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The atmosphere contains gases that act like the glass in a greenhouse. They are transparent to visible light from the sun, and allow it to pass through to the earth below; but they absorb and trap infrared light radiated outward from the earth and convert it into heat. The principal “greenhouse gases” are chloroflourocarbons (CFCs), methane, and most importantly, carbon dioxide. The concentration of greenhouse gases is rising due to two factors: (1) the manufacturing of CFCs; and (2) the burning of fossil fuel at a tremendous, and still increasing rate. If this trend is not reversed, research predicts that there will be a steady rise in the temperature of the earth. This global warming could cause drastic climatic changes with devastating results, including: (1) shifting of seasonal winds, with the creation and spreading of deserts in the northern areas; (2) alteration in crop patterns with social upheaval; (3) starvation; and (4) the inundation of large areas of land. When this chaos begins, developing countries such as Nigeria, Kenya, etc. also will be affected, along with developed countries. The solution to the problem of CFCs in principle, though not in practice is simple: STOP MAKING THEM!! But one cannot burn carbon without producing carbon dioxide. Which is why new ways to produce energy must be used?
The existence of a prehospital emergency care system signifies how secure an area is in aftermath of a health-related emergency. The systems save lives during most out-of-hospital health emergencies. Until 2010, there was no regular prehospital care system in Anuradhapura, or even in the entire north central region of Sri Lanka. Trauma patients were brought to the hospital generally with little or no prehospital care. They were transported to hospital by relatives or other people at the scene with using whatever vehicle was available at the time, which in many occasions was a trishaw. The concept of developing a prehospital emergency ambulance service to cover the municipality of Anuradhapura as a pilot project was formulated in 2009. The objectives were to: (1) provide emergency prehospital care in the municipality; (2) identify the difficulties; and (3) assess the feasibility of implementing it in the entire district. Some of the challenges faced in the process from the initial draft of the concept up to now include: 1. Studying an established emergency medical services (EMS) system; 2. Developing a pressure group in hospital; 3. Convincing the need to administration; 4. Funding in the initial period; 5. Selecting the proper team and supportive peers; 6. Providing standard training to selected staff; 7. Formulating duty norms and standard operating procedures; 8. Infrastructure development, acquiring instruments, and vehicles with limited fund capacities; 9. Cooperating with the trade unions and external/internal negative forces; 10. Rallying the collaborators with same interest; 11. Handling donors; 12. Getting the support of other key institutions (police/municipal council); 13. Utilizing local media to help promote the project; 14. Social mobilization to ensure sustainability; and 15. Ensuring worker satisfaction, encouragement, and liaison with other units of hospital.
With the current need for effective trauma center utilization, understanding how current trauma triage criteria may promote overtriage will enable both field and hospital teams to provide the most appropriate patient care. It is hypothesized that current Southwest Texas trauma criteria promote overtriage by prehospital emergency medical services (EMS) of patients in favor of a Level 1 trauma facility when compared to physician assessment and Injury Severity Score (ISS).
Methods
This prospective, observational study at a Southwest Texas military Level 1 trauma center compared adult trauma patients' prehospital status noted by EMS personnel with the triage criteria documented by the treating emergency physician. The patients were divided into four groups: Prehospital Criteria Met or Not Met; Arrival Criteria Met or Not Met. Each patient's ISS and mechanism of injury were also collected and compared to initial assessment for predictive value. Descriptive statistics were used.
Results
The study enrolled 278 adult trauma patients. EMS reported Level 1 trauma status similar to physician assessment (60.1% vs. 59.7%, respectively). The rates patients met Level 1 trauma status corresponded with trauma severity when compared to the ISS. Assessment between EMS and physicians for ISSs were similar among the four groups. Comparisons using multivariate analysis of the four groups found similar ISSs, except for the Prehospital Criteria Met/Arrival Criteria Not Met group. Seventy-five percent of these patients were assigned an ISS in the Minor (ISS < 9) category (p = 0.013).
Conclusion
Trauma triage criteria assessment skills were similar between EMS personnel and emergency physicians except for identifying minor trauma patients. While the criteria generally led to overtriage, EMS crews appear to overtriage minor trauma patients at a much higher rate.
To be effective, disaster preparedness training should continually meet the needs of the trainees. Most military medical personnel undergo training focused on practicing in austere environments with little support. However, while located at their home station, disaster response is conducted in a different manner due to staffing and available resources. This survey attempts to identify areas of the military medical disaster response staff are most concerned with in order to better formulate future training for home station as well as contingency operations, ultimately increasing confidence and effectiveness.
Methods
An online survey service was utilized to anonymously poll 106 military medical personnel assigned to a joint Level 1 trauma center in Iraq using 38 forced Likert-scale questions. The training issue of most concern for both arenas is the patient surge. Military-civilian collaboration was a key point regarding the home station setting and supplies/equipment for the deployed setting.
Results
Eighty-nine percent of responders rated disaster training as moderate to very important. However, there was a low perception of disaster exercises conducted in the manner of a real-world event. This was attributed to unrealistic participation and training methods. Computer-based training (CBT) was identified as an ineffective method of training; hands-on instruction clearly identified as the preferred method. Participants rated considerable confidence in Level C personal protective equipment, and the majority surveyed would report for duty despite exposure risk.
Conclusion
Current training methods may not optimally produce disaster response effectiveness. Management of the patient surge was a repeating training concern for both home and deployed settings. Future training efforts should focus on military-civilian collaboration for the home station, and management of the patient surge for both arenas.
Logistics has always been an important factor in humanitarian aid operations, to the extent that logistics efforts account for 80% of disaster relief. They often have to be carried out in an environment with destabilized infrastructures ranging from a lack of electricity supplies to limited transport infrastructure. Furthermore, since most natural disasters are unpredictable, the demand for goods in these disasters is also unpredictable. Thus it is evident that humanitarian logistics is challenging as it has to be more flexible, and has to function under severe constraints. In India, humanitarian logistics remains a neglected field ins disaster management, the cost of which is paid by loss of human lives and property. In recent Kosi Flood the total population of 33,45,545 people living in 993 villages of 412 panchayats of 35 blocks of 5 districts were affected. A total of 3, 40,742 houses were damaged and 7, 12,140 animals were affected. A total of 239 humans and 1232 animal's lives were lost (Department of Planning and Development, Government of Bihar). The Paper analyses, Madhepura district government's mechanisms of managing logistics while responding to Kosi floods 2008. It evaluates the efficiency of these mechanisms with respect to its outreach to flood affected people. It review and analyses the strengths and weaknesses of the adopted distribution network design for relief management with reference to strategic locations of the relief camps, during the first month of the kosi floods in 2008. It suggests ways to improve disaster logistics at district level in Bihar. The study looks into the possibilities of adopting newer approaches in the field of logistics that could be implemented with greater efficiency under similar conditions. The logistics in the devastating floods at the district level in a developing country has key learning lessons for similar resource poor environments.
Unpredictable environmental conditions, crowd dynamics, and a variety of medical emergencies create logistical and clinical obstacles when planning emergency medical response coverage for mass-gathering events. In a collaborative endeavor between a university athletics program and an academic division of Emergency Medicine, a stadium emergency medical response system was created consisting of hospital-based healthcare providers and pre-hospital healthcare providers.
Objectives
Provide descriptive statistics relevant to the nature and frequency of injury/illness, location of treatment within stadium confines, and resources used in the care of students, event staff, and spectators during collegiate football operations, to assist in future planning of mass-gathering events.
Methods
A continuously updated, quality assurance database of de-identified, aggregate statistics was utilized to analyze trends regarding aspects of medical operations.
Results
During a 7-game home football season, there were a total of 399 patients encounters, including 1 cardiac arrest (0.25%), 12 “life-threatening” (3.01%), 121 urgent (30.33%), and 266 routine (66.67%). Total season attendance was 201,248 attendees (28,749/game and 19.83 patients encounters per 10,000 in attendance). Twenty-eight patients were transported (1.39 per 10,000), with eight resultant hospital admissions. Encounters varied by complaint, with skin (42%) comprising the largest number of encounters. Other categories included: (1) heat-related (23.5%); (2) allergic (15%); (3) neurologic (10.3%); (4) cardiopulmonary (3.5%); (5) gastrointestinal (3.6%); (6) musculoskeletal (5%); and (7) other (5%). Encounters increased noticeably when the heat index was greater than 80 °F– (29.4 vs. 10.5 per 10,000 attendees).
Conclusions
The collaborative effort by a multi-level provider model adequately covered presenting medical conditions. Consistent with previously literature, a strong correlation existed between heat index and number of patient encounters deemed urgent and routine. Interestingly, the number of “life-threatening” encounters did not appear to vary much with the heat index. Further studies of medical presentations and provider/resource utilization could provide for predictive modeling of future staffing and supply models.
Although bile leaks are emerging as frequent complications of non-operative management of liver injury, the best method to use to diagnose intrahepatic biliary injury (IHBI) has not been established.
Methods
Fifteen patients with a blunt liver injury admitted to the hospital during a two-year period, were diagnosed by computed tomography as having a grade 3–4 injury, and underwent DIC-MDCT intended to diagnose IHBI in its early stages. These 15 patients included 11 with a grade 4 (Group A: five patients who underwent TAE; Group B: six patients who did not undergo TAE) and four with a grade 3.
Results
In Group A, all of the patients were found to have some signs of IHBI in DIC-CT. Of these patients, two were found to have extrahepatic leakage and underwent local drainage; one also underwent ENBD. Three patients were not found to have extrahepatic leakage even though they had signs of IHBI; these three underwent conservative therapy with no other care, and had a satisfactory course. In Group B, only one patient was found to have IHBI. However, all of the patients, including those not found to have signs of IHBI in DIC-CT, recovered. Patients with grade 3 did not have signs of IHBI. Compared to Group B, Group A had a high Injury Severity Scale Score of 38.5 ± 11.2, and a higher incidence of IHBI.
Conclusions
DIC-MDCT may, in cases of severe liver injury that might require TAE, help to diagnose IHBI in its early stages, and help to determine if additional treatment is needed based on the site and extent of the injury and whether extrahepatic bile leakage is present.
3880 fracture patients are admitted in the Emergency Department of Saiful Anwar General Hospital from January to August 2009. It signifies to the second place of the cause of patients' admission. Most cases are motorcyclist victims from road traffic accident. Driving license is encouraged by the government to reduce the number of road traffic accident victims.
Methods
This study utilizes observational with cross sectional study and purposive sampling to correlate the relationship between status of motorcycle driving license ownership and the obedience of traffic law, the relationship between the patterns of motorcycle driving license ownership and the obedience of traffic law, and the relationship between the obedience towards traffic law and the gradation of open fractures among motorcyclist victims in accordance with Sardjito Scoring system.
Results
Most patients have no driving license. And those who has driving license, mostly have never undergone driving license test. Patients with open fractures of cruris come with severe Sardjito scoring system, open fractures of antebrachii with moderate Sardjito scoring system, and open fractures of femur with moderate Sardjito scoring system.
Discussion
It is strongly related between the ownership of driving license and road traffic accidents. The most road traffic accidents cases of are open fractures of cruris, open fractures of antebrachii, and open fractures of femur respectively. High obedience and strict use of personal protective equipment (safety helmet, glove, and jacket) would be effective in mitigating road traffic accident injuries.
Handwashing has been shown to be the most effective means of reducing cross infection in the healthcare environment. However, staff compliance remains low in the real setting.
Methods
A prospective study was carried out over one month period in one cubicle of neurosurgery intensive care unit (ICU). A surveillance camera which was previously installed and functioning was focused on a cubicle of three patients, and recordings of the previous 24 hours were reviewed every day for 15 days. The number of incidents in which handwashing was required but not performed was recorded. An incident was defined as any one of the following: (1) handwashing not performed by healthcare workers; (2) touching different patients without handwashing; (3) using the same gloves for different patients and for different procedures; (4) not performing handwashing after finishing the procedures. Following this 15-day period, all staff were verbally instructed during every shift that they were under surveillance for the next 15 days. Camera recordings of the previous 24 hours were similarly reviewed every day for these 15 days and incidents recorded.
Results
In the first 15-days period, there was a total of 480 incidents when handwashing was not performed. Of the incidents, 83%(n = 401) occurred during the night shift, especially during the early morning hours. In the subsequent 15 days when the staff were informed that they were under camera surveillance, the total number of events when handwashing was not done was 140. The difference between the two periods was statistically significant(p < 0.01 > .
Conclusion
Handwashing is practiced poorly in this ICU. As the maximum number of incidents occurred during the night shift, poor motivation may be one of the factors for this behavior. This study shows that camera surveillance plays a major role in changing the staff behavior and may improve compliance for handwashing.
Nurses play an essential role in disaster response. All health care responders, including nurses, must have knowledge of the key principles of disaster medicine. The International Trauma and Disaster Institute (ITDI) at Massachusetts General Hospital has developed a core curriculum for Mass Casualty Incident (MCI) management. The curriculum provides all members of the multidisciplinary disaster team with the fundamentals of the MCI response. The proposed concurrent session will report on understanding of the fundamental knowledge in disaster medicine and preparedness for nurses in local and international disaster responses.
Discussion and Observations
Disasters follow no rules. Traditionally, medical providers have held the erroneous belief that all disasters are different, especially those involving terrorism. In reality, all disasters, regardless of etiology, have similar medical and public health consequences. A consistent medical approach to disasters, based on an understanding of their common features and the response they require, is becoming the accepted practice throughout the world. This strategy, called the MCI response, has the primary objective of reducing the mortality/morbidity caused by the disaster. The Advanced Disaster Medical Response (ADMR) Course, available in eight languages, including Chinese, is designed to train nurses in the ABC's of basic medical and public health disaster care. The delivery of optimal care in a disaster relies on a common understanding of each health professional's role and common mastery of defined essentials of disaster response such as the Incident Command System, field triage, decontamination, care of specific injuries, environmental considerations, psychological response to disasters, and care of the dead and their families. Understanding key principles and training in medical disaster response will guide nurses in disaster preparedness and response to future disasters.
SAFETY FUNCTION ACTION for Disaster Responders (SFA) trains a framework for achieving and maintaining a high level of disaster health. Within SFA, disaster health is defined as, “maximal safety, optimal function, and effective action in preparedness for, and response to, emergencies, disasters, and extreme events.” A set of six strategies forms the backbone of the framework with two strategies each for SAFETY (safeguard and sustain), FUNCTION (comfort and connect), and ACTION (advise and activate).
Methods
During 2008, a total of 2,553 participants were trained throughout the State of Florida. Participants were drawn from public health, healthcare, mental health, and professional/volunteer emergency responder workforces. During 2009, an additional 861 participants were trained as “SFA facilitators.” Facilitators were provided with guidance and training materials to return to their worksites and train peers on the SFA modules. Facilitators were in direct contact with a team of 5 DEEP Center “coaches” who supported their training efforts. To assess the training's effectiveness, pre/post-assessment data on the 2,533 SFA participants and 861 SFA facilitators were collected.
Results
Live-training evaluation data showed highly favorable quality ratings for the course, materials, presenters, and all individual course components. Pre/post comparisons of the data indicated consistent gains in self-reported confidence ratings for all 7 “facilitator skills” (recruiting, motivating, training colleagues; teaching SFA skills, working with coaches) and 15 SFA “strategies and response skills” (applying the six SFA strategies to responders (self, family, team) and disaster survivors). Consistent gains were evident for 12 scales asking facilitators to self-report their comfort in dealing with disaster survivors exhibiting distress or suffering trauma and loss.
Future Directions
SFA has been launched as an online training course and a cell phone “app” is in progress. SFA has recently been trained in South America and Europe. Experiential components of SFA are being refined and expanded.
More than 175 million landmines have been deployed since the end of World War II, including > 65 million since 1980. They differ from other weapons by remaining active in the ground long after hostilities have ended. They lie in fields and woodlands, alongside roads and footpaths, and in villages, creating a humanitarian problem with social, economic, and environmental dimensions. In addition to the threat from landmines, many areas of former conflict are contaminated by sub-munitions, unexploded ordnance, discarded weapons, improvised explosive devices (IEDs) and other hazardous debris of war. The victims of landmines and unexploded ordnance inevitably are the poorest and most vulnerable members of societies. It is the subsistence farmer, nomads and their herds, and fleeing refugees who are most affected. Economic necessity forces people to enter known mined areas in search of food and water, to graze livestock, or to gather thatch for their homes. Because landmines are designed to maim, their victims often require extensive treatment for long periods of time. The first aid administered to victims often is rudimentary; in some cases, inappropriately applied tourniquets result in amputations that otherwise might not have been necessary. Much has been achieved since the international community first was made aware of the threat from landmines in countries emerging from conflict in the 1990s. Over the past 20 years, the work of a few non-governmental organizations (NGOs) operating independently in Afghanistan, Angola, and Cambodia has developed into an international program involving the United Nations, the national authorities of 78 mine-affected countries, donor governments, and < 100 NGOs and demining companies. However, more must be done to develop sustainable national capacities. It is particularly necessary for the international community to assist national authorities develop effective and affordable local medical and rehabilitation capabilities.
Little is known about the risk perceptions and attitudes of healthcare personnel, in the event of an epidemic of H1N1 influenza. It is acknowledged that perception of risks, as opposed to actual risks, alters behaviour. Indian data on KAP is needed as the scenario of working in limited resource environment, can have a different risk perception and attitudes amongst the healthcare workers. This will help in chalking out a ‘model response planning’ The study is designed to investigate the Knowledge and attitudes amongst healthcare workers in Mumbai, India during H1N1 pandemic of 2008–2009.
Methods
Questionnaire based interviews were given to healthcare workers, selected by their place of work, level of education and income group. This is based on the priori hypothesis that KAP differs amongst these groups. Surveys were distributed randomly to 20% employees from each of the above categories. Also healthcare officials, making policy decisions and guidelines, and the patients approaching these healthcare centres for treatment were interviewed for their perceptions of adequacy of the response measures. The questions designed included assessment of demographic characteristics, individual's knowledge about swine flu, perceived adequacy of training, perception of preparedness to tackle the epidemic situation and perception of risk to them and their families during epidemic conditions. The responses were graded as ‘adequate or inadequate knowledge’, perceived ‘high or low risk’ and ‘tendency to apathy’. Results were analysed using statistical software (SPSS17).
Conclusion
Understanding the concerns and responses of healthcare personnel to a major infectious disease outbreak is critical to maintaining response capacity.
Overcrowding afflicts emergency departments (ED) worldwide. The CDC has reported that EDs in the metropolitan US provide 1 bed per 1800 patient visits per year on average.
Objective
We sought to improve patient flow in our 24-bed ED at Santa Clara Valley Medical Center, a large tertiary public hospital in San Jose, California.
Methods
We applied a bundle of interventions based on Lean principles aimed at improving overcrowding in our department step-wise from October 2006 to December 2010, ranging from rapid medical evaluation to physician on arrival. We measured patient volume, left without being seen (LWBS) rates, time to provider (minutes), and time to discharge (minutes) as monthly averages. We secondarily measured CMS core measure performance for pneumonia and STEMI care and patient satisfaction scores.
Results
Our emergency patient volume doubled from an average of 192 to 412 per day (peak). Our LWBS rate decreased from 16.0 to 1.4%. Our time to provider decreased from 86 to 32 minutes. Our time to discharge decreased from 210 to 145 minutes. Core measure performance improved to 100% for all five ED-related metrics. The percentage of patients who ranked their care as excellent increased from 30% to 45%.
Conclusion
The bundle of interventions based on Lean principles applied in our ED appears to have enabled us to significantly improve multiple operational outcomes, despite a doubling of our patient volume in our low capacity ED. Posting a physician on arrival, as the first healthcare worker that a patient meets when they enter the ED, may have had the greatest impact on operational performance.
On the night of 06 December 2007, an explosion occurred at a steelworks plant in the city of Turin. The incident involved 10 people. The emergency medical services (EMS 118 Turin) declared a mass-casualty incident (MCI).
Objectives
The aim of this case report is to analyze the response of the EMS 118 Turin to the MCI in order to identify problems or short-comings and improve the service for future responses.
Methods
Information from the dispatch center, medical report of the EMS, and hospitals that received the patients were analyzed.
Results
The emergency call was placed at 01:04 hours, and the MCI was declared closed at 04:40 hours. The disaster, in according to Disaster Severity Scale (DSS), was classified 3. The METHANE message was sent to the dispatch center by the first ambulance 4 minutes after the call. There were 10 patients: seven T1; one T2; and two T3. The dispatch center deployed nine teams, which consisted of five advanced life support (ALS) teams and four basic life support (BLS) teams. All of the casualties were able to walk when they arrived to the medical care. The T1 casualties had burns to > 80% of their body surface area (BSA), the T2 and T1 casualties suffered inhalation of smoke gas. The first casualties were evacuated to the hospital 28 minutes after the call. Four casualties (three T1 and one T3) were transported to the nearest hospital. the other four T1 casualties were transported to four different hospitals of the city. All the T1 casualties died in the next 24 days.
Conclusions
The management of resources during this MCI was suboptimal. The number of ALS teams that responded to the MCI was high considering the number of casualties and the time taken to resolve the incident. The lessons learned from this incident and other cases have permitted the EMS Turin to improve their response plan concerning the use of resources and surge capacity.
This paper considers the impact that a number of Australian emergency management policy and operational decisions are having on residential aged care facilities located in the community. For example, all residential aged care facilities applying for new federal government funded aged care places are required to demonstrate a plan for environmental disaster threats such as bushfires and floods. Another example is the adoption of new fire danger rating scale, with the inclusion of an extreme level called “catastrophic”-code red. This inclusion requires all services and community members, living in bushfire-prone areas to decide whether or not to evacuate the day before or morning of a Bureau of Meteorology fire danger index indicating a code red. There is evidence that these policy and operational decisions have been made without fully examining the practical implications, particularly for aged care facilities. While many of the facilities on which these decisions impact see the rational for such decisions, they argue that these decisions have serious implications for their services and patients. Many residential aged care facilities, which are privately operated, historically have not been involved in any state or local government emergency management planning. Therefore, the whole concept of risk assessment, preparation, and planning to increase the absorbing, buffering, and response capacity of their facilities against extreme weather events has become quite overwhelming for some. This paper presents a case study that demonstrates the tension between emergency management policy decisions on an aged care facility, and outlines their issues and response.
From 2007, it is decided officially to provide and support mobile hospital team for Iraqi people to enhance access to quality healthcare not only for primary healthcare but also for religious mass gathering and mass casualty situation. Multiple special vehicles were donated to two provincial governments in Iraq and Iraqui experts were invited to Korea for mobile hospital team training including field simulation.
Methods
The simulation was based on computer aided initially, and table top simulation was done and real field drills were performed twice. This process was performed for 2 years to different teams from different province in Iraq. The arrangement of mobile hospital vehicles differed between the first and second year field simulation for finding more efficient arrangement. All the table top simulation and real field drills were recorded by writing and camcoders, after the simulations the video was analyzed and discussed with experts and participants.
Results
Table top simulation has highest number of right decisions in individual simulation situation. The second field drill has more right decisions than the first field drill. The second year field simulation has less duration of drill, highest number of right decisions, and was more comfortable to trainees.
Conclusions
The necessity of mobile hospital team is increasing especially in some region and situation, however, the effort is not enough to seek the appropriate preparedness and method of operation academically. Specific knowledge and guideline for mobile hospital will be necessary as well as the up-to-date facilities and technologies.
To develop a common structure for reports on health crises and critical health events guidelines have recently been published (Kulling et al 2010). They try to capture the experiences gained and for promoting a standardized methodology for sharing results and lessons. If future reporting follows common standards, then the documented findings would be comparable and could be used to learn and apply lessons within an individual field of activity and to apply those lessons learned also to other related preparedness activities. It could also facilitate the implementation of joint activities and joint reports involving different sectors. The development of this proposed method for common reporting on health crises and critical health events has been derived mainly from the following processes: (i) Health Disaster Management: Guidelines for Evaluation and Research in the Utstein Style; (ii) the Swedish Disaster Medicine Study Organization (KAMEDO); (iii) the Swedish Emergency Management Agency network of observers; (iv) the WHO Regional Office for Europe project (supported by the EU Health Programme) ‘Support Health Security, Preparedness Planning and Crisis Management in the EU, EU accession and neighboring (ENP) countries’ including expert consultations. The guidelines include the following headlines: Title, Preface, Authors, Executive Summary, Introduction/Material/Methodology, Pre-Event Status (Background, Preparedness, Hazard(s)involved, Risks, Vulnerability, Resilience), Health Crises and Critical Health Events (Damage, Consequences of Damage (Changes in Functions/Disturbances), Responses (Relief Responses, Recovery Responses), Development, Discussion, Lessons Identified and Actions Recommended, Conclusions, References, Appendices, Keywords, Index, Abbreviations. Pilot testing is suggested followed by an extensive review process. The guidelines should be supplemented further with determinants and indicators when the guidelines are used for in depth reporting to evaluate crisis response operations. Reference Kulling P, Birnbaum M, Murray V, Rockenschaub G. Guidelines for Reports on Health Crises and Critical Health Events.
Undergraduate nursing students are expected to be responsive and competency, particularly during a disaster. Working as health volunteers is one strategy to develop these skills. However, little research has investigated the experiences of nursing students working as health volunteers during a disaster.
Objectives
This study aimed to investigate undergraduate nursing student perceptions and experiences of being health volunteer during the Mt. Merapi eruption.
Methods: A non-experimental, descriptive design was used. A sampling of 25 undergraduate nurse students who worked as health volunteers during the Mt. Merapi eruption completed a self-administered questionnaire. The questionnaire consisted open- and closed-ended questions, and was used to measure students' self awareness and what they have learned. Additional questions were asked to prioritize attributes required to be health volunteers. Data were aggregated and analyzed using a simple, descriptive analysis.
Results
Undergraduate nursing students had internal motivation of being health volunteers during disaster. Findings of this study illustrated benefits, future impact of being health volunteer, and required attributes of being good health volunteers.
Conclusions
Students' perceptions and experiences during disasters underscores important factors in the promotion of disaster management competency in nursing education.
Since 2009 automatic crash notification system(ACNS) using event data recorder(EDR) and mobile communication have been developed for early detection of traffic accident and prediction of physical injury of victims for increase of survival rate via early medical treatment. For adequate prediction of injury, authors developed the guideline and algorithm from parameters related to accident and medical situation. Methods: Expert survey was done about the adequate parameters related to accident and medical situation. Medical record of traffic accident admission was analyzed in a trauma center of a university hospital in Seoul, Korea. Additionally epidemiology of traffic accident death in a region was done. Afterwards data of medical record was linked to data of traffic accident insurance companies.
Results
The important parameters for prediction of physical injury of victims were as follows: Intercept, deltav, belt, age, intrus, sex, multiple, roll, ejection, narrow, height, weight, steering defect, track loc.
Conclusions
Prediction of physical injury severity of victims on traffic accident spot and immediate transfer of related information to adequate medical institution by automatic mobile communication can help the traffic accident victims and upgrade the trauma care system of traffic accident.