The COVID-19 pandemic presented obstacles to Emergency Medical Teams (EMT) deployment, including concern of exposure to COVID-19 and travel restriction in many areas of the world. Recognizing these challenges, EMTs sought alternatives to physical deployment, such as virtual deployment. However, concerns have been raised regarding access to internet in aid recipient countries, as well as patient privacy and data leakage in general due to insecure internet connections and intentional data hacking. There is limited literature, and no internationally agreed set of criteria, on the evaluation of deployment including the recipient countries’ ministries of health’s opinion on the deployments. In order to compare alternative deployment modalities, a set of criteria to evaluate an EMT deployment must be established.

The research will identify a set of criteria that can be used to evaluate a deployment; to identify the possible alternative modalities to traditional physical deployment; and to explore perceptions of acceptability and ability to meet the goals of international humanitarian assistance. A stakeholder analysis will be conducted to identify the key informants and relevant stakeholders, and the Delphi Approach will be utilized to seek experts’ opinions and reach consensus.

This research will help to establish a set of criteria for evaluating deployments, and to identify the alternative deployment modalities, the advantages, and disadvantages, and to evaluate each alternative modality, with the hopes of guiding EMTs to plan their future deployments, as well as to provide alternatives should there be further restrictions in the future.

At this moment, this research is at the planning stage and ethical approval has not yet been sought. Should this abstract be accepted, ethical approval will have been obtained, and data collection will have just started in May. The presentation will include a summary of relevant literature, the methods, and any preliminary results.

The transition to residency is a challenging time in the medical trainee’s career. In addition to learning and implementing knowledge specific to emergency medicine, logistics and system nuances can initially impede a learner’s ability to begin the process of mastering their profession. In an attempt to ameliorate this transition to residency an orientation was created to introduce concepts of local ultrasound documentation, resuscitation protocols, EMR navigation, and procedural kits.

Interns were given a pre-workshop survey on comfort level (1-5 Likert) of ultrasound documentation, resuscitation protocols, EMR navigation, and procedural kits. They rotated through four workshop stations in small groups. The first was an ultrasound workshop showcasing our commonly used ultrasound and how we capture images and videos into our medical system for review. The next was institution specific protocols for medical and trauma resuscitation using simulation. Third was a workshop on how to navigate our electronic medical record with simple overviews of documentation and order entry. Lastly, they went through arterial and central line kits to familiarize themselves with the contents. A post-workshop survey was given.

Comfort with ultrasound documentation pre-workshop mean was 4.0 with a post-workshop mean of 4.45 (p=0.068). Comfort with resuscitation pre-workshop mean of 2.91 increased to 3.91 (p=0.008). Electronic medical record documentation comfort rose from a mean of 3.5 to 4.27 (p=0.007). Comfort navigating procedural kits increased to a mean of 4.09 from 3 (p=0.002).

There was a statistically significant increase in comfort level with ultrasound documentation, resuscitation protocols, EMR navigation, and procedural kits after completion of the workshops. Only ultrasound documentation had a p value less than 0.05. It can be reasonably deduced that focusing on institutionally specific aspects of workflow can help interns expedite their education by familiarizing them with these nuances prior to their first shift.

The pandemic brought to the fore the importance of maritime transport as an essential sector for the continued delivery of critical supplies and global trade in times of crisis. Timely vaccination of seafarers secures their health and enables the chain of infection to be broken with the international propagation of the virus via maritime traffic. As part of the COVID-19 vaccination program, the Health Service Executive in conjunction with the Port of Cork company developed a unique pathway for seafarers to access COVID-19 vaccinations once they arrived in Cork.

An Excel template was developed by HSE and Port of Cork that would capture key information for seafarers to avail of vaccinations. Once data was captured by the ship's Captain, it was sent to the shipping agent and reviewed by the HSE South Emergency Management Office. Once the data was validated it was sent to the vaccination center so that the seafarer's details could be entered onto the system. Once confirmed, travel arrangements were made from the vessel to the vaccination clinic ensuring a safe staffing level remained on the vessel.

A total of 84 seafarers registered for the seafarer's vaccination program. 70 of these seafarers received one or more doses in Cork City Hall Vaccination Centre with the remainder having received one dose in pharmacies in Cork City.

This joint initiative developed by the HSE Emergency Management Office and the Port of Cork, the first seafarer's COVID-19 vaccination program in Ireland, ensured seafarers were allowed to avail of a COVID-19 vaccination when they arrived at the Port of Cork. This highlights the requirement for future vaccination programs to consider and incorporate the requirements of seafarers acknowledging the essential role they play in the global supply chain.

The consequences of missed lower-limb deep vein thromboses (DVT) can be life-threatening. Similarly, inappropriate treatment with anticoagulation in low-risk patients carries a significant risk of harm. Early diagnosis and appropriate treatment with anticoagulation rely on timely ultrasound access. The National Institute for Health and Care Excellence (NICE) recommends timeframes for ultrasound acquisition based on Well’s score and D-dimer value.

If rapid ultrasound (Point of care Ultrasound POCUS in our context) demonstrates no features of DVT, it is safe to arrange follow-up scan within eight days without empiric anticoagulation. If, however, no bedside ultrasound is performed, anticoagulation is commenced until a formal scan excludes DVT. NG158 recommends this scan be performed within 24 hours. This audit investigated our compliance with NG158 time standards at Wexford General Hospital (WGH) emergency department (ED).

Electronic records for patients undergoing formal ultrasound for suspected DVT between 08/01/2022-10/13/2022 were reviewed using the hospital’s databases. Charts were reviewed to determine if POCUS was performed. In total, 42 records met selection criteria. Audit Committee governance review was obtained. Fisher’s exact test was used to compare compliance rates between those that underwent bedside ultrasound and those that did not.

Overall compliance with NG158 was 40.5%. Compliance rates for those offered bedside ultrasound were significantly higher than those that weren’t (58.3% vs. 16.7% p<0.0106). The mean waiting time for a radiology department ultrasound is six days, 12 hours, and 16 minutes.

Overall compliance is low, and delays to obtaining formal ultrasound are long. We observed that compliance rates for those who underwent bedside ultrasound were significantly higher than for those who did not. This suggests that bedside ultrasound is under-utilized in our ED. Training more staff to perform bedside scans would alleviate current delays to ultrasound diagnosis and reduce risks associated with empiric anticoagulation.

In this study, assuming a toxic gas-generating disaster situation requiring multiple hyperbaric oxygen chambers at the same time in Korea, the regional arrangement of hyperbaric oxygen chambers and its adequacy for toxic gas-generating disasters were investigated and analyzed based on medical institutions equipped with hyperbaric oxygen chambers.

It is assumed that all hospitals with hyperbaric oxygen chambers should be included theoretically if a large number of patients require hyperbaric oxygen treatment in the event of a toxic gas disaster. First, we received data from the manufacturer that provided the hyperbaric oxygen chambers, interviewed the persons in charge, and then contacted the relevant hospitals to check the placement in the second step. Afterwards, the deployment of hyperbaric oxygen chambers and population-based deployment status, the simultaneous capacity of hyperbaric oxygen treatment, and the ability to perform hyperbaric oxygen treatment in response to toxic gas disasters based on region were analyzed.

The annual number of hyperbaric oxygen chambers showed the first increase period in 2015 and the second increase period after 2019. Even when analyzed based on population-based, simultaneous capacity, and treatment performance, the distribution of hyperbaric oxygen therapy chambers was uneven especially in special areas.

In preparation for future disasters, a regional arrangement plan for hyperbaric oxygen chambers should be established and implemented. The national monitoring system and the long-distance transport system should be established until proper distribution.

In comparison to many nations in the developed world, the United States has more cases of civilian ballistic injuries. Both low and high velocity firearm injuries are frequently encountered in American urban trauma centers, and physicians become familiar with these traumatic injury patterns. Physicians from other nations may rarely encounter such injuries. With an increase in international conflict, there is an increased need for clinicians to participate in international medical aid which may include patients with ballistic injuries. Clinicians with limited familiarity of such injuries may result in under-triage and delayed recognition of injury severity, resulting in increased morbidity and mortality of patients. This study aims to show that a course on ballistic injuries will improve clinician recognition of injury patterns and comfort levels managing these patients.

Clinicians participated in a course which was designed to introduce ballistic injury patterns. The course was reviewed and supported by emergency medicine physicians who work in a large level I trauma center in the Southeastern United States and serve in clinical roles with EMS and community law enforcement. Course content included demonstrations of firearm injuries by discharging weapons into gels and models designed to replicate human body tissue. Participants were surveyed prior to and after completing the course regarding their comfort with firearms and firearm related injuries.

Participants reported increased comfort level with the management of ballistic injuries. The course requires a full day of expert physician time, approximately US$600 in supplies if performing live demonstrations, and the cost of designated space for safe firearm discharge and use.

This course or a similar course with pre-fired demonstration rounds proved to be feasible and beneficial for those who will likely encounter firearm injuries in their clinical environment. There are both quantifiable and perceived benefits for physicians.

The KIRAMS establishes radiological emergency institutions and provides training for emergency medical agents. However, because of the uniqueness of radioactive accidents, the current training program has a limitation in the realistic description. Therefore, training programs based on virtual augmented reality technology that can describe radiological emergencies are required. In this study, the contents of practical training for decontamination of radiation-contaminated patients as a part of radiation disaster prevention personnel training using VR simulator are developed.

Environments and devices required for treating patients with complex radiation damage are made visible using VR simulator to enable practical training of techniques and practices that will be required in actual radiation emergencies or training. The VR decontamination training content uses three Point tracking techniques to calculate the location of the head-mounted display device and the hand to visualize the movements. Additionally, Universal Render Pipeline technology was used to develop realistic visualizations of situations.

In this study, VR decontamination treatment practice content was developed, which allows a single trainee to go through the entire treatment process of treating radiation-contaminated patients. The radiation-exposed patient’s treatment process is composed of nine subprocesses, including wearing personal protective equipment, obtaining samples from openings, taking measurements, cleaning contaminated injuries, and so on. A checklist user interface was used to enable trainees to check their progress. The trainee can practice patient treatment with a controller while using VR decontamination treatment content. Additional functions such as narration, sound effects, animation, and so on were added to high educational effects.

In this study, VR decontamination treatment content was developed using VR training simulator to practice the treatment of radiation-contaminated patients. The results of this study will contribute to fostering the workforce response to radiation through efficient education using a VR training simulator, as well as promoting the use of radiation safety regulations.

Whether it is COVID in New York, chemicals in Syria, or a radiological exposure from a dirty bomb or nuclear detonation, trauma is increasingly mixed with CBRN. Decontamination, isolation, and newer treatments all impact the patient as well as the physician. Military physicians regularly plan for these patients, but the civilian world has not. Civilian CBRN training has been spotty, at best. Our recent experience with COVID and the current threats of nuclear attack, emphasize the need to integrate CBRN exposure into our trauma treatment plans, both to help our patients and to protect the caregivers.

Literature review and US Department of Health and Human Services Guidelines.

A template for patient flow and treatment priorities is presented along with just-in-time references. Triage guidelines for trauma patients with Acute Radiation Syndrome (ARS) are also provided.

Civilian preparation for managing the CBRN contaminated trauma patient starts with a mental model of treatment priorities and self-protection strategies. Just-in-time treatment references can provide additional support and confidence.

Korea Institute Radiological Medical Sciences operates an emergency medical response system in case of a radiological accident or disaster. A radiation accident or disaster can affect large-scale patients and destroy medical infrastructure. However, there is currently a lack of specialized education for treating large-scale patients or high-dose exposure patients. This study aimed to evaluate the efficiency of radiological mass casualty triage education programs and present a new training method to improve the ability of 119 emergency medical teams in the event of a radiological accident or disaster.

The results of mass casualty triage for radiological events were analyzed using the audience response system and questionnaire for paramedics who participated in the radiation accident response training program. For 25 paramedics, a pre-post evaluation was conducted on two items: understanding the mass triage and understanding the radiological mass triage. The data were analyzed using the SPSS WIN 23.0 program.

Thirty simulated patient scenarios were developed with the addition of clinical symptoms of radiation exposure based on the four trauma classifications: immediate, urgent, delayed, and death. The triage results of 30 cases conducted by 119 emergency medical teams were evaluated, and the trainees were asked to respond to the level of improvement in their knowledge of triage through pre- and post-training questionnaires. As a result of the pre- and post-education questionnaire, the degree of understanding of the mass triage was 3.8 before education and 4.4 after education, showing a significant difference (p=.003/MAX=5). The pre- and post-education questionnaire results of radiological mass triage showed a difference between 2.3 before education and 4.1 after education (p=.000/MAX=5).

For effective radiation medical response, 119 emergency medical teams are required to have a repetitive mass triage education program for radiological events. It is especially important to provide a radiological triage system for field application.

Children are almost systematically involved in mass casualty events, especially in the context of terrorist attacks. Unfortunately, the emergency medical responder preparedness is quite often low when it comes to pediatrics, on both technical and emotional sides. Preliminary training is indispensable, and full-scale simulations are arguably the best solution to tackle the needs of the first responders. The purpose of the study was to describe a simulation-based pediatric training with pediatric psychological support set up for the drill.

A full-scale exercise involving children between five and fifteen years old was conducted in the Toulouse municipal stadium during the preparation of the 2016 UEFA (European Football Championship) in France. As children welfare was the primary concern, a psychological support team was present at each stage of the drill and assessed any mental harm that could have happened. Children were asked about their feelings at the end of the exercise with a 5-point Likert rating scale and their parents had to report any perceived changes in the following week.

Out of 16 children participating in the drill, four were in an immediate situation (P1), four were in an emergent situation (P2), and eight were in an urgent situation (P3). One hundred percent of them rated their experience as very good and expressed no stress to their parents in the week that followed, and no harm was detected by the psychological support team during the exercise.

The results of the study show that involving children as victims in pediatric disaster drills is possible in these conditions without impacting the mental welfare of children.

Due to the high number of road traffic accidents with acute injuries and fatalities–particularly in Mass Casualty Incidents (MCI) in low-resource urban sub-Saharan African cities–research was undertaken to create an evidence-based algorithm that could be used to assess and geospatially link EMS needs in Kumasi, Ghana, to trauma resources. Our examination showed that non-MCI fatalities was approximately 2.5%, however, MCI fatalities were found to be 1.8 times higher–at 4.3%, indicating significant opportunities in the planning, preparedness, care, and transport among MCI patient management.

Therefore, several studies (funded through Fulbright-Fogarty and Fulbright Specialist programs), supported the development of the A-E-M-S (Assess-EOP-Map-Simulate) Medical Mass Casualty Algorithm that began networking accident ‘hotspots’ to existing trauma-level capabilities and surge capacity competencies in eight specified Kumasi hospitals. This low-cost response model promises to be an innovative alternative to long-term infrastructure development and high-priced resource distributions. Use of GIS and UAV drones allowed response systems to geospatially locate, classify, shift, and/or augment resources as needed in conjunction with hotspots.

Sample sizes were averaged at 295 for all patients' ages, with only a sample size of 292 for adults at 95% confidence intervals, and a standard deviation of 0.5. A total of 300 road-traffic accident victims were collected at KATH A&E in February-May, 2017, utilizing handheld devices by four researchers 24/7 daily.

Our examination showed that non-MCI fatalities were approximately 2.5%, however, MCI fatalities were found to be 1.8 times higher–at 4.3%, indicating significant opportunities in the planning, preparedness, care, and transport among MCI patient management.

To date–and in partnership with Kwame Nkrumah University of Science and Technology, Komfo Anokye Teaching Hospital, Ghana Medical Council, Health Services, National Disaster Management Organization, and others–over 306 Ghanaian healthcare providers from 80 different facilities have been trained in the AEMS program.

Refugees encounter many obstacles en route to the United States. Refugees face very different disasters and response resources in the US than in their home countries. On arrival to the US, refugees receive a brief introduction to disaster preparedness, but do not receive specific education based on their home country or final location of residence. This study aims to determine the preparedness levels of Afghan refugees in the United States.

This study used a modified General Disaster Preparedness Belief Scale (mGDPBS). The mGDPBS consists of 20 of the 45 questions from the GDPBS, selected from each of the six subscales most applicable to the refugee population. Ten Afghan refugee families were selected from the Afghan community in Virginia.Refugees were interviewed by a recorded one hour interview via Zoom. A list of the questions were provided, and a translator was available to ask the questions in the respective language of the refugee: Dari or Pashtu.

Data collection and analysis to be completed by January 30, 2023.

Data collection and analysis to be completed by January 30, 2023.

Foot injuries are a common patient presentation at music festivals, and are resource-intensive patient encounters by virtue of their comparative volume. There are no published accounts devoted to these ubiquitous, typical, predictable festival injuries leading to presentation to on-site medical services for treatment.

A retrospective chart review was performed of visits to medical services for first aid or medical care involving feet at a multi-day music festival in Canada. Data extracted included demographics, injury characteristics, and type of footwear. Encounters were classified as initial or repeat visits, and repeat visits were assessed for having had previous dressings applied.

Over the five day festival period, foot care visits accounted for 416 of 1129 (37%) patient presentations for minor care. Most common injuries were blisters (51%), ankle sprains (10%), lacerations (8%), abrasions (6%), and bug bites (6%). Footwear was reported as shoes (28%), shoes and socks (28%), flip-flops (19%), sandals (28%) and bare feet only (5%). The most common blister sites were toes (48%) and the posterior heel (17%). 12% of cases were repeat visits, and 50% of repeat visits were for dressings failure.

Foot injuries make up a significant portion of presentations, and often re-presentations, to medical services at music festivals. Preparation for these common injuries should include (1) a dedicated and purposeful bandage selection and supply, (2) provider training in best foot care practices, including bombproof, danceable dressings, and (3) educational resources to inform attendees of risks and provide preventative upstream measures that might allow them to avoid injury.

The JDR Rescue Team has successfully completed the INSARAG External Re-Classification (IER) process, which evaluates the operational capability and capacity of Urban Search and Rescue (USAR) teams and has achieved the highest “Heavy” reclassification in November 2022. Two nurses participated in the IER process as part of the medical unit of JDR Rescue Team. In addition, ten registered nurses cooperated as Exercise Control (EXCON).

Summarize the JDR Rescue Team and medical unit and make observations on what nurses did in the IER.

The JDR Rescue Team is dispatched by the Government of Japan in response to large-scale disasters overseas. The task force team has 75 members from various specialties, including the rescuer, and medical unit. The medical unit consists of one medical manager, 2 doctors, and two nurses. There are currently about 50 registered medical unit members in our team, and of these, a total of 23 nurses are registered. The role of nurses during the IER process, includes a 36-hour non-stop scenario-based exercise. The team nurses are involved in various roles, such as Confined Space Medicine (infusion for patients, assisting on-site amputation), caring or treating injured rescuers and search dogs, providing health and welfare monitoring and operating a decontamination system. The EXCON nurses were involved in managing the simulation. One of their key roles was to play as a victim realistically so as to provide a sense of tension for the simulation.

The JDR Rescue Team has more medical unit members than those in other countries. In particular, teams with so many nurses are rare. nurses played a vital role in this IER. The contribution of nurses is identified in order to make the international USAR team more strong and more flexible.

Little is known about Self-Injurious Thoughts & Behaviors and Non-Suicidal Self-Injury in firefighters in two East Coast United States metropolitan fire departments based on fire service tenure.

• Study comprised of two parts, a survey and a questionnaire, both conducted online. Using the Computer Adaptive Test–Suicide Scale

• The only computer-based adaptive mental and behavioral health assessment clinically validated worldwide.

• Validated against face-to-face structured clinician-led assessment.

• Participants received a unique identifier and hyperlink allowing them access and confidentiality.

• Study was completed on participants' personal electronic devices, on their own time, at their own pace.

A single-factor or One-Way ANOVA tested for a significant relationship between the variables and the four tenure groups simultaneously. Time of administration averaged 86 seconds, with a median of eleven questions.

The C-SSRS identified six participants triggering suicide alerts. One in the early-career category and five in the late-career category. The CAT-SS identified one participant as high-risk and 33 participants for suicidality. One participant in the early-career category.

Early-career and late-career firefighters have more self-injurious thoughts and behaviors and mid-career firefighters have the least.

Subcutaneous adipose tissue (SAT) and bony thorax will deform and conduct driving force during cardiac arrest (CA). The association between short-term prognosis and deformation of adult thorax for patients acquired return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR) was unclear.

Clinical records and CT images were collected from eligible patients admitted to the hospital who received CPR and achieved sustained ROSC from May 31st, 2019 to June 30, 2021. The patients were divided into different groups according to discharge outcome, then into three subgroups according to the ventilation mode before and after CPR. After that, patients with the same ventilation mode before and after CPR are combined and analyzed.

Records from 1663 patients were reviewed. After selection, 70 patients were included into this study. Significantly thicker posterior SAT post-compression was found at the 7/8/10/11 spinous process plane in patients with favorable neurological outcome (p<0.05). For patients receiving same kind of respiratory support before and after CPR, significantly thicker posterior SAT pre-compression at the 6/7/8/9/10/11 spinous plane and thicker posterior SAT post-compression at the 7/8/9/10/11/12 spinous plane (p<0.05). For patients without mechanical ventilation before or after CPR, significantly thicker posterior SAT post-compression was found at the 10/11 spinous plane in patients with favorable neurological outcome (p<0.05). For patients receiving mechanical ventilation before or after CPR, thicker posterior SAT post-compression was found at the 10/11/12 spinous plane was associated with favorable neurological outcome. No difference was found in the bony thorax within a different vertebral plane after subgroup analysis (p>0.05).

Thicker posterior SAT and greater SAT depth difference after compression was associated with favorable neurological outcome at the discharge of patients who obtained ROSC after CA. A shorter duration of chest compression (<6 minutes) doesn’t cause calculable changes in patients’ bony thorax in patients who obtained ROSC after CA.

The Comprehensive Framework for Disaster Evaluation Typologies (CFDET) was originally developed in 2017 with minor updates in 2018 (CFDET2.0). CFDET was created to unify and provide agreement on the identification, structure and relationships between multiple evaluation typologies found in the disaster setting. Since the publication of this framework, the world has witnessed unprecedented disaster-related events including two (2) Public Health Emergencies of International Concern (PHEIC): COVID-19 and Monkey Pox as well as the emergence and continuation of armed conflict in various countries around the world. This work presents CFDET3.0 which incorporates updates on international disaster frameworks, disaster health updates and evaluation guidelines.

A scoping literature review on international disaster frameworks, disaster health updates and evaluation guidelines has been undertaken and included reviewing peer-reviewed and grey literature.

The scoping literature review revealed updates on the following important publications:

World Health Organization (WHO) Health Emergency Disaster Risk Management (H-EDRM) (2019);

International Health Regulations;

Universal Health Coverage (UHC);

Climate Change Conference (COP27);

Fragile and Conflict-affected Contexts (FCAC);

Public Health Emergencies of International Concern, and

Updated evaluation standards, guidelines, evidence-based reviews and knowledge management.

Incorporation of these international updates into CFDET2.0, strengthens global health and international disaster health responses with a focus on disaster health evaluation. The updated framework will be referred to as CFDET3.0. Future research is scheduled to develop a series of toolkits that will support an improved disaster evaluation process.

Considering the need for hospital disaster preparedness post-Nepal earthquake 2015, the Ministry of Health and Population of Nepal developed a Hospital Disaster Preparedness and Response Plan (HDPRP) for mass casualty management. However, until now, there is no scientific literature on how the district hospitals, which are the major health service providers in Nepal, implemented their HDPRP during mass casualty incidents (MCIs). So, this study aims to understand how the HDPRP was implemented during MCIs in three district public hospitals of Nepal.

A mixed sequential QUANT-QUAL study was designed. Out of seven districts under the severely hit category by Nepal Earthquake 2015, three districts were selected randomly. For the quantitative component, the WHO hospital emergency response checklist was adapted which was self-administered in each hospital. Based on a scoring system, each hospital was placed in one of three categories (effective, insufficient, unacceptable), to assess the level of HDPRP implementation. For the qualitative component, semi-structured interviews were conducted to understand how the HDPRP was implemented in each hospital. An inductive thematic analysis was carried out. All information was collected for the most recent management of MCI reported in the hospital.

Out of three hospitals, two hospitals have effectively implemented their HDPRP, whereas one has insufficient implementation. Three themes emerged during the data analysis: enablers in implementation of HDPRP, barriers in implementation of HDPRP, and recommendations for the future. Multiple enablers and barriers were identified for the implementation of HDPRP, and the recommendations were identified for the hospital, hospital staff, and external stakeholders.

Implementation of HDPRP as per the protocol is difficult due to many external and internal factors that arise while managing the MCIs. The findings of this study provide the basis for the Ministry of Health and Population and district hospitals for the future update of HDPRP and planning of MCIs.

Amid the escalating nuclear arms race in the latter half of the 20th century, civil defense preparedness drills, commonly known as “Duck-and-Cover” drills, were practiced throughout classrooms in the United States. Since then, education and preparedness measures have been largely replaced by fire evacuation and active shooter drills. This study endeavored to understand the likely actions that members of the public may take in the event of a nuclear detonation in the 21st century.

Scenarios for 5 kiloton and 100 kiloton near-surface nuclear detonations were modeled using the Hazard Prediction Assessment and Capability (HPAC) software. A video was created animating the models with a voiceover that explained the initial effects of a nuclear detonation. Using the Qualtrics platform, a survey was created in which the order of behavior-based questions and the video was randomized. Lucid distributed the survey to a representative sample of the American public.

Among 3,087 participants, only 921 (30%) indicated their confidence in knowing what to do in the event of a nuclear detonation in their city. Participants were most likely to listen to the radio, hide in an interior room, and seal windows or doors. Two thirds indicated they would “duck and cover” (n = 2034, 66%), an action that ranked below helping others (n = 2183, 71%) and wearing a mask (n = 2174, 70%). Study participants who indicated their likely behaviors after watching the video were significantly more likely to listen to the radio (p = 0.044) than those who answered such questions before watching the video.

The results of this study suggest there remains a need for emergency preparedness education for members of the public in the United States. As the threat of a nuclear detonation grows, educational methods such as video explanations may increase the preparedness of the American public.

Information sharing during disasters tends to be confusing. We started the trial operation of a digital whiteboard (DWB) as a communication tool during disasters in 2019 and fully introduced it in 2022. The DWB is a large tablet that allows interactive communication in close to real-time in remote locations through Wi-Fi.

To verify the usefulness of the system, DWBs were placed at triage posts in severely, moderately, and mildly damaged areas during a 2022 disaster drill responding to mass casualties to facilitate the sharing of patient information between Disaster Response Headquarters and each treatment area. In each treatment area, doctors, nurses and paramedics completed a standard form to share information about each patient. Information collected included the triage tag number, patient name, age, gender, type of injury or disease, and description of the treatment.

Six DWBs were remotely shared, with the triage post noting the number of patients passing through each severity level, and each treatment area noting the treatment status of each patient. The Disaster Response Headquarters replied with the results of adjustments such as hospitalization ward and time to start surgery. The descriptions were reflected in the remotely shared DWBs in about one second. Text conversations through the DWBs were also seen. In the post-event survey, some said that the smooth sharing of information led to quick decisions. Compared to conventional radios, DWBs have the advantage of allowing communication through text, which allows more detailed and accurate patient information to be communicated quickly. The results suggest the survival rate can be improved by assisting early medical intervention or rapid entry of patients into operating rooms. The next goal is to use DWBs for medical coordination among disaster base hospitals.

DWBs are effective for the rapid and accurate sharing of patient information during disasters.