In June of 2021, a heatwave resulted in high mortality across the Pacific Northwest region. The city of Portland, Oregon, had many advantages: emergency response personnel, science-based policies, political support for climate change adaptation, and collaboration among municipal, county, state, and federal authorities. Though the city’s response likely prevented many deaths, heat-related mortality was high.

This study presents a retrospective case analysis of the 2021 Western North American Heatwave in Portland, Oregon. Specifically, the study examines the limitations of current heatwave response paradigms by means of a narrative review of the heatwave response and impacts.

Most deaths occurred at home, and most of those who died lived alone. Most of the deceased did not have access to functioning air conditioning.

Heatwaves exhibit high predictability in the demographics of those most affected and have rising rates of recurrence. Given the effectiveness of residential cooling systems in preventing heat-related mortality, findings suggest that future public health and policy initiatives should put increased focus on the primary prevention of heat exposure.

Critically injured patients have experienced delays in being transported to hospitals during Mass Casualty Incidents (MCIs). Extended pre-hospital times (PHTs) are associated with increased mortality. It is not clear which factors affect overall PHT during an MCI. This systematic review aimed to investigate PHTs in trauma-related MCIs and identify factors associated with delays for triaged patients at incident scenes.

This systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Web of Science, CINAHL, MEDLINE, and EMBASE were searched between January and February 2022 for evidence. Research studies of any methodology, and grey literature in English, were eligible for inclusion. Studies were narratively synthesized according to Cochrane guidance.

Of the 2025 publications identified from the initial search, 12 papers met the inclusion criteria. 6 observational cohort studies and 6 case reports described a diverse range of MCIs. PHTs were reported variably across incidents, from a median of 35 minutes to 8 hours, 8 minutes. Factors associated with prolonged PHT included: challenging incident locations, concerns about scene safety, and adverse decision-making in MCI triage responses. Casualty numbers did not consistently influence PHTs. Study quality was rated moderate to high.

PHT delays of more than 2 hours were common. Future MCI planning should consider responses within challenging environments and enhanced timely triage decision-making.

Bleeding control measures performed by members of the public can prevent trauma deaths. Equipping public spaces with bleeding control kits facilitates these actions. We modeled a mass casualty incident to investigate the effects of public bleeding control kit location strategies.

We developed a computer simulation of a bomb exploding in a shopping mall. We used evidence and expert opinion to populate the model with parameters such as the number of casualties, the public’s willingness to aid, and injury characteristics. Four alternative placement strategies of public bleeding control kits in the shopping mall were tested: co-located with automated external defibrillators (AEDs) separated by 90-second walking intervals, dispersed throughout the mall at 10 locations, located adjacent to 1 exit, located adjacent to 2 exits.

Placing bleeding control kits at 2 locations co-located with AEDs resulted in the most victims surviving (18.2), followed by 10 kits dispersed evenly throughout the mall (18.0). One or 2 kit locations placed at the mall’s main exits resulted in the fewest surviving victims (15.9 and 16.1, respectively).

Co-locating bleeding control kits with AEDs at 90-second walking intervals results in the best casualty outcomes in a modeled mass casualty incident in a shopping mall.

The coronavirus disease 2019 (COVID-19) pandemic as well as other recent natural emergencies have put the spotlight on emergency planning. One important aspect is that natural disasters or emergencies often lead to indirect deaths, and studying the behavior of indirect deaths during emergencies can guide emergency planning. While many studies have suggested many indirect deaths in Puerto Rico due to Hurricane Maria; the specific causes of these deaths have not been carefully studied.

In this study, we use a semiparametric model and mortality data to evaluate cause of death trends. Our model adjusts for cause of death effect potentially varying over time while also inferring on how long excess deaths occurred.

From September 2017 to March 2018, after adjusting for intra-annual variability and population displacement, we find evidence of significant excess deaths due to Alzheimer’s/Parkinson, heart disease, sepsis, diabetes, renal failure, and pneumonia and influenza.

In contrast, for the same time period we find no evidence of significant excess deaths due to cancer, hypertension, respiratory diseases, cerebrovascular disease, suicide, homicide, falling accidents, and traffic accidents.

On February 12, 2021, Winter Storm Uri hit the United States. To understand the disaster-related causes and circumstances of death, the Centers for Disease Control and Prevention (CDC) activated media mortality surveillance.

The team searched the internet daily for key terms related to Uri and compiled the information into a standardized media mortality surveillance database to conduct descriptive statistics.

Between February 12 and March 2, 2021, the accessed media reported 136 Uri-related deaths from nine states. Most decedents were male (39%) and adults (62.5%). Exposure to extreme temperatures (47.1%) was the most common cause of death. Among indirect deaths, motor vehicle collision (12.5%), and carbon monoxide poisoning (7.4%) represented the top two circumstances.

This was the first time CDC activated media mortality surveillance for a winter storm. Media mortality surveillance is useful in assessing the impact of a disaster and provides timely data for an all-hazards response approach.

This work was carried out to determine the causes of violence against Prehospital Emergency Medical Services Personnel (PHEMSP) who performed their duties without any special security measures during the COVID-19 pandemic, and who were subjected to violence because of their work.

The approach of this research is in accordance with case study design, which is concerned with the examination of unique cases. For this study, a volunteer announcement was made on social media for PHEMSPs from 3 different branches (Emergency Medical Technicians or EMTs, paramedics, and doctors) who had been actively working in ambulances during the transportation of COVID-19 patients throughout the pandemic, and who had declared that they were subjected to verbal abuse or physical violence. The data was collected through structured interviews from 60 voluntary participants.

As a result of the analysis of the data, 3 main themes were revealed as the source of violence that PHEMSPs had been exposed to during the pandemic. They are the following: (1) violence caused by the nature of the disease, (2) violence caused by society, and (3) violence caused by working areas and systems. The reasons which created these themes, were accepted as codes. The codes that arose due to the theme of (1) violence caused by the nature of the disease were ‘the fear of contagion,’ ‘the requirement for disinfection,’ and ‘triage problems,’ which caused both verbal abuse and physical violence. In addition to these codes, the code of ‘stigma’ due to protective equipment was found only to elicit verbal abuse. The codes for the theme (2) ‘violence caused by society,’ were determined as societal perceptions regarding high wages, attempts to misuse health services, and distrust. All 3 of these codes were found to evoke both verbal abuse and physical violence. The codes for the theme (3) ‘violence caused by working areas and systems,’ included team mismatch in PHEMSPs, resignation ban, and long working hours, as well as mismatch between in-hospital HCWs and PHEMSPs, mobbing, feeling unsupported, and gender disadvantage. It has been revealed among these codes that only the team mismatch in PHEMSPs caused both verbal abuse and physical violence, while all the others only lead to verbal abuse.

If a 0 tolerance for ‘violence in the healthcare system’ is to be targeted, it should start in the pre-hospital phase and with all PHEMSPs, since this is the 0 point where the healthcare system, and patients first meet. Additionally, this group should be considered a vulnerable group for workplace violence (WPV), especially due to the COVID-19 pandemic.

The study aimed to increase the understanding of the lived experience of patients during the acute phase of a coronavirus disease 2019 (COVID-19) infection.

A Web-based survey was distributed through established patient and public engagement and involvement groups and networks, social media, and by means of word of mouth. The survey covered questions relating to patient demographics, COVID-19 diagnosis, symptom profile, and patient experience during acute COVID-19.

The findings demonstrate the varying symptom profiles experienced by people in the acute stage of COVID-19 infection, with participants sharing how they managed care at home, and/or accessed medical advice. Findings also highlight themes that people were concerned with being unable to receive care and believed they needed to rely heavily on family, with extreme thoughts of death.

Although the urgent threat to public health has been negated by efficacious vaccines and enhanced treatment strategies, there are key lessons from the lived experience of COVID-19 that should be used to prepare for future pandemics and public health emergencies.

This study aims to evaluate disaster preparedness of undergraduate nursing students.

This descriptive cross-sectional study included 302 voluntary nursing students from a university in Northern Cyprus. Data were collected through an online survey using Google Forms, which included a descriptive information form and the General Disaster Preparedness Belief Scale (GDPBS).

The mean age of the participants was 20.64 ± 2.02 years. Among the participants, 41.7% had prior experience with disasters, and 77.2% expressed a need for disaster education. The average GDPBS total score was high, and the mean score of the sub-dimensions was moderate. Nursing students who expressed a need for disaster education had higher scores on the severity and self-efficacy subscales of the GDPBS (p<0.05).

The level of disease preparedness was moderate in nursing students in Northern Cyprus. Therefore, education based on the health belief model, which assumes that positive health behaviors are affected by knowledge and attitudes, may be useful to improve disaster preparedness in nursing students.

Evacuation and relocation are key actions used to protect the public in response to natural or technological disasters, but there are inherent risks to both. Unfortunately, these risks have not been fully quantified, which limits the ability of emergency managers and the public to effectively balance the risks and benefits of evacuation or relocation. This work provides quantitative data on the risks of health effects from displacement following evacuation or relocation.

Researchers performed a literature review and meta-analysis of published studies and quantified risks of 14 different health effects, including both physical and socio-behavioral outcomes, from studies of 9 different disaster types.

The findings show statistically significant increases in 9 of the 14 health effects in displaced populations, indicating an increased likelihood of experiencing detrimental health effects compared with nondisplaced populations. A pooled analysis of all negative health effects found an odds ratio of 1.49 (95% confidence interval: 1.24-1.79), which shows a significant relationship between displacement and negative health outcomes.

These findings demonstrate that evacuated or relocated populations have an increased risk of experiencing negative health effects associated with displacement. The broad number of disaster types included mean that findings are applicable to any emergency evacuation or relocation.

At the onset of the COVID-19 pandemic, and to this day, US state, tribal, local, and territorial health departments lacked comprehensive case investigation and contact tracing (CI/CT) guidelines that clearly define the capabilities and capacities of CI/CT programs and how to scale up these programs to respond to outbreaks. This research aims to identify the capabilities and capacities of CI/CT programs and to develop a conceptual framework that represents the relationships between these program components.

This study conducted a narrative literature review and qualitative interviews with 10 US state and local health departments and 4 public health experts to identify and characterize the capacities and capabilities of CI/CT programs.

This research resulted in the first comprehensive analysis of the capabilities and capacities of CI/CT programs and a conceptual framework that illustrates the interrelationships between the capacities, capabilities, outcomes, and impacts of CI/CT programs.

Our findings highlight the need for further guidance to assist jurisdictional health departments in shifting CI/CT program goals as outbreaks evolve. Training the public health workforce on making decisions around CI/CT program implementation during outbreaks is critical to ensure readiness for a variety of outbreak scenarios.

The coronavirus disease (COVID-19) pandemic necessitated alternative methods to ensure the continuity of medical education. Our study explores the efficacy and acceptability of a digital continuous medical education initiative for medical residents during this challenging period.

From September to December 2020, 47 out of 60 enrolled trainee doctors participated in this innovative digital Continuous Medical Education (CME) approach. We utilized the Script Concordance Test to bolster clinical reasoning skills. Three simulation scenarios, namely Advanced Trauma Life Support (ATLS), Advanced Life Support (ALS), and European Paediatric Life Support (EPLS), were transformed into interactive online sessions via Zoom™. Participant feedback was also collected through a survey.

Consistent Script Concordance Testing (SCT) scores among participants indicated the effectiveness of the online training module. Feedback suggested a broad acceptance of this novel training approach. However, discrepancies observed between formative SCT scores, and summative Multiple-Choice Questions (MCQ) assessments highlighted areas for potential refinement.

Our findings showcase the resilience and adaptability of medical education amidst challenges like the global pandemic. The success of methodologies such as SCT, endorsed by prestigious bodies like the European Resuscitation Council and the American Heart Association, suggests their potential in preparing health care professionals for emergent situations. This research offers valuable insights for shaping future online CME strategies.