18 research outputs found
Chester Step Test as a Reliable, Reproducible Method of Assessing Physical Fitness of Disaster Deployment Personnel
Malaysian disaster medicine research: a bibliographic study of publication trends
Introduction: Despite the increasing risks and complexity of disasters, education for
Malaysian health care providers in this domain is limited. This study aims to assess scholarly
publications by Malaysian scholars on Disaster Medicine (DM)-related topics.
Methodology: An electronic search of five selected journals from 1991 through 2021
utilizing multiple keywords relevant to DM was conducted for review and analysis.
Results: A total of 154 articles were included for analysis. The mean number of publications
per year from 1991 through 2021 was 5.1 publications. Short reports were the most common
research type (53.2%), followed by original research (32.4%) and case reports (12.3%). Mean
citations among the included articles were 12.4 citations. Most author collaborations were
within the same agency or institution, and there was no correlation between the type of collaboration
and the number of citations (P = .942). While a few clusters of scholars could
build a strong network across institutions, most research currently conducted in DM was
within small, isolated clusters.
Conclusion: Disaster Medicine in Malaysia is a growing medical subspecialty with a
significant recent surge in research activity, likely due to the SARS-CoV-2/coronavirus disease
2019 (COVID-19) global pandemic. Since most publications in DM have been on
infectious diseases, the need to expand DM-related research on other topics is essentia
Emergency medical services preparedness in dual disasters: war in the era of COVID-19 in Armenia
Introduction: Emergency Medical Services (EMS) is a critical part of Disaster Medicine
and has the ability to limit morbidity and mortality in a disaster event with sufficient training
and experience. Emergency systems in Armenia are in an early stage of development and
there is no Emergency Medicine residency training in the country. As a result, EMS physicians
are trained in a variety of specialties.
Armenia is also a country prone to disasters, and recently, the ArmenianEMSsystem was
challenged by two concurrent disasters when the 2020 Nagorno-Karabakh War broke out in
the midst of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic.
Study Objective: This study aims to assess the current state of disaster preparedness of the
Armenian EMS system and the effects of the simultaneous pandemic and war on EMS
providers.
Methods: This was a cross-sectional study conducted by anonymous survey distributed to
physicians still working in the Yerevan EMS system who provided care to war casualties and
COVID-19 patients.
Results: Survey response rate was 70.6%.Most participants had been a physician (52.1%) or
EMS physician (66.7%) for three or less years. The majority were still in residency (64.6%).
Experience in battlefield medicine was limited prior to the war, with the majority reporting
no experience in treating mass casualties (52.1%), wounds from explosives (52.1%), or performing
surgical procedures (52.1%), and many reporting minimal to no experience in treating
gunshot wounds (62.5%), severe burns (64.6%), and severe orthopedic injuries (64.6%).
Participants had moderate experience in humanitarian medicine prior to war. Greater experience
in battlefield medicine was found in participants with more than three years of experience
as a physician (z-score โ3.26; P value <.01) or as anEMS physician (z-score โ2.76; P
value <.01) as well as being at least 30 years old (z-score โ2.11; P value = .03). Most participants
felt they were personally in danger during the war at least sometimes (89.6%).
Conclusion: Prior to the COVID-19 pandemic and simultaneous 2020 Nagorno-Karabakh
War, EMS physicians in Armenia had limited training and experience in Disaster Medicine.
This system, and the frontline physicians on whom it relies, was strained by the dual disaster,
highlighting the need for Disaster Medicine training in all prehospital medical providers
Preparing for the next COVID-19 wave in Canada: managing the crisis facing emergency management leaders in healthcare organisations
Crisis standards of care in a pandemic: navigating the ethical, clinical, psychological and policy-making maelstrom
The COVID-19 pandemic has caused clinicians at the frontlines to confront difficult decisions regarding resource allocation, treatment options and ultimately the life-saving measures that must be taken at the point of care. This article addresses the importance of enacting crisis standards of care (CSC) as a policy mechanism to facilitate the shift to population-based medicine. In times of emergencies and crises such as this pandemic, the enactment of CSC enables concrete decisions to be made by governments relating to supply chains, resource allocation and provision of care to maximize societal benefit. This shift from an individual to a population-based societal focus has profound consequences on how clinical decisions are made at the point of care. Failing to enact CSC may have psychological impacts for healthcare providers particularly related to moral distress, through an inability to fully enact individual beliefs (individually focused clinical decisions) which form their moral compass