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The conceptual framework for disaster medicine is weak and unstructured. There is a need to reinforce disaster medicine education and research with appropriate conceptual models. This paper outlines the development and structure of one such model—a “work-in-progress”.
Methods:
A literature review of contemporary education programs in disaster medicine was performed and used to enhance the outcomes of the evolving framework of the World Association for Disaster and Emergency Medicine (WADEM) Education Committee.
Results:
The literature review identified some consistent themes representing “new” thinking on conceptualizing the field of disaster medicine.
Four domains were constructed to develop a new framework for conceptualizing disaster medicine, namely: an expanded disaster health framework developed by the WADEM Education committee, which includes the primary disciplines of public health (the collective), emergency and risk management (the organizational), the clinical and psychosocial (the individual), secondary disciplines, the community, and, the socio-political-cultural context; a contemporary view of the disaster cycle; the disaster epidemiology of the region; and the generic personal attributes expected of the humanitarian professional.
The consequent model demonstrates the relationships between these domains.
Conclusions:
As a “work-in-progress”, this model has been used to successfully guide the development of undergraduate and graduate programs in emergency preparedness and disaster health. The model provides a framework for common communication and subsequent modification in the light of further research and discussion.
The selection and training of medical specialists for field activities in emergencies requires a set of methods for providing professional capacities. The complex psycho-physiological approach allows a new system for the selection and preparedness on the psychological and professional level to be applied.
objective:
The objective of this study was to mobilize psycho-physiological instruments for the staff selection procedure, and to follow an approach of psycho-physologically based methods for staff mental preparedness.
Methods:
The battery of quantitative evaluation methods for study and practice for use in laboratory and field conditions is proposed. The methods are underlined by complicated, bilateral, sensorial reactions in modeled conditions of ipsi- and contra-lateral visual deprivation and conditioned environments on the computer screen. In processing experimental conditions, the mechanisms of integrative factors regulating the characteristics of hemisphere asymmetry have been evaluated and managed as a result of the influence of specific procedures. The conditions of selection and ultimate correction, if necessary, are determined as a result of preliminary professional preparedness and initial mental status. The methods are completely objective based on the quantitative criteria. The selection procedure does not include any subjective evaluation.
Conclusions:
The method battery is registered in the national registry of patents and inventions. The results and conclusions could be included in the training of search-and-rescue teams, medical emergency teams, and other hazard staff.
The objective of this study was to compare the operational viability and performance of the Sacco Triage Method (STM) to that of the Simple Triage and Rapid Treatment (START) protocol.
Methods:
Following a 20-minute review of the mandated START protocol and a 20-minute training session of STM, parallel disaster exercises were conducted. Emergency responded used START in the morning and STM in the afternoon on a simulated building collapse involving 99 victims. Data were collected on the accuracy of patient assessment (START) and scoring (STM), the timeliness in clearing the scene, and me prioritization of patients leaving the scene.
Results:
The STM scoring was more accurate than START assessments at 91.7% and 71.0%, respectively. The time to clear the scene was 16% less using STM than START (53 minutes and 63 minutes, respectively). The 13 most seriously injured patients left the scene in the first seven ambulances using STM; while only two of the 13 most seriously injured patients left the scene in the first 13 ambulances under START, and the three most serious patients were transported by bus. Surveyed providers preferred START to STM and believed it to be more accurate, faster, and better able to identify the most serious patients.
Conclusions:
Emergency responders did not implement START successfully Despite refresher training and 12 years of using START as their statewide protocol, tagging was inaccurate and patient prioritization was poor. In comparison, STM was implemented after 20 minutes of introductory training, was shown to be operationally viable, and outperformed START in all objectives.
Universities have fallen victim to many disasters over the years, ranging from those caused by natural hazards to campus violence. Most institutions have disaster plans in place and attempt to update those plans on a regular basis. Yet historically, universities do a poor job in testing those emergency operation plans as part of their routine preparation and mitigation practices. In July 2008, Philadelphia University participated in a full-scale, multi-agency exercise in order to test their disaster plan. The purpose of this study was to examine the lessons learned from the drill, analyze the benefits of the drill, and determine if the drill brought value to the university.
Methods:
Interviews were conducted with 21 of the 25 university personnel who participated in the exercise. The interviews were taped and analyzed with the use of qualitative methods and content analysis techniques.
Results:
The emerging themes from the study included the benefits and values of the drill, the lessons learned, how perceptions were changed after the drill, views about the current level of disaster preparedness, and recommendations for improving disaster management practices.
Conclusions:
The results demonstrated that the disaster drill was a valuable learning experience for the participants. The university benefited from the drill in multiple ways, learned many lessons, and discovered ways to begin improving their disaster management practices.