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People are increasingly embarking on expeditions into remote wilderness environments and subjecting themselves to increased medical risk. Medical provisions for the management of anticipated injuries and illnesses must be selected carefully due to financial and size and weight constraints on expeditions. Literature suggests decisions surrounding medical resource provisioning are rarely made using evidence-based methods.
Aim:
The aim of this study was to evaluate the medical provisions taken on expeditions against the medical provisions recommended as best practice in published treatment protocols for the management of conditions encountered on expeditions.
Methods:
Firstly, a mixed methods study approach was used to develop a conceptual model linking injuries and illnesses with the medical resources (equipment and medications) recommended for their management. In the second part of the study, injuries and illnesses reported in four studies from the published literature were analyzed using the conceptual model.
Results:
Expected medical resources for the injury and illness burden were compared to the medical resources included in published equipment and medication lists. It was found that medical resources taken on expeditions were both significantly underequipped (p<0.01) compared with the list of provisions recommended by the treatment protocols, but also included a range of resources that were not indicated as part of best practice.
Discussion:
These findings suggest that unnecessary over-provisioning and under-provisioning risks are being assumed on expeditions. Further research supporting the development of a medical provision recommender system may provide a more evidence-informed method of matching medical resource requirements to anticipated injury and illness profiles on expeditions.
The earthquake-resistant standard of the buildings of Japan is maintained by several levels. After the Great Hanshin-Awaji Earthquake(1995) the Ministry of Land, Infrastructure, Transport, and Tourism in Japan classified the earthquake-resistant performance for the base facilities into 3 levels. The hospital manager often selects the middle level of earthquake-resistance. However, 10 hospitals were closed down for the destruction of facilities by the Kumamoto earthquake. Who may evaluate the safety of a hospital after a great earthquake? The purpose of this study is to consider the methods to evaluate the safety of hospital buildings just after a great earthquake.
Methods:
The damage to hospitals and the measures based on Japanese Law are arranged. Then it is considered who can declare the safety of hospital buildings after a great earthquake.
Results:
Hospital buildings collapsed in the Hanshin-Awaji Great Earthquake and many hospitals lost a function by a tsunami in the Great East Japan Earthquake. In addition, the glass and the ceilings of the hospital were damaged in the Kumamoto Earthquake. The damage occurred although these many hospitals had an earthquake-resistant standard established in the Building Standard Act of Japan. It is necessary for the experts to judge the safety of the hospital building just after a great earthquake.
Discussion:
The safety of hospital buildings is the responsibility of the hospital manager. However, there isn’t an expert of building structure employed as staff at a hospital. Thus, the hospital personnel must allow the expert of the building structure to advise a manager. In the future, it is important that the evaluation methods that can judge the damage of a hospital are developed, and the practical training for the hospital personnel are repeated.
Wellington, New Zealand has a significant earthquake risk with unique response challenges posed by its geography and limited road, rail, and sea access. In 2014, the World Health Organization (WHO) Emergency Medical Team (EMT) initiative published minimum and technical standards for EMTs in response to failures by responding teams to deliver appropriate and ethical clinical care during a number of disasters (Norton, 2014). The initiative has evolved to develop national and International EMTs in addition to a support capacity building within Ministries of Health to better coordinate clinical capacity during an emergency.
Aim:
Over the last two years, the WHO EMT Coordination Cell (EMTCC) course has trained over 300 health personnel globally to coordinate clinical surge capacity using a three-step Impact Assessment, Needs Assessment, and Tasking process informed by disaster epidemiology and mass casualty ratios.
Methods:
EMTCC planning methodology was applied to the “Wellington Earthquake National Initial Response Plan” (MCDEM, 2017) to develop a Health Action Plan for a significant Wellington earthquake. Known earthquake impact modeling for injuries was applied against predicted capacity in receiving hospitals in the affected region, and the ability to transfer patients nationally to determine unmet response needs. EMT minimum standards and operational insights from recent disasters were then used to determine the number of EMTs required for optimal tasking.
Discussion:
The surge planning methodology provided a theoretical framework for national and local health emergency management staff to engage with clinical colleagues. This allowed likely EMT assistance to be pre-planned, which facilitates further planning with national and local emergency management, border, and registration agencies for rapid entry into NZ, including onward transport and logistical support. While injury treatment ratios had to be refined to reflect NZ context, the methodology proved useful for Ministries of Health to pre-identify the need for international assistance in national emergencies.
The science supporting event medicine is growing rapidly. In order to improve the ability of researchers to access event data and improve the quality of publishing mass gathering cases, it would be of benefit to standardize event reports to permit the comparison of similar events across local and national boundaries. These data would support the development of practice standards across settings.
Aim:
The authors propose the creation of a publication guideline to support authors seeking to publish in this field.
Method: Derivation study via analysis of published case reports using the Delphi process.
Results:
Data elements were inconsistently reported within published case reports. Categories of variables included: event demographics (descriptors of date, time, genre, activity, risks), attendance and population demographics, data related to climate and weather conditions, composition and deployment of an onsite medical team, highest level of care available onsite, patient demographics, patient presentations and measures of impact on the local health care system such as transfer to hospital rates. Of note, there was a high incidence of “missing” variables that would be of central interest to researchers.
Discussion:
Approaches to standardizing the collection and reporting of data are often discussed in the health care literature. The benefits of consistent, structured data collection are well understood. In the context of mass gathering event case reporting, the time is ripe for the introduction of a guideline (with accompanying guidance notes and dictionary). The proposed guideline requires the input of subject matter experts (in progress) to enhances its relevance and uptake. This work is timely as there is ongoing work on improving an international event medicine registry. If the evolution of both proceeds in lockstep, there is a good chance that access to a rigorous data set will become a reality.
Information systems (IS) have facilitated workflow in the health care system for years. However, the utilization of IS in disaster medical assistance teams (DMATs) has been less studied.
Aim:
In Taiwan, we started a program in 2008 to build up an information system, MEDical Assistance and Information Dashboard (MED-AID), to improve the capability and increase the efficiency of our national DMAT.
Method: The mission of our national DMAT was to provide acute trauma care and subacute outpatient care in the field after an emergency event (e.g., earthquakes). We built the IS through a user-oriented process to fit the need of the DMAT. We first analyzed the response work in the DMAT missions and reviewed the current paperwork. We evaluated the eligibility and effectiveness of the core functions of DMATs by experts in Taiwan and then developed the IS. The IS was then tested and revised each year in two table-top exercises and one regional full-scale exercise by the DMAT staffs who came from different hospitals in Taiwan.
Results:
During the past 10 years, we identified several core concepts of IS of DMAT: patient tracking, medical record, continuity of care, integration of referral resources, disease surveillance, patient information reporting, and medical resources management. The application of the IS facilitate the DMAT in providing safe patient care with continuous recording and integrate patient referral resources based on geographic information. The IS also help the planning in real-time disease surveillance and logistic function in the medical resources monitoring.
Discussion:
Information systems could facilitate patient care and relieve the workload on information analysis and resources management for DMATs.
Midline shift (MLS) in the brain is a life-threatening emergency, which requires immediate surgical intervention following diagnosis. Currently, CT Brain is accepted as the gold standard in detection of MLS. Unfortunately, the diagnosis may be delayed when the patient is unable to undergo a CT Brain immediately due to several reasons. This has led to a constant endeavor to identify and develop other methods for detection of MLS, among which Transcranial Sonography (TCS) is included.
Aim:
To validate point-of-care TCS for detection of MLS in neuro-emergency patients in the Emergency Department, and compare it to CT values of MLS.
Methods:
This double-blinded prospective study was conducted from March 2018 to August 2018 in the Emergency Department of VIMS Hospital, Salem. All patients above the age of 18 who required a CT Brain were included, and a TCS was performed. MLS on TCS was calculated by measuring the distance between the outer table of the skull and the third ventricle on both sides, through the temporal window using a 2.8 MHz Sector Probe. MLS on CT was defined as the difference between ideal midline and septum pellucidum.
Results:
A total of 87 patients were included in this study. The MLS (mean ± SD) was 0.21cm ± 0.31cm using TCS, and 0.20cm ± 0.34cm using CT. The Pearson’s correlation coefficient between CT and TCS was 0.97 (p < 0.01). The area under the ROC curve for detection of a significant MLS using TLS was 83.7%. Using 0.5cm as a cut-off, the sensitivity, specificity, and positive likelihood ratio were 86.7%, 98.6%, and 61.92, respectively.
Discussion:
This study concludes that Transcranial Sonography could detect Midline Shift with reasonable accuracy, and can be used as a point-of-care tool in the Emergency Department to facilitate early diagnosis of MLS and intervene accordingly in neuro-emergencies.
There are an estimated 15,600 nursing homes with a total of 1.4 million residents in the United States. The number of residents will continue to increase due to the aging population, and the associated morbidities will make it difficult to evacuate them safely.
Aim:
This study is the first of its kind to provide an analysis of the number of nursing home deaths caused by external and internal events following evacuations.
Methods:
Information from the databases Lexis Nexis and PubMed were compiled and limited to news articles from 1995-2017. The gathered information included the reason for evacuation, injuries, deaths, and locations within the United States.
Results:
From 1995 to 2017, there was a total of 51 evacuations and 141 deaths in nursing homes. 27 (53%) evacuations were due to external events which resulted in a combined 121 (86%) deaths, and 24 (47%) evacuations were due to internal events which resulted in a combined 20 (14%) deaths. Hurricanes were responsible for the majority of deaths during evacuations, followed by fires and floods. The number of evacuations and deaths increased the greatest between 2005 to 2008.
Discussion:
External events have the greatest impact on loss of life. Internal disasters are about equal in the number of incidents, however, external events have a much greater mortality rate. Exact numbers on injuries, morbidity, and mortality are difficult to ascertain, but it appears to be related to natural disasters. In view of the increasing likelihood of natural disasters related to global warming, a drastic improvement of standard evacuation procedures of long-term nursing homes is critical to decreasing mortality of nursing home residents. There also needs to be a nationally standardized method of reporting evacuations in order to better analyze data on nursing homes.
Nepal experienced a massive earthquake on 25th April, 2015 measuring 7.8 Richter scale followed by large aftershock on 12th May that further added to the destruction, especially in Sindhupalchowk and Dolakha. On request of Government of Nepal, international community extended financial and technical assistance to overcome the impact of the earthquake. Foreign Medical Teams (FMTs); now known as emergency medical team, from different countries and volunteers from within the country had helped in health service delivery.
Aim:
to get a clear picture of Strengths, Weaknesses/Gaps and Areas of Improvement that would be very important in making the response better in any future events of such scale when discussed and shared with all relevant stakeholders in Nepal.
Methods:
It was a multi-method study. Both quantitative and qualitative approaches were used to have an in-depth overview of the research question and the objectives set for the study. Records and reports relating Foreign Medical Team Coordination Committee (FMTCC) and meeting minutes of Health Emergency Operation Centre were reviewed.
Results:
Total of 8,962 deaths and 22,302 injuries occurred following earthquake of which 8,864 deaths and 21,156 injuries occurred in the most affected 14 districts of Nepal. In FGD and KIIs, most of the participants highlighted the earthquake had a huge impact on infrastructures. A large number of casualties were reported immediately after earthquake. Health facilities were overloaded with injured patients. One hundred and thirty-seven FMTs from 36 countries worked in Nepal to provide medical relief.
Discussion:
Timely preparation and readiness of the procedures to handle the FMTs including their registration process, medical licensing procedures, procedures of coordinating mechanisms with the district, case management and treatment guidelines to be followed by the FMTs are crucial to have a better health sector response including that of FMTs.
The basis of International Humanitarian Law (IHL) is the Theory of Natural Law, which states that the laws of morality and the ability to use reason in the determination of inalienable human rights, are innate to humans, and cannot be taken away by any states or laws. IHL is an agreement among nation-states that applies to situations of conflict to protect civilians and guides conduct in time of war. IHL extends protection to civilian medical personnel. The recent escalation in chemical weapons use by states has violated IHL and the 1997 Chemical Weapons Convention (CWC) treaty, with little repercussion from the international community.
Aim:
We review the increase in chemical weapons use, international chemical weapon treaty violations, and violations of IHL against medical personnel.
Methods:
A review was conducted of existing medical and grey literature for sources discussing chemical agents, their history, and violations of laws prohibiting their production, stockpiling, or use. The following publications were reviewed: PubMed, EBSCHost, and Google Scholar.
Results:
The use of sarin, chlorine, and mustard gas against civilians has been confirmed multiple times in Syria by the United Nations since 2011. Physicians for Human Rights mapped 537 attacks, both violent and chemical, against 348 different medical facilities in Syria from March 2011 to July 2018. Since March 2011, at least 847 civilian medical personnel have reportedly been killed. Many were killed by government forces as part of a war strategy creating further incapacitation. Most recently, Medecins Sans Frontiers concluded its Yemen mission due to repeated attacks, including two in one week in October 2018.
Discussion:
There must be recognition and emphasis on the health severity of such attacks and the violations of IHL and the CWC. Physicians must use their unique positions for advocacy and call for action in upholding international treaties.
On February 6, 2018, a magnitude 6.2 earthquake struck Hualien, Taiwan. Over 150 patients crammed into the emergency department of nearby hospitals within two hours. Mass casualty incident (MCI) management was activated. During the recovery phase, little attention was paid to the mental health of hospital staff.
Aim:
To analyze the prevalence of post-traumatic stress disorder (PTSD) among healthcare providers (HCPs) and explore the possible risk factors.
Methods:
63 HCPs in the emergency department of the single tertiary hospital near the epicenter were included. The Chinese version of the Davidson Trauma Scale (DTS-C) was used to evaluate the prevalence of PTSD. Questionnaires were sent to explore the possible contributing factors.
Results:
The average age of the HCPs was 32.7 years (30.3 years for nurses; 40.4 years for physicians). The prevalence of PTSD was 3.2% eight months after the incident. The mean DTS-C score was 8.9/136. Nurses had a higher score than physicians (10.8 and 4.7). HCPs with 6-10 years working experience had the highest score (14.2), while those with less than 3 years experience had the lowest (4.8).
Discussion:
We found HCPs had a lower prevalence of PTSD compared with earthquake survivors (Chou 2007), and physicians had longer working years and lower DTS-C scores. The professional training may help HCPs going through psychological impacts during the disaster. HCPs with 6-10 years of experience in the emergency department were found to have a higher risk of developing PTSD. Most of them were taking the responsibility of a team leader during the MCI, which may cause significant stress to these staff. Adequate training regarding MCI management could help to relieve tension and frustration, hoping to prevent the development of PTSD. Based on our study, PTSD among HCPs is an ignored issue, and we should follow-up HCPs’ psychological condition in the future.
Events such as the Sydney Quakers Hill Nursing Home fire highlighted the great need for robust evacuation plans for Residential Aged Care Facilities (RACFs). However, plans alone are not sufficient and routine exercises are necessary to test the capability of a facility’s emergency plan. Current methods of exercising facility evacuations, such as live drills, are limited and only test isolated elements of the evacuation process, which fall drastically short of being able to simulate the real-time resources and procedures required to perform a large scale evacuation of a RACF.
Aim:
To develop an exercise tool that assists Residential Aged Care Facilities (RACF) to evaluate their evacuation procedures using quantifiable data, based on real-time and providing minimal disruption to existing residents.
Methods:
Utilizing the existing ETS framework, an aged care resident patient bank was developed by NSW Health Emergency Management Unit, including:
A bank of 200 residents from data sourced from the Australian Institute of Health and Welfare.
Layout for the resident gubers and Summary Care Plans.
Resources and equipment routinely used in RACF’s.
Real-world testing of the prototype in exercises across NSW, Australia
Mortality and morbidity data to measure outcomes.
Validation of the exercise tool nationally and internationally.
Results:
A bank of residents was developed to test evacuation systems and processes, in a scalable, realistic simulation based on patient outcomes. This will result in improved planning and process, empowerment of RACFs, better patient outcomes, and increased resilience and preparedness.
Discussion:
A significant investment of data, time, and effort has gone into producing this resident bank for use in RACF evacuation exercises across NSW Australia. A presentation delivered at the ETS World Congress in the Netherlands (2018), by NSW Health Emergency Management Unit, showcased the relevance and suitability of this tool across the world.
Invasive mosquito species present significant organizational and health risks of covert disease outbreaks (dengue, Zika, or chikungunya) following an incursion into novel geographies. In Australia, detections at international First Points of Entry will trigger a multi-agency response to prevent escape into nearby urban environments that are largely unmonitored. Brisbane’s mosquito surveillance and response systems were challenged in 2017-2018 by the unprecedented frequency of detections in imported oversized tires that stretched the biosecurity response with escape opportunities.
Aim:
Describe the unique challenges to Metro South Public Health Unit within a complex stakeholder environment represented by federal, state, and municipal agencies.
Methods:
We present as a case study of an invasive mosquito detection that escalated to a public health incident of statewide significance through an incident management team structure. We focus on describing the significant governance and logistic challenges to the emergency mobilization of Metro South Health staff.
Results:
Since mid-December 2017 biosecurity have reported 12 detections of invasive mosquito species (Aedes aegypti, Ae. albopictus, Ae. japonicus) in infested tires arriving in Brisbane. Each emergency response was successful due to amendments to operational protocols and policy review. The legacy is a permanent enhancement of local mosquito monitoring, improved response systems, and greater operational preparedness.
Discussion:
The organizational impact of invasive mosquitoes is likely to be underestimated and under-resourced in jurisdictions beyond their expected distributions. Our experiences demonstrate the value of a clear and shared understanding of interagency emergency frameworks to effectively integrate each response. Resolution of uncertainties around organizational roles and responsibilities, and interpretations of guidelines, implementation strategies for mosquito surveillance, and control in novel contexts will require organizational agility and robust partnerships. Strategic re-focus is recommended to embed robust preventative measures and review of policy to mitigate the risk and impact of emergency responses to future invasive mosquito detections.
The effort of medical and health services distribution requires data. However, the data and information were ignored in an emergency situation. For improving the distribution of data and information, the Center of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada (UGM) developed forms based on Health Crisis Response Guideline by Ministry of Health 2016 and the World Health Organization (WHO).
Aim:
Describing the implementation and development of forms based on Lombok and Central Sulawesi earthquake in 2018 for health cluster.
Methods:
The form contains (1) a volunteer registration form; (2) a monitoring potential outbreak disease form; (3) health problem in health cluster daily report form; (4) a chronological situation form. This will be implemented in health policymaking by the Sulawesi district health office (DHO) and will be regularly analyzed in every week.
Results:
North Lombok DHO, Central Sulawesi health office, and volunteers accepted these forms well. Periodically volunteers had reported their activity to DHO. All these reports contain many health indicators including environmental health. Reproductive health and health promotion. Implementation of this form in the other type of disaster in Indonesia is suggested.
Discussion:
First, these forms are important to attach to the guideline of health crisis response in order to be accessed by all DHO. Second, all forms are printed documents. It needs to develop into data input and analysis applications.
To describe the types of surgical procedures performed by emergency medical teams (EMTs) with general surgical capability in the aftermath of sudden-onset disasters (SODs) in low- and middle-income countries (LMICs).
Methods:
A search of electronic databases (PubMed, MEDLINE, and EMBASE) was carried out to identify articles published between 1990 and 2018 that describe the type of surgical procedures performed by EMTs in the impact and post-impact phases a SOD. Further relevant articles were obtained by hand-searching reference lists.
Results:
16 articles met the inclusion criteria. Articles reporting on EMTs from a number of different countries and responding to a variety of disasters were included. There was a high prevalence of procedures for extremity soft tissue injuries (46.8%) and fractures (28.3%). However, a significant number of genitourinary/obstetric procedures were also reported.
Discussion:
Knowledge of the types of surgical procedures most frequently performed by EMTs may help further determine the necessary prerequisite surgical skills required for the recruitment of surgeons for EMTs. Experience in basic plastic, orthopedic, urological, and obstetric surgery would seem desirable for surgeons and surgical teams wishing to participate in an EMT.
To develop a simulation-based pediatric procedural sedation curriculum for acute care attending physicians to achieve and maintain privileges in this important skill.
Methods:
Neonatal and pediatric intensive care physicians participated in simulation-based sedation training to achieve and maintain sedation privileges. Participants were required to review pediatric sedation materials prior to participation. Demographic data were collected prior to the simulations, and all participants completed a pre-test to assess their baseline knowledge. Sessions were held in the simulation center or neonatal intensive care unit (depending on group), and the attending physicians, in pairs, participated in two high-fidelity mannequin scenarios (sedation for a painful procedure; hypoxia during sedation). Simulations were followed by a facilitated debriefing session while utilizing a standard performance checklist. All participants completed a program evaluation at the conclusion of their training.
Results:
Neonatal (n=11) and pediatric (n=9) intensive care attending physicians participated in the sedation simulation training. The program was well received and 100% rated it as “excellent” or “very good”. All participants strongly agreed the instructors allotted time for questions/answers, 100% strongly agreed the debriefing/feedback was effective, 95% strongly agreed instructors had a thorough knowledge and understanding of the program, were supportive, and facilitated learning, and 95% strongly agreed the equipment and physical environment were conducive to learning. Participants reported that simulation-based training and the use of a standardized checklist during facilitated debriefing were very helpful and effective for sedation training. Additionally, many participants indicated the desire for more simulation-based training.
Discussion:
Simulation-based sedation training is a feasible, easy to implement, and viable learning technique for acute care physicians.
In 2017 the New Zealand Medical Assistance Team (NZMAT) were verified by the World Health Organization (WHO) as an Emergency Medical Team Type 1. During the verification process, the WHO highlighted the need for further NZMAT capability in the specialty areas of reproductive, sexual, and maternal health. The NZMAT consists of doctors and nurses from many different clinical subspecialties but with a predominance of emergency and rural medicine or general practice. Due to the subspecialist nature of hospital medicine in the New Zealand environment most GPs, emergency physicians, and nurses have very little exposure to normal labor and birth in their day-to-day work and limited exposure to obstetric complications.
Methods:
To increase the knowledge and skill level of the NZMAT, a two day Basic Emergency Obstetric Care (BEOC) course was designed by Kass Jane, a midwifery educator, researcher, and member of NZMAT, in consultation with the NZMAT Clinical Director Emma Lawrey.
Results:
This presentation will outline the curriculum design, the course delivery, and the feedback from participants on this inaugural BEOC for the NZMAT, as well as the findings of a post-course review and plans for further BEOC courses for NZMAT members.
Discussion:
This presentation will address why courses of this type have value, especially where the delivery of basic obstetric care in a low technology or austere environment may translate into skills for other Australian clinicians wishing to work either in a humanitarian or developing world context.
Unpredictable events, such as disasters, can change the organizational configuration of health facilities. In a situation of multiple victims, this scenario modifies the flow of care to adapt to the reality that is there. In addition, emergency and emergency units provide immediate care to maintain and preserve the lives of these victims, making it a challenge for all health professionals.
Aim:
To construct an Operational Protocol for nursing care with multiple victims and disasters in a Hospital Emergency and Emergency Service.
Methods:
We used a descriptive study with a qualitative approach using the Focal Group technique (GF). The participants included nursing staff and residents who work in the emergency and emergency unit in a hospital in the south of Brazil. The topics from the GF discussion were analyzed by the scientific content of Minayo (2013).
Results:
The operational assistance protocol for multiple victims and disasters was planned with a redistribution of materials, equipment, human resources of the service, and physical restructuring of the service and other units with the construction of a flow chart to meet the proposed demand.
Discussion:
In the study, we observed the importance of discussing and planning proposals for care with multiple victims. In addition, the interest of the participants was fundamental to the success of this protocol. This protocol serves as an incentive for nursing professionals and academics for future research that evaluates the effectiveness of using nursing competencies to assist multiple victims in emergency and disaster situations.
As of May 2018, a new European privacy law called the General Data Protection Regulation (GDPR) is in order. With this law, every organization operating in the European Union (EU), needs to adhere to a strict set of rules concerning collection and processing of personal data.
Aim:
To explore the consequences of the GDPR for data collection at mass gatherings in the European Union.
Methods:
Since the law was published on April 27, 2016, a thorough reading of the law was conducted by 4 persons with a background in mass gathering health. The GDPR consists of 99 articles organized into 11 chapters. There are also 173 recitals to further explain certain ambiguities. Key articles and recitals relating to healthcare and scientific research were identified. Possible pitfalls and opportunities for data collection and processing at mass gatherings were noted.
Discussion:
Under article 4, key definitions are noted. There is a clear definition of “data concerning health”. According to the GDPR, health data is a special category of personal data which should not be processed according to article 9(1). However, there is an exception for scientific research (article 9(2)(j)). There are a few safeguards in place, as laid out in article 89. One interesting point is that according to article 89(2), certain derogations can take place if the law interferes with scientific research. The GDPR has major consequences for data collection and processing in the EU. However, with the use of certain safeguards (e.g., pseudonymization) there are still ample opportunities for scientific research. It is important to review one’s method of data collection to make sure it complies with the GDPR.
Floods are common worldwide and are the leading cause of fatalities. They are destructive to property, crops, and livestock, and leave survivors homeless or displaced to evacuation camps.
Aim:
To explore the needs of family survivors of floods in Molepolole, determine assistance received and needed, and identify coping strategies used to deal with the impact and effects of floods.
Methods:
Jordan (2015) model of disaster survivors’ hierarchy of needs guided the study. Purposive sampling selected six families, and seven participants from these families enrolled in the study. A pilot-tested semi-structured interview guide collected data. Data were analyzed using the content style.
Results:
The study findings confirmed that survivors of floods had immediate and long-term needs, and these were classified into basic, safety, recovery, stress reaction, grief and loss, and growth. Not all survivors were grateful for the assistance they received following floods. Survivors used varied coping strategies to deal with their stressors. The study was conducted in Molepolole, hence, the findings may not be applicable in other settings. Individuals were interviewed on behalf of the entire family.
Discussion:
There is a need for a multidisciplinary team which will keep the community at the forefront in tackling flood mitigation and developing policies specific to floods. Policies will include indigenous flood mitigation practices and will strengthen awareness of communities to improve knowledge, skills, and attitude. More research is needed on the needs of each survivor.
Following a mass casualty incident (MCI), it can take several minutes for emergency medical services (EMS) to arrive. The course was developed by Magen David Adom (MDA) based on unique experience in dealing with MCIs, and the time between alerting emergency services to such an incident until they arrive. The course is focused on teaching the general public to channel their desire to help in such a situation into useful skills which can potentially improve patient outcomes. The seminar focuses on key principles such as safety, calling for help, providing an accurate picture of the scene, and initiating basic treatment with an emphasis on hemorrhage control.
Aim:
MDA examined the ability of the general public with no previous medical training to perform a basic triage and treatment in an MCI situation. Additionally, the study examined the abilities of the study groups to manage a scene until the arrival of EMS based on the principles taught in the course.
Methods:
MDA has sent teams of instructors around the world to teach over 1,000 participants. Upon completing the course, the participants partake in a drill that assesses their ability to manage a scene of 20 patients. Their ability to initiate the call for help, provide an accurate picture, initiate treatment, and give an accurate report to arriving emergency responders are examined.
Results:
The average times were recorded. Within 38 seconds, dispatch was alerted to the situation. Within 2:30 minutes, treatment was initiated for all patients. Within 4:37 minutes, the scene was fully under control, and within 6:37 minutes, an accurate report was transferred to EMS on the scene.
Discussion:
The participants demonstrated an unexpected willingness to learn, practice, and partake in the drills, and the results were unexpected.