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The objective of this study was to collect epidemiological injury data on patients presenting to the emergency department of a tertiary care hospital after the bombing on 29 December 2009.
Methods
This was a retrospective review of the medical records of the victims that were brought to a tertiary care hospital. Bombing victims were described as requiring acute care due to the direct effect of the bombing.
Results
The results are derived from a sample size of 198 bomb blast victims, most of which were first transported to government hospitals by private cars rather than ambulances. After the government announced free treatment, there was a wave of patients, among which, most were stable and already had received some form of treatment. Approximately 5–6 patients who had life-threatening injuries were brought directly to the tertiary care facility and needed surgical intervention. The lack of security in the emergency department could have lead to another terrorist activity. There were no procedures done in the field as there is lack of emergency medical services training in Pakistan, but in the hospital most of the interventions included intravenous (IV) lines, wound care, and laceration repair. The most common treatments included the administration of IV fluids, antibiotics, and analgesia. Radiographs of specific sites and trauma series were used to rule out bone injuries. There was lack of documentation in most of the medical charts.
Conclusions
The emergency department was overwhelmed with the number of patients that it received. Therefore, an updated disaster plan and regular disaster drills are required. Rapid and accurate triage could minimize mortality among bombing survivors significantly. The majority of patients were discharged home.
Immediate resuscitation and early disposition to definitive care improves outcomes. Homeless patients are neglected in emergency department (ED). The duration of ED stay and profile of injury of homeless patients at a Level-1 Trauma center were measured.
Methods
The study was performed from October 2008 to September 2009. Homeless patients were defined as patients who had no attendant and did not have any shelter. Duration of ED stay was noted from the ED arrival time to entry time at the definitive care (intensive care unit/ward). Clinical and demographic details were recorded. Subjects who had: (1) an attendant; (2) were discharged from the ED; or (3) expired in the ED were excluded.
Results
Forty-one homeless patients were admitted. The mode of injury was road traffic crash in 73.2%; assault in 7.3%; fall from height in 7.3%; and in 12.2%, the mode of injury unknown. The average Injury Severity Score (ISS) was 6.76, with a maximum of 34 and minimum of 1. A total of 24 subjects (59%) had a Glasgow Coma Scale (GCS) score of ≤ 8 (severe head injury), 10 patients (24%) had GCS score 9–12 (moderate head injury), and seven subjects (17%) had GCS score 13–15 (minor head injury). Breath alcohol test was positive in 13%. The average duration of ED stay was 35 (3–173) hours in the homeless group and 12 (0.5–18) hours for patients with an attendant. Twenty-one subjects were admitted to neurosurgery (51.2%) with an average ED stay of 22.4 hours, five to surgery (12.20%) with average ED stay of 56.6 hours, and 15 to orthopedics (36.6%) with average ED stay of 45.3 hours.
Conclusions
The emergency department stay of homeless patients was 35 hours. Orthopedic trauma subjects had a prolonged disposal time. This addresses serious patient safety concerns and immediate remedial measures.
Disaster preparedness is one of the national priorities. In Japan, disaster medicine is defined as a part of the national medical plan initiated by Ministry of Health, Welfare and Labor. The Japan Medical Association is the largest professional physicians' group in Japan, and has contributed to all kinds of disaster relief work regionally and nation-wide for years. Based on past successes, the Japan Medical Association proposes a new disaster action plan named Japan Medical Association Team (JMAT). The primary mission of JMAT is to deploy to the disaster scene requested and work for disaster relief. JMAT covers the acute to sub-acute phase of disaster response, and also collaborate with other agencies. In the preparation and mitigation phases, the Japan Medical Association work for establishing mutual disaster aid partnerships, disaster plans, networks with other agencies, team building, disaster medicine training and education, etc. In Japan, the Disaster Medical Assistant Team (DMAT) has been established based on the experience of the 1995 Kobe Earthquake, when lots of preventable trauma deaths occurred because of delayed medical response. The mission of DMAT is to deploy to the scene immediately and triage/transfer the most serious disaster victims outside the scene for advanced medical care. DMAT covers the first 48 hours of disaster response phase, and then JMAT takes charge of the work. JMAT will also respond to chemical, biological, radiological and nuclear disasters, and international humanitarian work. The present issues of establishing JMAT are 1.training and education for Japan Medical Association members, 2.establising cooperation with other agencies, and 3.having presence at the Central Disaster Committee, Cabinet Office, Government of Japan.
The term terror medicine emerged early in the 21st century to describe medical issues associated with terrorist events. While related to emergency and disaster medicine, the field also includes several features that are specific to terrorist attacks. The Israeli healthcare experience as related to terrorist attacks during the intifada (2000–2006), provides a base for comparison to responses elsewhere including to events in Oklahoma City (1995), Madrid (2004), and London (2005). Terror medicine covers four broad areas. First is preparedness, which encompasses hospital surge capacity, training and exercises, and the stockpiling of medical provisions for conventional and non-conventional attacks. Second is incident management, which includes protocols for on-site care, triage, distribution of victims to hospitals, and hospital-receiving procedures. Third is mechanism of injuries and responses, which ranges from determining treatment priorities in someone with multiple injuries (burn, crush, ruptured organs, etc.) to dealing with biological, chemical, or radiological exposures. Fourth, psychological consequences, involves care for acute and long-term emotional effects of a terrorist attack. Growing interest in terror medicine has been manifested in recent publications and conferences. (Egs., SC Shapira and LA Cole, Terror Medicine: Birth of a Discipline, J Homeland Security and Emerg Management, Vol. 3, No. 2 [2006] http://www.terrormedicine.com/publications_files/Terrormedicine.pdfAC; SC Shapira, JS Hammond, LA Cole, eds., Essentials of Terror Medicine, NY: Springer [2009]; Symposiums on Terror Medicine and Security, University of Medicine and Dentistry of New Jersey [Newark, NJ, July 2009; Montclair, NJ, Sept. 2010]). Efforts to prevent terrorist attacks should be among a society's highest priorities. No less important are the requirements to prepare for, respond to, and recover from these events. The more that individuals and institutions become familiar with the essentials of terror medicine, the greater the protection they can provide to others.
In 2009, a Boeing 737 crashed near Amsterdam, traumatically injuring 126 people. In trauma patients, some injuries initially escape detection. The aim of this study is to evaluate the incidence of Delayed Diagnosis of Injury (DDI) and the effects of tertiary survey on the victims of a plane crash.
Methods
Data collected included documentations of DDI, tertiary surveys, Injury Severity Scale (ISS) score, Glasgow Coma Scale score, number and type of injuries, and emergency intervention. Clinically significant injuries were separated from non-clinically significant injuries. Comparison was made to a crash in the UK (1989), before advanced trauma life support became practiced widely.
Results
All 126 victims were evaluated in a hospital emergency department; 66 were admitted with a total of 171 clinically significant injuries. Twelve clinically significant DDIs were found in eight patients (12%). In 65%, a tertiary survey was documented. The DDI incidences differed for several risk factors. Eighty-one survivors of the UK crash had a total of 332 injuries. Of those with > 5 injuries, 5% had a DDI, versus 8% of those with ≤ 5 injuries.
Conclusions
The DDI incidence in this study was 7% of the injuries in 12% of the population. A tertiary survey was documented in 65%; ideally this should be 100%. In this study, a high ISS score, head injury, > 5 injuries, and emergency intervention were associated with DDI. The DDI incidence in the current study was lower than in the UK crash.
Psychosoical Care For Children Affected By Tsunami-Through Child Care Activities Centers Kavitha. P*, Sekar Kasi** Tsunami of 26 December 2004 shattered the lives, hopes and dreams of the people living in the coastal belts especially that of children where 37-39% of total death reported were children. Sad faith of children continued as many became orphans, single parented, lost their friends, school and happy environs where they enjoyed their life with their parents and friends. Displacement to the temporary shelters snatched away the emotional from family members, the unhygienic conditions resulted in the epidemics beyond their coping. A need assessment conducted among 1120 children in Kanniyakumari, Nagapattinam and Karaikkal revealed that impact is seen in all the children survided, 2/3 parents reported of probable problem behavior and conduct problem in children, 1/10 children were identified by teachers to have conduct problem, 1/10 children were identified by parent and child to have emotional problem due to the impact, 1/100 children impacted were behaviorally disturbed, 1/ 100 children is definitely behaviorally disturbed and has a probability of mental health problem. Children are young and in experienced to understand, comprehend or verbalize the trauma. An integrated approach model was initiated through community level workers using art as a medium. Psychosocial care was provided to children through seven mediums: Facial expressions, Thematic cards, Drawing, Family portrait, Writing, Story and Clay, in stages repeatedly. The results of the intervention revealed that the intervention was effective in reducing the trauma among children as mean for the impact has reduced from 31 to 26 after the intervention. The behavior problem reported among children reduced form 65% to 45% after intervention confirming the effectiveness of psychosocial mediums in reducing trauma among children affected by disaster. *Ph.D. Scholar, Department of Psychiatric Social Work, NIMHANS, Bangalore, India **Professor, Department of Psychiatric Social Work, NIMHANS, Bangalore, India.
Triage is an important aspect of the management of mass-casualty incidents (MCIs). This study evaluates triage after the Turkish Airlines aircraft crash near Amsterdam in 2009. What were the results of triage? What were the injuries of priority 3, and of “walking” casualties? Did the mechanism of trauma have a factor in this mass-casualty triage? How does this affect spinal immobilization rate during transport?
Methods
A retrospective analysis of investigational reports, ambulance forms, and medical charts of survivors of the crash was performed. Outcomes included triage classification, type of injury, Abbreviated Injury Scale (AIS) score, Injury Severity Scale (ISS) score, need for emergency intervention according to the “Baxt criteria”, and spinal immobilization during transport.
Results
There was minimal documentation of prehospital triage. According to the in-hospital triage, 28% of patients were priority 1, 10% had an ISS score ≥ 16, and 3% met the Baxt criteria for emergency intervention. Forty percent were priority 3, 72% had an ISS score ≤ 8, and 63% were discharged from the emergency department. Approximately 83% were over-triaged, and the critical mortality rate was 0%. Nine percent of priority 3 casualties. and 17% of “walking” casualties had serious injuries. Twenty-five percent of all casualties were transported with spinal immobilization; 22% of patients with diagnosed spinal injury were not transported with spinal immobilization.
Conclusions
After the Turkish Airlines crash, documentation of triage was minimal. According to the Baxt criteria, there was a great amount of over-triage. Possible injuries sustained by plane crash survivors that seem minimally harmed (P3) must not be underestimated. Considering spinal immobilization, Not insufficient consideration given the high-energy trauma mechanism.
The Hospital Preparedness Program, prompted by the 9/11 terrorist attacks, emphasizes the value of developing coordinated response capabilities by community leaders. Immediately following Hurricanes Katrina and Rita, this study examined the hospital emergency preparedness coordinators' leadership style and applied leadership theory to Louisiana planners as an integral part of a complex National Response Framework. This regionally coordinated system remains in place today and has been tested a minimum of 15 times in hurricane activations and state-wide exercises and drills.
Methods
Three hospital groups participated: (1) regional coordinators representing nine geographic areas; (2) coordinators at acute care facilities; and (3) coordinators at non-acute care facilities. A total of 744 study participants represented over 150 hospitals. The Multifactor Leadership Questionnaire (Bass, 1995) assessed three dimensions of leadership style and the Emergency Preparedness Indicator assessed planning priorities, performance ratings, demographic variables of gender, education, and Healthcare Performance Partners (HPP) planning experience and disaster declarations.
Results
Transformational leadership was highest among all three groups and included characteristic of: idealized influence, idealized behaviors, inspirational motivation, intellectual stimulation, and individual consideration. Transactional leadership was highest (but still lower than transformational) among the non-acute care group and included characteristics of: contingent reward and management by exception (both active and passive). Gender and education were not significant predictors of leadership style but positive associations of time spent on emergency preparedness activities were found.
Conclusions
Previous studies reported the relationship of transformational leadership style to cohesion scores of 2.1. This study expands those results by further detailing leadership styles to the hospital emergency preparedness coordinator. It builds on a standardized approach to assess coordinator leadership style and effectiveness measures.
The purpose of this presentation is to compare the lessons learned in acute nursing care in the post-disaster settings of Aceh Jaya, Indonesia (2004) and Port-au-Prince, Haiti (2010). The impact of such disasters disproportionally affects populations made vulnerable by poverty, marginalization, and structural violence. The recognition of these vulnerabilities heightens the role of the nurse as an advocate for the ill and injured. In addition, the lack of adequate human and material resources on all levels necessitates insisting on best practices for patient care despite the resource constraints. Consideration of best practices begins with rigorous personnel selection of nurses adequately trained in emergency/critical care, complex humanitarian emergencies, and disaster response. A proficient level of resource-specific triage knowledge is required to adequately provide the most effective care to patients. Not infrequently, disaster nursing care involves being tasked with a clinical skill or procedures that would be outside the scope of practice in the home country. While the expansion to such practices often is justified by need, an ethical framework demands consideration of the central tenet of “first do no harm”. A heavy burden of coordination among other caregivers, family, and the local staff is required by nurses in this environment. The substantial challenges include communication and continuity of care during the initial response phase among multiple partners with varied backgrounds and goals. Drawing from experiences in Haiti and Aceh, this presentation seeks to define the best practices in disaster nursing care and explore the ethical considerations that arise in such challenging environments.
Blunt trauma is a leading cause of injury in the teenage population. The early detection of injury is the primary goal of emergency medicine in order to maintain an optimal functional capacity. This is of particular importance in the pediatric population. The following is a case presentation of monocular vision loss in a 14-year-old girl as a result of traumatic optic neuropathy. A motor vehicle collision was the cause of injury for this patient. She was an unrestrained rear seat passenger and struck her head on the driver's headrest during a frontal impact. A delayed presentation of over seven hours added to the complexity of this presentation. Further, a non-contrasted computed tomography (CT) scan of the head and orbits was unremarkable except for soft tissue swelling. The child was left with only light perception in the affected eye. This case presentation will illustrate the importance of immediate care, diagnostic studies, proper consultant input, follow-up care, and the natural history of the injury for this most unusual case.
To assess the preparedness of hospitals with respect to protecting health care workers (HCWs) during a pandemic.
Methods
A self-administered questionnaire was performed between November 2009 and January 2010, and a scoring system was developed to provide a quantifiable measure of preparedness.
Results
A total of 12 hospitals in NSW, Australia, were approached – six regional hospitals (RHs) and six tertiary referral centres (TRCs). The study was extended to assess three hospitals in England, allowing a limited comparison between the hospitals in Australia that had faced the initial wave of the H1N1 (“swine flu”) pandemic and the hospitals in the UK that had more time to prepare for the outbreak. Response rates were 66% from the TRCs, 33% from the RHs, and 100% from the English hospitals. The overall preparedness scores were relatively high, with a median TOTAL score (adjusted) of 50.75 out of 70. The demographic that scored the highest Total was tertiary referral centres in Sydney. All English hospitals scored below the median. However, the range of scores across hospitals was quite narrow (45.1 – 57.1 adjusted). Scores were generally high for the areas of Preparedness, Infection control, Education and Training. Scores for Vaccination were more variable. The category that consistently demonstrated the lowest scores was that of Psychosocial Welfare and Assistance, despite this being found in previous research to be an integral part of that which HCWs have identified as important.
Conclusions
Given their integral role in pandemic response, protecting HCWs must be a priority as part of any pandemic preparedness plan. This goes beyond protection from infection, extending into aspects of physical and psychological wellbeing. Identifying these issues and addressing them is the key to maximising staff support and morale, and minimising staff absenteeism at such a crucial time.
Search and rescue plays a major role in today's society. Whether lost at sea, stranded in a remote area, or trapped in a confined space, countless rescuers and volunteers will attempt to find you and get you to safety.
Discussion and Observations
Rescue teams consist of highly trained professionals including firefighters, EMT's, paramedics and other local volunteers who are willing to risk their lives to help others. Special teams and robotics were sent into ground zero after 9/11, locating and providing immediate extrication to those who were injured. The U.S Coast Guard's search and rescue efforts during Katrina were crucial saving countless lives in New Orleans.
In August 2008, Georgia was subjected to a brutal Russian military invasion and occupation of some its territories. A total of 364 citizens of Georgia were killed, another 2,234 were injured, and 127,589 were internally displaced. This historic military act of a superpower nuclear state invading a small, neighboring country produced population-wide psychological distress and debilitating psychopathology. The key features of the Russian invasion for Georgia were examined, and the consequences of this particular event were defined. Casualty figures, ethnic cleansing facts, numbers of refugees and displaced persons, impact on Georgia's education, damage to cultural heritage, the role of mass media, economic loss, and environmental destruction also were examined. Data suggest that exposure to hazards, loss, change, human causation/culpability, information as a stressor, multiple traumatic events contributed significantly to the mental health outcomes of the population in Georgia. Mental health, psychological trauma, post-traumatic stress disorder (PTSD), resilience, suicide risk, and secondary trauma were highly prevalent among impacted persons. There is an urgent need to focus on the protective nature of preserving and restoring psychosocial and material resources in the prevention and treatment of PTSD and major depressive disorder following traumatic events.
The role of FAST in diagnostic protocols has been adopted in most major trauma centers in well-developed countries. This procedure has become the initial diagnostic way in blunt abdominal trauma patients. However there are researches which show FAST is not reliable triage tool in patients with pelvic fracture.
Objectives
To evaluate the usefulness of Focused Assessment with Sonography for Trauma in diagnostic of blunt abdominal trauma patients and to bring attention to patients with pelvic fracture who should receive additional tests for the presence of peritoneal fluid.
Methods
An analysis of high-quality evidence resources was performed, limited to the articles published since 2005 year.
Results
99 articles were found during the search, of which 23 were accurate. 16 articles were based on original research.
Conclusion
Focused Assessment with Sonography for Trauma plays a key role in the investigation of blunt abdominal trauma and should be used in all emergency departments. FAST-negative patients can remain under observation except major pelvic injury patients. The evaluation of peritoneal fluid in this group has low sensitivity.
Communication and information are cornerstones of management during major incidents and disasters. To support medical command and control, the Web-based support system called Paratus Major Incident can be used. The Paratus Major Incident system can provide management staff with online information from the incident area, and support management and patient handling at both single and mass-casualty incidents. The purpose of the Web-based information technology (IT) system is to ensure communication and information between the medical management at the scene, hospital management, and regional medical command and control (gold level).
Experiences
In the region of Östergötland, Sweden, Paratus Major Incident system is used in operating topics such as: (1) information dissemination from the incident area; (2) communication between prehospital, regional, and hospital management; (3) continuous updates between the dispatch centre and medical commanders at all levels; (4) digital log-files for medical management and patient records; (4) database used for follow-up studies and quality control.
Results
During 2,161 incidents, 746 “first incident reports” from ambulance on scene were sent to regional medical command and control within 2 minutes. Four hundred and fifty-six “verification reports” were sent within 10 minutes. During 15 incidents, the designated duty officer on regional level confirmed “major incident” directly via the digital system, thereby notifying all arriving ambulance resources and involved medical managements.
Conclusion
This Web-based IT system successfully has been used daily within prehospital management since 2005. The system includes medical command and control at the regional level and all involved hospitals in a major incident.
Building Resilient Extended-Care Facilities During Natural Disasters – Lessons Learned from the 2007 Tulsa, Oklahoma Ice Storm. In the last decade, increasing importance has been placed on building resiliency into critical healthcare systems. This has meant shifting the paradigm from focusing on response to one of preparedness. In 2007, an ice storm as part of a series of winter storms occurred in the south central United States causing extensive power outages, in Tulsa, Oklahoma, for a period of up to 3 weeks. Five of the six tertiary care hospitals in Tulsa suffered power outages, phone system failures or oxygen and/or suctioning system failures. Local water treatment plants were without power for 48 hours. During this time, multiple extended-care (nursing home) patients were discharged to homes or transferred to hospitals because the nursing homes were not prepared to cope with an extended power outage. This paper is a retrospective analysis and discussion of lessons learned with respect to the vulnerability of these extended-care healthcare systems and the public health response during natural disasters.
Israeli Hospitals are required to maintain a high level of emergency preparedness.
Objectives
To investigate the effect of on-going use of an evaluation tool on acute-care hospitals' emergency preparedness for mass casualty events (MCE).
Methods
Evaluation of emergency preparedness for MCE was carried out in all acute-care hospitals, based on an evaluation tool consisting of 306 objective and measurable parameters. Two cycles of evaluations were conducted in 2005 to 2009 and the scores were calculated to detect differences.
Results
A significant increase was found in the mean total scores of emergency preparedness between the two cycles of evaluations (from 77.1 to 88.5). An increase was found in scores for standard operating procedures, training and equipment, but the change was significant only in the training category. The relative increase was highest in hospitals that did not experience real MCE.
Discussion
This study offers a structured and practical approach for ongoing improvement of emergency preparedness, based on validated measurable benchmarks. An ongoing assessment of the level of emergency preparedness motivates hospitals' management and staff to improve their capabilities and thus results in a more effective response mechanism for emergency scenarios.
Conclusions
Utilization of predetermined and measurable benchmarks allows the institutions being assessed to improve their level of performance in the evaluated areas. The expectation is that these benchmarks will allow for a better response to actual MCEs. The study further demonstrated that even hospitals without “real-life” experience can gear up using preset benchmarks and reach a high standard of mass casualty event preparedness.
Manipur is a state in northeastern India and in civil war for > 45 years. Healthcare delivery and access is affected due to poor security, restricted accessibility, and the incapacity of this fragile state.
Methods
The burden of morbidity and mortality in the conflict area of Manipur was estimated using data sources (hospital attendance, hospital inpatient, and death registries, national family and health registries, and in-depth interviews of healthcare providers) and compared to national averages. These findings were co-related with violent events reported in the local newspaper.
Results
Excess mortality was observed in the 21–50 year age group, but not in females or the elderly. The major causes of deaths were non-communicable diseases, cerebrovascular accidents, and chronic pulmonary disease. Chronic conflict increased the burden of alcohol liver disease and of mental health diseases. Suicidal deaths were common in the mid-twenty age group and usually due to agricultural pesticide consumption. These deaths were higher in men, and suicide attempts were higher in women. The prevalence of intravenous drug users and of HIV was reported to be five times as higher than the national average. High rates of disappearances, mutilation, torture, kidnapping, and hostage-taking, spousal physical violence and attacks on healthcare facilities and medical personnel were events of concern. There were no reported events of suicide bombers.
Conclusions
Protracted conflict dramatically changes the demographics and disease burden. Humanitarian space constantly is under threat of attack and the insecurity interferes with the provision of sustained preventive and curative services. Recommendations to be implemented would measures to continue treatment in the insecure environment through telephonic or online medical helplines, vaccination, and drug supplies during negotiated ceasefires or curfew times and protecting humanitarian spaces. However, militarization of healthcare may not be favorable solution.
Psychosocial support is essential to prevent mental health disorders in the elders subjected to trauma in emergencies that induces to isolation as well as risks or vulnerability for them and their environment. Financial crisis, natural disasters, attacks, poverty, violence and loneliness in the social environment turn threatening for them. Reality becomes hard and produces disorganization in mental health.
Objectives
Elder people who have gone through one or more of the following situations are the ones who are prone to develop intense or immediate character disorder. With strategies that increase the existing psychosocial protection factors stress at different intervention levels is lowered. Those who have gone through one or more violent experiences are the ones who are prone to develop intense or immediate character disorder. Cultural transferring (between adults and between adults and children) and mutual help between adults and children is held.
Methodology
Cognitive processing factors associated to each individual's anxiety: stress, depression, loneliness, panic attacks etc. Some techniques have been developed to understand emotions and learn how to manage them: songs, classic tales, puppets, advertisements and anagrams, Kessen cards, etc. All the material and the results were evaluated with clinic tests and professional help.
Conclusion
Additionally, a good cultural understanding of the situation and the adult's feelings are needed in order to provide assistance. The one providing help as well as the one receiving bio-psychosocial help are both part of the link created to overcome the impact of violence, committed to build bridges in the adversity. To prevent post-traumatic stress they are trained in facing disturbing anxiety when facing catastrophes produced by nature or men.
Disaster response is an emergency nursing responsibility. Responding to disasters, however, is hazardous as terrorism, pandemics and chemical industrial accidents challenge the safety of nurses and their families. International experience has shown that nurses can become victims of disasters and that fear of contaminating family and friends may prevent nurses from attending work or returning home during a disaster response. An understanding of the factors that enable or disable their disaster preparedness will underpin future disaster policy and planning for Australian and international health care organizations.
Methods
This study examines the willingness of Australian emergency nurses to attend work to respond to a health care disaster, using a 3-phase mixed-method design. Phase 1 was a national online survey, with 451 responses. Phase 2 involved 6 focus groups at 4 hospital sites, with 41 participants and Phase 3 involved in-depth interviews with emergency nurses at different sites, with 11 participants. This presentation will highlight results from the study on the willingness of Australian emergency nurses to respond to a health care disaster.
Results
Preliminary findings indicate that emergency nurses' willingness to respond to health care disasters was dependent on a number of factors, including their out-of-work responsibilities, the changes to their roles and responsibilities at work, their confidence in management and their work team, the information they are given about the disaster, the type of disaster and the degree of risk involved.
Conclusions
The contribution the findings this study will make to disaster planning and preparedness for nursing staff, health planners and administrators will be outlined.