Emergency departments (EDs) are critical sources of care after natural disasters such as hurricanes. Understanding the impact on ED utilization by subpopulation and proximity to the hurricane’s path can inform emergency preparedness planning. This study examines changes in ED utilization for residents of 344 counties after the occurrence of 7 US hurricanes between 2005 and 2016.

This retrospective observational study used ED data from the Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases. ED utilization rates for weeks during and after hurricanes were compared with pre-hurricane rates, stratified by the proximity of the patient county to the hurricane path, age, and disease category.

The overall population rate of weekly ED visits changed little post-hurricane, but rates by disease categories and age demonstrated varying results. Utilization rates for respiratory disorders exhibited the largest post-hurricane increase, particularly 2–3 weeks following the hurricane. The change in population rates by disease categories and age tended to be larger for people residing in counties closer to the hurricane path.

Changes in ED utilization following hurricanes depend on disease categories, age, and proximity to the hurricane path. Emergency managers could incorporate these factors into their planning processes.

Drive-through clinics (DTCs) are a novel type of point of dispensing where participants drive to a designated location and receive prophylaxis while remaining inside their vehicle. The objective of this review was to identify effective practices and recommendations for implementing DTCs for mass prophylaxis dispensing during emergency events.

A systematic review was conducted for articles covering DTCs published between 1990 and 2019. Inclusion criteria were peer-reviewed, written in English, and addressed DTCs sufficiently. Effective practices and recommendations identified in the literature were presented by theme.

A total of 13 articles met inclusion criteria. The themes identified were (1) optimal DTC design and planning via decision support systems and decision support tools; (2) clinic layouts, locations, and design aspects; (3) staffing, training, and DTC communication; (4) throughput time; (5) community outreach methods; (6) DTC equipment; (7) infection prevention and personal protective equipment; and (8) adverse events prevention and traffic management.

DTCs are an essential component of emergency preparedness and must be optimally designed and implemented to successfully dispense mass prophylaxis to a community within 48 hours. The effective practices and recommendations presented can be used for the development, implementation, and improvement of DTCs for their target populations.

The aim of this systematic review is to analyze the relevant research on religious organizations’ participation in disasters risk management and to understand the ways in which these organizations impact on disaster management. Today, community-based disaster risk management is emphasized as a very effective approach. Religious organizations are one of the most important components of community. They have access to resources that can be critical to help government agencies to manage disasters successfully.

This systematic review was conducted since August 2018 to investigate the role of religious institutions in disasters management and was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Web of Science (WOS), Scopus, Proquest, Embase, and Google scholar were the primary databases used for search of literature. Keywords used in this review were “religious institution,” “disaster management,” and their equivalents were obtained from Mesh, Emtree, or extracted from related articles. The papers from a broad range of disciplines related to keywords were included, and those articles that focus on response to disaster based on religious beliefs’ and religion rather than participation of religious institutions in disaster risk management were excluded. From the 18,071 records identified through database searching in the early stage, 22 articles were selected for this review followed by analysis of the characteristics and content analysis of the included studies to answer the study questions.

The findings of this systematic review that emerged from content analysis are summarized in 11 themes: religious institutions’ potential for disaster management, preparedness of religious institutions for disasters, response, recovery, the social capital, partnership with all stakeholders, collaboration and communication between mental health professionals and faith-based organization leaders, unity of information and message, religious institution shelters, dealing with disaster in old and new approaches, and barriers and challenges.

Religious institutions have a vital role and great potential in disasters management. They often contribute in response and recovery phases of disasters, although these services are valuable but the great potential of these groups should also be recruited to participate in preparedness and mitigation efforts as part of disasters cycle. Coordination and collaboration of all stakeholders is essential in this way.

A systematic literature review (SLR) was performed to elucidate the current triage and treatment of an entrapped or mangled extremity in resource scarce environments (RSEs).

A lead researcher followed the search strategy following inclusion and exclusion criteria. A first reviewer (FR) was randomly assigned sources. One of the 2 lead researchers was the second reviewer (SR). Each determined the level of evidence (LOE) and quality of evidence (QE) from each source. Any differing opinions between the FR and SR were discussed between them, and if differing opinions remained, then a third reviewer (the other lead researcher) discussed the article until a consensus was reached. The final opinion of each article was entered for analysis.

Fifty-eight (58) articles were entered into the final study. There was 1 study determined to be LOE 1, 29 LOE 2, and 28 LOE 3, with 15 determined to achieve QE 1, 37 QE 2, and 6 QE 3.

This SLR showed that there is a lack of studies producing strong evidence to support the triage and treatment of the mangled extremity in RSE. Therefore, a Delphi process is suggested to adapt and modify current civilian and military triage and treatment guidelines to the RSE.

Emergency preparedness becomes more important with increased age, as older adults are at heightened risk for harm from disasters. In this study, predictors of preparedness actions and confidence in preparedness among older adults in the United States were assessed.

This nationally representative survey polled community-dwelling older adults ages 50-80 y (n = 2256) about emergency preparedness and confidence in addressing different types of emergencies. Logistic regression was used to identify predictors of reported emergency preparedness actions and confidence in addressing emergencies.

Participants’ mean age was 62.4 y (SD = 8); 52% were female, and 71% were non-Hispanic white. Living alone was associated with lower odds of having a 7-d supply of food and water (adjusted odds ratio [aOR] = 0.74; 95% confidence interval [CI]: 0.56-0.96), a stocked emergency kit (aOR = 0.64; 95% CI: 0.47-0.86), and having had conversations with family or friends about evacuation plans (aOR = 0.59; 95% CI: 0.44-0.78). Use of equipment requiring electricity was associated with less confidence in addressing a power outage lasting more than 24 h (aOR = 0.66; 95% CI: 0.47-0.94), as was use of mobility aids (OR = 0.65; 95% CI: 0.45-0.93).

These results point to the need for tailored interventions to support emergency preparedness for older adults, particularly among those who live alone and use medical equipment requiring electricity.

To summarize characteristics and commonalities of non-technical competency frameworks for health professionals in emergency and disaster.

An electronic literature search was conducted in PubMed, MEDLINE, ERIC, Scopus, Cochrane database, and Google Scholar to identify original English-language articles related to development, evaluation or application of the nontechnical competency frameworks. Reviewers assessed identified articles for exclusion/inclusion criteria and abstracted data on study design, framework characteristics, and reliability/validity evidence.

Of the 9627 abstracts screened, 65 frameworks were identified from 94 studies that were eligible for result extraction. Sixty (63.8%) studies concentrated on clinical settings. Common scenarios of the studies were acute critical events in hospitals (44;46.8%) and nonspecified disasters (39;41.5%). Most of the participants (76; 80.9%) were clinical practitioners, and participants in 36 (38.3%) studies were multispecialty. Thirty-three (50.8%) and 42 (64.6%) frameworks had not reported evidence on reliability and validity, respectively. Fourteen of the most commonly involved domains were identified from the frameworks.

Nontechnical competency frameworks applied to multidisciplinary emergency health professionals are heterogeneous in construct and application. A fundamental framework with standardized terminology for the articulation of competency should be developed and validated so as to be accepted and adapted universally by health professionals in all-hazard emergency environment.

Crisis management in major accidents requires the collaboration among different organizations. One of the most important problems of crisis management is the lack of coordination between executive organizations. The aim of this study was to examine the structural characters and problems of interorganizational network during crisis in the petrochemical industry and provide solutions to achieve the highest performance in crisis management.

The organizations involved in crisis management were identified through interviews and questionnaires. Gephi (0.9.1) software was used to examine interorganizational relationships.

In this study, the crisis management team consisted of 25 public and private organizations and non-governmental organizations. The highest betweenness centrality was observed in Crisis Management of Provincial Government (CMPG) (142.16) and Fire Department of Petrochemical Complex (FDC) (89.3). The highest closeness centrality was observed in FDC (0.77), CMPG (0.7), Shazand Governorate (0.7), and Crisis Management of University of Medical Sciences (0.7).

Coordination between organizations plays an important role in crisis and emergency management, and social network analysis helps identify strengths and weaknesses of organizations involved in crisis management, overcome those weaknesses, and consequently achieve the best performance in crisis management.

This review systematically explores the current available evidence on the effectiveness of interventions provided to first responders to prevent and/or treat the mental health effects of responding to a disaster.

A systematic review of Medline, Scopus, PsycINFO, and gray literature was conducted. Studies describing the effectiveness of interventions provided to first responders to prevent and/or treat the mental health effects of responding to a disaster were included. Quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and the Critical Appraisal Skills Programme (CASP) checklist.

Manuscripts totaling 3869 met the initial search criteria; 25 studies met the criteria for in-depth analysis, including 22 quantitative and 3 qualitative studies; 6 were performed in low- and middle-income countries (LMICs); 18 studies evaluated a psychological intervention; of these, 13 found positive impact, 4 found no impact, and 1 demonstrated worsened symptoms after the intervention. Pre-event trainings decreased psychiatric symptoms in each of the 3 studies evaluating its effectiveness.

This review demonstrates that there are likely effective interventions to both prevent and treat psychiatric symptoms in first responders in high-, medium-, and low-income countries.

The aim of this study was to explore the mortality pattern due to Gorkha earthquakes in 2015 and review the response and recovery efforts immediately following the earthquakes.

Data from published reports of the Nepal Police showed over 8000 deaths. These death counts were categorized by gender, ethnicity, and age groups (interval of 5 years). The mortality rate was calculated (per 100 000 population), using the projected population as the denominator as of April 2015.

Children < 10 years and older adults > 55 years showed a higher rate of deaths, with similar trends for the most affected districts. Almost 8 more females’ deaths were reported per 100 000 population compared with their male counterparts. There was a higher death rate from Province 3 with a notable gender difference: Nearly 20 more females’ deaths were reported per 100 000 population compared with their male counterparts. There was a higher death rate in mountains (542.4 per 100 000) compared with hills (55.0 per 100 000) and the southern Terai region (0.96 per 100 000) of Nepal.

Young and older adults, female, and residents of remote, mountainous regions of Nepal were vulnerable to the earthquakes. Future earthquake preparedness should focus on the vulnerable population by age and gender and the geographical accessibility.