injury. Twenty-four patients were on ventilator support and two were on oxygen masks. The mean dose of dopamine which the patient receives during the treatment was 7.5 mcg/kg/min with the maximum and minimum doses of 20mcg/kg/min and 2 mcg/kg/min. The mean duration of dopamine support was 17 days (Range 6–48 days). Eight patients (31%) required intermittent dopamine support and 18 patients (70%) required continuous support. The in-hospital mortality was 61% (n = 16). Mortality was significantly lower in patients who received intermittent ionotropic support as compared to those who required continuous ionotropic support (p < 0.01).ConclusionThe patients with spinal cord injury are dependent on dopamine throughout their recovery period. The patients who required intermittent ionotropic support had significant better outcome compared to those who required continuous ionotropic support.
(A123) Developing World Disaster Health Research - Present Evidence and Future Priorities
Authors: Ralte H. , Roy N. , Chatterjee K. , More V. 
Published: May 2011

Developing world disaster Health research - Present Evidence & future prioritiesIntroductionConsidering that 85% of disasters and 95% of disaster-related deaths occur in the developing world, the overwhelming number of casualties has contributed insignificantly to the world's peer-reviewed literature. The existing & available evidence on disasters in peer-reviewed journals about the developing world, was examined for quality and quantity in this systematic review.MethodsThe free PubMed database was searched using the MeSH (Medical Subject Heading) terms ‘disasters’, ‘disaster medicine, ‘rescue work’, ‘relief work’ and ‘conflict’ and then refined using the MeSH terms ‘developing country’. The final list of selected manuscripts were analyzed by type of article, level of evidence, theme of the manuscript and topic, author affiliation & region of the study.ResultsCitations using MeSH search terms ‘disasters’, ‘disaster medicine, ‘rescue work’, ‘relief work’ & ‘conflict’ yielded 63,196 results. After these results were refined using the second MeSH term “developing country”, 438 articles were retained. Less than 1% (0.69%) citations in PubMed dealt with developing country disasters. Half of the manuscripts (46.5%) were found to be original research articles (36.1%) or reviews (10.4%), while more than a quarter (29.5%) were commentaries. 97.4% (149/153) of all ‘original research articles’ were Level IV or V evidence. A fifth (20.3%) of the authors of all manuscripts on developing world disasters were from the developing world (82/404); Predominant themes (29.1%) were missions, healthcare provision and humanitarian aid during the acute phase of developing world disasters.ConclusionLess than 1% of all disaster-related publications are about developing world disasters. Also, the developed world, authors four-fifths of the articles about developing world disasters, and contributes the predominant perspective. Aid for sustaining long-term disaster research may be a more useful investment in mitigating future disasters, than short-term humanitarian aid missions to the developing world.
(A127) Major Trauma in a Swedish Paediatric Population – A Survey of Children Admitted to a Neuro Intensive Care Unit (NICU)
Authors: Franzén L.E. 
Published: May 2011

PurposeTo describe the demographics, mechanism, pattern, and severity of injury, prehospital and hospital care (first 24 hours) and the patient outcome in severely injured children in a NICU. This study was made to complete the study of Swedish children admitted to a paediatric intensive care unit (PICU) due to major trauma in the same region and during the same period.MethodThe medical records of 124 traumatized children (0–16 years of age), admitted to the NICU in Gothenburg 1992–2001, were retrospectively examined. The Injury Severity Score (ISS), Glasgow Paediatric Coma Scale (GSC), Revised Trauma Score (T-RTS/RTS), Paediatric Trauma Score (PTS), Trauma Score Injury Severity Score (TRISS) and Paediatric Risk of Mortality Score (PRISM) estimated the severity of injury.ResultsAbout 7/100 000 children with severe injuries were admitted to the NICU each year from 1992–2001 inclusive. Epidemiology showed a similar pattern as in other OECD countries. Severity of injury was recorded as an ISS median of 17. Mortality rate in our series was 6%.ConclusionMajor trauma with admission to a NICU is rare in Swedish children. With management in conjunction with a pediatric centre, these children have a good survival rate.
(A136) Eldery in Emergency
Authors: Saenz M.C. 
Published: May 2011

Elderly in emergency -PresentationPsychosocial support is essential to prevent mental health disorders in the elders subjected to trauma in emergencies that induces to isolation as well as risks or vulnerability for them and their environment. Financial crisis, natural disasters, attacks, poverty, violence and loneliness in the social environment turn threatening for them. Reality becomes hard and produces disorganization in mental health.ObjectivesElder people who have gone through one or more of the following situations are the ones who are prone to develop intense or immediate character disorder. With strategies that increase the existing psychosocial protection factors stress at different intervention levels is lowered. Those who have gone through one or more violent experiences are the ones who are prone to develop intense or immediate character disorder. Cultural transferring (between adults and between adults and children) and mutual help between adults and children is held.MethodologyCognitive processing factors associated to each individual's anxiety: stress, depression, loneliness, panic attacks etc. Some techniques have been developed to understand emotions and learn how to manage them: songs, classic tales, puppets, advertisements and anagrams, Kessen cards, etc. All the material and the results were evaluated with clinic tests and professional help.ConclusionAdditionally, a good cultural understanding of the situation and the adult's feelings are needed in order to provide assistance. The one providing help as well as the one receiving bio-psychosocial help are both part of the link created to overcome the impact of violence, committed to build bridges in the adversity. To prevent post-traumatic stress they are trained in facing disturbing anxiety when facing catastrophes produced by nature or men.