Internationally, Disaster Victim Identification (DVI) activities are conducted under the International Criminal Police Organization system for handling a large number of bodies during disasters. However, the police have taken the initiative and commissioned clinicians and dentists to estimate the cause of death and identify the deceased, under a unique system in Japan. In this presentation, we examine the problems in the current DVI activities in Japan through DVI training.

We held DVI training sessions three times in preparation for the occurrence of a large-scale disaster in Chiba Prefecture with Chiba Prefectural Police, Chiba Medical Association, Chiba Dental Association, local government staff in Chiba, and forensic staff in other institutions. We conducted desktop trainings using paper dolls, under a simulation of an aircraft disaster, and a natural disaster such as flooding and landslides caused by typhoon damage in the third session. After the training, participants reflected on their activities through a questionnaire.

In accordance with the conventional method, the police officers numbered the bodies, photographed and checked their personal belongings, followed by the estimation of the cause of death with a doctor, the preparation of documents. Subsequently, dentists collected postmortem findings and matched with antemortem data. On the other hand, police officers and local government staff interviewed the bereaved family members under simulations. In the post-survey, participants were generally satisfied with the training, but some said that it was difficult to understand the activities of other professions.

In Japan, where there are no DVI teams, this training was a good opportunity for all the job categories involved in DVI activities to meet each other. While the activities conducted by each profession helped to improve skills, the collaboration among professions was poor. We would like to improve the quality of DVI activities by introducing a team system for collaboration among multiple professions.

In 2014, the residency program adopted a new chief resident model. Multiple other programs had adopted a similar style of having all final-year residents have a “chief” role. Chief residents are meant to be leaders in the residency, have a direct influence on the program, and serve as liaisons with other department chiefs.

Prior to 2014, the program had three chief residents a year: one Admin, one Academic, and one Recruitment. They were chosen using a vote amongst residents/faculty, with the ultimate decision made by the residency leadership. Many other residents were interested, and often qualified, but were ultimately not chosen. In 2014, the all-chief model was adopted. Each PGY-3 would have a responsibility. The goal was to give each a leadership opportunity, and a tangible product as they transition to fellowships or new jobs. The residents were allowed to pick their position, with some influence by residency leadership. Residents were encouraged to create new roles which aligned with their personal interests or career goals. Examples included Medical Director Chief, U/S chief, PEM chief and Wellness Chief.

Some residents thrived when given responsibility, while others did not. Some could not manage more responsibility: there was a clear disparity in the effort. At the start of this, all residents’ total shifts/month decreased equally. This created some controversy when the workload was not equal. The alteration of details, requirements, and expectations occurred every year in an attempt to correct the failures.

Ultimately, the all-chief model was a failure. The program reverted to a traditional chief model, allowing only those the residency leadership felt could manage chief responsibilities to have a role. Those not doing a chief role were given additional shifts and those with less added work were given only a partial shift reduction.

Health Organizations (HOs) worldwide are vital to any nation’s capacity to withstand crises. The COVID-19 pandemic increased the HOs’ awareness of the importance of Organizational Resilience to ensure Operational Continuity during crises.

This study aimed to identify the main elements affecting HOs’ resilience, to enable their application in long-term processes of capacity building.

A cross-sectional study examining the level of organizational resilience in HOs was performed, in a general hospital (group A) and one region of Emergency Medical Services–EMS (group B). A structured questionnaire, consisting of 29 items, was developed, validated, and subsequently used to assess organizational resilience. The questionnaire encompassed: ethos, organizational culture, leadership and human capital, situational awareness, adaptability, organizational performance, and learning ability.

The respondents included 225 participants from the hospital and 214 from the EMS. Both HOs presented a high level of organizational resilience (average score among hospital and EMS personnel was 3.79 versus 3.91 respectively).

In a multivariate linear regression test, the factors found to predict the organizational resilience (in both organizations) were education (academic/non-academic), gender (male/female), and two age groups (20-30 & 31-40).

These factors explained 11% of the organizational resilience. Other factors such as profession or seniority at work, were found to be non-significant.

As the operational continuity of health organizations is vital during crises, the developed evaluation tool contributes to the capacity of managers and policymakers to continuously monitor the level of organizational resilience. In line with the factors identified as predictors of organizational resilience, health managers should focus on educational interventions to increase their organization’s resilience. It is recommended that follow-up studies be initiated to examine additional variables that may predict the level of organizational resilience.

A prepared and well-trained workforce is essential to reducing the loss of lives from health emergencies. However, it is uncertain what should be included in the common set of core competencies for the health emergency and disaster risk management (Health EDRM) workforce. The objective of the study is to provide evidence mapping for the competencies in existing professional development programs and courses in Health EDRM.

A survey conducted using an online platform (Survey Monkey) was conducted from October to November 2021. Experts in the Health EDRM Research Network including experts identified for the Delphi studies were invited to join the study. Participants should be ≥ 18 years of age, and had relevant experience in Health EDRM and in disaster education and training programs. A self designed questionnaire containing 28 questions in four domains including competencies; curriculum; evidence gaps; work and personal details were used.

There were 65 respondents from 20 countries participating in the survey. Most of the respondents worked in academic institutions (60%), followed by government employees (19%), and non-governmental organizations (7%). These organizations have roles throughout the disaster cycle with 95% in the preparedness phase. For management skills, EDRM managers should be competent in planning, organizing, applying management processes, establishing effective communication systems and providing effective leadership. For technical competencies, emergency communications, hazard specific knowledge, communicable diseases were essential for frontline workers. In terms of designing the competency matrix, WHO resources were frequently used for the competencies and the curriculum design.

Health EDRM managers are expected to master a large number of managerial and technical skills, including the increasingly recognized leadership and decision-making skills for effective planning and implementation. These competencies need to be established for the development of a Health EDRM workforce.

Particular skills are critical when participating in trauma response. Engagement and practice with these skills can help build staff confidence, however, ensuring competency across all staff can prove challenging. Establishing a training utilizing skill stations can positively affect staff experience and confidence measures on predetermined dates to capture all team members is a way to ensure confidence in skills vital for patient care in ED settings. Execution of the “skill station” exercises at measured intervals demonstrated improved confidence in trauma skills by ED staff. Exercises with specific skill-oriented practicum offer low-cost, dynamic training opportunities. Improving confidence and competence in critical trauma-related clinical skills directly improves patient outcomes.

Six trauma skill stations were created, aimed at specific skill-based practices. These measured skill competencies include arterial line setup, rapid blood infuser use, defibrillator use, chest tube management, pelvic binder application, and tourniquet application. Competency was reached when participants could effectively perform the skills through teach-back technique.

Qualitative feedback demonstrated that nurses felt more confident responding to a patient needing trauma interventions in an ED setting. Nursing staff were more engaged with trauma skills in their scope. All participants were able to appropriately and adequately teach-back the skill with 100% accuracy. Improved knowledge retention will be measured in future training sessions.

Pre and post-tests could be utilized to demonstrate more dynamic results. This measurement tool will be utilized in the formal training process moving forward to capture baseline and improvement data more objectively.

This low-cost and highly efficient method of strengthening novice nurses’ trauma skills competency and confidence can be utilized across various skills and departments. More confident nurses show improved readiness to respond to a patient in need of trauma interventions.

Unfortunately, before SARS-CoV-2, a global workforce crisis in health care had already been flagged internationally and is only expected to grow. Health care workers are the critical driving force underpinning all health systems. A skilled workforce takes years to develop, and staff shortages have enduring negative impacts on patients, patient safety, and the ability to deliver Universal Health Coverage.

A scoping literature review on health care worker mortality and morbidity resulting from SARS-CoV-2 was undertaken and included reviewing the peer-reviewed and grey literature.

Four opportunities for improving the protection of health care workers during a pandemic were identified:

1. 1) Strengthening data collection and reporting standards of health care worker mortality and morbidity due to SARS-CoV-2

2. 2) Improving the protection of health care workers

3. 3) Accelerating the vaccination of health care workers against SARS-CoV-2, and

4. 4) Addressing gender inequities in health care

These four approaches provide opportunities for improvement and are only preliminary steps in addressing the ‘perfect storm’ that the shortage of global health care workers and the ongoing SARS-CoV-2 pandemic have created.

The global community has a unique opportunity to protect health care workers and improve pandemic preparedness and response. The health and socioeconomic impact of SARS-CoV-2 has been unprecedented, and health care workers have borne the brunt of this pandemic. We owe our health care workers more. Without a well-trained and adequately resourced health care workforce that is prepared to face the next pandemic, we as a global community will not be able to deliver global health care or global security at the level that is required.

Germany is a highly developed country. Nevertheless, there are reports that people have supply problems or die lonely and alone in their homes. Despite a differentiated social system, there seem to be significant gaps for individuals or old people. The rescue service is often involved in situations with unclear emergency calls or calls from third parties regarding social and supply problems. In some emergency cases the rescue service is alerted to someone's home but there is no response. Depending on the available information, a timely decision must be made to have the opportunity for life-saving. The door opening procedure is executed by the fire department. Afterward, the medical emergency teams take over. The goal of the study is to analyze findings discovered after opening the door.

Data of all emergencies from the dispatch center of Dresden operated by the fire and rescue department between January 2021 and December 2021 were recorded and transferred to a central database. All cases with the need to force the door open were extracted and analyzed.

There was a total number of 157.522 cases of emergency. In 847 cases the door was opened by the fire department. After door opening there was no emergency reported in 265 cases. 100 patients were found dead, six patients had cardiac arrest and received cardiopulmonary resuscitation, and 310 patients were transported to a hospital. The causes for emergencies were social problems, downfall and injuries, hypoglycemia, convulsion, stroke, psychiatric emergencies, dementia and suicide attempt. The mean age was 71 [18-103], 54,15% of patients were female.

There is a high number of emergencies with the need to open the door. The number of patients transported to a hospital is also high and justified the procedure. Since numerous patients were found dead, this underlines a gap in the German social system.

Emergency Medical Service (EMS) workers are critical to effective disaster response in Saudi Arabia. The World Health Organization requires countries and governments to have prepared emergency health workers and disaster action plans. Therefore, it is important to understand the disaster knowledge, skills, and preparedness of Saudi Arabian EMS workers. This study investigated factors influencing EMS workers’ disaster knowledge, skills, and preparedness in the Saudi Arabian context.

A descriptive cross-sectional survey using The Disaster Preparedness Evaluation Tool was distributed to EMS workers in military and government hospitals across three Saudi Arabian cities. Responses were recorded on a 6-point Likert scale where higher scores indicated higher knowledge, skills, or preparedness. The results were analyzed using descriptive and inferential statistical analysis.

272 EMS workers participated in this study. EMS workers reported a moderate level of knowledge (3.56), skills (3.44), and preparedness (3.73) for disasters. Despite the moderate level, EMS workers reported a high level of involvement in regular disaster drills (M=4.24, SD=1.274) and a strong interest in further disaster education opportunities (M=5.43, SD=1.121). Participants also reported a high skill level with the triage principles used in their workplace during a disaster (M=4.06, SD=1.218). The study findings revealed a significant positive correlation between disaster preparedness levels and age, years of experience, education level, and the facility worked in.

EMS workers have moderate disaster knowledge, skills, and preparedness levels. Knowledge, skill, and preparedness have a significant relationship with the EMS workers’ demographics. These findings demonstrate the need to invest in preparing Saudi Arabian EMS workers to effectively respond to bioterrorism disasters.

Standardization of data collection and reporting within EMT’s is challenging. In past deployments, the Red Cross Red Crescent Type one and two facilities (Emergency Response Units- ERU’s) have collected data by hand using paper-based form and Excel spreadsheets. This process can be laborious, time consuming and often inaccurate.

RCHIS is both an electronic medical record (EMR) and health information system (HIS). RCHIS has been designed to produce pre-made reports including the MDS in seconds extracting data from the patient records. Through significant testing and pilot deployments in a domestic type one fixed clinic, the rapid production of reports such as the MDS has increased compliance and accuracy with reporting.

The utilization of an EMR and integrated HIS system for increasing compliance and accuracy with the MDS has been hugely successful. An in-depth analysis of the export data was done to confirm the 100% accuracy within the MDS report.

Furthermore, feedback from users and managers within the ERU’s expressed the excitement for the ease of reporting not only to the EMTCC, but also to IFRC and back-donors. Moving forwards, this data collection will also be used to collect essential data to audit and improve the quality of care provided within the RCRC ERU’s.

In conclusion, the utilization of RCHIS within a domestic ERU (equivalent to an EMT type one or two) has been hugely successful. The next steps will involve the deployment of RCHIS within an international deployment.

Children are frequently victims of disasters. However, gaps remain in disaster planning for pediatric patients. The New York City Pediatric Disaster Coalition (NYCPDC) is funded by the NYC Department of Health and Mental Hygiene (DOHMH) to prepare NYC for mass casualty incidents that involve large numbers of children.

On April 26, 2018, the NYC PDC conducted a first in NY, full-scale exercise with the NYC Fire Department (FDNY) testing evacuation, patient tracking, communications, and emergency response of the Obstetrics, Newborn and Neonatal units at a NYC based hospital. The goal of the exercise was to evaluate current Ob/Newborn/Neonatal plans and assess the hospital’s ability to evacuate patients.

The exercise planning process included a review of existing OB / Newborn / Neonatal plans, four group planning meetings, as well as, targeted specific area meetings and plan revisions. The exercise incorporated scenario-driven, operations-based activities, which challenged participants to employ the facility's existing evacuation plans during an emergency.

The Exercise assessed the following: Communication, Emergency Operation Plans, Evacuation, Patient Tracking, Supplies and Staffing. Internal and external evaluators rated exercise performance on a scale from 1-4. Evaluators completed an exercise evaluation guide based on the Master Scenario Event List.

An After Action Report was written based on the information from the exercise evaluation guides, participant feedback forms, hot-wash session, and after action review meeting. Strengths included the meaningful improvement of plans before the exercise (including the fire department) and the overall meeting of exercise objectives.

Lessons learned included: addressing gaps in effective internal and external communications, adequate supplies of space, staff, equipment needed for vertical evacuations; providing staging and alternate care sites with sufficient patient care and electrical-power resources. The lessons learned are being utilized to improve existing hospital plans to prepare for future full-scale exercise and or real-time events.

Mass gathering events (MGE), can attract sufficient attendees to strain the planning and response resources of the host community, state, or nation, thereby delaying the response to emergencies. The organization of such a MGE can be even more problematic when the event continues across much of downtown (including hospitals) and makes some parts of the city inaccessible. The aim of this study was describing the health care management of the Grand Départ of the Tour de France, July 6-7th, 2019. On both days, the stages drew crowds of 300,000 attendees, adding a quarter of the regular number of inhabitants of Brussels (1,2 million) and closing parts of downtown Brussels.

Data were retrospectively collected from the in-event health services (coordinated by the University Hospital Brussels). Data regarding medical interventions, as well as data generated by the advanced medical posts (AMP) were recorded and handed to us after anonymization. For analysis, patients were divided into two groups: those seen by first-aid responders and paramedics (triage code green) and those seen and treated by health professionals (emergency nurses and physicians) (triage codes yellow or red).

During the event, three AMPs were established along the route of the stage as were six ambulances, three mobile medical crews (one emergency nurse and one physician), and seven mobile first aid teams. Over the two days, 84 patients were seen; 80 green codes (95,2%), 3 yellow (3,6%), and one red (1,2%) resulting in a patient presentation rate of 0.28/1,000. In total eight patients were transported to hospital for further diagnosis and treatment (ambulance transfer rate: 0.02/1,000).

In-event health services for this event proved adequate according to the number of attendees and the severity of the patients. No hospital reported disruptions to their standard operational capacity.

Distilling from the National Risk Assessment for Ireland, the Regional Working Group for Major Emergency Management Region South (Cork and Kerry) assessed threats in the region and 22 hazards were identified which were distributed over the natural, transportation, technological and civil categories. The hazards were plotted on an Interagency (Health, Police and Local Authority) Emergency Management Risk Matrix

A three-hour ‘Introduction to Emergency Management’ educational program was developed in May 2022 with the aim of introducing frontline members of the Principal Response Agencies (Health, Police and Local Authority) across the Cork and Kerry region to the concept of emergency management. As part of this educational session, participants (N = 55) were given an overview of the regional risks as identified through the risk assessment process by the Regional Working Group for Major Emergency Management. As part of a breakout session, course participants were asked to identify their perspective on ‘worst case scenario’ risks.

An analysis of the operational risks identified by members of the Principal Response Agencies (Police, Health and Local Authority) were categorized into the four risk sub-headings: natural, civil, technical and transport and compared with the strategic regional risk assessment. The differences identified based on the comparative analysis, detailed that those holding operational portfolios identified that concurrent risks, as evidenced during the Cyberattack on the Health Service Executive in May 2021 during a wave of the global pandemic in Ireland were a perceived 'greater' risk that those traditional risks identified in the regional risk assessment.

This study highlights the importance of engaging operational staff when developing regional emergency management risk assessments. The requirement to consider and incorporate concurrent emergency management risks is vital to ensure that the Cork and Kerry regions are prepared for future events.

Management of outbreaks rely on hospitals’ health information technology (IT) to electronically share data to public health systems. Studies show that half of non-federal hospitals reported a lack of capacity to exchange information with public health agencies, placing a variable burden on institutions to meet the government mandated reporting requirements. This study aims to contrast the impact of COVID-19 reporting requirements across two New York City institutions with disparate health IT capabilities.

A retrospective, qualitative study contrasting the impact of reporting requirements on a small independent hospital (SIH) with 198 staffed beds and a large, networked hospital (LNH) with eleven campuses during the COVID-19 pandemic. Researchers conducted 51 interviews with hospital leadership, clinical directors, and infection control personnel. Interviews were transcribed and coded using qualitative analysis software.

The LNH had a 50-person analytic team that handled reporting tasks, a centralized data warehouse that was automatically updated, electronically generated reports with universal access, and limited burden of clinical staff. The SIH had no dedicated analytic team. Seventeen departments were utilized to handle reporting tasks with no centralized place to share electronic data, limited capacity to create automatically updated reports, a daily manual information gathering processes, and significant need of clinical staff to collect data. Both SIH and LNH faced challenges associated with the distribution of responsibilities and resources with pressure to report in a timely fashion. However, the burden on the SIH was so onerous that it significantly impeded routine hospital work and patient care.

The disparity in health IT capabilities highlights significant institutional inequities and variability in response during a pandemic. The findings have implications for how government and other regulatory bodies may adjust policies to equitably meet public health needs and not unfairly burden small hospitals.

The NO FEAR project is dealing with operational aspects of the response to security-related incidents. Recent attacks globally demonstrate the complexity of the scenes and the fact that by nature the scene is not safe, though EMS personnel are intervening in those unsafe environments.

During a series of workshops with different EMS providers and managers the following ideas have been discussed: 1) Acceptable risk is part of EMS work 2) EMS personnel should be trained to conduct a personal risk assessment on-site and take appropriate action 3) EMS personnel on site should not think about the "large scene" but on the specifics of their site of operations

This new way of thinking requires a shift of paradigm in EMS, which for many years was "safety first" or "don't engage unless the scene is safe", ignoring the change like deliberate attacks against the population.

Recent attacks present new threats and risks for EMS personnel, coupled with public expectations (who are on the scene providing assistance to their fellow injured citizen) are a call to EMS leaders to re-think the way we teach and address scene safety in security related incidents.

People around the world are affected by traumatic experiences, ranging from collective events like natural disasters, mass violence, war, terrorism and to personal, even "everyday life" traumas such as road traffic accidents and the sudden football attack. The mTBI caused by traumatic events is a significant public health international matter. There is a greater demand for mTBI research from all cultures and societies. This paper attempts to explore the research status, focus and challenges by using a bibliometric analysis on mild traumatic brain injury (mTBI).

Publications on mTBI were retrieved from the Web of Science Core Collection by the title advanced search strategy from January 1, 2000, to October 31, 2022. Articles and reviews were included, and no language restrictions were applied. Microsoft Excel, RStudio, VOSviewer, and CiteSpace were used to extract, integrate and visualize the bibliometric information.

A total of 3,464 documents were retrieved from 2000-2022, with a general upward trend despite slight fluctuations in annual publications. The USA had an overwhelmingly dominant position in terms of both the number of publications (n = 2 028) and citations (n = 63 287). The Department of Veterans Affairs (n = 380) and Veterans Health Administration (n = 370) were the most productive institutions. Collaborations in cross-national, cross-institutional and different authors were weak. Iverson GL was the leading scholar and the Journal of Neurotrauma and Brain Injury were the most influential journals. Based on keyword co-occurrence analysis, the research focus could be divided into four clusters: epidemiology and prevention, characterization of mTBI, outcome assessment and prognosis.

The mTBI research has drawn increasing attention over the years. However, the research on mTBI is still relatively limited and challenging, and collaborations that cross national, institutional, disciplinary, and sector boundaries are important to the advancement of improving mTBI worldwide.

The Japanese Red Cross Society has been supporting MCI response support for Palestine hospitals in Lebanon since 2018.

It was started from a hospital as a single topic in a one-year ER trauma course, which was combined with an ER triage course. In the next hospital it was revised into not only a theological lecture course but also a field triage training course with pre-hospital volunteers. As a result, when the Beirut explosion happened in 2020, the first hospital could accept more than 50 green patients at once, and the second one sent a pre-hospital team to do triage at the scene showing that training courses were useful in a real MCI case .

At this time, support is being provided in a new hospital by making use of these experiences. A current report will be available when this association is held.

MCI response support for refugee camps is improving through trial and error, which would have much in common with other MCI responses in many countries and areas.

The COVID-19 pandemic created a public health crisis worldwide. Mass vaccination efforts in some cases were initiated without adequate civilian manpower due to critical medical staffing shortages. The governments of many nations deployed their military assets to fill gaps in care and to initiate projects to promote vaccinations. The COVID-19 pandemic created a unique international military vaccination response to an infectious disease disaster.

This literature review highlights creative solutions, abilities utilized, projects completed, overall effectiveness, and lessons learned by the military community worldwide to support their vaccination efforts within their countries. By collating this information into a single document, the collective global experience can be better analyzed and this information utilized to develop a framework for future disaster preparedness and mitigation planning efforts.

Medline (PubMed), GoogleScholar and the JSTOR Security Studies collection were searched for English language articles from January 1, 2020 and onwards. Keywords used included civil-military coordination, military, COVID-19, vaccination, vaccine. Titles were initially screened for relevance. The abstracts were then reviewed for a decision on inclusion. Article inclusion was determined by author consensus based on relevance to the objectives. Key papers were also hand searched for additional unidentified references.

Data collection and analysis planned for completion by January 2023.

The COVID-19 pandemic created a public health need for mass vaccination distribution that was assisted by militaries throughout the world. This literature search demonstrates the ways in which military resources contributed to COVID-19 vaccination efforts, including creative techniques, successes and opportunities for future improvement.

Around two billion people globally were affected by natural disasters between 2008 and 2018. Countries are required to effectively prepare their healthcare workers for disaster response. A greater level of preparedness is associated with a more effective response to disasters. The World Health Organization requires countries and governments to have disaster plans and emergency health workers ready and prepared at all times. This integrative review aims to understand emergency healthcare workers’ perceived preparedness for disaster management.

An integrative literature review using the PRISMA checklist guidelines was conducted to explore physicians, nurses, emergency medical services, and allied medical professionals’ preparedness for disasters. Literature was searched from 2005, published in the English language and from MEDLINE (PubMed), Google Scholar, EMBASE, PsycINFO, SCOPUS, ProQuest and CINAHL databases. Reviews, case reports, clinical audits, editorials and short communications were excluded. Studies were critically appraised using the Mixed Methods Appraisal Tool.

The initial search yielded 9,589 articles. Twenty-seven articles were included following the application of the eligibility criteria. Included studies were geographically diverse including North America, the Middle East, and the Asia Pacific. Most studies (n=24) assessed the knowledge of healthcare workers in general disasters. Studies using the Disaster Preparedness Evaluation Tool reported moderate disaster preparedness and knowledge, while studies using other instruments largely reported inadequate disaster preparedness and knowledge. Regional variations were recorded, with high-income countries’ reporting a higher perceived preparedness for disasters than low-income countries.

The majority of emergency healthcare workers appear to have inadequate disaster preparedness. Previous disaster experience and training improved disaster preparedness. Future research should focus on interventions to improve emergency healthcare workers' preparedness for disasters.

The trauma care system in Ireland is being re-configured to have major trauma centers for severe injuries and other sites for less severe injuries. This is to ensure patients are brought quickly to the most appropriate hospital to manage their injuries. The National Ambulance Service (NAS) electronic Patient Care Record (ePCR) records what happens to patients before they reach the hospital and the Major Trauma Audit (MTA) captures data on patients’ hospital treatment. These datasets are currently separate and if they could be joined, they would inform important decisions on which hospitals to take patients. This study aims to investigate joining these datasets to create a seamless database of the patient journey from roadside to recovery.

Proof of Concept–The ePCR and MTA datasets will be linked on a once-off basis. The combined anonymized dataset will then be analyzed to identify pre-hospital characteristics that determine the need to bypass smaller hospitals and bring patients to a larger major trauma center or trauma unit.

Stakeholder input for ongoing dataset combination and utilization–A stakeholder consultation process will explore the best way to make a GDPR-compliant combination of datasets on an on-going basis, including geo-location data and the inclusion of patient reported outcome measures. This will incorporate the requirements of the Data Protection Commissioner, National Office of Clinical Audit, patients, clinicians, NAS, HSE and other stakeholders.

Geospatial implications of major trauma services–Once ongoing data combination is approved, we will determine geospatial implications of the trauma network for prehospital care configuration and the patient journey.

Study results will inform prehospital service configuration to ensure safe and equitable patient management.

The data arising from this study will capture the full trauma patient journey. This data is essential to inform policy and practice for trauma care in Ireland.

The pandemic of COVID-19 in the northeastern part of Thailand established the response mechanism to COVID-19.

This study aimed to explore the PHER model of the COVID-19 pandemic in three provinces located in northeastern Thailand. The target group was 78 people who were responsible for COVID-19 response from the sub-district, district, and provincial levels. The data was collected through in-depth and group interviews following the non-structure interview guide and data was analyzed by content analysis.

Two levels of the PHER model were: 1) The response of the provincial level related to national and global situations. The provincial’s measure of the COVID-19 response was run by the Provincial Communicable Disease Committee (PCDC) and followed by the COVID-19 Epidemic Administrative Center (CEAC). The core team was a public health subcommittee who ran the Emergency Operation Center (EOC) and COVID-19 pandemic. The PCDC launched the provincial measure, risk communication response to COVID-19, and issues of the pandemic from CEAC and EOC. 2) The response inside the provincial level two components of the structure were the PCDC and the PEOC and the district EOC. They composed the Situation Analysis Team (SAT) and Joint Investigation Team (JIT), which was an operation to surveillance, investigation, real-time situation and reported to PEOC and PCDC as the issues of measures decision. Thailand’s identity of the PHER model was the village and sub-district on behalf of the Communicable Disease Control Unit (CDCU) and Community COVID-19 Respond Teams (CCRTs) in which members were Health Volunteer (HV), Village’s leader, and Local organization. Core activities were screening the risky group and surveillance: Home or Local quarantine and Home isolation (HI) or community isolation (CI) of rehabilitation from Covid-19 post treatment.

The strengthening of PHER depended on the CCRTs and CDCU which supported the PEOC and PCDC to prevent and control Covid-19.