bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing Contents of Practical Training for Decontamination of Radiation-contaminated Patients Using VR Training Simulator
Authors: Nam HyungWoo , Kim JungJin , Cho MinSu 
Published: June 2023

Introduction:The KIRAMS establishes radiological emergency institutions and provides training for emergency medical agents. However, because of the uniqueness of radioactive accidents, the current training program has a limitation in the realistic description. Therefore, training programs based on virtual augmented reality technology that can describe radiological emergencies are required. In this study, the contents of practical training for decontamination of radiation-contaminated patients as a part of radiation disaster prevention personnel training using VR simulator are developed.Method:Environments and devices required for treating patients with complex radiation damage are made visible using VR simulator to enable practical training of techniques and practices that will be required in actual radiation emergencies or training. The VR decontamination training content uses three Point tracking techniques to calculate the location of the head-mounted display device and the hand to visualize the movements. Additionally, Universal Render Pipeline technology was used to develop realistic visualizations of situations.Results:In this study, VR decontamination treatment practice content was developed, which allows a single trainee to go through the entire treatment process of treating radiation-contaminated patients. The radiation-exposed patient’s treatment process is composed of nine subprocesses, including wearing personal protective equipment, obtaining samples from openings, taking measurements, cleaning contaminated injuries, and so on. A checklist user interface was used to enable trainees to check their progress. The trainee can practice patient treatment with a controller while using VR decontamination treatment content. Additional functions such as narration, sound effects, animation, and so on were added to high educational effects.Conclusion:In this study, VR decontamination treatment content was developed using VR training simulator to practice the treatment of radiation-contaminated patients. The results of this study will contribute to fostering the workforce response to radiation through efficient education using a VR training simulator, as well as promoting the use of radiation safety regulations.
The Training Effects of Mass Casualty Triage in Radiological Events for 119 Emergency Medical Team
Authors: Hwang Kyung il , Kim Jungjin 
Published: June 2023

Introduction:Korea Institute Radiological Medical Sciences operates an emergency medical response system in case of a radiological accident or disaster. A radiation accident or disaster can affect large-scale patients and destroy medical infrastructure. However, there is currently a lack of specialized education for treating large-scale patients or high-dose exposure patients. This study aimed to evaluate the efficiency of radiological mass casualty triage education programs and present a new training method to improve the ability of 119 emergency medical teams in the event of a radiological accident or disaster.Method:The results of mass casualty triage for radiological events were analyzed using the audience response system and questionnaire for paramedics who participated in the radiation accident response training program. For 25 paramedics, a pre-post evaluation was conducted on two items: understanding the mass triage and understanding the radiological mass triage. The data were analyzed using the SPSS WIN 23.0 program.Results:Thirty simulated patient scenarios were developed with the addition of clinical symptoms of radiation exposure based on the four trauma classifications: immediate, urgent, delayed, and death. The triage results of 30 cases conducted by 119 emergency medical teams were evaluated, and the trainees were asked to respond to the level of improvement in their knowledge of triage through pre- and post-training questionnaires. As a result of the pre- and post-education questionnaire, the degree of understanding of the mass triage was 3.8 before education and 4.4 after education, showing a significant difference (p=.003/MAX=5). The pre- and post-education questionnaire results of radiological mass triage showed a difference between 2.3 before education and 4.1 after education (p=.000/MAX=5).Conclusion:For effective radiation medical response, 119 emergency medical teams are required to have a repetitive mass triage education program for radiological events. It is especially important to provide a radiological triage system for field application.
EMS Calls for Service at Adult Detention Centers–A Descriptive Study
Authors: Wood Jeffrey , Klassen Aaron , Rogerson M , Sztajnkrycer Matthew 
Published: June 2023

Introduction:Incarcerated individuals represent a particularly vulnerable sector of society, with a disproportionate burden of drug use, mental health problems, and chronic illness. The purpose of this study was to perform a descriptive analysis of EMS response to detention facilities.Method:Retrospective review of EMS calls to detention facilities between 1/1/2002 and 12/31/2021 within our EMS system. Data were analyzed using descriptive statistics and Student’s t-test. This study was deemed exempt by the Institutional Review Board.Results:3,126 requests for service occurred during the study period. Average patient age was 40.2 ± 13.3 years, compared with 54.0 ± 25.9 years for non-detention center calls (p < 0.001). The majority (80.8%) of patients were male. Mean scene time was 14:13 ± 7:49 minutes, compared with 12:04 ± 12:27 minutes (p < 0.01) for non-detention center calls. The most common complaints were chest pain (15.6%), trauma (13.6%), seizure (11.7%), behavioral (9.2%), and overdose (4.7%); OB requests accounted for 5.8% of calls for female patients. Most calls (86.0%) to detention centers involved incarcerated individuals. Four percent of patients refused treatment; 27.8% of these patients were still transported. One hundred and eight patients were identified by EMS as not needing transport. Consent for treatment/transport by the patient was documented in 5.2% of charts.Conclusion:Within our 911 service area, calls to detention facilities are not uncommon, predominantly involve incarcerated individuals, and are primarily due to chest pain, trauma, or seizures. Consent for treatment/transport was not documented in most EMS encounters. Further study is needed to better understand the health care needs of these patients, including ability to consent and access to chronic medications.
Our Trial of Disaster Victim Identification Training in Chiba, Japan
Authors: Motomura Ayumi , Ishii Namiko , Saito Hisako , Yoshida Maiko , Iwase Hirotaro , Yajima Daisuke 
Published: June 2023

Introduction:Internationally, Disaster Victim Identification (DVI) activities are conducted under the International Criminal Police Organization system for handling a large number of bodies during disasters. However, the police have taken the initiative and commissioned clinicians and dentists to estimate the cause of death and identify the deceased, under a unique system in Japan. In this presentation, we examine the problems in the current DVI activities in Japan through DVI training.Method:We held DVI training sessions three times in preparation for the occurrence of a large-scale disaster in Chiba Prefecture with Chiba Prefectural Police, Chiba Medical Association, Chiba Dental Association, local government staff in Chiba, and forensic staff in other institutions. We conducted desktop trainings using paper dolls, under a simulation of an aircraft disaster, and a natural disaster such as flooding and landslides caused by typhoon damage in the third session. After the training, participants reflected on their activities through a questionnaire.Results:In accordance with the conventional method, the police officers numbered the bodies, photographed and checked their personal belongings, followed by the estimation of the cause of death with a doctor, the preparation of documents. Subsequently, dentists collected postmortem findings and matched with antemortem data. On the other hand, police officers and local government staff interviewed the bereaved family members under simulations. In the post-survey, participants were generally satisfied with the training, but some said that it was difficult to understand the activities of other professions.Conclusion:In Japan, where there are no DVI teams, this training was a good opportunity for all the job categories involved in DVI activities to meet each other. While the activities conducted by each profession helped to improve skills, the collaboration among professions was poor. We would like to improve the quality of DVI activities by introducing a team system for collaboration among multiple professions.
Not Everyone Can be a Chief
Authors: Desai Sameer , Katirji Linda 
Published: June 2023

Introduction:In 2014, the residency program adopted a new chief resident model. Multiple other programs had adopted a similar style of having all final-year residents have a “chief” role. Chief residents are meant to be leaders in the residency, have a direct influence on the program, and serve as liaisons with other department chiefs.Method:Prior to 2014, the program had three chief residents a year: one Admin, one Academic, and one Recruitment. They were chosen using a vote amongst residents/faculty, with the ultimate decision made by the residency leadership. Many other residents were interested, and often qualified, but were ultimately not chosen. In 2014, the all-chief model was adopted. Each PGY-3 would have a responsibility. The goal was to give each a leadership opportunity, and a tangible product as they transition to fellowships or new jobs. The residents were allowed to pick their position, with some influence by residency leadership. Residents were encouraged to create new roles which aligned with their personal interests or career goals. Examples included Medical Director Chief, U/S chief, PEM chief and Wellness Chief.Results:Some residents thrived when given responsibility, while others did not. Some could not manage more responsibility: there was a clear disparity in the effort. At the start of this, all residents’ total shifts/month decreased equally. This created some controversy when the workload was not equal. The alteration of details, requirements, and expectations occurred every year in an attempt to correct the failures.Conclusion:Ultimately, the all-chief model was a failure. The program reverted to a traditional chief model, allowing only those the residency leadership felt could manage chief responsibilities to have a role. Those not doing a chief role were given additional shifts and those with less added work were given only a partial shift reduction.
Evidence Mapping Survey on Professional Development Programs and Courses in Health Emergency and Disaster Risk Management
Authors: Hung Kei Ching Kevin , MacDermot Makiko , Kayano Ryoma , Abrahams Jonathan , Huda Qudsia , Chan Emily , Graham Colin 
Published: June 2023

Introduction:A prepared and well-trained workforce is essential to reducing the loss of lives from health emergencies. However, it is uncertain what should be included in the common set of core competencies for the health emergency and disaster risk management (Health EDRM) workforce. The objective of the study is to provide evidence mapping for the competencies in existing professional development programs and courses in Health EDRM.Method:A survey conducted using an online platform (Survey Monkey) was conducted from October to November 2021. Experts in the Health EDRM Research Network including experts identified for the Delphi studies were invited to join the study. Participants should be ≥ 18 years of age, and had relevant experience in Health EDRM and in disaster education and training programs. A self designed questionnaire containing 28 questions in four domains including competencies; curriculum; evidence gaps; work and personal details were used.Results:There were 65 respondents from 20 countries participating in the survey. Most of the respondents worked in academic institutions (60%), followed by government employees (19%), and non-governmental organizations (7%). These organizations have roles throughout the disaster cycle with 95% in the preparedness phase. For management skills, EDRM managers should be competent in planning, organizing, applying management processes, establishing effective communication systems and providing effective leadership. For technical competencies, emergency communications, hazard specific knowledge, communicable diseases were essential for frontline workers. In terms of designing the competency matrix, WHO resources were frequently used for the competencies and the curriculum design.Conclusion:Health EDRM managers are expected to master a large number of managerial and technical skills, including the increasingly recognized leadership and decision-making skills for effective planning and implementation. These competencies need to be established for the development of a Health EDRM workforce.
MCI (Mass Casualty Incident) Response Support for Palestine Refugee Hospitals in Lebanon
Authors: Masuda Mitsuru 
Published: June 2023

Introduction:The Japanese Red Cross Society has been supporting MCI response support for Palestine hospitals in Lebanon since 2018.Method:It was started from a hospital as a single topic in a one-year ER trauma course, which was combined with an ER triage course. In the next hospital it was revised into not only a theological lecture course but also a field triage training course with pre-hospital volunteers. As a result, when the Beirut explosion happened in 2020, the first hospital could accept more than 50 green patients at once, and the second one sent a pre-hospital team to do triage at the scene showing that training courses were useful in a real MCI case .Results:At this time, support is being provided in a new hospital by making use of these experiences. A current report will be available when this association is held.Conclusion:MCI response support for refugee camps is improving through trial and error, which would have much in common with other MCI responses in many countries and areas.
Emergency Health Care Workers’ Preparedness for Disaster Management: An Integrative Review
Authors: Almukhlifi Yasir , Crowfoot Gary , Hutton Alison 
Published: June 2023

Introduction:Around two billion people globally were affected by natural disasters between 2008 and 2018. Countries are required to effectively prepare their healthcare workers for disaster response. A greater level of preparedness is associated with a more effective response to disasters. The World Health Organization requires countries and governments to have disaster plans and emergency health workers ready and prepared at all times. This integrative review aims to understand emergency healthcare workers’ perceived preparedness for disaster management.Method:An integrative literature review using the PRISMA checklist guidelines was conducted to explore physicians, nurses, emergency medical services, and allied medical professionals’ preparedness for disasters. Literature was searched from 2005, published in the English language and from MEDLINE (PubMed), Google Scholar, EMBASE, PsycINFO, SCOPUS, ProQuest and CINAHL databases. Reviews, case reports, clinical audits, editorials and short communications were excluded. Studies were critically appraised using the Mixed Methods Appraisal Tool.Results:The initial search yielded 9,589 articles. Twenty-seven articles were included following the application of the eligibility criteria. Included studies were geographically diverse including North America, the Middle East, and the Asia Pacific. Most studies (n=24) assessed the knowledge of healthcare workers in general disasters. Studies using the Disaster Preparedness Evaluation Tool reported moderate disaster preparedness and knowledge, while studies using other instruments largely reported inadequate disaster preparedness and knowledge. Regional variations were recorded, with high-income countries’ reporting a higher perceived preparedness for disasters than low-income countries.Conclusion:The majority of emergency healthcare workers appear to have inadequate disaster preparedness. Previous disaster experience and training improved disaster preparedness. Future research should focus on interventions to improve emergency healthcare workers' preparedness for disasters.
Under Pressure–TrolleyGar, a Metric Reflecting a Hospital System at Crisis-Capacity
Authors: Conradie Maria , Smit Marco , Rensburg Rochelle Janse van , Taqvi Sayed , Orsmond Brendan , Andrews Robin , Vegte Andrea van der , Dowle Aishleigh , Wickham Bryce , Vythilingam Darshini , Fayyaz Fahd , Kennedy Keith , Jordaan Phillip , Abraham Ria , Neduchelyn Yuni , Kelly Thomas , Molloy Michael 
Published: June 2023

Introduction:Health service capacity has been an issue in Ireland since the 1980s swinging cuts. Government reports from 2003 have consistently identified a requirement for 3,000-5,000 extra beds on top of the current approximately 10,500 capacity. Acute hospital bed capacity issues have escalated, the formal system of recording “over capacity” patients or “patients on trolleys” has developed. A “Trolleygar” reports issues from the Health Service Executive (HSE) three times daily. This count is an underestimate as patients temporarily housed in day care units, surgical, or medical assessment units, discharge lounges and other clinical areas which have a bed space are not counted in this overcapacity measure. This study's aim is to calculate the annual number of days on which no patients were lodged on trolleys in Wexford General Hospital.Method:Descriptive study using anonymized freely available data from the national HSE Trolley GAR reports on trolley patients in Wexford General Hospital from January 2019 until September 2022. A Golden Zero trolley day was stated as a day on which there were no reported trolley-patients at the three time points, Silver Zero trolley day when two of the time periods recorded no trolleys and a Bronze Zero Trolley day when one period recorded a zero trolley count.Results:Data was collected on 1,369 days, with 90 days excluded due to missing data sets. There were 162 Golden days recorded (12.67% of total days). The year 2020 recorded the highest number of Golden days at 28.69% (105 days), followed by 2021 with 11.23% (41 days). During 2019 there were 3.84% (14 days) Golden days and 2022 had the lowest number (January-September) with 0.73% (2 days).Conclusion:Despite a zero-tolerance policy, Golden days are disappearing rapidly, capacity is urgently required with post-pandemic ED attendance surges worldwide. True recording of overcapacity patients is required for appropriate capacity modeling.
Improving PET and Reducing Coagulation Sample Requests in ED
Authors: Bilal Muhammad , Yousuf Syed , Nedujchelyn Yunitra , Kelly T Paul , Wickham Bryce , Molloy Michael S. 
Published: June 2023

Introduction:Front loading tests reduce Patient Experience Time (PET) in Emergency Departments (ED). “Blanket” or “scattergun” approach to test requests results in prolonged PET, increase in laboratory workload with wastage of resources. Coagulation studies are one of the most commonly ordered investigations. Previous to the 2020 audit, it was suggested that 70% of ED coagulation requests were unnecessary not changing management. By establishing local guidelines, we worked to reduce coagulation test requests.Method:The aim of this study was to assess reduction in coagulation tests following implementation of local guidelines in ED. The coagulation indicator checklist was introduced to ED areas storing coagulation bottles. Presentations, small group education, reminders about clinical indications for appropriate coagulation requests were given to nurses, doctors, and advising about audits of practice. From February 1-14, 2022, nurses and doctors were instructed to send coagulation samples after filling out audit forms for the laboratory indicating the purpose of the request.Results:Prospective data in February demonstrates a 20% decline in coagulation requests. Only 47% of requests had accompanying coagulation forms filled and the remaining 53%was not filled. In 57% of cases, coagulation samples were requested appropriately, and in 43% there were no indications.Conclusion:Through microsystem interventions and awareness campaigns, unnecessary coagulation requests can be reduced. By introducing local guidelines, regular training of new doctors and nurses at induction and intervals, clinical practice changes can be embedded. Consideration should be given to specific coagulation request forms stating the indication for the request. The cost of each sample is 2.87 euro. Obtaining 90% compliance with coagulation requests can save approximately 100,000 euros annually.
What do you Need to Know to Respond to a Disaster? A Review of Competencies and Skills Needed Among Health Professionals
Authors: Westman Anja , Hugelius Karin , Kurland Lisa 
Published: June 2023

Introduction:There is no universal agreement on what competence in disaster medicine is, nor what competences and personal attributes that add value in a medical disaster situation. Some studies suggest that not only technical skills are needed, but also non-technical skills. However, little is known about the actual demands and skills needed to manage a medical disaster situation. Therefore, this scoping review aimed to identify core competencies required for the disaster medicine response.Method:A scoping review using the Arksey & O´Malley framework (1) was used. Structured searchers in the databases PuBMed, CINAHL full plus, Web of Science, PsychInfo and Scopus was conducted. Thereafter, data was structured and analyzed. Inclusion criteria were (1) original papers published in English during the last ten years, (2) covering any aspect of competence or skills needed to respond to a disaster situation. (3) Both qualitative and quantitative studies were included. Exclusion criteria were (1) reviews, editorial texts or similar, (2) papers focusing on the care of single patients.(1) Arksey H, O’Malley L. Scoping Studies: Towards a methodological framework. Int. J. Social Research Methodology. 2005;8(1):19-32.Results:To be presented at the congress.Conclusion:To be presented at the congress.