Ready or Not? Protecting the Public's Health From Diseases, Disasters, and Bioterrorism, 2009

Based on ten indicators, assesses progress in the readiness of states, federal government, and hospitals to respond to public health emergencies, with a focus on the H1N1 flu. Outlines improvements and concerns in funding, accountability, and other areas

Chemical Disaster Preparedness for Hospitals and Emergency Departments

Preparing to evaluate and treat victims of a chemical exposure incident is one aspect of hospital disaster preparedness. Past chemical disasters, including terrorist attacks and industrial or transit accidents, have highlighted the need for hospital planning, preparation, and training. Emergency department and hospital staff members must be familiar with their facility-specific protocols and be trained for their individual roles during these incidents. This article provides a brief review of the requirements and guidelines related to chemical disaster response from a healthcare perspective. Resources for training and the evaluation of chemically contaminated patients are discussed. Decontamination procedures, including pre-hospital and hospital-based decontamination of ambulatory, non-ambulatory, and at-risk patients are also reviewed. Physicians and clinicians, especially in the emergency department, must be familiar with methods of evaluating chemical exposures, identifying substances, recognizing toxidromes, ensuring appropriate personal protective equipment (PPE) use, performing decontamination, and initiating treatments for life-threatening conditions. By understanding the guidelines and resources available, clinicians will be better equipped to safely evaluate and treat chemically exposed or contaminated patients

Advancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage

PurposeThe European Union Horizon 2020 research and innovation funding program awarded the NIGHTINGALE grant to develop a toolkit to support first responders engaged in prehospital (PH) mass casualty incident (MCI) response. To reach the projects' objectives, the NIGHTINGALE consortium used a Translational Science (TS) process. The present work is the first TS stage (T1) aimed to extract data relevant for the subsequent modified Delphi study (T2) statements.MethodsThe authors were divided into three work groups (WGs) MCI Triage, PH Life Support and Damage Control (PHLSDC), and PH Processes (PHP). Each WG conducted simultaneous literature searches following the PRISMA extension for scoping reviews. Relevant data were extracted from the included articles and indexed using pre-identified PH MCI response themes and subthemes.ResultsThe initial search yielded 925 total references to be considered for title and abstract review (MCI Triage 311, PHLSDC 329, PHP 285), then 483 articles for full reference review (MCI Triage 111, PHLSDC 216, PHP 156), and finally 152 articles for the database extraction process (MCI Triage 27, PHLSDC 37, PHP 88). Most frequent subthemes and novel concepts have been identified as a basis for the elaboration of draft statements for the T2 modified Delphi study.ConclusionThe three simultaneous scoping reviews allowed the extraction of relevant PH MCI subthemes and novel concepts that will enable the NIGHTINGALE consortium to create scientifically anchored statements in the T2 modified Delphi study

Evaluation of medical response in disaster preparedness : with special reference to full-scale exercises

Background: Disaster exercises and simulations serves as teaching and training tool for improving medical response in disaster preparedness. Rapid and effective medical response in major incidents is known as a “key phase” to optimise resources, and this requires that management systems have an “all hazards” approach. Decision-making at all levels of management is based on available information and involves allocation of medical resources and triage decisions. Aim: The overall aim of this thesis was to increase our knowledge of the impact of quantitative evaluation of medical response on disaster preparedness. The specific aims were: to increase the ability to learn from full-scale exercises by applying quality indicators at two levels of command and control (I, II); to identify key indicators essential for initial disaster medical response registration (III); to explore ambulance staff attitudes towards practising triage tagging (IV); and to increase our knowledge of the applicability of a technical support system and its potential to provide real-time, overall situation awareness available to those overseeing the medical management of the operation. Methods: Study I, II and V were observational studies based on data collections from full-scale exercises. Templates with measurable performance indicators for evaluation of command and control were used in Study I and II and the same performance indicators combined with outcome indicators was also included in Study II. A consensus method, the Delphi technique, with 30 experts was used in Study III. Study IV used mixed methods, a pre-and post web survey answered by ambulance nurses and physicians (n=57 respectively 57) before and after a time limited strategy with triage tags and three focus groups interviews comprising 21 ambulance nurses and emergency medical technicians. Study V used major two incidents simulations to test the applicability of Radio Frequency Identification (RFID tags) technology and compare it with traditionally paper-based triage tags (n= 20 respectively 20). The quantitative data were analysed using descriptive statistics, and content analysis was used for the qualitative data. Results: The evaluation model exposed several problems occurring in the initial decision-making process that were repeatedly observed (I, II). These results in study II also demonstrated to have a major impact on patient outcome.Out of 17 severely injured patients five respectively seven were at risk for preventable death. A total of 97 statements were generated, of these 77 statements reached experts consensus, and 20 did not (III). Ambulance staffs believe in the usefulness of standardised triage methods, but the sparse application of triage tags at the scene indicates that the tags are not used frequently. Infrequent use in daily practice prevents participants from feeling confident with the triage tool (IV).The Radio Frequency Identification system improved situational awareness in disaster management. Triage information was available at least one hour earlier compared to a paper-based triage system (V). Conclusions: The presented evaluation model can be used in an objective, systematic and reproducible way to evaluate complex medical responses, which is a prerequisite for quality assurance, identification of problems, and the development of disaster preparedness

Ready or Not? Protecting the Public's Health From Diseases, Disasters, and Bioterrorism, 2008

Examines ten indicators to assess progress in state readiness to respond to bioterrorism and other public health emergencies. Evaluates the federal government's and hospitals' preparedness. Makes suggestions for funding, restructuring, and other reforms

The use of drones during mass events

The concept of a mass event has been defined by the law on mass event security. The use of drones to monitor events involves numerous benefits. Surveillance provided by means of drones is particularly beneficial as far as large open areas are concerned. Unmanned aerial vehicles (UAVs) alert one to any issues in the crowd

Using the Minimum Data Set (MDS) to Triage Long Term Care Facilities’ Residents for a Systematic Evacuation in the Case of Mass Casualty Disaster Events

Long Term Care facilities preparedness for disasters has been questioned, and evacuation before or during disasters is crucial for life saving. This thesis attempted to develop a systematic triage methodology based on the use of the Minimum Data Set (MDS), which is a powerful resource for gathering residents’ vital information including physical ability, cognitive functioning, and other health related conditions. Our assumption was that 90% of caregivers’ triage categorization will match with the categorization generated from the MDS dataset. To achieve our objectives and aims, we compared the triage categorization carried out by residents’ caregivers versus the MDS generated triage categories. Overall we did not found a strong agreement between caregivers and MDS triage categorization. However, the triage categorization of both homemakers and cooks versus CNAs yield a substantial correlation. Also we found that the work experience was closely related to the agreement between RN and CNAs versus MDS. In conclusion we think that MDS can be used to generate triage categories for long term care residents to facilitate the systematic evacuation of buildings in the case of mass casualty event. But before that, it will be important to conduct further studies with a large sample size of caregivers and the accessibility to the MDS dataset. The validation of the use of MDS dataset to generate triage categories will hugely help long term care facilities to be prepared for evacuation, because it can be the start point for the development of triage application which can be use on both portable and mobile electronic devices

A Wearable Platform for Patient Monitoring during Mass Casualty Incidents

Based on physiological data, intelligent algorithms can assist with the classification and recognition of the most severely impaired victims. This dissertation presents a new sensorbased triage platform with the main proposal to join different sensor and communications technologies into a portable device. This new device must be able to assist the rescue units along with the tactical planning of the operation. This dissertation discusses the implementation and the evaluation of the platform

Analysis and Development of Emergency Management Information System for Railway Systems in Taiwan

Railway is one of the most efficient, convenient, and comfortable ways with maximum mobility to meet people. Railway accidents or disasters often cause delays and service interruptions, resulting in operational and other loss. Despite many railway systems in Taiwan having a variety of monitoring systems for natural disasters, they still need an efficient platform for the emergency management of disasters and accidents since time and efficiency are the keys to emergency management. This study aims to fill in this gap by developing an emergency management information system for Railway Systems in Taiwan, i.e. “Railway Emergency Management Information System”, to support railway emergency management center and its sub-divisions in resource management, communication, messaging, and information sharing among different groups. The system includes many features that will improve communications between emergency management center and the mobile emergency management center to facilitate the progress of the disaster control units and dispatching at the disaster site. The study’s information system has been designated by local railway administration as the core system and starts trial since February 2012. Information requirement analysis, framework and design of the aforementioned information system will be discussed in this paper. It is hoped that the present study's information system research will help improve the emergency response of railway administration and provide safer rail transport service for the passengers

Analysis of Texas Nurses\u27 Preparedness and Perceived Competence in Managing Disasters

Awareness of disaster preparedness has penetrated every level of the government and has captured the attention of citizens around the world. The increased prevalence of natural disasters cannot be denied, and the growing turbulence of world affairs is the focus of intense media attention. Nurses make up the largest sector of the healthcare workforce and are integral responders to major natural and human-induced disasters. It is essential that nurses have the knowledge and preparation needed to respond effectively, not only for the benefit of health care organizations, but for the safety of the community at large. This article explores the scope and strength of nurse preparedness on an international, national, and local level. While a number of studies related to disaster response are available, there appears to be a dearth of research studies that examine nurses in relation to disaster preparedness. The purpose of this article is to explore the current state of science regarding disaster preparedness among nurses