Hospital-related incidents; causes and its impact on disaster preparedness and prehospital organisations

<p>Abstract</p> <p>Background</p> <p>A hospital's capacity and preparedness is one of the important parts of disaster planning. Hospital-related incidents, a new phenomenon in Swedish healthcare, may lead to ambulance diversions, increased waiting time at emergency departments and treatment delay along with deterioration of disaster management and surge capacity. We aimed to identify the causes and impacts of hospital-related incidents in Region Västra Götaland (western region of Sweden).</p> <p>Methods</p> <p>The regional registry at the Prehospital and Disaster Medicine Center was reviewed (2006–2008). The number of hospital-related incidents and its causes were analyzed.</p> <p>Results</p> <p>There were an increasing number of hospital-related incidents mainly caused by emergency department's overcrowdings, the lack of beds at ordinary wards and/or intensive care units and technical problems at the radiology departments. These incidents resulted in ambulance diversions and reduced the prehospital capacity as well as endangering the patient safety.</p> <p>Conclusion</p> <p>Besides emergency department overcrowdings, ambulance diversions, endangering patient s safety and increasing risk for in-hospital mortality, hospital-related incidents reduces and limits the regional preparedness by minimizing the surge capacity. In order to prevent a future irreversible disaster, this problem should be avoided and addressed properly by further regional studies.</p

Regional coordination in medical emergencies and major incidents; plan, execute and teach

<p>Abstract</p> <p>Background</p> <p>Although disasters and major incidents are difficult to predict, the results can be mitigated through planning, training and coordinated management of available resources. Following a fire in a disco in Gothenburg, causing 63 deaths and over 200 casualties, a medical disaster response centre was created. The center was given the task to coordinate risk assessments, disaster planning and training of staff within the region and on an executive level, to be the point of contact (POC) with authority to act as "gold control," <it>i.e</it>. to take immediate strategic command over all medical resources within the region if needed. The aim of this study was to find out if the centre had achieved its tasks by analyzing its activities.</p> <p>Methods</p> <p>All details concerning alerts of the regional POC was entered a web-based log by the duty officer. The data registered in this database was analyzed during a 3-year period.</p> <p>Results</p> <p>There was an increase in number of alerts between 2006 and 2008, which resulted in 6293 activities including risk assessments and 4473 contacts with major institutions or key persons to coordinate or initiate actions. Eighty five percent of the missions were completed within 24 h. Twenty eight exercises were performed of which 4 lasted more than 24 h. The centre also offered 145 courses in disaster and emergency medicine and crisis communication.</p> <p>Conclusion</p> <p>The data presented in this study indicates that the center had achieved its primary tasks. Such regional organization with executive, planning, teaching and training responsibilities offers possibilities for planning, teaching and training disaster medicine by giving immediate feed-back based on real incidents.</p

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Bombattentatet i Oslo och skjutningarna på Utøya 2011 : Kamedo-rapport 97

Fredagen den 22 juli 2011 kl. 15.25 detonerade en sprängladdning i regeringskvarteret i centrala Oslo. Bomben var mycket kraftig – åtta personer dödades, minst 90 skadades och kringliggande byggnader fick omfattande skador. Senare samma eftermiddag klev en man som utgav sig för att vara polis iland på ön Utøya, där det norska Arbeiderpartiets ungdomsförbund höll ett sommarläger. Väl iland på ön började mannen skjuta omkring sig. När han senare greps av polis hade 69 personer dödats och 65 skadats. De flesta var barn eller ungdomar. Händelserna den 22 juli involverade stora delar av det norska samhället. De många skadade krävde stora insatser från hälso- och sjukvården och det fanns ett stort behov av psykosocialt stöd till de många överlevande och deras anhöriga, samt till de avlidnas anhöriga. Vidare väckte händelserna ett mycket stort medialt intresse som de berörda aktörerna var tvungna att förhålla sig till. Rapporten omfattar en diskussion kring den norska hanteringen av 22 juli 2011,  samt hur det svenska samhället hade kunnat hantera en motsvarande händelse.Tre huvudområden belyses: hälso- och sjkukvård, psykosocialt stöd samt kommunikation och mediehantering.KAMEDO-rapporterna ges ut av Katastrofmedicinska observatörsstudier (KAMEDO) vid Socialstyrelsen. Utsända observatörer studerar de medicinska, psykologiska, organisatoriska och sociala aspekterna av katastrofer. Resultaten med fokus på erfarenheter presenteras i rapporterna.Medförfattare och redaktör: Anders Eklund, utredare på enheten för krisberedskap, Socialstyrelsen</p

The bomb attack in Oslo and the shootings at Utøya, 2011 : Kamedo report 97

The Kamedo observer reports study the medical, psychological, organizational and social aspects of disasters. This report summaries experiences from the bomb attack in Oslo and the shootings at Utøya, 2011. That may be valuable for the further development of the Swedish disaster preparedness system.(Article number: 2012-12-23)Co-author and editor: Anders Eklund, Investigator at the National Board of Health and Welfare's Unit for Emergency Preparedness</p

Health among disaster survivors and health professionals after the Haiyan Typhoon: a self-selected Internet-based web survey

Abstract Background Natural disasters affected millions of people worldwide every year. Evaluation of disaster health and health response interventions is faced with several methodological challenges. This study aimed (1) to describe survivors’ and health professionals’ health, 30 months after a natural disaster using a web-based self-selected Internet sample survey designed and (2) to evaluate the health effects of disaster response interventions, in the present study with a focus on disaster radio. Methods A web-based survey was used to conduct a cross-sectional study approximately 30 months after typhoon Haiyan. The GHQ-12, EQ-5D-3L, and EQ-VAS instruments were used in addition to study-specific questions. A self-selected Internet sample was recruited via Facebook. Results In total, 443 survivors, from what 73 were health professionals, participated in the study. The Haiyan typhoon caused both physical and mental health problems as well as social consequences for the survivors. Mental health problems were more frequently reported than physical injuries. Health professionals reported worse overall health and a higher frequency of mental health problems compared to other survivors. Conclusions There were short-term and long-term physical, psychological, and social consequences for the survivors as a result of the Haiyan typhoon. Mental health problems were more frequently reported and lasted longer than physical problems. Health professionals deployed during the disaster reported worse health, especially concerning mental health problems. The survey used was found useful to describe health after disasters