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

Smart hospital emergency system via mobile-based requesting services

In recent years, the UK’s emergency call and response has shown elements of great strain as of today. The strain on emergency call systems estimated by a 9 million calls (including both landline and mobile) made in 2014 alone. Coupled with an increasing population and cuts in government funding, this has resulted in lower percentages of emergency response vehicles at hand and longer response times. In this paper, we highlight the main challenges of emergency services and overview of previous solutions. In addition, we propose a new system call Smart Hospital Emergency System (SHES). The main aim of SHES is to save lives through improving communications between patient and emergency services. Utilising the latest of technologies and algorithms within SHES is aiming to increase emergency communication throughput, while reducing emergency call systems issues and making the process of emergency response more efficient. Utilising health data held within a personal smartphone, and internal tracked data (GPU, Accelerometer, Gyroscope etc.), SHES aims to process the mentioned data efficiently, and securely, through automatic communications with emergency services, ultimately reducing communication bottlenecks. Live video-streaming through real-time video communication protocols is also a focus of SHES to improve initial communications between emergency services and patients. A prototype of this system has been developed. The system has been evaluated by a preliminary usability, reliability, and communication performance study

Knowledge acquisition and dissemination for emergency situation

Emergency situation is highly uncertain, dynamic, time pressure in making decisions and involves multi organizations and multi jurisdiction level. This paper presents a conceptual architecture that can be used by emergency response task force in assisting the victims of the disaster. Flood disaster is used as a case study. The architecture describes the knowledge and communication for flood emergency response management

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

Europe's growth emergency

The European Union growth agenda has become even more pressing because growth is needed to support public and private sector deleveraging, reduce the fragility of the banking sector, counter the falling behind of southern European countries and prove that Europe is still a worthwhile place to invest. The crisis has a similar impact on most European countries and the US: a persistent drop in output level and a growth slowdown. This contrasts sharply with the experience of the emerging countries of Asia and Latin America. Productivity improvement was immediate in the US, but Europe hoarded labour and productivity improvements were in general delayed. Southern European countries have hardly adjusted so far. There is a negative feedback loop between the crisis and growth, and without effective solutions to overturn the crisis, growth is unlikely to resume. National and EU level policies should aim to foster reforms and adjustment and should not risk medium term objectives under the pressure of events. A more hands-on approach, including industrial policies, should be considered. Earlier versions of this Policy Contribution were presented at the Bruegel-PIIE conference on Transatlantic economic challenges in an era of growing multipolarity, Berlin, 27 September 2011, and at the BEPA-Polish Presidency conference on Sources of growth in Europe, Brussels, 6 October 2011.

The role of the emergency department in the management of acute heart failure: an international perspective on education and research

Emergency departments are a major entry point for the initial management of acute heart failure (AHF) patients throughout the world. The initial diagnosis, management and disposition - the decision to admit or discharge - of AHF patients in the emergency department has significant downstream implications. Misdiagnosis, under or overtreatment, or inappropriate admission may place patients at increased risk for adverse events, and add costs to the healthcare system. Despite the critical importance of initial management, data are sparse regarding the impact of early AHF treatment delivered in the emergency department compared to inpatient or chronic heart failure management. Unfortunately, outcomes remain poor, with nearly a third of patients dying or re-hospitalised within 3 months post-discharge. In the absence of robust research evidence, consensus is an important source of guidance for AHF care. Thus, we convened an international group of practising emergency physicians, cardiologists and advanced practice nurses with the following goals to improve outcomes for AHF patients who present to the emergency department or other acute care setting through: (a) a better understanding of the pathophysiology, presentation and management of the initial phase of AHF care; (b) improving initial management by addressing knowledge gaps between best practices and current practice through education and research; and (c) to establish a framework for future emergency department-based international education and research

Handbook of Emergency Management For State-Level Transportation Agencies, MTI Report 09-10

The Department of Homeland Security has mandated specific systems and techniques for the management of emergencies in the United States, including the Incident Command System, the National Incident Management System, Emergency Operations Plans, Emergency Operations Centers, Continuity of Government Plans and Continuity of Operations Plans. These plans and systems may be applied to the state-level transportation agency�s disaster response systems to enhance efficiency and effectiveness. Specific guidance and management techniques are provided to aid emergency planning staff to create DHS-compliant systems

A Fault-Tolerant Emergency-Aware Access Control Scheme for Cyber-Physical Systems

Access control is an issue of paramount importance in cyber-physical systems (CPS). In this paper, an access control scheme, namely FEAC, is presented for CPS. FEAC can not only provide the ability to control access to data in normal situations, but also adaptively assign emergency-role and permissions to specific subjects and inform subjects without explicit access requests to handle emergency situations in a proactive manner. In FEAC, emergency-group and emergency-dependency are introduced. Emergencies are processed in sequence within the group and in parallel among groups. A priority and dependency model called PD-AGM is used to select optimal response-action execution path aiming to eliminate all emergencies that occurred within the system. Fault-tolerant access control polices are used to address failure in emergency management. A case study of the hospital medical care application shows the effectiveness of FEAC

Improving Emergency Response in the Outpatient Clinic Setting

Background: Effective triage, assessment, and activation of necessary systems in emergent situations of clinical instability is vital in reducing morbidity and mortality of patients in any clinical setting. When medical emergencies occur outside of the hospital, organized and expedited transfer to a higher level of care reduces the potential for adverse events, lasting deficits, and patient death. Aim: The aim of this project was to identify weaknesses in the emergency response system in the community-based outpatient clinic setting and to propose solutions. Methods: The “Swiss Cheese” theoretical framework was used to do a root cause analysis of two clinical scenarios. Weaknesses in the emergency response system in the community-based outpatient clinic setting were identified. Results: Several tools were utilized including a fish bone diagram and the 5-Whys tool. Two root causes were identified. The first is that clinic staff does not have a working knowledge with specifics regarding the emergency response process. The second is that the existing emergency response checklist document is visually confusing and duties are not in sequence. Discussion and Implications for the CNL: Weaknesses in the emergency response system will be discussed. Knowledge and experience from inpatient care will be translated to the outpatient clinic setting. The role of the CNL in designing an effective emergency response system will be discussed with the proposal of several plans of action