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Road tunnel systems are becoming increasingly complex. Regardless of incident, the confined nature of the road tunnel impairs responding emergency services accessibility, with a risk for delay in treatment of time-sensitive injuries such as pneumothorax or internal hemorrhage. Consequently, the need for rapid decision-making by the emergency services commanders is increased. However, in Sweden ambulance commanders lack experience and training in managing road tunnel incidents. This may further delay the medical response.
The aim is to investigate if the ambulance commander decision-making in simulated road tunnel incidents may be improved by a specific road tunnel incident e-learning course.
Method:
A web-based intervention study was performed with 20 participants; 10 participants in the intervention and control group, respectively. The control group received a pre-recorded general lecture on incident management. The intervention group received a specific road tunnel incident e-learning course, consisting of five interactive modules with learning materials (e.g. road tunnel structures, collaboration and safety). All participants participated in web-based simulations of major road tunnel incidents at one and six months post-intervention. In these simulations, participants acted as ambulance commanders and decided on the best course of action in 15 dissimilar and multiple choice-based management decisions. For each decision, time and choice of decision were recorded as outcome measurements.
Results:
Preliminary analysis from the one-month follow up simulation indicates that none of the participants decided to enter the road tunnel system at the early stage of the incident. The motivation for the participants decision-making was not clear.
Conclusion:
The cautiousness to enter the road tunnel system will impair the emergency medical services response, including delaying vital medical care. Further research into the reasoning behind this decision is needed and identified causes may be further addressed in updated educational materials and collaborative discussions.
The 2022 Russian invasion of Ukraine exacts a heavy death toll throughout Ukraine. Morbidity and mortality of warfighters and vulnerable civilian communities are inversely proportional to quality access to a viable medical evacuation chain. The military inspector is one option to fill the gap in prehospital medicine to reduce morbidity and mortality by providing damage control resuscitation/surgery (DCR/DCS).
Method:
Qualitative and quantitative methodologies are applied. Qualitatively describing the medical evacuation of Shane, providing death estimates of the point of injury to receipt of DCR/DCS. Provide interoperable care across the military-civilian and humanitarian sectors. Describe the standardized and consistent evacuation chains across the entire battlefront from the point of injury to the Role 1/Role 2 echelons of care.
Results:
The medical evacuation chain for this current iteration of Russian violence is currently inadequate, not standardized, not well integrated at the military-civilian interface. Preventable morbidity and mortality from conventional Russian weapon systems have increased.
Conclusion:
Armed Forces of Ukraine to engage with NATO and EU colleagues to acquire the methodology and practical applications to reduce preventable morbidity and mortality. Standardized approaches to the concept of damage control resuscitation and damage control surgery to the paradigm of tactical combat casualty care can help reduce morbidity and mortality. The Ukraine crisis and Russian war is killing people in Ukraine, prehospital medicine must address and focus on reducing preventable causes of morbidity and mortality.
Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the COVID-19 pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services (EMS), even in the accelerating environment of biothreats.
Method:
This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS providers. The survey was available for 1 month in 2021 during which 190 EMS providers responded to the survey.
Results:
Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a biological agent. Provider Clinical Competency levels ranged from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution, and community). Only 10% of the respondents were both willing and able to effectively function in a bioterror environment.
Conclusion:
To effectively prepare for and respond to a bioterrorist attack, all levels of the healthcare system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed to biological agents. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system, which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.
Environmental degradation and climate change can lead to humanitarian crises and undermine humanitarian operations. Therefore, Emergency Medical Teams should try to reduce environmental impacts.
Method:
Collaborative development with companies was started by trimming the weight of tents, improving lights, and introducing renewable energy to our emergency medical unit to reduce greenhouse gas emissions.
Results:
The mechanism of the medical tent, and materials was changed. The weight of tents was cut by 30%. The final goal is to develop an 8 x 6 meter tent which is set up by four women.
Light-weight and low-power tent light was created. It is 50% weight and 60% power consumption of our conventional light.
All the power of the emergency clinic was run by renewable energy. introducing a 1 x 2 m, 5,5kg solar panel that produces 350 Wh/day. If 18 panels were put on the tent roof, they produce 6,300 Wh. This is equivalent to the power consumption of a standard household in Japan, and it is estimated this can cover the power consumption of the patient department of the emergency clinic. Experimental tests will now be conducted.
Conclusion:
Nowadays, even emergency medical teams are required to reduce their impact on the environment on the field. Therefore, trying to reduce the greenhouse gas emissions from the emergency medical team. The challenge is still on the way, but marching steadily.
Mass-casualty incidents (MCI) featuring a large number of injured persons caused by human-made or by natural disasters are increasing globally. During these incidents, medical first responders (MFR) need to take appropriate action that saves lives. In this context, the adage “practice makes perfect” is befitting to MCI training. However, providing large-scale MCI training is often difficult due to the significant effort required to create these types of exercises. Drawbacks include a large number of actors needed to portray victims, availability of infrastructure, and realistic treatments. Virtual Reality (VR) has been demonstrated in several domains to be a serious alternative, and in some areas also a significant improvement to conventional training. As an advanced alternative to VR, Mixed Reality (MR) have the potential to provide a dynamic simulation of an VR environment and hands-on practice on injured victims.
The aim is: 1) to present insights of a newly developed MR training system for increasing MCI preparedness and 2) discuss pedagogical aspects e.g. how the intended learning outcomes are perceived in MR training, how the participants experience the learning in MR training, and what impact MR training will have in their future work practice.
Method:
An MR training system, designed for teams of up to four MFRs to perform training in real-time, will be pilot-tested at the beginning of 2023. The system features a fully functional touch-enabled human manikin design for practicing skills in emergency situations. The pilot tests will be carried out within the Med1stMR project (https://www.med1stmr.eu/) where approximately four teams of MFR will be evaluated based on the intended learning outcome.
Results:
Preliminary results from the pilot tests will be available at the conference.
Conclusion:
Research is needed to strengthen the knowledge and impact of MR training as a pedagogical method to better support MCI training and preparedness.
The COVID-19 pandemic and the measures taken to contain it, have had a substantial effect on mental health of populations worldwide. Uncertainties about the future and one’s own health, as well as restrictive measures drastically altered people’s lives. To anticipate and mitigate the probable mental health impact, mental health and psychosocial support (MHPSS) interventions have been recommended and implemented. The objective of this systematic review is to provide an overview of different types of MHPSS interventions and the quality of the scientific evidence in the context of a pandemic.
Method:
A systematic search of interventions for reducing mental health problems or risks due to the COVID-19 pandemic was performed in November 2021 and repeated for new records in August 2022. APA PsycInfo, Embase, Ovid MEDLINE(R) ALL, EBM Reviews and Web of Science databases were systematically searched for relevant articles. The methodological quality of selected articles was assessed using the NHLBI Quality Assessment Tool for Systematic Reviews and Meta-Analyses.
Results:
A summary of the content and quality of MHPSS interventions during the COVID-19 pandemic is provided. The interventions could be clustered predominantly into existing MHPSS categories of “Basic aid”, “Information”, “Emotional and social support”, “Practical support” and “Health care”. Nevertheless, the evidence supporting the applicability and the effectiveness of such measures is limited when it comes to the mitigation of mental health problems.
Conclusion:
The clustered overview of different COVID-19 interventions points at strong similarities with interventions in general evidence-based MHPSS guidelines. However, there is a need to integrate more systematic monitoring, evaluation and research to appraise the applicability and effectiveness of MHPSS measures in future pandemics and other crises.
Self-affirmation is known to buffer the development of anxiety symptoms into depressive symptoms, and a study during the early days of the COVID-19 pandemic revealed a role for this self-affirmation. In Japan, the COVID-19 pandemic has occurred repeatedly, and at this point (November 16, 2022), prior to an eighth wave. The possibility of ameliorating the psychological effects of this prolonged COVID-19 pandemic through efficient interventions targeting self-affirmation will be examined.
Method:
Study dates: June 25, 2020; September 25, 2020; February 10, 2021; November 24, 2021; February 7, 2022; August 31, 2022
Survey participants: Registered monitors of the research company (Neo Marketing Co., Ltd.) Each 1,000 respondents
Questionnaire:
1) Attributes: gender, age, region, number of family members
2) DASS-21 (Depression, Anxiety, Stress Scale-21)
3) LSNS-6 (the Lubben Social Network Scale-6)
4) Self-affirmation
CIPS (Clance Impostor Phenomenon Scale)
Rosenberg Self-Esteem Scale (Japanese version)
The self-affirmation scale (CIPS; Rosenberg Self-Esteem Scale) was measured from the 4th to the 6th survey.
Contribution of each factor to depressive symptoms:
The DASS-21 Depressive Symptom Scores from the 4th through 6th surveys were examined using Prediction One with the DASS-21 Anxiety Symptom Score, DASS-21 Stress Score, Connections Score, Rosenberg, and CIPS score as factors to determine their contribution.
Results:
At the time of the second survey (September 25, 2020), DASS-21 scores peaked and then declined. CIPS and Rosenberg Self-Esteem Scale scores showed no change from the 4th to the 6th session. The result of contribution of each factor to depressive symptoms by Prediction One showed anxiety symptoms contributed the most to depressive symptoms.
Conclusion:
A model in which self-affirmation prevents anxiety symptoms from progressing to depressive symptoms is reasonable until the 7th wave of the COVID-19 pandemic in Japan.
Three years into the COVID-19 pandemic, experience and studies have shown that public behavior significantly contributes to the disease spread increase or reduction. As the pandemic becomes a chronic threat, maintaining public trust to comply with health regulations proves challenging as people develop pandemic fatigue. This study aims to analyze the long-term trends in public attitudes toward the COVID-19 pandemic and compliance with health regulations.
Method:
A longitudinal cohort study was performed from February 2020 until January 2022, collecting data from nationally representative samples (N=2,568) of the adult population in Israel. Data Collection was timed with the first five morbidity waves of the COVID-19 pandemic. We examined public trust in Israeli health regulations, public panic, worry, and compliance with health regulations, particularly self-quarantine.
Results:
The data shows that public trust in health regulations in January 2022 is at an all-time low (25%) compared to the maximum value measured in March 2020 (~75%). The perceived worry from COVID-19 is steadily declining, whereas the perception of public panic is increasing as the pandemic progresses into a chronic threat. While public compliance with self-quarantine was reported to be close to 100% in the early stages of the pandemic, it has dropped to 38% in early 2022, mainly when compensation for lost wages is not offered. Regression analysis suggests that trust is a significant predictor of compliance with health regulations.
Conclusion:
The findings, spanning more than two years of the pandemic, highlight the importance of maintaining public trust as a significant driver of public compliance with health regulations. The "fifth wave" of the pandemic resulted in an all-time low in public trust. The Israeli public, usually highly compliant, shows signs of crumbling conformity. Decision-makers ought to consider means to foster public trust.
Mass gathering events (MGE), can attract sufficient attendees to strain the planning and response resources of the host community, state, or nation, thereby delaying the response to emergencies. The organization of such a MGE can be even more problematic when the event continues across much of downtown (including hospitals) and makes some parts of the city inaccessible. The aim of this study was describing the health care management of the Grand Départ of the Tour de France, July 6-7th, 2019. On both days, the stages drew crowds of 300,000 attendees, adding a quarter of the regular number of inhabitants of Brussels (1,2 million) and closing parts of downtown Brussels.
Method:
Data were retrospectively collected from the in-event health services (coordinated by the University Hospital Brussels). Data regarding medical interventions, as well as data generated by the advanced medical posts (AMP) were recorded and handed to us after anonymization. For analysis, patients were divided into two groups: those seen by first-aid responders and paramedics (triage code green) and those seen and treated by health professionals (emergency nurses and physicians) (triage codes yellow or red).
Results:
During the event, three AMPs were established along the route of the stage as were six ambulances, three mobile medical crews (one emergency nurse and one physician), and seven mobile first aid teams. Over the two days, 84 patients were seen; 80 green codes (95,2%), 3 yellow (3,6%), and one red (1,2%) resulting in a patient presentation rate of 0.28/1,000. In total eight patients were transported to hospital for further diagnosis and treatment (ambulance transfer rate: 0.02/1,000).
Conclusion:
In-event health services for this event proved adequate according to the number of attendees and the severity of the patients. No hospital reported disruptions to their standard operational capacity.
The NO FEAR project is dealing with operational aspects of the response to security-related incidents. Recent attacks globally demonstrate the complexity of the scenes and the fact that by nature the scene is not safe, though EMS personnel are intervening in those unsafe environments.
Method:
During a series of workshops with different EMS providers and managers the following ideas have been discussed: 1) Acceptable risk is part of EMS work 2) EMS personnel should be trained to conduct a personal risk assessment on-site and take appropriate action 3) EMS personnel on site should not think about the "large scene" but on the specifics of their site of operations
Results:
This new way of thinking requires a shift of paradigm in EMS, which for many years was "safety first" or "don't engage unless the scene is safe", ignoring the change like deliberate attacks against the population.
Conclusion:
Recent attacks present new threats and risks for EMS personnel, coupled with public expectations (who are on the scene providing assistance to their fellow injured citizen) are a call to EMS leaders to re-think the way we teach and address scene safety in security related incidents.
On October 12, 2019, an 18-story building under construction collapsed in downtown New Orleans. Three construction workers were killed in the incident and their bodies were trapped in the rubble of the unstable structure.
Method:
This presentation includes public information on how and why the structure collapsed, the timeline of events for the protracted response, and feedback provided by the Urban Search and Rescue medical team about their experience and lessons learned.
Results:
The scene included a partially collapsed building still under construction, two construction cranes that were destabilized in the incident, two major roadways that required closure, several surrounding buildings impacted by debris, multiple injured workers, and three missing workers later determined to be deceased. Only two of three deceased individuals were able to be located on scene. One victim was safely recovered one day after the collapse. One victim was partially visible to the public but in an area of extreme danger to responders. His recovery required partial deconstruction of the building, which was significantly delayed due to safety, infrastructure, legal, and insurance concerns. The body of the third victim was located and recovered on day 310 of the response.
Conclusion:
The prolonged demolition of the Hard Rock collapse site resulted in emotional anguish for affected families, public anger about the perceived lack of response, and significant impacts for local businesses in the area. This event offers many lessons learned about prevention and response of urban structural collapse incidents.
Covid-19 pandemic had a massive impact on the capabilities of the healthcare system. The development of the vaccines and the setup of the vaccination program of the general population required an important coordination and organizational work, from an already worn-out system.
The implementation of mass vaccination centers is known as the most efficient way of vaccinating rapidly and efficiently a large part of the population, but requires a non-negligible amount of resources. For Covid-19 vaccination, time sustainability was an important challenge to consider due to the timespan needed between boosters; unfortunately, most of the models presented up to 2020 are short duration systems.
A mass vaccination center (MVC) organizational model was proposed and staffed with only two health care workers on a daily basis, with a more than 10,000 shots a day capacity over a seven-month duration.
Method:
The MVC was under the supervision of one medical coordinator, one nurse coordinator and one operational coordinator. Students (both in health and non-health studies) were the most important part of the human resources. Data concerning the population vaccinated, the number and the type of vaccines used were routinely recorded.
Results:
From March 28 to October 20, 2021, 501,714 vaccines were administered at the MVC. A mean rate of 2951 ±1804 doses was injected per day with a staff of 180 ±95 persons working every day. The peak was reached with 10,095 injections in one day. The average time spent by a patient in the MVC was 43.2 ± 15 minutes. The average time to be vaccinated was 26 ±13 minutes.
Conclusion:
Provided with adequate supervision, an optimized organization and adequate training, the use of a student workforce allows for the implementation of a functional, efficient, and sustainable mass vaccination center.
Region V for kids (originally known as Eastern Great Lakes Consortium for Disaster Response ) is one of the US-ASPR (Administration for Strategic Preparedness and Response) funded Pediatric Center of Disaster Excellence (PCOE), serving nearly 12 million children and families in a six state region of the United States.
Method:
The original goals set forth were: to develop a coordinated pediatric disaster care capability, strengthen pediatric disaster preparedness plans and coordination, enhance state and regional medical pediatric surge capacity, increase healthcare professional educational competency and enhance situational awareness of pediatric disaster care across the spectrum.
Results:
The COVID-19 pandemic occurred shortly after original funding and caused a pivot from preparation to response for the partners, enhancing the collaboration and coordination for the region. The many lessons from the COVID response have been important to creating more partnerships with federal agencies around situational awareness and considering social and physical determinants of health that effect children and families. The partnerships with state agencies and other key stakeholders have been valuable to close the gaps in the pediatric/family disaster cycle. There has been a multitude of tools and products that have been created and disseminated from this PCOE, including educational tools, behavioral health training and tools, virtual exercises and quality improvement projects. The best practices and ongoing projects highlight how to improve coordinated care for children and families within a region and is an example for the United States and beyond. There are also challenges to coordinated preparedness due to jurisdictional barriers and these are as important to highlight and create mitigation strategies.
Conclusion:
This US supported PCOE is an example of a regional disaster coordination to mitigate and prepare for response concentrating on the needs of children and families in the larger disaster cycle.
Refugees encounter many obstacles en route to the United States. Refugees face very different disasters and response resources in the US than in their home countries. On arrival to the US, refugees receive a brief introduction to disaster preparedness, but do not receive specific education based on their home country or final location of residence. This study aims to determine the preparedness levels of Afghan refugees in the United States.
Method:
This study used a modified General Disaster Preparedness Belief Scale (mGDPBS). The mGDPBS consists of 20 of the 45 questions from the GDPBS, selected from each of the six subscales most applicable to the refugee population. Ten Afghan refugee families were selected from the Afghan community in Virginia.Refugees were interviewed by a recorded one hour interview via Zoom. A list of the questions were provided, and a translator was available to ask the questions in the respective language of the refugee: Dari or Pashtu.
Results:
Data collection and analysis to be completed by January 30, 2023.
Conclusion:
Data collection and analysis to be completed by January 30, 2023.
Melbourne hosted WCDEM-13 in May 2003 when Congress participants endorsed a Melbourne Statement with five actions. Twenty years on, WCDEM-22 in Ireland provides an opportunity to reflect on the impact of the Melbourne Statement.
Method:
A desktop review of Congress and subsequent documents informed by the personal experiences of the co-authors, who contributed to the Local Organizing Committee for the Melbourne Congress and/or subsequently through the WADEM Oceania Chapter.
Results:
The WADEM Education Sub-committee, co-chaired by a Melbourne member, followed through with one of the key actions from the Melbourne Statement: “WADEM will promote international professional standards and education programs for persons involved in disaster prevention, preparedness, response, and recovery.” The Education Sub-committee held a series of European meetings, resulting in an international meeting in Brussels in 2004 producing ‘International Guidelines and Standards for Education and Training to Reduce the Consequences of Events that May Threaten the Health Status of a Community’. This was presented to the 2005 WCDEM in Edinburgh, and later published in PDM (2007), thereby meeting a second action from the Melbourne Statement. However, this energetic, collaborative, and productive process subsequently ‘failed to thrive.’ The influence of three further Melbourne Statement actions, were harder to analyze. WADEM members in Australia led other identifiable actions e.g. formation and leadership of the WADEM Oceania Chapter (2008); a National Framework for Disaster Health Education in Australia (2010); and Teaching Emergency and Disaster Management in Australia: Standard’s for Higher Education Providers (2017).
Conclusion:
The insightful Melbourne Statement reflected the times and led to identifiable, but limited, WADEM outcomes. Congress participants endorsed an Outcomes Statement at WCDEMs in Edinburgh (2005) and Amsterdam (2007) but not at subsequent WCDEMs. Outcome Statements have become commonplace in professional congresses, and it may be timely to re-introduce Congress Statements as a feature of future WCDEMs.
Pre-deployment training for nurses ensures readiness.
Method:
A quantitative descriptive research methodology was used to conduct an anonymous survey distributed to all registered nurses deployed in 2017 to Hurricane Maria with a hospital-supported team and a federal team. The project sought to improve the pre-deployment preparation experience of nurses to positively impact nurses' willingness to redeploy. The survey was administered for ten days in January 2021.
Results:
This quantitative descriptive study sought to understand nurses’ perceptions of their readiness for deployment during a disaster response. Thirty-nine surveys were distributed with a 46% response rate (n = 18).
Gender was not related to agreement with the role variable (p = 0.070). Marital status was significantly related to role (p = 0.015), as was age (p = 0.022). Single individuals and individuals >50 yo were more likely to agree that they understood their role during the disaster.
Gender was not related to agreement with the preparedness variable (p = 0.465), nor was marital status (p = 0.067). Age was significantly related to perceptions of preparedness (p = 0.004). Individuals >50 yo were more likely to respond that they were prepared for their deployment.
Gender was not related to perceptions of knowledge of providing clinical care during a disaster (p = 0.235), nor was marital status (p = 0.627) or age (p = 0.674).
Conclusion:
The results suggest that single nurses > 50 yo with more years of nursing experience who have previously deployed may understand the role better and feel more prepared to deploy.
However, their responses do not indicate that they feel more knowledgeable about the type of nursing care they are expected to provide in a disaster response.
The 2022 Commonwealth Games (B2022) was hosted by Birmingham, United Kingdom (UK) from July, 28 2022 to August 8, 2022. As a major global sporting event and mass gathering, B2022 included over 4,500 athletes (from 72 countries and territories) and attracted 1.5 million spectators. Robust public health surveillance and support for health protection incidents was required from the UK Health Security Agency (UKHSA) to protect the health of both those directly involved in B2022, and the local population.
Method:
UKHSA surveillance activities in the UK West Midlands region were enhanced, utilizing lessons learned from the response to the London 2012 Olympic and Paralympic Games and the 2021 G7 Summit (hosted in England). Enhancements included: adaptation of existing and development of new methods for the identification of increased activity of a range of pathogens/diseases/conditions of particular concern to a mass gathering; standardized daily situation reporting to inform both public health action and the B2022 organizing committee. Three streams of routine UKHSA surveillance data were assessed each day: a UKHSA health protection/clinical management system, statutory laboratory reports of infection, and syndromic surveillance. Bespoke surveillance was also implemented using B2022 health data sources.
Results:
Enhanced daily surveillance activities successfully met the need for next-day public health surveillance and reporting during B2022. No outbreaks or incidents of public health significance to the Games were identified. Syndromic surveillance reported an increased impact on local health services due to periods of extremely hot weather before and following the competition period, although these impacts were not unique to the Birmingham area.
Conclusion:
Surveillance and epidemiology reporting for B2022 provided reassurance there were no incidents/outbreaks of public health significance to the Games. The enhancements made will inform future routine surveillance and reporting activities and will be employed for similar activities during future mass gathering events.
With the publication of the Health Emergency and Disaster Risk Management (H-EDRM) Framework in 2019, the World Health Organization (WHO) emphasized the need for disaster preparedness in all sectors of the health system, including primary health care (PHC). PHC disaster preparedness plays a crucial role in guaranteeing continuity of care and responding to the health needs of vulnerable populations during disasters. While this is universally acknowledged as an important component of disaster management (DM), there is still a severe paucity of scholarship addressing how to practically ensure that a PHC system is prepared for disasters. The objective of this study is to propose a new framework that describes key characteristics for PHC disaster preparedness and lays the groundwork to deliver operational recommendations to assess and improve PHC disaster preparedness.
Method:
A systematic literature review including the following online scientific databases was performed: Cochrane Library, Embase, Medline, National Library of Medicine, PubMed, Scopus, and Web of Science. Gray literature was also found by searching in: Trove, Mednar, and OpenGray. A total of 145 records were analyzed.
Results:
Twenty-five characteristics that contribute to a well-prepared PHC system were identified and categorized according to the WHO Health System Building Blocks to form a new PHC disaster preparedness framework.
Conclusion:
The findings will contribute to the elaboration of a set of guidelines for PHC systems to follow in order to assess and boost their disaster preparedness. This will hopefully help to raise awareness among international policymakers and health practitioners on the importance to design interventions that integrate PHC into overall DM strategies, as well as to assess the preparedness of PHC systems in different political, developmental, and cultural contexts. The proposed framework is currently being used by our research group as groundwork for the creation of an assessment tool for evaluating all-hazards preparedness at the PHC level.
On the night of October 29, 2022, a crowd crush occurred during Halloween festivities in the Itaewon neighborhood of Seoul, Korea. At least 156 people were killed and at least 173 others were injured. In this study, the author tried to learn a lesson by investigating the worldwide crowd crush disaster and analyzing the differences and results.
Method:
First, the crowd crush disasters were investigated and summarized through literature and internet searches. Second, based on this, the prevention and management of crowd crush disasters, emergency medical response, and necessary research/development contents were derived through a Delphi survey of experts.
Results:
Crowd crush disasters have been experienced from developed countries to developing countries since the 1800s. Commonly the crowd density was high, and the crowds continued to move and then the crowd collapsed above a certain limit. The biggest casualty occurred during a pilgrimage to Mecca in Saudi Arabia in 2015, but the theme of the event, such as concerts, sporting events, and funerals, was varied. Experts survey was that the manager's efforts not to increase the crowd density, and efforts to maintain order and prevent contingencies were important. They said that it is important to comply with the principles of disaster medicine, but it is difficult to access the patient in the crowd crush state, so the management of the crowd may be more important. They said that it is necessary to establish a realistic guideline and a real-time crowd density monitoring system using CCTV or drones.
Conclusion:
Crowd crush disasters can occur in any type of crowd gathering events where the crowd density increases, and prevention through crowd management and real-time crowd density monitoring should be implemented.
Emergency Medical Service (EMS) workers are critical to effective disaster response in Saudi Arabia. The World Health Organization requires countries and governments to have prepared emergency health workers and disaster action plans. Therefore, it is important to understand the disaster knowledge, skills, and preparedness of Saudi Arabian EMS workers. This study investigated factors influencing EMS workers’ disaster knowledge, skills, and preparedness in the Saudi Arabian context.
Method:
A descriptive cross-sectional survey using The Disaster Preparedness Evaluation Tool was distributed to EMS workers in military and government hospitals across three Saudi Arabian cities. Responses were recorded on a 6-point Likert scale where higher scores indicated higher knowledge, skills, or preparedness. The results were analyzed using descriptive and inferential statistical analysis.
Results:
272 EMS workers participated in this study. EMS workers reported a moderate level of knowledge (3.56), skills (3.44), and preparedness (3.73) for disasters. Despite the moderate level, EMS workers reported a high level of involvement in regular disaster drills (M=4.24, SD=1.274) and a strong interest in further disaster education opportunities (M=5.43, SD=1.121). Participants also reported a high skill level with the triage principles used in their workplace during a disaster (M=4.06, SD=1.218). The study findings revealed a significant positive correlation between disaster preparedness levels and age, years of experience, education level, and the facility worked in.
Conclusion:
EMS workers have moderate disaster knowledge, skills, and preparedness levels. Knowledge, skill, and preparedness have a significant relationship with the EMS workers’ demographics. These findings demonstrate the need to invest in preparing Saudi Arabian EMS workers to effectively respond to bioterrorism disasters.