bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Novel Technologies to Implement Belize's First Formal Prehospital Emergency System
Authors: Friesen Jason 
Published: June 2023

Introduction:Belize has no formal prehospital emergency medical system, leaving the majority of acutely sick and injured persons overwhelmingly dependent on private transport. To address this issue, a collaboration of public and non-profit partners worked with the Belize National Fire Service to implement the country's first formal prehospital emergency medical service using novel communications technologies. With new resources and vehicles already donated to the fire service, the collaboration focused specifically on the communications component of the response system, specifically to improve the handling of incoming requests for emergency assistance from the public, as well as to improve the process of dispatching prehospital personnel using readily-available mobile technologies.Method:Working with the Belize National Fire Service, program partners implemented the country's first emergency communications center, trained new dispatchers, field-tested the dispatch technology through intensive training sessions, and launched the system in the capital district of Cayo.Results:Launched in June 2022, the program has thus far achieved the following outcomes:
Active Dispatchers: 26Active Responders: 104Emergencies Dispatched: 156Average Scene Response Time: 7m45sConclusion:Over the past year, partner NGOs Trek Medics and Empact Northwest have worked collaboratively to implement a first-ever centralized emergency dispatch system for the Belize National Fire Service, using a novel cloud-based dispatch software running on readily-available mobile phones and mobile. In addition to drastic improvements in response performance, satisfaction among system managers and response personnel is high, with plans currently underway to scale the program nationally.
Development of a Logistics System for Disaster Medical Container Operations Using Drones and GIS
Authors: Maebayashi Asuka , Nakata Keiji , Showa Naoki , Takada Takamitsu 
Published: June 2023

Introduction:To quickly operate a temporary hospital using disaster medical containers in the event of a large-scale disaster, dozens of large trailers must be quickly brought to the disaster site. This study aims to establish a logistic system for transporting and installing containers using drones and GIS.Method:By linking drones and GIS, a theoretical model was created to quickly determine routes and installation sites for large trailers transporting medical containers from candidate routes simulated in advance by taking into account hazard maps and road conditions.Results:Using this system, it is possible to(1) Establish whether the roads planned to be passed through are passable.By narrowing down candidate routes through preliminary simulations that overlay hazard maps and roads that are passable for large trailers, it is possible to narrow down the routes that need to be confirmed. Immediately after a disaster, a drone can be used to confirm road damage, flooding, landslides, etc., and map them on the GIS to determine the extent to which they are passable.(2) Identify locations that take into account demand and safety.Locations that are close to the disaster area, safe, and in demand for medical care can be determined and identified based on the population mesh and the damage situation.Conclusion:GIS and drones have a high affinity and are used in various ways. However, there is still no linkage between GIS and drones adapted to medical care and logistics at disaster sites in Japan. This system is indispensable to comprehensively determine the safety and demand of roads and installation sites.
An Innovative Mobile Hospital for the Management of a Massive Flow of Victims.
Authors: Houze-Cerfon Vanessa , VIAULT Benoit , Marcou Eric , Pardon Thomas , Ribera-Cano Anna , Nouzières Cédric , Bounes Vincent 
Published: June 2023

Introduction:In order to deal with disastrous situations needing massive healthcare support, a new tool, financed by FEDER European funds (Interreg POCTEFA program) has been designed: the multipurpose mobile hospital Europe Occitanie (UMPEO). It is a projectable, foldable, versatile and autonomous truck with an interchangeable function from advanced medical post to operational command center, for acute events involving mass gathering or during multiple victims disasters. This study aims to show the usefulness of this structure during the COVID-19 health crisis.Method:The UMPEO is a shelter deployable in an emergency ward or intensive care unit, mobilizable in one hour, projectable by truck and autonomous for the first two hours. A descriptive, transversal, European study was carried out to describe its use in the cross-border countries of the Pyrenees (France, Spain and Andorra). When applicable, demographic data were gathered and/or a satisfaction questionnaire was given to the caregivers involved.Results:Between September 8, 2020 andFebruary 25, 2021, UMPEO was mobilized as a COVID-19 testing center, emergency department, vaccination center or as a command center at a political summit. Thus, 1322 screening tests were carried out over the screening three weeks deployment and 91% of the volunteers considered the screening operation useful. Used as a hospitalization ward, UMPEO was able to accommodate 266 patients over a period of four weeks. Eight hundred people were able to benefit from two doses of vaccines during the six weeks of the mobile vaccination campaign.Conclusion:This tool, initially designed to be used in the event of a catastrophic event of an accidental or terrorist type or as a help station during mass gathering, has been diverted without any modification of its structure to meet the challenges of the global health crisis and provide a solution adapted to the population of countries bordering the Pyrenees.
Nurses' Perception of Humanitarian Training Post-deployment on Plans to Redeploy
Authors: Mount Monica 
Published: June 2023

Introduction:Pre-deployment training for nurses ensures readiness.Method:A quantitative descriptive research methodology was used to conduct an anonymous survey distributed to all registered nurses deployed in 2017 to Hurricane Maria with a hospital-supported team and a federal team. The project sought to improve the pre-deployment preparation experience of nurses to positively impact nurses' willingness to redeploy. The survey was administered for ten days in January 2021.Results:This quantitative descriptive study sought to understand nurses’ perceptions of their readiness for deployment during a disaster response. Thirty-nine surveys were distributed with a 46% response rate (n = 18).Gender was not related to agreement with the role variable (p = 0.070). Marital status was significantly related to role (p = 0.015), as was age (p = 0.022). Single individuals and individuals >50 yo were more likely to agree that they understood their role during the disaster.Gender was not related to agreement with the preparedness variable (p = 0.465), nor was marital status (p = 0.067). Age was significantly related to perceptions of preparedness (p = 0.004). Individuals >50 yo were more likely to respond that they were prepared for their deployment.Gender was not related to perceptions of knowledge of providing clinical care during a disaster (p = 0.235), nor was marital status (p = 0.627) or age (p = 0.674).Conclusion:The results suggest that single nurses > 50 yo with more years of nursing experience who have previously deployed may understand the role better and feel more prepared to deploy.However, their responses do not indicate that they feel more knowledgeable about the type of nursing care they are expected to provide in a disaster response.
Exploring Advanced Nursing Practice in Australian Disasters: A Scoping Review
Authors: Hutton Alison , Conlon Lisa , Kako Mayumi , Wilson Rhonda , Ranse Jamie 
Published: June 2023

Introduction:As the largest body of health professionals, nurses are looked upon during a disaster for leadership, clinical assistance, and support during these events. Nurses are at the forefront of managing disasters in their communities, yet their complex role as advanced nurse practitioners, clinicians, managers, and leaders is not always fully understood and/or recognized. The aim of this paper is to explore the level of Advanced Nursing Practice (ANP) in Australia that takes place in a disasterMethod:This scoping review was guided by Arksey and O’Malley’s framework. The review searched five relevant databases. A scoping review design was chosen as the authors expected that evidence in the field would be produced using a wide variety of methodologies.Results:Nurses work long hours during a disaster with hospitals and nurses becoming the center of events and the "go to" place during a disaster. During disasters nurses often have little sleep, have limited time to meet their individual/personal needs, and frequently put others needs before themselves. Nurses mentioned in these studies were reported to have worked while they were worried for themselves and their families. These nurses reported feeling capable and reported that all their experience and skills came to the fore during these challenging situations.Conclusion:During disasters, most nurses are found to be flexible and adaptable, with many taking on a variety of roles. Nurses are quick to find solutions with problem-solving keys and their ability to respond to disasters "just what you do." The nurses in these studies demonstrated fundamental expertise and had the agility to pivot when the occasion demanded. As a result of this study, it is evident, and not surprising, that these Australian nurses work beyond conventional limits during a disaster.
Designing a Robust Methodology to Evaluate Emergency Health and Medical Responses to Disasters
Authors: Finnigan Gerard 
Published: June 2023

Introduction:Health and medical disciplines have traditionally preferred experimental and quasi-experimental methods to evaluate interventions. More recently, mathematical modeling was used to test intervention efficacy in the SARS-CoV-2 pandemic. The challenge for disaster researchers is neither approach suits examining phenomena about emergency health responses in disasters. This study applied an alternative methodology to examine questions of how and why emergency health and medical responses reduced mortality during six different natural hazard disaster events.Method:The case study methodology is orientated by the researcher’s perspective and ‘not assigned a fixed ontological, epistemological or methodological position’. This flexibility allows alignment of the researcher’s worldview with the methodology best fitting the research problem and its context, such as post-positivism. Qualitative case study design carefully links five key design elements and sequences, including research questions, propositions, a unit of analysis, data collection, and data analysis.Results:Six holistic single case studies described how and why the emergency health response reduced mortality risk of people affected by different disasters. An evidenced-based theoretical emergency health program logic model compared and contrasted inputs, activities, outputs, and outcomes between theoretical and actual responses. Rival explanations were tested before data collection for each single case and applied to challenge the logic model. Each case applied four strategies to increase the validity and reliability of the holistic single case study findings.Conclusion:Qualitative case study methodology provides a robust and flexible framework to examine complex questions about emergency health and medical responses, including questions about events, processes, activities, performance, and outcomes. The methodology is equally suited to real-time or retrospective studies. The strength of the approach is the high compatibility for examining phenomena within the context they occur, and linking program logic, data collection, and data analysis methods to the specific question being investigated.
A National Survey of Hospital Cyber Attack Emergency Operation Preparedness
Authors: Sullivan Natalie , Selzer Jordan , Tully Jeffery , Dameff Christian , Opara Chibuzo , Snead Mackenzie 
Published: June 2023

Introduction:Cyberattacks on healthcare systems are increasing in frequency and severity. Hospitals need to integrate cybersecurity preparedness into their emergency operations planning and response in order to mitigate adverse outcomes during increasingly likely cyber events. No data currently exists regarding the level of preparedness of US hospital systems for cybersecurity attacks. We surveyed hospital emergency managers to assess cybersecurity preparedness for these events.Method:Fifty-seven emergency managers representing hospitals across the US participated in an online Qualtrics survey regarding current preparedness and response procedures for cybersecurity hazards.Results:Survey responses between April 2019 and May 2021 demonstrated that a majority of hospital systems surveyed included cybersecurity disasters in their HVA (82.4%, 47/57), and most ranked it as one of their top five priorities (57.4%, 27/47). However, over half denied specifically mentioning cybersecurity in their EOPs (52.6%, 30/57). Fourteen of the 57 hospital systems (24.5%) endorsed previously activating an Emergency Response for a cybersecurity incident unrelated to Information Technology (IT) failure.Conclusion:The survey results suggest that American hospitals are currently underprepared for cybersecurity disasters. We emphasize the importance of prioritizing cybersecurity in HVAs and implementing specific EOP annexes for cybersecurity emergencies.
The Isolation System for Treatment and Agile Response for High-Risk Infections (ISTARI) Unit, a Carecubes Design: Moving PPE Around the Patient, An Assessment of Provider Safety and Infection Control with Emergency Medicine Residents During Simulation
Authors: Willet Katie , Huff Brad , Wadman Tori , Broadhurst Jana , Lawler James , Brett-Major David , Prudhomme Rachel 
Published: June 2023

Introduction:The ISTARI unit is designed to be assembled in buildings or field hospitals to provide negative-pressure rooms in low-resource areas and decrease PPE use in the setting of highly-infectious diseases. Each unit is designed to perform ~20 air exchanges/hour with HEPA filters with multiple access points for providers to perform patient care without entering the unit while decreasing overall PPE usage. The goals of the design include patient safety, ease of use for, decreased infectious spread, and unit affordability.Method:A survey was obtained following a medical simulation within the ISTARI unit with Emergency Medicine resident physicians. The case involved an Ebola patient with Ventricular Tachycardia which progressed to cardiac arrest. Teams were given written and video instructions for the ISTARI unit and Ebola-level PPE. They were limited to one set of high-level PPE for the case. The survey scoring was a 0-5 scale, five being the highest.Results:Medical history-taking provider safety (PS)- 2.87, infection control (IC)-3.09, physical examination PS-3.52, IC-3.78, ultrasound usage PS-3.35, IC-3.43, intubation PS-2.35, IC-2.57, CPR PS-3.43, IC-3.65, cardioversion PS-3.35, IC-3.78, and overall average PS-3.145, IC-3.383.Limitations were noted compared with traditional care, but 100% of teams met critical actions for patient management, including intubation, cardioversion, and CPR. GloGerm showed no contamination to those providing care outside the unit, but a small amount of contamination after doffing for those who entered the unit.Conclusion:The ISTARI unit is a cost-effective isolation unit maximizing provider safety in management of patients with highly-infectious diseases, particularly in low-resource settings. It allows for easy mobilization of units and decreased medical supplies waste. The preliminary study shows satisfactory data about provider safety and infection control when using ISTARI for a highly-infectious patient, especially in providers unfamiliar with typical high-level PPE. Providers were able to provide all necessary critical actions for highly-infectious, critically-ill patients.
The Impact of Previous Disasters on Hospital Disaster Surge Capacity Preparedness in Finland
Authors: Kerola Anna , Hirvensalo Eero , Franc Jeffrey 
Published: June 2023

Introduction:In a disaster, the number of victims and severity of injuries may overwhelm the treatment capacity of the local hospital. Surge capacity is the hospital’s ability to receive and treat an increased number of patients. This study aimed to explore if a past disaster or mass casualty incident (MCI) affects local hospital surge capacity preparedness.Method:The current hospital preparedness plans (HPPs) of University and central hospitals receiving surgical emergency patients in Finland were collected (n=28). The HPPs were read and analyzed using the World Health Organization (WHO) hospital emergency checklist tool with eight key components and 67 action items. The scores of key components were compared by percentage of the maximum score. The surge capacity score was compared between the hospitals that had been exposed to a disaster or MCI with those who had not. The effective level was considered as 70% of total points.Results:The overall median score of all key components was 76% (range 24%). The highest score was in command and control (median 93%, range 29%) and the lowest in post-disaster preparedness (median 50%, range 90%). The median surge capacity score was 65% (range 39%). There has been 12 disasters or MCIs during the past 25 years in Finland, all anthropogenic. There was no statistical difference between the surge capacity score of the hospitals with a history of a disaster or MCI compared to those without (65% for both, p=0.735).Conclusion:In Finland, the overall hospital preparedness level is effective with command and control being the best covered area. Surge capacity preparedness was below the effective level and it was not affected by a past disaster or MCI. Present-day challenges with the lack of resources in the health care system, more attention should be drawn to the surge capacity aspect in hospital preparedness plans.
Healthcare and Media Interaction in Major Incidents and Disasters: Experiences Based on Swedish KAMEDO Reports in 20 years
Authors: Englund Liselotte 
Published: June 2023

Introduction:Major Incidents and Disasters are often associated with early, extensive and prolonged media reporting. It is important to understand the interaction between first responders/rescue services and the media to create better conditions for providing and making available correct and objective information to as many people as possible.Method:A systematic literature review and content analysis was made on all Swedish KAMEDO reports (emergency medicine observations published by the National Board of Health and Welfare) from the last twenty years, in total 39 reports. KAMEDO’s primary task is to feedback experience data (lessons learned) from disasters worldwide, through expert observers at the site of an emergency event. The aim of this study was to evaluate and analyze the experiences made regarding the interaction between media and healthcare in connection with major incidents and disasters, both on site and in hospitals.Results:The analysis resulted in the following main themes:(1) Communication problems and other challenges in Major Incidents and Disasters
No protection and restrictionsInformation craving and news huntInterviews as intervention(2) Recommendations for efficient interaction between healthcare and the media:
Strategies from alert to actionSatisfying information needsClarity measures on siteKey actors of importanceProactive media alertnessConclusion:Some conclusions regarding lessons learned about interaction between healthcare and the media, as well as about communication with the afflicted and citizens, in brief: The hospital management should take control of the communication through efficient communication strategies. An accommodating approach to the media's presence can facilitate the dissemination of the necessary early, correct and balanced information. Joint authority press conferences are a model tested and positively evaluated. Healthcare communicators are key actors in hospital crisis communication and media management. Healthcare and media both benefit from developing routines and reciprocal respect for proactive and efficient interaction in emergencies.
The Dark Side of the (Preparedness) Moon: Why Promoting Public Preparedness Remains Illusive
Authors: Bodas Moran 
Published: June 2023

Introduction:Despite advancements in health behavior theories, understanding the human motivation to engage in disaster preparedness remains elusive. Most attempts at engaging the public in protective behavior rely on risk communication that assumes an information deficit among the people; ergo, risk communicators operate under the assumption that by increasing awareness of risks, sufficient motivation can be generated for preparedness behavior. Yet, this is far from being true.A growing body of literature indicates the prevalence of fear-directed preparedness behavior, which is suboptimal in motivating behavioral change. This should come as no surprise, as using fear appeal tactics in risk communication designed to promote health behaviors have been proven to be primarily a failure.Arguably, the phenomenon of failed risk communication campaigns could be linked to unconscious concerns about death, as proposed in the context of the Terror-Management Theory (TMT). According to TMT, since the experience of death-related thoughts triggers the potential for anxiety, the human psyche responds with motivated avoidance. In other words, the mind utilizes mechanisms that prevent death from becoming salient and remove death-related thoughts from focal attention when they arise. In turn, these defense mechanisms may yield procrastination in adopting protective behavior generated by denial as an adaptive coping mechanism.Preliminary data suggest that procrastination in preparedness behavior until the threat becomes actual and imminent might be explained by TMT; however, explicit evidence for this association is yet to be provided. Should this understanding of the phenomenon be substantiated, it could significantly contribute to expanding our knowledge of the theoretical model behind public preparedness behavior.The presentation will discuss the state-of-the-art research currently being done by the author to support the above claims. It will provide preliminary findings and will call the community to reconsider the current paradigm of disaster risk reduction and risk communication.Method:n/aResults:n/aConclusion:n/a