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Following the New Zealand November 2016 earthquake, mental health staff were deployed to assist with the immediate levels of distress in the community. The work included working with individuals, couples and families, staff wellbeing sessions, psychosocial education, and participating in outreach clinics to isolated communities.
Aim:
Aware of international evidence and the experience following the 2010/11 earthquakes, the aim was to provide mental health assistance to address issues as early as possible with the intent that this would reduce the future demands on specialist services.
Methods:
Following the response phase, a small team of mental health specialists formed the Recovery and Wellbeing Team working in the affected communities undertaking clinical, consult, advisory, and educational work as needed. The team flexed and evolved to meet the changing needs. A range of data was collected and analyzed to monitor the work and the outcomes of this team.
Findings:
With additional support provided following the earthquake, there has been a significant positive change in the numbers of referrals to secondary mental health services in Christchurch. A new model of care has now been collaboratively developed, as the mental health system positively adapted to a changed reality. This model is essentially an easily accessed, early intervention, comprehensive model of mental health service to maintain the positive gains.
Discussion:
Following a significant disaster, all involved will benefit from some form of psychosocial support. For most, this will be achieved through the person’s own networks. For some, the event will trigger responses from previous traumatic experiences and a few mental health supports will be required. Having skilled professionals with the ability to cope with the constantly changing needs, and who are available to meet people at the earliest opportunity, has enabled issues to be resolved rather than leaving these issues to escalate over time.
Civil emergencies occurring with little warning can quickly produce mass casualties. To develop an Emergency Department’s surge capacity, medical student involvement in the disaster response has been advocated. Duke-NUS Medical School in Singapore is located in proximity to Singapore General Hospital (SGH) and represents an untapped manpower resource. With appropriate training, medical students can be leveraged upon as ready and reasonably qualified manpower.
Aim:
This review provides a snapshot of the conceptualization and setting up of the Disaster Volunteer Corps (DVC) program. We discuss the overall strategy and benefits to stakeholders, emphasizing the close symbiotic relationship between academia and healthcare services.
Methods:
Duke-NUS medical students will be recruited to receive training from SGH emergency physicians. The frequency of training will be four times yearly, with ad hoc participation in disaster simulation exercises. A call-tree will be employed for DVC activation. The DVC curriculum includes disaster response principles, HAZMAT, crowd control, marshaling, logistics, psychological support, and basic first aid. Teaching methods include didactic lectures, case discussions, involvement in event medical cover, and participation in disaster simulation exercises and response planning.
Results:
To date, there are 10 medical students and four emergency physician faculty volunteers involved in the program. Support is provided by adjunct instructors from nursing, nuclear medicine, social work, and security, for training in decontamination, radiological disasters, psychological first aid, and crowd control measures respectively. Assessment by faculty will be conducted to ensure the quality of training and competency of skills.
Discussion:
The DVC provides a unique way of teaching medical students disaster medicine principles in a hands-on experiential format, while simultaneously enhancing the operational readiness of the hospital in times of disaster. This model of close collaboration between university educational and healthcare services provides a feasible model of structured volunteerism that could be replicated in other similar settings.
Over the last two decades, Frequency Modulation (FM) radio has been established as the only form of sound broadcasting in Ghana. Radio is the most accessible of mass media. There are more than 40 operational radio stations in the Ashanti region of Ghana. Most stations are commercial, broadcasting in the local language (Asante-Twi). Many urban radio health slots discuss various diseases and their treatments mainly for the benefit of patients. Complementary and Alternative Medicine (CAM) practitioners who are able to pay for airtime dominate as ‘experts’ in most of these shows.
Methods:
We identified an IEC gap regarding policies governing healthcare delivery, healthcare financing, training, ethics and research, and environmental issues. In June 2015, orthodox medical practitioners collaborated with a private, local, English-speaking radio station to produce and host a weekly health show whose content was aimed at holistically discussing health from the viewpoint of practitioners, clients, policy makers, administrators, and financiers in a simplified language for the general public, including healthcare trainees.
Discussion:
The show dubbed “Staying Alive” first aired on Tuesday, July 7, 2015, at 20:00 GMT and continues to air to date, appealing to a wide range of active listeners. “Staying Alive” to the best of our knowledge remains the only show with a holistic approach to health. Over the last 23 months, we have experienced challenges in sustaining sponsorship to fund the cost of production and airtime for the show, and the cost of effectively assessing the public health impact of the show. Orthodox medical practitioners can employ mass radio as an effective tool for advocacy, information dissemination, and education of clients or health trainees in low or middle-income urban settings through effective collaboration with media stations.
Understanding the difficulties of sharing knowledge generated from disaster situations is essential to allow for a better process of disseminating the “lessons learned” from the ongoing natural and man-made situations which result in healthcare crises.
Aim:
To explore nurses ways of gaining knowledge from previous experiences, with a particular focus on earthquakes and natural disasters in the New Zealand (NZ) setting.
Methods:
Initial analysis of a series of individual, semi-structured interviews with a small group (n=10) of emergency department registered nurses from a range of geographical areas in NZ.
Results:
While familiar with the major earthquake events that have recently affected different areas of NZ (most notably Canterbury, Kaikoura, and Wellington), few could recall detailed information or lessons generated from these events. When asked about the most effective means of learning about and from disasters, the direct experience was identified as the most effective, followed by narrative retelling and vicarious experience.
Discussion:
Recognition of the value of “story-telling” in sharing information, and of the importance of offering experiences in a way that allows colleagues to experience or place themselves in the situation in a “virtual” sense is necessary for learning to occur. This involves an emotional as well as an intellectual connection to occur. There is a risk for knowledge to be lost, and lessons to be constantly “re-learned,” as each succeeding generation needs direct involvement to retain the information and insight generated. We need to tailor the medium by which this information is shared, for maximum effect.
Moulage is the art of creating faked injuries on actors for training purposes. Moulage is commonly used in disaster and emergency medicine training, as it is believed to improve learning through enhanced realism.
Aim:
The aim of the current study was to test the effect of moulage on perceived realism and learning during a joint exercise featuring students from the police, rescue service, and ambulance service.
Methods:
The scenario was a car accident with two victims. Students (n = 135) were divided into 12 groups. Moulage was applied to the victim actors for half the groups (n = 67), whereas the other half (n = 68) experienced the scenario without moulage. Victim cards were used in both scenarios. Immersion, realism, and learning was measured on a 100-point scale immediately post-scenario using a questionnaire.
Results:
Two (moulage group) by three (student population and police, rescue service, or ambulance) ANOVAS on realism, immersion, and learning found no effects on realism or immersion (all p>0.10). There was an effect of student group on learning, F(2, 92) = 3.518, p = 0.034, partial eta square = 0.071, such that the rescue service students had overall lower scores on learning (M = 53.87, SD = 28.29) compared to the police (M = 66.07, SD = 27.55) and ambulance students (M = 74.99, SD = 24.51). Cohen’s ds for moulage effect was calculated to 0.144 for immersion, 0.112 for realism, and 0.003 for learning.
Discussion:
The current study did not find any effects of moulage on immersion, realism, or learning. The effect sizes indicate that any effect of moulage on realism and immersion, should it exist, is in the approximate size of 2-3 points on a 100-point scale. The lack of effect may be due to limitations in the study design, but may also indicate that the use of moulage in addition to victim cards is not necessarily beneficial for novice students’ learning.
Triaging plays an important role in providing suitable care to the largest number of casualties in a disaster setting. We developed the Pediatric Physiological and Anatomical Triage score (PPATS) as a new secondary triage method.
Aim:
This study was performed to validate the accuracy of the PPATS in pediatric patients with burn injuries.
Methods:
A retrospective review of pediatric patients with burn injuries younger than 15 years old registered in the Japan Trauma Databank from 2004 to 2016 was conducted. The PPATS, which was assigned scores from 0 to 22, was calculated based on vital signs, anatomical abnormalities, and need for life-saving intervention. The PPATS categorized the patients by their priority and defined the intensive care unit (ICU)-indicated patients as those with PPARSs more than 6. This study compared the accuracy of prediction of ICU-indicated patients between the PPATS and Triage Revised Trauma Score (TRTS).
Results:
Among 87 pediatric patients, 62 (71%) were admitted to the ICU. The median age was 3 years (interquartile range: 1 to 9 years old). The sensitivity and specificity of the PPATS were 74% and 36%, respectively. The area under the receiver-operating characteristic curve was not different between the PPTAS [0.51 (95% confidence interval: -0.51–1.48) and the TRTS [0.51 (-1.17–1.62), p=0.57]. Regression analysis showed a significant association between the PPATS and the Injury Severity Score (ISS) (r2=0.39, p<0.01). On the other hand, there is no association between the TRTS and the ISS (r2=0.00, p=0.79).
Discussion:
The accuracy of the PPATS was not superior to that of current secondary-triage methods. However, the PPATS had the advantage of objectively determining the triage priority ranking based on the severity of the pediatric patients with burn injuries.
The Electronic Health Record (EHR) is now the standard means for recording and maintaining medical notes in most emergency departments. The EHR is an independent cause of physician burnout, and maintenance of the EHR may occupy 30 to 50% of clinical time. There are software solutions available, but they are connected to fixed, expensive, distracting, and bright electronically powered computers. Scribes have been successfully trialed, but are also expensive and attached to computers on wheels. Portable digital word processors in the form of the AlphaSmart Neo is a redundant technology designed primarily for children with typing difficulties. It has recently enjoyed a resurgence in popularity among professional writers, journalists, and field researchers for the ultimate distraction-free writing experience. The Alphasmart Neo is cheap, nearly indestructible, intuitive, and requires almost no recharging. It is compatible with all software across Mac OS, Windows, and Linux. Notes are entered by the clinician or scribe, independently of computers, at the bedside, and uploaded to any software via USB cable.
Aim:
To describe the introduction and impact of the AlphaSmart Neo on the EHR in emergency departments across Australia.
Methods:
We will examine the role of the Alphasmart Neo in austere, low power, extreme environments with a demonstration on how to enter, maintain, and transfer an electronic health record independent of any computer or power source.
Discussion:
We believe the AlphaSmart Neo is an ideal, personalized, cheap, effective, and efficient hardware solution to entering notes independent of other software and hardware. It is distraction free at the patient’s bedside, resulting in better notes that the clinician enjoys writing.
Tourniquets (TQ) save lives. Although military-approved TQ are more effective than improvised TQ in controlling exsanguinating extremity hemorrhage, their bulk may preclude every day carry (EDC) by civilian lay-providers.
Aim:
The purpose of the current study was to compare the efficacy of 3 novel commercial TQ to a military-approved TQ.
Methods:
A convenience sample of EM residents was utilized. Four different TQ were evaluated: Gen 7 Combat Application Tourniquet (CAT; control), Stretch Wrap and Tuck Tourniquet (SWAT-T), Gen 2 Rapid Application Tourniquet System (RATS), and Tourni-Key (TK). Popliteal artery occlusion was determined using a ZONARE ZS3 ultrasound. Steady-state maximal generated force was measured for 30 seconds with a thin-film force sensor (Singletract). Opinions were solicited at the conclusion of the study.
Results:
Nine residents participated in the study (7 male, 2 female). Success rates for complete arterial occlusion were 89% CAT, 67% SWAT-T, 89% RATS, and 78% TK (H 0.89, p = 0.83). Mean (± SD) times to achieve occlusion were 10.4 ± 1.7 sec CAT, 23.1 ± 9.0 sec SWAT-T, 11.1 ± 3.8 sec RATS, and 20.0 ± 7.1 sec TK (F 9.71, p < 0.001). Steady-state maximal forces were 29.9 ± 1.2 N CAT, 23.4 ± 0.8 N SWAT-T, 33.0 ± 1.3 N RATS, and 41.9 ± 1.3 N TK. Participants felt that the CAT was easiest to apply (61%), followed by the RATS (33%). Participants were most likely to select the TK (44%) for EDC, followed by the RATS (33%).
Discussion:
In this small convenience sampling, all novel TQ systems were non-inferior to the military-approved CAT TQ. Mean application times were less than 30 seconds. The size and unique nature of these novel TQs may make them more conducive to lay-provider EDC, thereby improving the response to high threat events.
The swiftwater rescue (SWR) concept of operations (CONOPS) is to access as many victims as quickly as possible using strategies and tactics that maximize safety and minimize risk to all involved. “Reach, throw, row, go” has defined the primary water rescue strategy for 50+ years. However, this paradigm, originally designed for rescue from swimming pools, ponds and lakes, slow-moving rivers, and the ocean, is not conducive to SWR incidents involving submerged vehicles, which is the most common scenario during urban and small stream flash flooding.
Aim:
To present a new SWR strategy for urban and small stream flood response.
Methods:
Water rescue strategies and tactics were mapped against the SWR CONOPS to determine which ones are most likely to be successful in the rescue of victims trapped in submerged vehicles.
Results:
Rescue should be attempted via high water vehicles (HWVs) whenever possible, followed by watercraft and “go rescues” using advanced line systems techniques and/or tethered rescuers, dependent on incident characteristics. Positioning HWVs at the incident site permits rescuers to access victims quickly from the rear or sides of the vehicle, thereby reducing rescuer time in floodwaters. Multiple sequential rescues can be made since victims are held and medically monitored in the cargo area rather than transporting them to shore individually.
Discussion:
SWR from submerged vehicles is unique among emergency incidents because neither shelter-in-place nor self-evacuation are tenable options until the water recedes. "Reach" and "throw" rescue attempts are only possible if the victim is close to shore. Watercraft operations, whether motorized or manually pulled, can be technically complex, require numerous rescuers, and typically take 30-60 minutes per vehicle. Use of HWVs meets the CONOPS for SWR on flooded roadways since this strategy facilitates the rescue of multiple victims quickly while reducing the time rescuers spend in the water.
Current literature suggests that a large percentage of the health workforce may be unwilling to work during a disaster. The willingness of pharmacists to work during a disaster is under-researched internationally and non-existent in Australia.
Aim:
To determine if Australian pharmacists are willing to work in a disaster and the factors that affect the willingness to work.
Methods:
A 13-question survey was developed from the current literature and released nationally through professional organizations and social media.
Results:
Sixty Australian pharmacists completed the survey. Most participants believed their pharmacy was an essential service for their community. Pharmacists reported they would be likely to report to work during a pandemic or biological disaster (73%) or natural disaster (78%). The two major factors likely to prevent pharmacists from working in a disaster are family and safety concerns. Pharmacists perceived that their duty of care to their patients would make them likely to work during a disaster. Most pharmacists noted they would work even if they were expected to work outside their scope of practice, or if their place of work lacked electricity or was damaged.
Discussion:
Depending on the disaster, up to 27% of the pharmacy workforce may be unwilling to work in a disaster. Family and safety concerns were the primary barriers to pharmacists reporting to work in the aftermath of a disaster. Providing guidelines on how pharmacists can prepare their family for a disaster may assist in ensuring pharmacists are willing to work. The pharmacists surveyed demonstrated a strong commitment to their duty of care with the majority stating they would be likely to work in austere work environments. This research raises questions of the safety of pharmacists working outside their scope and in austere environments and whether it is safe for them, their patients, and the broader community.
If there is consensus about how to handle a patient with a specific condition, from the ambulance service point of view, it matters less for the patient which ambulance arrives to take care of the patient. Guidelines are a way of standardizing treatment or management of the patient for a given patient condition. Clear and implemented guidelines that promote the handling of the patients is done from best practice and are evidence-based according to the best ability of the organization.
Aim:
The aim of the current study was to implement guidelines into an organization that was not currently using guidelines. The study was conducted as a collaborative effort between a Swedish pre-hospital training organization and the local ambulance service organization in Kosovo.
Methods:
An iterative process of implementing the guidelines was applied:
1. Identify guidelines appropriate for the local organization. For each iteration, five guidelines are chosen.
2. Have the five guidelines translated into Albanian.
3. The guidelines are adapted to local conditions and context.
4. The five guidelines are approved by an expert group.
5. The five guidelines are implemented in the organization.
Results:
The initial iteration included was carried out in the form of a workshop where 22 persons (doctors and nurses) from the local ambulance service in Kosovo participated. During the workshop, the first three implementation steps were taken, while remaining steps were carried out by the local organization.
Discussion:
With the local management and ambulance personnel involved throughout the process, the implementation of guidelines were delivered in a more feasible way as well as more easily accepted and adhered to. Supporting a standardized treatment or management of the patient will benefit future patients. These standards should be based in evidence-based practice adopted to local conditions.
There are many health challenges faced by those returning from military service. Posttraumatic stress disorder (PTSD) is a serious problem in veterans. PTSD is a risk factor for suicide in veterans. Standard treatments include medication and talk therapy. Non-traditional treatments include civil service and leadership training.
Aim:
Assess the effectiveness of Veteran Focused Train-the-Trainer (TTT) Community Disaster Response and First Aid (DRAFA) Programs in promoting health, wellness, reintegration, and decreasing PTSD symptoms of veterans.
Methods:
A longitudinal cohort study was conducted using a convenience sample of veterans living in Denver, Colorado or Reno, Nevada. The sample size was over 50 (N=50+), with 25+ case-matched veterans at each location. This is an ongoing project lasting through the end of 2020. Inclusion criteria selected veterans interested in DRAFA training and education. Exclusion criteria disqualified those who are not a veteran or those unable to perform physical tasks required by curriculum. The null hypothesis was that there is no relationship between the DRAFA TTT program and the health, well-being, and reintegration of veterans back into their communities. Statistical tools used were SPSS Statistics (Version 25) and NVivo 12-12.2.0.3262. Research activities were conducted under the auspices of the University of Colorado and guided by the principles of the Institutional Review Board (IRB).
Results:
Results are being evaluated using a mixed methods impact model. The main outcomes measured health, wellness, and reintegration using Veterans RAND-12 Health Quality of Life Survey, the Military to Civilian Reintegration Survey, and a satisfaction survey. Preliminary analysis may indicate a correlation between participation in the DRAFA TTT program and improved health/wellness outcomes, better reintegration into society, and decreased PTSD.
Discussion:
There is growing evidence that expedited structured reintegration programs in community preparedness and disaster leadership roles for veterans alleviate PTSD symptoms and improves quality of life.
On June 23 and 24, 2016, a heavy hailstorm in the south of the Netherlands destroyed farms, greenhouses, and crops, and caused severe damage to many residences and cars in multiple communities. The size of the massive hailstones ranged from 3 to 5 centimeters in diameter. The farm damages alone were estimated to be 100 million euros, while total insurance industry losses were expected to exceed half a billion euros. In addition to the storm, the affected region also had its first tropical day of the year, with temperatures reaching 32 degrees Celsius. To date, the psychosocial impact and possible adverse health effects caused by the storm have not been thoroughly investigated.
Aim:
To explore whether the occurrence of chronic and acute health problems in the affected region increased after the hailstorm compared to “control” areas.
Methods:
Health data for the time period before (2013-2015) and immediately after the hailstorm (2016-2018) will be collected based on electronic health records (morbidity, psychosocial problems, and prescribed medication) from general practices (GP) located in the affected municipalities. For the same period, health problems in the affected region will also be compared with GP-registered data from different Dutch municipalities with similar urbanization levels, which will be used as a control group. The combination with external datasets (e.g. socioeconomic status, environmental exposures) will also be considered.
Results:
Multilevel regression analyses will be carried out to test the health impact of this sudden, onset event. The current study is a work in progress. Final results are expected in February 2019 and are presented during the conference.
Discussion:
The present study illustrates how routinely collected patient health records, recorded by GPs, can be used for epidemiological research in the aftermath of a disaster within the context of climate and weather extremes in Europe.
Modern hospital systems are highly dependent on computerized information technology (IT) systems. The integration of laboratory and radiology ordering and resulting cannot be easily replicated with a “paper” processes. This poses challenges for no-notice events, where the rapid registration of patients is a must for effective clinical care. This weakness in hospital response has been demonstrated in events such as the Boston Marathon bombing, the Aurora Theater (to be discussed), and Las Vegas shootings.
Aim:
To discuss lessons learned in configuring IT systems for disasters.
Results:
A integrated system of IT system preparation was implemented at the University of Colorado Hospital. This system has been demonstrated to be effective in multiple real-world events.
Discussion:
Four areas of IT preparedness are needed for hospital IT response to disasters. First is rapid disaster registration with prepared disaster medical record numbers and packets. The medical records must be active in the hospital IT environment, and a visit or case number must be preassigned or rapidly generated. The medical record number alone in the IT environment will allow the initiation of test ordering. The packet should include preprinted labels, a demographic data sheet, and downtime charting and ordering forms. The second item for response is templated order sets to allow rapid ordering of multiple studies such as laboratory, and especially radiology, without having to reenter clinical information. The third is a method of patient care charting scalable, from paper to electronic, depending on the patient volume, acuity, and workstation access. The fourth is a method for patient care in the IT downtime in a disaster setting. Simple inexpensive measures will allow rapid placement of patients in the IT environment and therefore allow rapid and accurate test ordering and resulting.
Indian railway systems are fourth largest in the world, and cause on average 15 deaths daily due to various intentional and unintentional reasons. This study presents a 5-year retrospective data analysis of polytrauma patients with train-related injuries.
Aim:
To highlight key lessons learned from data analysis to inform better safety measures and laws.
Methods:
Trauma registry data between 2012 and 2016 were analyzed for patients with train-related injuries. Data from 726 patients were analyzed for demographics, event, injuries, management, and final outcome. ISS was used to quantify the extent of injury.
Results:
Mean patient age was 33 years with an 86% to 14% male to female ratio. 62% of patients were in the 20- to 40-year age group. Average time of arrival at health facility post-injury was 3.3 hours. Half of the patients were trespassers. Mean ISS was 11.65. Chest injuries were present in 24.6% of patients, with half requiring interventions like ICD insertion or surgery. 20% of patients underwent amputations of extremities. 40% of patients needed admission to the ICU. 3.5% died in the Emergency Department (ED). Mean hospital stay was 17 days with an in-hospital mortality of 17.4%.
Discussion:
This analysis is the largest to date showing comprehensive injury patterns and outcomes of train-related injuries from a developing country. Patients injured on the platform and off the platform had the same severity of injuries. This analysis shows the need for safety measures and strict law enforcement both at the station and at the track.
Emergency physicians play a frontline role in hospital disaster responses and require appropriate training.
Aim:
The aim of the current study was to pilot and compare the effectiveness of two emergency preparedness teaching interventions: the first employing traditional lecture-based instruction (LEC) and the second utilizing interactive simulation/game-based teaching (SIM).
Methods:
A two-group randomized pre- and post-test design was implemented into the didactic curriculum of the Emergency Medicine (EM) Residency Training Program at the San Lucas Episcopal Hospital in Ponce, Puerto Rico. Residents (n=23) completed either a LEC (control) or SIM teaching module (single day, one to two hours) focusing on emergency preparedness concepts, disaster-related clinical decision-making, and physician responsibilities during hospital disaster protocols. Knowledge-based multiple-choice exams and scenario-based competency exams were administered at three different time points: one-week pre-intervention, immediately post-training, and two-weeks post-training. Test scores were compared between groups at each time point using the Mann-Whitney U test.
Results:
Following the teaching interventions, no significant differences were found between the LEC group versus the SIM group in knowledge-based exam performance (LEC 81.1%[9.4] vs. SIM 74.9%[12.1]; U=42.50, p=0.15) and scenario-based exam performance (LEC 80.0%[9.7] vs. SIM 80.2%[9.2]; U=62.00, p=0.83), suggesting both teaching methods were similarly effective. Indeed, knowledge-based exam scores improved two-fold and scenario-based exam scores improved by over 50% immediately following training relative to baseline exam scores. Two-weeks post-training, a significant decrease in scenario-based exam performance was found in the LEC group relative to the SIM group (LEC 63.1%[11.6] vs. SIM 75.4%[11.5]; U=91.50, p=0.036), suggesting residents who train with simulations show greater retention of scenario-based concepts compared to those who train with lecture-based training alone.
Discussion:
The current study highlights the potential dual value of incorporating simulation training in EM emergency preparedness curriculums in improving both knowledge and concept retention of physician disaster responsibilities.
All Fire and Emergency Services (FES) personnel must balance FES work with their other responsibilities. Given that women tend to take on a greater responsibility for management of household/domestic activities than men, the on-call component of their FES work may be associated with very different challenges. Despite this, women have rarely been the focus of on-call research.
Aim:
To explore women’s on-call experiences in the FES by examining coping styles and strategies, with the goal of helping to innovate the way women are supported in FES roles.
Methods:
Relevant findings from two studies are included. The first study involved FES personnel from two agencies in Australia (n=24) who participated in a semi-structured interview. The second study was an anonymous online survey to determine work characteristics, sleep, stress, and coping in on-call workers more broadly, with workers from all industries across Australia (n=228) invited to participate.
Results:
Interview data identified two major themes in terms of coping with on-call work. Support (from family, social, and work), planning, and preparation were identified as important in helping women cope in the context of on-call unpredictability. Results from the survey (43% women) showed that on-call workers were an engaged group in terms of their coping, with 67% classified as having a positive coping style and 58% of women indicating that they agreed/strongly agreed with the statement, “I cope well with on-call work.”
Discussion:
Taken together, these data highlight engagement with positive coping by women who do on-call work, including in the FES. Importantly, positive coping strategies, such as talking about emotions, problem-solving, and seeking support have been linked to increased shift work tolerance in other populations. Coping style and strategies represent modifiable variables which could be specifically applied to assist women to manage the unique challenges associated with on-call work in the FES.
In July 2013, a train transporting oil derailed and exploded in Lac-Mégantic, causing major human, environmental, and economic impacts. A community-based survey of people aged 10-25, conducted in 2017, revealed that many young people suffer in silence and report feeling isolated. These observations led to the conclusion that we must make room for young people, and that opportunities for engagement and participation must be provided within the community.
Aim:
The Public Health Direction of Estrie aimed to identify strategies to promote health and wellbeing for young people living in and around Lac-Mégantic.
Methods:
A collective reflection half-day was hosted with sixty key stakeholders (school board, other education institutions, health and social services, community sector, municipal/political sector, parents, youth). Throughout the event, participants were invited to build on and learn from accomplishments and experiential knowledge, and develop a common vision of the solutions to be pursued or implemented. All qualitative data sources (verbal and written data from large- and sub-group activities) were analyzed through a content analysis.
Results:
Several themes (i.e. potential solutions) emerged from the analysis: common venue, diversified activities, communication, collaboration, involvement, support for at-risk youth, intergenerational component, etc. Participants agreed on four priorities for action: 1) creating a gathering place, 2) establishing a Youth Committee, 3) supporting adults working with youth, and 4) fostering a better flow of information.
Discussion:
Several positive outcomes of the collective reflection half-day were observed, including the mobilization of the participants who greatly appreciated the event, and many promising ideas launched by stakeholders. A social worker is now fully dedicated to supporting youth wellbeing and engagement in Lac-Mégantic. A Youth Committee has been established and projects by and for youth are being implemented. Bottom-up approaches to identify solutions to complex situations are not only effective but also respectful of the local culture.
Main functions of the Russian Federation in disasters and emergencies are loaded on All-Russian Center for Disaster Medicine of Ministry Health (ARCDM). The principal strategies of the staff are to play leading roles in preparedness, emergency response, evacuation, recovery of health systems, and education.
Methods:
Our presentation includes selection, classification, analysis, and statistics. There about 80 territorial Disaster Medicine Centers working under the leadership of ARCDM. One experience from the Moscow Territory Disaster Medicine Center will be presented.
Results:
At the operational and informational department, there are nine special medical emergency teams (three with helicopters). Time of arrival takes between seven and ten minutes, and transport to the hospital takes about five to seven minutes with 33 landing places for helicopters. The operational and control department uses an early warning system. About 1,300 exercises were organized in these centers and hospitals. We will discuss the examples of medical care delivery to the injured in metro Slaviynskie, Basar park Pobedi, Narofominskay, two major fires, and hurricanes. The mobile field hospital worked in more than 12 countries and in many territories in the Russian Federation over 25 years.
Discussion:
The last year was very difficult due to the Football World Cup, working hard as a collaborating center in emergencies, and working in the framework of a memorandum with China. Preparedness for an international event next May, which includes a field drill with participants from emergency medical teams of Health Ministries of CIS Countries and from State Health of China. We invite others to observe or join this event. Thus, we have some difficulties and problems, but we must increase solidarity and collaboration due to the scale, frequency, and number of losses in emergencies and disasters. Humanity could be able to cope with emergencies if we take into account these issues.
Effects of a disaster on a community’s mental health can persist after the physical effects of the event have passed. The pediatric population is often overrepresented in disasters and prone to serious mental health disorders based on their age and parental/community response. Pediatric primary healthcare providers require the psychosocial skills necessary to work in disaster zones and to care for children in disasters.
Aim:
Pediatric Disaster Mental Health Intervention (PDMHI) was initially developed in response to Superstorm Sandy’s impact on children and their families in New York City. The objective was to develop training for primary care providers in pediatric disaster mental healthcare and to study its impact on the trainees.
Methods:
A faculty of experts in pediatric mental health, psychiatry, psychology, and disaster preparedness was convened to develop curriculum. The faculty developed a four-hour intervention to equip healthcare providers with the skills and knowledge necessary to care for pediatric patients with mental health problems stemming from a disaster via evaluation, triage, intervention, and referral.
Results:
Three PDMHI training sessions were held. A total of 67 providers were trained. Of these, there were 31 pediatricians, 18 nurses, 8 social workers, 4 psychologists, 2 psychiatrists, and 4 others. Pre- and post-tests measured knowledge before and impact 3 months post-intervention. 62.5% of responding primary care providers made changes to their practice. 92% felt better equipped to identify, treat, and refer patients. 81% would be willing to work in a disaster zone and felt prepared to treat patients with disaster mental health issues.
Discussion:
PDMHI covers psychosocial responses to disasters from normal to mental health disorders. Participants gained tools for managing pediatric mental health issues in primary care. Study data showed an increase in the participants perceived knowledge and skills about pediatric disaster mental health, and willingness to participate in future disasters.