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There are some tools for teaching disaster countermeasure in Japan. Cross Road Game was developed to get a concrete image of a disaster situation and is based on interviews from Kobe city government officers in an area affected by the 1995 Great Hanshin-Awaji Earthquake. The alternative includes a lot of ‘dilemmas’ that sacrifice something based on whichever outcome is chosen. For example, “There are 2000 meals at the evacuation center with 3000 refugees. Do you distribute these foods or not?” This game was developed for five to seven players, however, it is not suitable for class lessons with a hundred students. Thus, we tried to employ the Clicker-Nano system for an interactive lesson.
Aim:
To provide a brief introduction to this new style of teaching disaster countermeasure.
Methods:
The study included involved a classroom discussion using Clickers-Nano system in addition to Cross Road Game.
Results:
Nursing students could learn the concrete details of disaster countermeasure in an enjoyable format. They could share thoughts and compare opinions while deciding how to resolve the dilemma at the time of disaster.
Discussion:
The most important issue faced was how to develop an educational effect for nursing students. Even if five or seven students (players) could enjoy the game, it would not lead to the accumulation of unified knowledge of disaster countermeasure compared to a lecture at the university. The use of the Clickers-Nano system avoided differences in the reach of learning due to differences of facilitators’ capabilities. This study suggests a new style that combines interactive discussion not only with small but also large numbers of students.
St. John Ambulance Victoria provides first aid and medical services at a variety of mass gathering events (MGEs) throughout Victoria. Volunteer healthcare professionals and students (termed “volunteers”) form Medical Assistance Teams (MAT) at these MGEs. MAT deployments manage a variety of patient presentations which include critically ill patients. This reduces high acuity patient transfers to the hospital and, where possible, avoid ambulance and hospital utilization.
Aim:
To determine the effectiveness of interdisciplinary prehospital simulation workshops in preparing volunteers for MAT deployment at MGEs.
Methods:
A one-day, simulation-based training session within the MAT environment was implemented to introduce volunteers to the management of various scenarios faced at MGEs. All volunteers were provided an orientation to the equipment and setting up MAT deployments at MGEs. Volunteers then participated in interdisciplinary group-based scenarios such as cardiac arrest management, drug intoxication, spinal injuries, agitated patients, and airway management. To determine the effectiveness of this training session, volunteers were invited to participate in a post-training survey, comprising of Likert scores and open-ended responses.
Results:
Seventeen volunteers attended the training session with 10 (58.8%) completing the post-training survey. Volunteers were satisfied with environment familiarization in the MAT (Average 4.47/5.00) and found the simulation-based training helpful (Average 3.67/4.00). The induction overall was well-received (4.60/5.00) with volunteers feeling more confident in being deployed at MGEs (4.20/5.00).
Discussion:
The results of the simulation-based training session were positive with volunteers receptive to the need for a training day prior to MAT deployment at MGEs. The simulation session enables volunteers to be comfortable with working in MAT and managing a diverse range of patients at MGEs. This session is likely to improve interdisciplinary communication and teamwork in the MAT. Future research is aimed at following these volunteers after several MAT deployments to improve the training session for future participants.
According to the Federal Bureau of Investigation (FBI), there were fifty active shooter incidents in 2016 and 2017. In the first five months of 2018, there have been 23 school shootings where someone was injured or killed. Hemorrhage-control tourniquets have proven their life-saving capability in the military and civilian EMS. Now, they are being advocated for use by civilians – the true “first responders.” Since Combat Application Tourniquets (CATs) are strap-and-windlass devices, the question remains whether a naïve population can intuitively apply them efficaciously.
Aim:
To determine the efficacy (speed, correct placement) of a CAT by an interprofessional group of healthcare students naïve to tourniquet hemorrhage control.
Methods:
Consenting students attempted to apply a CAT to a standardized patient with a simulated hemorrhaging brachial artery. No instruction was given except for the directions included in the package. Timing began upon removal of the tourniquet from the package and ended when the participants stated they completed their attempt. Errors in application were documented. Afterward, students received education and an opportunity to properly re-apply the tourniquet. The completion times of the students were compared to ten emergency medical technicians (EMT-P), serving as subject matter experts. Errors in application were categorized.
Results:
50 students from the following professions participated: Medicine, Nursing, Public Health, and Respiratory Therapy. The mean time of tourniquet application was 96.16 seconds (range: 25.12-226.31). This was statistically different from the EMT-Ps’ time of 42.83 seconds (range: 23.89-82.94). Additionally, only five (10%) placed the tourniquet correctly. Errors included improper location and windlass misuse or non-use. The instructions were frequently critiqued for being difficult to read and containing confusing graphics.
Discussion:
Provision of commercial tourniquets in public access areas must be accompanied by civilian education and the creation of CAT instructions that are simplistic, comprehensible, and suitably graphic.
On October 1, 2017, a gunman fired on a festival in Las Vegas, Nevada, killing 58 people and wounding over 500. Multiple casualties were received at two nearby hospitals that sponsor residency programs: Sunrise Hospital and Medical Center and University Medical Center.
Aim:
To evaluate the impact of the most lethal mass-shooting event in US history on graduate medical education (GME) at the involved hospitals.
Methods:
Anonymized surveys were sent to 210 physicians at SMC and 110 physicians at UMC. Surveys incorporated 4 validated instruments: The Post Traumatic Growth Inventory (PTGI), The Impact of Events Scale-Revised (IES-R), The Multidimensional Scale of Perceived Social Support (MSPSS), and The Team Cohesion Factor (TCF).
Results:
Sixty-six physicians completed the surveys (38 attendings; 17 residents). 10% of physicians scored in the likely posttraumatic stress disorder (PTSD) range and 15% found themselves avoiding or struggling with managing similar patients, though overall survey response rate was low. The majority of physicians did not believe the event impacted their specific GME activities. No attending physician rated the event as negative in terms of global impact on GME, and 34% rated it as positive. However, 12 of 17 residents rated the event as a hurdle in its GME impact. A regression model predicting the IES-R score demonstrated a trend that those with higher pre-event stress and lower social support reported more adverse impact (p<0.06).
Discussion:
We believe our study is the first to examine the impact of mass casualty traumatic events on graduate medical education. Attendings and residents differ in their global perception of the impact, with attendings viewing it as a positive event and residents as a challenge. Pre-event level of stress and perceived social support predicted the impact of the event and may partially explain these results if residents and attendings vary on these parameters.
Between 2015 and 2018, a number of influential disaster-related International Consensus Frameworks evolved.
Aim:
To locate these Frameworks and identify commonalities, potential interactions, and possible implications for WADEM.
Methods:
A targeted literature review and thematic analysis.
Results:
The review identified the following Frameworks: Sendai Framework for Disaster Risk Reduction 2015–2030; Sustainable Development Goals 2030 Agenda; Paris Climate Change Conference; WADEM Position Statement on Climate Change; World Humanitarian Summit; Core Humanitarian Standards; Sphere Handbook, Humanitarian Charter and Minimum Standards in Humanitarian Response; Habitat111 - the new Urban Agenda; Sphere Guidelines for Urban Disasters; Rockefeller Foundation’s 100 Resilient Cities Project; New York Declaration for Refugees and Migrants; Dhaka Declaration on Disability and Disaster Risk Management; WHO Emergency Medical Teams and Accreditation; WADEM’s Disaster Research and Evaluation Frameworks; ALNAP’s Evaluation of Humanitarian Action Guide; and Evidence Aid’s Use of Evidence in the Humanitarian Sector: A Practice Guide.
Discussion:
All Frameworks used substantial theoretical and/or evidence-based underpinnings, and evolved from structured processes. One subset had major political and government influences while others reflected applied, professional influences. A number of the Frameworks further evolved during 2017-18, providing indicators, international reporting, and interpretative guidelines. Common themes included a desire to improve the quantum and quality of science, evidence-based and accountability, use of Resilience as a conceptual framework, commonalities, and interactions between the new generation humanitarian, development concepts, and traditional disaster concepts, particularly in the global influence of climate change and greater urbanization. Other themes included new paradigms (e.g. international influence of Rockefeller’s Acute Shocks), Chronic Stressors concept, and the anchoring theme of the Sustainable Development Goals and capacity building. The ALNAP, Rockefeller, Sphere, and WADEM Evidence Aid Frameworks provide useful guidelines on how the objectives of these International Consensus Frameworks may be achieved and measured. All Frameworks have implications for the future direction of WADEM.
Post-disaster psychosocial support (PSS) is an indispensable element of disaster management. A variety of studies contributed to the development of guidelines, information about guideline implementation, and evidence-based practice, as well as the status of local PSS planning and delivery systems in different European regions. However, the multi-disciplinary nature of the organization of post-disaster PSS requires interprofessional and inter-organizational collaboration, but is presently insufficient institutionalized on individual, organizational, and governmental levels, locally, within the region, and nationally.
Aim:
Objective of this research is to map the existing post-disaster PSS network in the Netherlands in the context of a terrorism scenario, and to identify probable collaboration problems rooted in weak ties and lack of alignment between actors at different levels.
Methods:
Focus groups were organized in Belgium, France, Norway, and the United Kingdom to learn from the inter-agency response to recent terrorist attacks. Next, social network analysis methods were used to analyze the structure of the collaborative network for post-disaster PSS in the Netherlands. A scenario-based questionnaire was distributed amongst relevant stakeholders through snowballing methods. Respondents were asked to identify organizations they collaborate with on different PSS activities during the preparedness, acute, and recovery phase.
Results:
The international focus groups resulted in valuable lessons for the Dutch PSS network. Data collection for social network analysis is currently in progress. Based on previous research we expect limited ties between disciplines during the preparedness phase and during the “registration of affected persons” in the acute phase. Most of the interactions between agencies will be linked to one-stop-shop service delivery, and less to commemorations and health monitoring.
Discussion:
Lessons from the focus groups, verification of whether or not the expectations are supported by the social network data, and reflections on opportunities for improvement will be presented at the conference in Brisbane.
Major earthquakes with a magnitude of 8-9 are anticipated to occur in the next 30 years at a 60 percent chance on the southern coast of Japan. Since the most part of our Prefecture is likely to be damaged by tsunami and landslides, residents are expected to take a self-reliant approach on the initial several days after the earthquakes and tsunami.
Aim:
To improve the resilience of the local communities we have developed and applied an educational program of disaster response.
Methods:
An active learning program was designed on roles of rescuers and sufferers, and conducted two-hour sessions for high school students using a scenario in which they encountered an earthquake during a field trip. Half of the participants were assigned to play students on a field trip and asked to discuss options as a small group to survive and secure their safety in an isolated situation after an earthquake. They exchanged ideas to stay alive, cooperate with local residents and request disaster assistance using very short radio messages to the appropriate counterpart. The other half of the participants were assigned to be school administrations and asked to estimate the situation of sufferers. Their task as a small group was to organize assistance based on the best assumption from the limited information of the isolated students and local villagers.
Results:
After the sessions, the participants expressed their discovery in the discrepancy of situational recognition between the two groups and they learned about assumption-based planning as well as good information sharing.
Discussion:
Through this program, the participants experienced simulated situations and learned perspectives from both sides; providing relief as rescuers and receiving aid as sufferers. The participants were motivated to share and utilize their knowledge and skills to make their community resilient to disasters.
The project was provided under the auspice and support of the Israel Agency for International Development Cooperation (MASHAV) at the Ministry of Foreign Affairs (MFA). Togo, one of the smallest and least developed countries in West Africa, has a population of ~7.9 million. About 65% of its population lives in rural areas. Due to the lack of medical resources, Togo suffers from health problems including those related to trauma and mass events. In May 2017, a trauma and disaster team came to Togo to train the medical team in the new trauma unit, donated and built by the MFA. The unit was built in the Atakpame Regional Hospital (ARH), located 160km north of the capital, Lomé. ARH serves one million inhabitants, mostly from rural areas.
Methods:
The training included lectures, simulations, drills, case studies, bedside teaching, and operation of medical technologies.
Results:
Following the training, it was recommended to continue the program and to move forward with advanced training. Following the team’s recommendations, MASHAV decided to expand the program and to provide a multilateral project to Togo and ten other West African countries within five months after the first training ended. Twenty participants (mostly senior doctors) were chosen from ten Western African countries and brought to Lomé. The participants joined a two-day Trauma and Disaster Preparedness seminar. Following the seminar, they were moved to Atakpame to join the local team and the facilitators, to visit the trauma unit, and to learn about it as a model for trauma care that can be modified to the capabilities of the local facility.
Discussion:
Lessons learned and recommendations from those two projects were brought to the MFA that will try to develop more training and cooperation models to help and establish better trauma care and disaster response, supported by the Israeli team.
More and more hospitals are using the Hospital Incident Command System (HICS) for organizational management under emergency conditions. HICS is an incident management system based on principles of the Incident Command System (ICS), which assists hospitals and healthcare organizations in improving their emergency management planning, response, and recovery capabilities for unplanned and planned events. This study aims to explore how Chinese hospitals manage their organizations with HICS in Mass Casualty Incidents (MCI).
Aim:
To explore the feasibility of HICS in Chinese hospitals under MCI.
Methods:
A combination of literature analysis and empirical research was used in this study. Through case studies and experience summarization, the necessity and feasibility of the incident command system (ICS) and the emergency medical response system (EMRS) was demonstrated in the early stage of MCI. Based on this, a new "1 SECTION-5 GROUPS-10 TEAMS " model was proposed, and its value of practical application was discussed in MCI.
Results:
Multiple resources must be mobilized In MCI, and it is necessary to establish an ICS and an EMRS as soon as possible in the early stages of MCI. The earlier ICS is set up, the more initiative can be taken. The "1 SECTION-5 GROUPS-10 TEAMS" model proposed in this study has a good effect on the practice of drills and rescues, indicating that this model has a certain promotion effect in the hospital's response to MCI.
Discussion:
The "1 SECTION-5 GROUPS-10 TEAMS" model has high feasibility and can be further verified in the subsequent rescue practice.
The public ambulance system in Ukraine is the primary deliverer of prehospital care for trauma patients in this Eastern European country, but no national assessment has previously been made to ensure the presence of essential medical equipment on these ambulances.
Aim:
Working with the Ukraine Ministry of Health, our aim was to assess the availability of public ambulances of medical equipment essential for managing traumatic injury using an internationally recognized standard for prehospital care.
Methods:
We identified 53 Advanced Life Support (ALS) ambulances from randomly selected cities for evaluation. We performed an inventory of available medical equipment and supplies on these ambulances against a matrix of essential equipment for prehospital providers developed by the World Health Organization (WHO).
Results:
Essential medical equipment in the categories of personal protection, patient monitoring, hemorrhage control, and immobilization were generally available in the ALS public ambulances surveyed. Deficiencies were noted in equipment and supplies for basic and advanced airway monitoring and management.
Discussion:
Public ALS ambulances across Ukraine are adequately equipped with many essential medical supplies to manage traumatic injury, but have deficiencies in both basic and advanced airway management. Correcting these deficiencies may improve prehospital survival of the traumatically injured patient. The results of this study will enable the Ukraine Ministry of Health to develop requirements of essential medical equipment for all public ALS ambulances in the country, to inform resource allocation decisions, and to guide public health policy regarding prehospital trauma care.
On February 6, 2018, a magnitude 6.2 earthquake struck Hualien, the eastern part of Taiwan. The quake resulted in 17 deaths and more than 300 people injured. Four buildings completely collapsed and hundreds of houses were damaged.
Aim:
The aim of this research was to use the patient data to analyze the reasons for visits, the trauma sites, and the severity.
Methods:
We obtained the patient information from the Taiwan Eastern Medical Emergency Operation Center. Medical records were reviewed to analyze the primary diagnosis, the trauma mechanisms, and the sites of injury. Injury severity score (ISS) was used to assess trauma severity.
Results:
Two hundred and eighty patients were included in the study, with 90.3% being traumatic patients. Among them, 18.2% was geriatric trauma, 4.7% was pediatric trauma, and 0.4% was obstetric trauma. The most common injury site was lower extremities (33.2%), followed by head (31.4%) and upper extremities (27.1%). The mean injury severity score (ISS) was 1.9. The geriatric population had an average ISS of 2.4, and the pediatric group had a mean ISS of 1.2.
Discussion:
In our study, the majority of the patients had minor trauma. Lower extremities may be more vulnerable during the evacuation of an earthquake, and thus, became the most common injury site. The elderly patients had a higher ISS, which may be explained by their immobility and fragility of the body. In the future, it is critical to educate citizens about self-protection during earthquakes, focusing on protecting the head and the extremities. Healthcare providers and emergency medical technicians need to be well-trained to handle geriatric trauma since it poses unique challenges and is associated with increased mortality.
Patan Hospital, located in Kathmandu Valley, Nepal is a 400-bed hospital that has a long history of responding to natural disasters. Hospital personnel have worked with the Ministry of Health (MOH) and the World Health Organization (WHO) to develop standardized disaster response plans that were implemented in multiple hospital systems after the earthquake of 2015. These plans focused primarily on traumatic events but did not account for epidemics despite the prevalence of infectious diseases in Nepal.
Aim:
To develop and test a robust epidemic/pandemic response plan at Patan Hospital in Kathmandu that would be generalizable to other hospitals nationwide.
Methods:
Using the existing disaster plan in conjunction with public health and disaster medicine experts,we developed an epidemic response plan focusing on communication and coordination (between the hospital and MOH, among hospital administration and staff), logistics and supplies including personal protective equipment (PPE), and personnel and hospital incident command (IC) training. After development, we tested the plan using a high-fidelity, real-time simulation across the entire hospital and the hospital IC using actors and in conjunction with the MOH and WHO. We adjusted the plan based on lessons learned from this exercise.
Results:
Lessons learned from the high-fidelity simulation included the following: uncovering patient flow issues to avoid contamination/infection; layout issues with the isolation area, specifically accounting for donning/doffing of PPE; more sustained duration of response compared to a natural disaster with implications for staffing and supplies; communication difficulties unique to epidemics; need for national and regional surveillance and inter-facility planning and communication. We adjusted our plan accordingly and created a generalizable plan that can be deployed at an inter-facility and national level.
Discussion:
We learned that this process is feasible in resource-poor hospital systems. Challenges discovered in this process can lead to better national and system-wide preparedness.
Japan International Cooperation Agency has started the project for strengthening the ASEAN regional capacity on disaster health management (ARCH Project) since 2016. This project conducted the start-up regional collaboration drill in ASEAN. All participants from ASEAN countries realized the need for a standardized assessment tool. Several UN agencies and international organizations launched assessment tools, but there is no standard assessment tool.
Aim:
To develop an integrated rapid health needs assessment (HNA) tool in the ASEAN region. This paper reports the development process of the HNA tool.
Methods:
The project established the project working group (PWG) to developing some tools. PWG consisted of the expert team, project team, Japanese Advisory group and twenty delegates from ten ASEAN member states. PWG established the cycle of the developing process of the HNA tool.
Results:
We created a health needs assessment form and a summary form. The assessment form consists of (1) Informant information, (2) Site information, (3) Overall situation of the site, (4) Public health, (5) Health facility damage. The summary form consists of (1) Informant information, (2) Site information, (3) Critical areas for support, (4) Situation of the site.
Discussion:
Frequently, the public health emergency operation center in an affected country is not able to obtain the critical information of an affected area in the acute phase of disasters. This HNA tool would be used in the acute phase by the Emergency Medical Teams (EMTs) because the EMT has mobility and workforce for assisting the affected country. We have agreed on the usage of the assessment form as a kind of an “interview guide”. The purpose of this assessment form is to assess a disaster situation. The next step will be to provide more opportunities for the ASEAN member states to use and learn more about this HNA form.
Emergencies and disasters need inter-discipline and inter-professional approaches because many problems in a disaster are due to poor coordination and collaboration. The disaster events during a decade in Indonesia highlighted the limitations of the healthcare system in responding to large-scale public health problems. Disaster health preparedness is the key to an effective response to any problems in community and family. Thus, education for health students has become a priority.
Aim:
Preparing fourth-year health students to be aware of disaster health problems in family and community with an inter-professional approach.
Methods:
Faculty of Medicine, Public Health, and Nursing UGM were prepared for the fourth year undergraduate health students through a semester “Emergency and Disaster Course” under Community Family and Healthcare with the Inter-professional Education Program, first given in 2016 for four hundred students. Mix method between class lecture, training skill, and simulation. The course goals are to (1) educate students on disaster health management, (2) understand the health preparedness and disaster family kit, and (3) define the principle of health worker’s role and collaboration in disaster.
Results:
The course was well received and at the 2017-2018 session was improved based on students and faculty feedback. Disaster knowledge of students changed. However, they still had a problem in communication between professions. And addition, they became aware of the function and each role of health profession competency during a disaster.
Discussion:
A course for fourth-year health students about emergency and disaster health management is extremely relevant because they will be health workers soon. They must have good awareness, knowledge, and attitude to cope with disaster health problems in the future.
The rationale for undertaking this study was to investigate how characteristics of population health relate to and impact disaster risk, resilience, vulnerability, impact, and recovery. The multi-disciplinary environment that contextualizes disaster practice can influence determinants of health. Robust health determinants, or lack thereof, may influence the outcomes of disaster events affecting an individual or a community.
Aim:
To investigate how the social determinants of health inform community perceptions of disaster risk.
Methods:
Community perception of disaster risk in reference to the social determinants of health was assessed in this study. Individual interviews with participants from a community were conducted, all of whom were permanent community residents. Thematic analysis was conducted using narrative inquiry to gather firsthand insights on their perceptions of how characteristics of population health relate to and impact an individual’s disaster risk.
Results:
Analysis demonstrated commonality between interviewees in perceptions of the influence of the social determinants of health on individual disaster risk by determinant type. Interviewees sensed a strong correlation between low community connection and disaster risk vulnerability. Specific populations thought to have low community connection were perceived to be socially isolated, resulting in low knowledge or awareness of the surrounding disaster risks, or how to prepare and respond to disasters. In addition, they had reduced access to communication and support in time of need.
Discussion:
The importance of a strong social community connection was a feature of this research. Further research on how health determinants can enable disaster risk awareness and disaster risk communication is warranted.
Tactical Emergency Medical Response (TEMS) originated in the 1990s in Finland. It is a nationally standardized joint-effort with EMS and police special units, such as SWAT.
Aim:
To describe a national system of TEMS in Finland.
Methods:
In Finland, TEMS is a national response system of specially trained paramedics and pre-hospital doctors, working normally in HEMS or a local physician staffed rapid response car. There is a two-tier selection to get accepted in the basic course. The police run background checks for all participants before they are accepted to the course. The course itself is four days and it covers the basics of police tactics, protective gear, penetrating wounds, evacuation, etc. After graduating from the basic course, the paramedic/doctor is qualified to participate in missions. Although healthcare professionals are involved, a TEMS mission is under the police command and is used as one of the police’s special teams to operate in areas where normal EMS cannot be allowed for safety reasons. TEMS does not carry any weapons. The Police provide the teams with the same protective equipment that the SWAT/CTU has. After some years, there is a three-day refresher course for active TEMS service. In this course, the main training points are working in austere environments, such as helicopters, boats, and in urban environments wearing civilian clothing. Police pay for the usage of TEMS in missions, but they do not pay for training days.
Results:
TEMS has good national coverage. In 2017, there were 131 TEMS activations. The normal response to a mission is a team of one or two TEMS operators.
Discussion:
TEMS has achieved good national coverage and is deployed often. TEMS has also channeled information and training, such as TECC, to normal EMS personnel and raised their preparedness as well.
One of the key components in any effective disaster response is the capacity of local communities to respond in a timely and efficient manner. Over the last 3 years, the National Critical Care and Trauma Response Centre in Darwin has been involved in building regional capacity across the Asia-Pacific, supporting local leadership and building local skills and knowledge in order to develop a systematic approach to disaster medical management.
Aim:
This presentation is to describe the Regional Engagement Program, its strengths, weaknesses, and outcomes.
Methods:
We will describe the background to the program, the process for regional engagement and the Results of our evaluation. The program used the Major Incident Medical Management Systems (MIMMS) approach which was delivered in-country and included identifying and using local personnel to deliver the program. The program was conducted across the region in Myanmar, Fiji, Tonga, Vanuatu, Samoa, Timor, and Indonesia. Initially the courses were run by personnel from Australia but through engagement with local Ministries of Health and collaboration with identified key stakeholders, we have been able to build local faculty to ensure sustainability and local ownership.
Results:
Thirty-six personnel have been trained across four countries. Thirty-six candidates are now instructors, with a further 36 identified for future development as instructors. The evaluation illustrates the long-term partnerships that have been developed and the ongoing capacity development of key regional partners.
Discussion:
The Regional Engagement program demonstrates that prolonged engagement with key regional stakeholders and adequate and sustained mentoring will successfully build local capacity to the level needed to mount a successful response to a disaster. Personnel trained through this program helped guide the response to the Lombok earthquake and in Fiji, a MIMMS Team Member training program was conducted with minimal external support.
Global conversations emphasize strengthening communities’ resilience to disasters. These conversations inspired the Victorian Compendium of Community-Based Resilience Building Case Studies. The Compendium motivates community members to build expertise, reduce program duplication, and save valuable resources. Case study analysis identified critical success factors. Between 2012 and 2018, community groups completed an Expression of Interest to present at the MUDRI Advancing Community Resilience Forums, which provided an opportunity to impart resilience activities and knowledge. It also solved challenges and shared unforeseen learning. Over six years, 72 groups presented. Subsequently, 35 submitted their activity for consideration into the Compendium. Of these 35, 30 were included.
Aim:
This updated research analyses critical success factors of 30 case studies. Success factors support the key tenet of the Victorian Compendium of Community-Based Resilience Building Case Studies: to promote the sharing of achievable, practical resilience building activities. The online Compendium provides free access for all communities to explore activities before, during, and after disasters.
Methods:
A thematic analysis identified critical success factors of 30 Compendium case studies.
Results:
Case studies revealed unique and valuable learning in diverse settings. The critical success factors included: (1) strong governance, Board support, leadership and trust; (2) partnerships; (3) commitment, adaptability, and stamina; and (4) community-based initiatives. Other success factors included a paid facilitator and local government support, stamina, and celebrating success.
Discussion:
The Compendium represents an Australian first and offers an innovative contribution to resilience practice and research. It enhances other Victorian initiatives such as the Rockefeller funded Resilient Melbourne Strategy, which incorporates the Compendium to bring people together from across sectors to deliver distinct, yet connected actions to strengthen resilience. The Compendium enables diverse communities to adopt or adapt proven resilience activities, thereby preserving valuable resources. It offers the opportunity to extend to a national or international Compendium.
After a 6.0 magnitude earthquake struck Hualien on February 6, 2018, over one hundred and fifty patients crammed into the emergency department of a nearby tertiary hospital within two hours. The mass casualty incident (MCI) call was activated, and over 300 related personnel responded to the call and engaged with the MCI management.
Aim:
This research aimed to analyze the practice of an MCI call and to form the strategies to improve its efficiency and effectiveness.
Methods:
The research was conducted in a tertiary hospital in Hualien, Taiwan. Questionnaires regarding the practice of the MCI call were sent out to the healthcare providers in the emergency department who responded to that MCI operation.
Results:
Thirty-seven responders in the emergency department were involved in this study. 78% had participated in training courses for hospital incident command system (HICS) or MCI management before this event. On arrival at the emergency department, 69.4% of the responders were aware of the check-in station and received a clear task assignment and briefing. During the operation, 25.7% reported the lack of confidence carrying out the assigned tasks and 54.1% of the participants experienced great stress (stress score over 7 out of 10).
Discussion:
MCI is an uncommon event for hospital management. It is universally challenging owing to its unpredictable and time-sensitive nature. Furthermore, the administration could be further complicated by the associated disasters. Despite regular exercises and drills, there are still a significant number of participants experiencing stress and confusion during the operation. The chaotic situation may further compromise the performance of the participants. This study showed that optimizing task briefing and on-site directions may improve the performance of the MCI participants.
Focused or point of care ultrasound applications have been integrated into prehospital assessments, triage capacities, military applications, trauma, and emergency health care settings, and medical school curriculums. Often, the inclusion of focused ultrasound is to answer specific clinical questions. However, the value is ultimately determined by the experience, skills, and training of the operator performing and interpreting the examination. Ultrasound was reserved for traditional imaging providers as little as two decades ago. However, as the application of ultrasound expands within clinical medicine, there is an increasing necessity for associated education and training.
Aim:
To highlight the applications and uses of focused ultrasound in the current diverse health care landscape while identifying the associated educational considerations, including the undergraduate tertiary education sector.
Methods:
A search of peer-reviewed published literature was undertaken to determine the range of current usage of ultrasound imaging across professions, and to identify the education and training available.
Results:
The results discussed within this presentation will highlight identified trends, ultrasound applications, educational considerations, and potential future practices based on the content of the literature explored.
Discussion:
Technology is rapidly advancing in the field of medical ultrasound with handheld ultrasound scanners now smaller, less expensive, and more accessible than ever before. Paralleled with these advances and the more generous use of ultrasound come the expectation and pressures of competent skill diversity among healthcare staff and specialists. Significantly, sonography is still considered by many as the most technically demanding and operator dependent medical imaging modality available. Therefore, as the application of ultrasound expands within clinical medicine, educational considerations must also align with this expansion to maintain diagnostic accuracy. This means an increasing demand for associated education and training, including in the undergraduate tertiary education sector.