Emergency medicine and general practice

Emergency Medicine and Immediate Medical Care are relatively new specialties. In Malta, there is quite a considerable area of overlap between these specialties and general practice. Indeed, the family physician is confronted with some sort of medical emergency quite regularly. The brief of this article is to go through recent developments in Emergency Medicine as applied to General Practice. The areas considered are Basic Life Support, Head Injury, Asthma, Anaphylaxis, Community Acquired Pneumonia, Burns and Controlled Hypotensive Resuscitation. Whenever possible, distinct practical guidelines will be suggested as an aid in the clinical management of emergency situations which the family physician may encounter. This overview of new developments is by no means comprehensive but serves to highlight the increasing importance given to the role of the first-line medical practitioner in the emergency situation.peer-reviewe

An Overview of the “New” Emergency Management

In the aftermath of 9/11 and the creation of the Department of Homeland Security, it is tempting to suggest that emergency management (EM) has attained a new level of significance in the national consciousness. Indeed, the emergence of the profession and the creation of FEMA itself owe much to the national defense mania of the Cold War era. But, if the past is any indication, the national security concerns that periodically increase public awareness and political attentiveness to EM do not result in a broad commitment of new resources to the array of natural and manmade disasters that threaten communities. Aside from the increased attention on immediate security threats, often without new resources being made available to local governments, the commitment to comprehensive disaster planning is generally lacking. It could even be suggested that the current focus on national security holds as much potential to distract the EM profession as it does to increase its operational scope, but the current security crisis could also be an opportunity to recast EM as a more strategic component in the local communities it serves.National security concerns aside, the EM profession is presently confronting the challenge to manage new realities. This requires expanding the role of the EM function beyond its traditional scope. The emergency manager requires new skills, and the profession must be identified with the emergency manager as a proactive public actor as much as it is with institutions and technical functions. This suggests that political and organizational analysis, strategic thinking, and leadership—concepts that have already been applied to all other public management functions—may be increasingly important concepts of study for emergency managers. What follows is a new conceptual framework for the EM profession as well as a basic organizational theme for its implementation. The limitations of the “old EM” must be overcome for the profession to advance to the “new EM,” which requires a broader, strategic, and more proactive orientation

Landfills and disaster waste management

Printed proceedings of abstractsDisasters can generate large volumes of waste and debris (EPA 2008). In some cases, many years worth of waste can be generated in a single event – often overwhelming local solid waste management facilities and personnel, refer Figure 1. The availability and suitability of disposal sites can affect the efficiency of a disaster waste management programme and overall disaster recovery effort. Disaster waste impacts almost every aspect of an emergency response and recovery effort. Debris can impede rescuers and emergency services reaching survivors; inhibit provision of lifeline support; pose a public and environmental health hazard; and hinder the social and economic recovery of the affected area (Johnston, Dolan et al. 2009). Poor management of a clean-up effort can exacerbate these problems, and can result in a slow and costly recovery which is potentially risky to public and environmental health in both the short and long term. Landfills are an integral part of any disaster waste management strategy. Landfills are an efficient and, if constructed and operated appropriately, effective means of managing disaster waste. However, available airspace in existing landfills is often limited so disaster waste managers must consider 1) expanding existing facilities (in terms of size and waste acceptance) (Luther 2008), 2) constructing new facilities, or 3) reducing waste to landfill by recycling and reuse. Landfill operators may also change health and safety management procedures to facilitate faster management of the waste. All these options has social, environmental and economic impacts, and their consideration is an integral part of both the emergency response/recovery and solid waste management systems. Figure 2 shows the conceptual framework used by the New Zealand Ministry of Civil Defence and Emergency Management for all recovery works of which debris will be managed within. So what are the decisions facing landfill and disaster waste managers? What is the best way to manage a landfill in a disaster situation? Is it appropriate to reduce environmental and health and safety standards to increase landfill capacity? How do you appropriately site a new landfill without time to assess the environmental impact? What are the acceptable risks in a disaster situation and who carries the liability (Luther 2008)? In the poster the challenge of landfill and disaster waste managers will be introduced. An overview of the social, environmental and economic issues facing landfill managers is presented and we ask the question - if you were in charge – what would you do

Peritonitis – the Western experience

Peritonitis is a common surgical emergency. This manuscript will provide an overview of recent developments in the management of peritonitis in the Western world. Emphasis is placed on the emergence of new treatments and their impact of outcomes

An approach to stakeholders involvement in the preparedness for nuclear and radiological emergency response & recovery in Spain

The elaboration of a generic decision-making strategy to address the evolution of an emergency situation, from the stages of response to recovery, and including a planning stage, can facilitate timely, effective and consistent decision making by the response organisations at every level within the emergency management structure and between countries, helping to ensure optimal protection of health, environment, and society. The degree of involvement of stakeholders in this process is a key strategic element for strengthening the local preparedness and response and can help a successful countermeasures strategy. A significant progress was made with the multi-national European project EURANOS (2004-2009) which brought together best practice, knowledge and technology to enhance the preparedness for Europe's response to any radiation emergency and long term contamination. The subsequent establishment of a European Technology Platform and the recent launch of the research project NERIS-TP ("Towards a self sustaining European Technology Platform (NERIS-TP) on Preparedness for Nuclear and Radiological Emergency Response and Recovery") are aimed to continue with the remaining tasks for gaining appropriate levels of emergency preparedness at local level in most European countries. One of the objectives of the NERIS-TP project is: Strengthen the preparedness at the local/national level by setting up dedicated fora and developing new tools or adapting the tools developed within the EURANOS projects (such as the governance framework for preparedness, the handbooks on countermeasures, the RODOS system, and the MOIRA DSS for long term contamination in catchments) to meet the needs of local communities. CIEMAT and UPM in close interaction with the Nuclear Safety Council will explore, within this project, the use and application in Spain of such technical tools, including other national tools and information and communication strategies to foster cooperation between local, national and international stakeholders. The aim is identify and involve relevant stakeholders in emergency preparedness to improve the development and implementation of appropriate protection strategies as part of the consequence management and the transition to recovery. In this paper, an overview of the "state of the art" on this area in Spain and the methodology and work Plan proposed by the Spanish group within the project NERIS to grow the stakeholder involvement in the preparedness to emergency response and recovery is presented

Emergency preparedness and response in New Zealand schools : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Emergency Management at Massey University, Wellington, New Zealand

International disaster risk reduction efforts prioritise school safety. Providing a safe learning environment for students and ensuring their continued access to education after an emergency has a positive influence on student, family, and community resilience. Existing school-based emergency management literature is limited. The project aimed to investigate current emergency preparedness and response activities in New Zealand schools, and identify key practices that support efforts to keep students safe during emergencies. A multiphase mixed methods research design, underpinned by a pragmatic philosophical approach, was employed to conduct three separate but linked studies that investigated: Emergency preparedness in schools (Study 1); Emergency management requirements and expectations of schools (Study 2); and Emergency response in schools (Study 3). Study 1 employed a survey to collect quantitative (n=355) and qualitative (n=514) data from schools throughout New Zealand about their experiences participating in the nationwide 2012 New Zealand ShakeOut earthquake drill, and the types of emergency preparedness activities undertaken. Findings identified lessons learned, and presented ways in which drills can be linked to other aspects of school preparedness. Schools were also found to undertake a range of preparedness activities (e.g., develop emergency plans, conduct frequent drills, and provide students with hazards education). However, differences in preparedness levels were identified, suggesting that some schools may be under-prepared to keep students safe in emergencies. A lack of clarity in the legislative requirements for school-based emergency management was proposed as a possible reason for differences in preparedness. Study 2 combined interviews of three emergency management practitioners with a review of New Zealand legislation, policy, and guidelines to identify the preparedness activities New Zealand schools are required to undertake to ensure the safety of the students in their care. The legislation was found to be generic, at times ambiguous, and schools were not provided with clear guidance. As a result, it was recommended that preparedness benchmarks be established and that standard operating procedures for core emergency response actions (i.e., shelter-in-place, lockdown, building evacuation, relocation, and family reunification) be developed to provide a consistent approach to school-based preparedness efforts. Studies 1 and 2 discussed emergency preparedness in New Zealand schools. However, there remained a need to investigate the link between preparing for and responding to emergencies by investigating how schools responded to real emergency events. Study 3 used three case studies to explore how three schools responded in a range of emergency events. Findings included the identification of generic, recurring response activities across a selection of emergency types, which were used to develop a six-stage school-based emergency response model. The lessons learned from participant’s first hand experiences of various emergency events enabled the identification of factors that contribute to an effective emergency response, including activities undertaken before, during, and after an emergency. Research exploring emergency management in New Zealand schools is still in its infancy. This project has contributed significant knowledge to understanding how New Zealand schools prepare for and respond to emergencies to keep their students safe. Findings from the research may also have relevance for an international audience

Research Directions in Information Systems for Humanitarian Logistics

This article systematically reviews the literature on using IT (Information Technology) in humanitarian logistics focusing on disaster relief operations. We first discuss problems in humanitarian relief logistics. We then identify the stage and disaster type for each article as well as the article’s research methodology and research contribution. Finally, we identify potential future research directions

Emergency Management Training for Transportation Agencies

State transportation agencies have a variety of responsibilities related to emergency management. Field personnel manage events--from day-to-day emergencies to disasters--using the Incident Command System (ICS) as their organizational basis. At the headquarters level, the Emergency Operations Center (EOC) coordinates the use of resources across the department and its districts, with other state departments and agencies, and through the federal Emergency Support Function 1. District-level EOCs coordinate with the department. In extreme events, the transportation department may only be able to deliver limited essential services in austere conditions, so a continuity of operations/ continuity of government plan (COOP/COG) is essential. This research applied the principles of andragogy to deliver ICS field level training, EOC training and COOP/COG training to state transportation agency’s staff in all districts and at headquarters. The data supports the need for adult-oriented methods in emergency management training

A Survey on IT-Techniques for a Dynamic Emergency Management in Large Infrastructures

This deliverable is a survey on the IT techniques that are relevant to the three use cases of the project EMILI. It describes the state-of-the-art in four complementary IT areas: Data cleansing, supervisory control and data acquisition, wireless sensor networks and complex event processing. Even though the deliverable’s authors have tried to avoid a too technical language and have tried to explain every concept referred to, the deliverable might seem rather technical to readers so far little familiar with the techniques it describes