Computer simulation in mass emergency and disaster response: An evaluation of its effectiveness as a tool for demonstrating strategic competency in emergency department medical responders

This study examined the capability of computer simulation as a tool for assessing the strategic competency of emergency department nurses as they responded to authentically computer simulated biohazard-exposed patient case studies. Thirty registered nurses from a large, urban hospital completed a series of computer-simulated case studies of virtual biohazard-exposed patients. The completed case studies were assessed by the host computer according to computer-programmed criteria. The same case studies were also assessed by a trio of emergency medicine physicians acting as subject matter experts according to their own criteria. The results of this study demonstrated a significant correlation between computer-assessed and physician-assessed simulation exercises against pre-determined performance objective criteria. The data suggests computer simulation can play an important role in emergency and disaster response that offers readily accessible cost-effective training where the opportunity for hands-on practice is limited or impractical. In addition, use of computer simulation can make an effective evaluation of emergency response preparedness possible at more frequent intervals and with greater efficiency

Bio+Terror: Science, Security, Simulation

The United States government has spent more than $125 billion since 2001 to prepare the nation for bioterrorism. This dissertation examines the emergence of bioterrorism as a credible threat in the contemporary moment, considering how the preparedness practices of the security state constitute new biopolitical formations. To explore how changing ways of knowing disease and risk are reshaping communities, this multi-sited study investigates the material outcomes of biosecurity in people\u27s lives. It shows how complex histories of disease and terror are remade in the modern age to bring about new spaces and forms of biological citizenship.Through interview, observation and detailed historical research, this research considers three sites where bioterrorism is reshaping public life. At Montana\u27s Rocky Mountain Laboratory, the community protest of the first high-security Biosafety Level-4 facility built in the 21st century exemplifies how public fear of microbes reshapes laboratory spaces and constructs environmental geographies around new conceptions of life, risk, and disease. The creation and implementation of new biopreparedness programs at the Centers for Disease Control and Prevention in Atlanta show how the alliance of public health practices with the nation\u27s security complex brings a new level of militarism to everyday practices of health and wellness. Finally, a case study of bioterrorism simulation exercises in New Mexico considers how the public rehearsal of terrorism events creates a perpetual state of emergency as governments and citizens publicly perform their responses to a crisis.By studying the technoscientific extensions of war in the modern age, this research questions how the care-giving acts of governance have been militarized and how enlisting the bioscience industry in the War on Terror is changing societal norms of knowing life, death, nature, and disease, grounded in these re-articulations of life itself. The emerging spaces and economies of terrorism preparedness exemplify how the fusion of new genomic biologies with national security practices brings material change to the spaces where people live and work. This research aims to convince scholars as well as policymakers and activists that the ways in which bioterrorism has been produced have consequences in how people live

When Terrorism Threatens Health: How Far are Limitations on Personal and Ecomonic Liberties Justified

The government is engaged in a homeland-security project to safeguard the population\u27s health from potential terrorist attacks. This project is politically charged because it affords the state enhanced powers to restrict personal and economic liberties. Just as governmental powers relating to intelligence, law enforcement, and criminal justice curtail individual interests, so too do public health powers

Medical Response for Terrorist and Public Health Threats: One Region\u27s Experience (Pittsburgh)

This site visit, planned and convened in conjunction with the Agency for Healthcare Research and Quality’s User Liaison Program, examined the efforts underway in the greater Pittsburgh area to develop emergency medical response capabilities for mass causality events. The site visit explored efforts to improve infectious disease surveillance capabilities and looked at the Region 13 collaborative’s development of a regionalized approach to emergency management planning and response. Hospital preparedness activities were also studied, including a discussion of lessons learned from a recent drill to test response to a radiological event and an exploration of conceptual frameworks to guide hospital planning efforts. Also examined were efforts to improve emergency medical surge capacity, which encompassed both mobilizing health care providers and planning for increased resource needs related to pharmaceuticals, hospital beds, and equipment. Local efforts to improve preparedness were considered in the context of state-wide planning efforts. The site visit included a visit to the Allegheny County Emergency Operations Center and the University of Pittsburgh Medical Center’s Emergency Department at Presbyterian Hospital

Smallpox Bioterrorism Preparedness: The Importance of Technology and Education for Early Detection and Response

The use of biological agents as weapons has been prevalent throughout history. Only when the US experienced a bioterrorist attack in 2001 did additional funding begin to invest in preparing for other potential attacks. These initial investments, along with others, have funded preventative measures such as mass surveillance through biosensor technology and the development of preparedness programs such as the Laboratory Response Network and Hospital Preparedness Program. Based on learnings from previous outbreak events, in the event of a bioterrorist attack involving smallpox early detection will be the key to initiating a rapid and effective response. Additionally, further measures need to be taken to detect smallpox release either in the form of lab modified pathogens or laboratory compromise. Technologies must be made more accessible especially in rural areas where access may be limited. Because access may be limited, investments must be made into programs to better train medical personnel in identifying smallpox. This education must include topics not only on how to identify potential cases and management, but include topics related to identifying available resources and correct use of personal protection equipment to prevent further infection. Based on research, this education would improve healthcare personnel’s willingness to respond during an attack to improve containment. Finally, preparing education for the public prior to an event is important as they can assist in early identification and reduce panic. Improving bioterrorist attack readiness involving smallpox in the above areas is the key for reducing morbidity, mortality, and its overall impact on public health

Perceived Confidence Levels of NC School Nurses with Emergency Preparedness

School nurses have a critical role in a school setting during an emergency. In many situations, they are the first and only health responders on the scene. School nurses must be confident in their knowledge and skills to implement in many different types of emergencies. This study presents the results of the perceived competence levels of NC School Nurses with emergency preparedness. An anonymous survey showed results that more school nurses are more confident with medical emergencies and least confident with pandemic and bioterrorism related emergencies. Some types of emergencies may only pose a low threat of incidence in a NC school, however, school districts, administrators, school nurses, and local health departments have a responsibility in collaborating together to develop an emergency plan of school nurse responsibilities in all types of emergencies