Behaviors to avoid infection are key to minimizing casualties of the COVID-19 pandemic. Even so, infection-avoidance behavior may also cause distant health impacts like immobility and obesity. This research aims at identifying behavioral patterns associated with SARS-CoV-2 infection, exercise habits, and being overweight in the Japanese population.

Nationwide online questionnaires were conducted five times from October 2020 to October 2021. Individuals who answered with consistency to have been diagnosed with SARS-CoV-2 at a medical facility were categorized into a SARS-CoV-2 group. The difference in lifestyle is compared using multiple regression and inverse probability weighing. In addition, the change in exercise habits, body mass index (BMI), and status of overweight (BMI>25kg/m2) were compared between the first questionnaire and the later ones. Risk factors of losing exercise habits or developing overweight were analyzed using multiple regression.

Diagnosis of SARS-CoV-2 was negatively correlated with crowd avoidance, mask wearing, hand washing behavior. On the contrary, the diagnosis was positively correlated with some behaviors that appear as preventive actions against the infection, such as changing clothes frequently, sanitizing belongings, and remote working. Regarding exercise habit and overweight, people with high income and elderly females showed higher risk of decreased exercise days. The proportion of overweight was increased from 22.2% to 26.6% in males and from 9.3% to 10.8% in females. Middle-aged males, elderly females, males who experienced SARS-CoV-2 infection were at higher risks of developing overweight.

It is important to conduct an evidence-based intervention on people’s behaviors and to avoid excessive intervention that is less effective so that people can minimize indirect harm such as exhaustion, economic loss, and other chronic health impacts. Our findings suggest that high-risk groups of COVID-19 infection and immobility and/or overweight are quite different. Further research may enable us to establish more effective interventions for each group.

In January 2021, the State of Louisiana approved COVID-19 vaccine distribution to elderly and immunocompromised persons. From annual hurricane planning assessments, the city of New Orleans recognized medical and transportation barriers would prevent some eligible residents from accessing vaccines at public point of dispensing (POD) sites. A new vaccine distribution system was needed for homebound individuals and their caregivers. By February, the city developed and implemented a homebound vaccination plan under the direction of New Orleans Emergency Medical Services (NOEMS) and the New Orleans Health Department. This presentation will review this vaccine distribution model and the opportunities and challenges identified in maintaining this model for future medical POD interventions.

The City of New Orleans, along with news outlets and service providers, instructed homebound residents and caregivers to self-identify their need for a homebound vaccine by calling 311 and adding their name to a centralized waitlist. NOEMS/NOHD staff would schedule appointments based on resident and provider availability and geography of their home residence. Two 2-person teams were deployed simultaneously to provide ten doses within a five-hour time frame to minimize waste. Each deployment team included one city employee with an EMS certification and one volunteer, along with a cooler, ancillary supplies, registration form, and educational sheet to complete the appointment.

350 homebound residents and caregivers were vaccinated with the COVID-19 vaccine from February 2021 to January 2022. Vaccine doses were rarely wasted due to the availability of a centralized city-wide vaccine request list.

The COVID-19 pandemic exposed gaps in mass dispensing plans and procedures. This local plan, created in haste to meet community need, became a model practice for other Parishes within the State of Louisiana and nationwide. This distribution modality needs to be maintained and tested, in addition to traditional POD sites, to be utilized in future dispensing events.

Various COVID-19 countermeasures were taken at Japan border control policy, especially, the return mission of Japanese nationals from Wuhan and the response to the Diamond Princess are considered to be cases that have stood out worldwide attention.

On the other hand, in response to the variants after December 2020, strict measures were taken, such as testing all those who entered Japan, quarantining those who tested positive, and requiring those who entered from certain regions to wait at some hotels even if they tested negative.

Report the response of quarantine in Japan.

In particular, for the Omicron variant in December 2021, the government took measures such as limiting the total number of people entering Japan, securing a maximum of over 20,000 rooms in a very short period of time, and providing domestic air transportation when necessary. The results of measures will be reported in this study.

Various countermeasures taken as border control against COVID-19 in Japan were reported.

In the Netherlands, a nationally coordinated research program has been initiated to monitor the immediate and long-term public health impact of the COVID-19 pandemic. This contribution describes the design and early results of a continuous dialectic process to involve national and local public health authorities and professionals in monitor-driven decision-making to anticipate the health impact of viral infections and mitigation measures.

An ongoing series of dialogue sessions was organized upon the release of quarterly and annual results of the monitoring program. Apart from supporting public health decision-making, the stepwise dialectic process aimed to ensure multi-sectoral learning and co-creation and nurture a sense of ownership among stakeholders from policy, practice and science. National and regional public health authorities served as hub coordinators and participated in determining and approaching relevant stakeholders. Whenever considered relevant, new stakeholders were invited to participate.

In the first year, three dialogue sessions were organized, with an emphasis on youth and young adults. Representatives from ministries, municipalities, health organizations, experiential experts and knowledge institutes attended the sessions. Based on the exchange, policy recommendations were formulated and shared among participants. The themes prioritized included mental health issues, overburdened healthcare services, involvement of vulnerable groups in policy development and understanding the complex myriad of risk factors. Moreover, several factors were identified that might facilitate or hinder the implementation and uptake of monitoring findings.

The dissemination and discussion of monitoring data proved to be of added value in developing evidence-informed solutions and areas of attention for future monitoring, including the need to track progress of local and national implementation of recommendations. More broadly, the methodology piloted during the program requires further testing as a community engagement strategy and might be meaningful in other crises or problem contexts as well.

As the number of individuals impacted by disasters rises, an adaptation of Psychological First Aid (PFA) into a group intervention is warranted. Such a model would allow for more people to receive the support they need, while harnessing the power of group interventions. Groups have established effectiveness that is equivalent, if not superior, to individual treatment. Additionally, the five essential elements of early intervention for mass trauma (safety, calm, efficacy, connectedness, and hope) are closely related to the established mechanisms of change in groups. Groups are particularly well-suited to promote connectedness, the element with the strongest empirical link to recovery. Nevertheless, groups are underutilized in disasters and caution is warranted as some models have been shown to cause potential harm by over-exposing those involved to one another’s trauma and attempting to process the trauma when the focus should be on stabilization. This presentation proposes a model for group-based PFA that incorporates the known risks and benefits of disaster response and group interventions.

Literature on group interventions for disaster was reviewed and compared to established best practices in disaster mental health including PFA, Skills for Recovery, and related interventions. This literature was combined with the clinical and training experience of the presenters to develop an initial model for adapting PFA into a group intervention.

The model proposed involves dissemination of PFA’s general tenets among large groups and then utilizing small groups to provide the PFA core skills most applicable to each group. The model also incorporates group processes known to promote recovery that are not available in individual interventions, emphasizing the role of group cohesion to create connectedness and social support.

This proposal is conceptualized as a tabletop presentation to allow for discussion, with a goal of advancing Group PFA and recommending next steps in its development and dissemination.

The risk internationally of terrorist attacks and other mass trauma incites societies to strengthen the planning and implementation of psychosocial care. Prior findings have documented that psychosocial care responses, especially long-term follow-up, differ substantially between countries. With the aim to strengthen future psychosocial care responses and research, this presentation describes the models for psychosocial care and research activities following terrorist attacks in European countries.

Pre- and post-attack policy documents and reports addressing the psychosocial care responses to terrorist attacks were identified, and research on the mental health of affected individuals and psychosocial care provision was reviewed.

Although several aspects of the acute psychosocial care responses to terrorist attacks were similar across countries, there were substantial differences as to if and how long-term follow-up interventions were planned and implemented. There were also major differences in whether or not monitoring of and research on the psychosocial care responses were conducted, and existing research had important limitations.

In order to strengthen the public health responses to future terrorist attacks and other mass casualty incidents, there is need for more standardized registration of affected individuals, as well as international models for monitoring their health and longitudinal research on the countries’ psychosocial care provision. During the presentation, it will be discussed how monitoring and research can be improved in this context.

Medical and paramedical staff endure a psychological toll of burn-out as part of the heavy personal consequences of their work, with an immeasurable increase during the Covid-19 pandemic outbreak. In Israel, there is an added stress of the highly unstable political situation, including war and racial-riots with direct hits of missiles leading to mass casualty events. Members often had to stay in the hospitals for days as the roads home were blocked. Wolfson Medical Center (WMC) is a medium size, level II hospital in the center of Israel. It serves a complex population, most from low to medium socioeconomic status, and a large population of displaced persons. The responsibilities of the staff weigh heavy, leading to psychological trauma, with clear signs of anxiety, depression and suicide.Israel Trauma Coalition (ITC) is a non-profit organization collaborating with over 40 organizations to create a continuum of care in psycho-trauma, response and preparedness.

ITC has initiated a Resilience-Trustees program, establishing a strong and active group within the organization, with adequate representation from each department and profession. Training the team to identify a colleague in distress, to respond adequately and to refer to professional help as needed. The program has started implementation in various hospitals in Israel, including WMC.

The expected results of this program is a change in the organization's culture of discourse and daily interaction so as to promote resilience and mutual trust and to help cope favorably with crisis situations. The actual results will be shown through a case study of the WMC team of Resilience Trustees, in accordance with the steps of the program (resilience in the original team, then the overall staff).

This initiative will promote awareness and acceptance of mental, personal and team difficulties, as well as reduce risks of secondary traumatization, burnout and other disorders.

Compassion, calming down and providing aid are common ways of helping people in need soon after traumatic events. However, such forms of help were seldom tested and other research suggests that active coping may have more positive long-term effects. The SIX C's model was created to provide simple and effective evidence-based Psychological First Aid guidelines that help shift the person from helpless into active and effective activation in a very short time. The model emphasizes the need for cognitive communication as well as effective activation in contrast to the previous concepts of calming and emotional communication

This retrospective cross-sectional study examined empirically the SIX C's Model's basic concepts. We checked the association between whether people received activating versus more passive forms of aid during crises, their self-efficacy and post-traumatic stress disorder (PTSD) symptoms. 428 participants completed scales on the type of aid received during past traumatic events including activating aid (encouraging active and effective responses) versus passive aid (receiving compassion, calming down and general aid), as well as their current general self-efficacy (GSE) and PTSD symptoms

Results revealed that passive aid was not related to PTSD while activating aid correlated inversely with PTSD. Importantly, both resilience and GSE emerged as mediators and moderators between activating aid and PTSD. The moderation showed that receiving activating aid was associated with less PTSD only in people low on resilience or GSE

The study revealed a major role for self-efficacy in protecting people from PTSD. Self-efficacy not only statistically mediated the relationship between active aid and PTSD but also moderated this relationship. The findings underline the importance of encouraging the person to act effectively during the event and to maintain cognitive communication. This type of aid leads to increased self-efficacy and contributes to the reduction of risk for PTSD.

Historically, the child care industry has been unprepared for emergencies. A previous study identified gaps in Michigan’s child care programs’ emergency plans. Study objectives were to reassess programs’ preparedness plans after the introduction of state-mandated emergency plans and to examine the effect of the COVID-19 pandemic on programs’ operations.

A 29-question survey was sent to ~500 child care programs across Michigan in 2020 to assess emergency plans and response to COVID-19. Data were analyzed using descriptive statistics and qualitative methods.

Overall, 346 programs (70%) responded. Most (92%) reported having a written plan, but one-third reported having no infectious outbreak plan pre-pandemic. One-third of programs lacked plans for special needs children (vs. 40% in 2014); 62% lacked plans for child reunification (vs. 60% in 2014); 46% reported staff received no preparedness training. COVID-19 impacted programs substantially: 59% closed, 20% decreased capacity, and 27% changed disinfecting protocols. Several themes related to the pandemic’s effect on programs were identified: 1) changes in learning 2) changes in socialization 3) increased family burden 4) financial challenges 5) lack of guidance.

Significant preparedness gaps remain among Michigan’s child care programs, suggesting the need for increased support and the addition of emergency preparedness to programs’ quality ratings.

During the 2022 Multinational Monkeypox Response, cases of Monkeypox illness reported in children and adolescents in the US were rare. Early in the response, little was known about MCM safety and efficacy for treating monkeypox in children and adolescents. As cases in children and adolescents increased, knowledge about safety and efficacy evolved.

Cases of monkeypox in children <18 years of age across the US were reported to CDC. MCM consultations from clinical and regulatory affairs subject matter experts supported clinician administration and management of antiviral and immunoglobulin treatment. Data from the first pediatric cases were collected to help answer some of these questions on the use of MCM in pediatric populations.

Across the US, 116 cases of monkeypox in children <18 years of age have been verified through October 2022. Of these cases, 41 occurred in patients twelve years of age or less, with 75 cases in adolescents 13-17 years of age. Ten percent of patients were hospitalized, none required ICU care and no deaths occurred. Children were most commonly hospitalized due to young age, rash near or including the eye, secondary bacterial infections, or pain management. At least eleven patients with confirmed orthopoxvirus were treated with tecovirimat and two with Vaccinia Immune Globulin. Those who received MCM recovered and tolerated treatments well with one patient stopping treatment secondary to development of a drug rash.

Data on the safety and efficacy of MCM for monkeypox are limited in pediatric populations. As of November 3, 2022, most cases of monkeypox in the pediatric population in the 2022 monkeypox outbreak were mild and self-limited. Patients who received MCM recovered and tolerated treatments without serious adverse events. These findings can inform clinicians and public health providers about the clinical features of monkeypox in children and provide information about MCM treatment options.

Endovascular procedures in emergencies like the implantation of tubes for a life support system are increasing. Guidewires are the essential basis for the regularly used Seldinger Technique. We present a novel concept that may further optimize the safety and efficacy of guidewire handling and navigation during endovascular procedures.

Using specifically designed luminescent particles, a novel, clinical-grade coating protocol was created to develop a new luminescent guidewire. Different prototypes were designed and tested for their luminescent capacity following a short exposure to any light-source. Chemical-analysis, hemocompatibility, hemolysis and cytotoxicity testing of the new guidewire was performed. The usability of the new prototype was compared to regular guidewires by application into needles, catheters and tubes which are used during percutaneous procedures.

The engineered guidewires demonstrated a luminescent capacity of at least 20 minutes after less than ten seconds of exposure to a light source. Chemical analysis, cytotoxicity, hemolysis, and hemocompatibility indicated a biocompatibility profile of the guidewire. Good usability, safe and rapid handling was demonstrated when simulating endovascular procedures. Under dimmed-light conditions, the luminescent guidewire demonstrated substantially enhanced visibility when compared to the standard-of-care.

We present a new, luminescent guidewire that may enhance the safety and efficacy of endovascular procedures, especially where light conditions are suboptimal or for emergency situations when procedures have to be as fast and efficient as possible.

Severe bleeding from external wounds is a major reason for death. Immediate control of hemorrhage is of highest priority. We present the novel Acute Wound Occluder (AWO) which was developed for rapid and targeted wound occlusion. Here, we present the design, in-vitro testing, and in-vivo performance compared to QuikClot® using a clinically-relevant pig model.

AWO is made of an applicator with pushing function into which a self-expanding, Silicone coated Nitinol meshgraft is mounted to enable plugging into the wound-channel. In-vitro tests included biocompatibility, cytotoxicity, skin sensitization, and aging validation. Next, 12 pigs underwent standardized sized femoral-artery puncture to mimic life-threatening bleeding and were either treated with the AWO (n=6) or QuikClot® (control). Animals were followed-up for 4hrs, before device-removal macroscopic assessment.

The AWO successfully passed all in-vitro tests. The AWO could be delivered within 40±15 seconds to the wound to achieve instant bleeding control, and no additional manual compression needed. Quick Clot application was less convenient, with approximately four minutes (application 56±8ss, plus three minutes of manual compression) to achieve bleeding control. In all AWO treated pigs, exsanguination could be prevented immediately, no major blood-pressure drops occurred, with four pigs where bleeding could be completely stopped, and two pigs with irrelevant oozing which stopped within 75-150 seconds leading to minimal blood-loss of 12ml and 2ml. Tissue-analysis showed only small hematomas in five out of six animals. In contrast, QuickClot treated pigs showed significant bleeding and a blood-loss of 19ml. All six pigs showed substantial hematomas, two out of six showed very large hematomas. AWO application appeared to be safe with no peri-procedural adverse-events (AEs) or collateral damage to surrounding tissues.

The AWO enables rapid and targeted control of life-threatening bleeding without any AEs. The AWO may represent a promising hemostatic device for bullet or knife-stab wounds.

Radiofrequency Identification (RFID) is becoming a ubiquitous technology that provides methods of tracking and organizing complex processes, and has had previously described benefits when used in medical and clinical situations such as disaster and mass casualty incidents. However, the potential benefits of this technology have not yet been examined or applied to mass gathering events such as music festivals using the medical lens.

RFID at music festivals was observed and characterized at a Canadian multi-day festival through a combination of (1) observation of real world application of the use of RFID-enabled attendee wristbands and (2) the development of a proposed implementation framework using expert input in event medical care, public health, festival safety and event organization. Potential roles for RFID technology in enhancing attendee safety, facilitating event medical care and collaborating with other on-site services, and promoting research agendas for these unique events were explored.

Observed and theoretical roles for RFID fell into four main domains: (1) the presence of important encoded personal health data and contacts specific to individuals that would be accessible in case of an emergency, (2) the unique, anonymous identification of attendees who access (and re-access) medical as well as other services, including during handovers between these services, (3) support for any larger public health research projects aimed at understanding the behaviors and flow of attendees, including recreational substance use and related harm reduction efforts, and (4) the storage of festival-tailored data throughout the event on RFID-enabled wristbands (eg previous medical visit details, self-entered substance use history, etc).

The use of RFID at music festivals has clear benefits. It allows for the dynamic access and retrieval of important data that can aid safety and support the provision of timely and tailored medical care. Security and privacy issues need consideration where attendee data is concerned.

Large-scale mass-sporting events pose unique challenges for emergency health teams. Data is limited in athletes with sudden cardiac arrests (SCAs) and the emergency medical services (EMS) in major sporting events that took place after the coronavirus pandemic.

This retrospective observational study describes data from the Taipei Marathon event that took place on December 19, 2021, in Taiwan. The temperature was about 15.2–19.3°C. Four SCAs among 18,144 half-marathoners and the EMS were enrolled.

A medical command center was set up 100 meters from the finish line. Ten medical tents, one first-aid station, and nine event ambulances were distributed along the course, and one medical tent was placed near the baggage storage area. Each medical tent comprised: 1 doctor, 1–3 nurses, and 1–3 paramedics. The in-event EMS also comprised a mobile first-aid team. Thirty paramedics rode motorcycles and carried automated external defibrillators and emergency medical kits throughout the racecourse.

Among the 7,811 full- and 18,144 half-marathoners, the total number of SCAs was four male half-marathoners. Three runners (75%) stated that they decreased their weekly running volume during the pandemic restrictions’ period. Two runners (50%) experienced cardiac arrest in the final quarter of the race. The median interval of time between SCA occurrence and EMS arrival was 2.5 minutes (interquartile range, 0.5–4 minutes). Electric shocks were delivered to all the four runners (100%) experiencing ventricular fibrillation, and all of them were successfully resuscitated in the field. The median interval of cardiopulmonary resuscitation duration before return of spontaneous circulation was 8.5 minutes (interquartile range, 6–9.5 minutes).

4/18144 is a significantly high number of SCA compared to data from the annual Taipei Half-Marathon between 2016 and 2020 and past half-marathons worldwide. The high prevalence rate of SCA (22 per 100,000) may be due to inadequate acclimation and training volumes.

International humanitarian aid is crucial in disasters but must be needs-driven and coordinated with requests from local authorities. We identify disaster and population factors associated with international aid appeal during disasters and hence guide preparation by international humanitarian aid providers.

In this retrospective database analysis, we searched the Emergency Events Database for all disasters from 1995 to 2015. Disasters with and without international aid appeals were compared by location, duration, type of disaster, deaths, number of people affected, and total estimated damage. Logistic regression was used to examine the association of each factor with international aid appeal.

Of 13,961 disasters recorded from 1995 to 2015, 168 (1.2%) involved international aid appeals. Aid appeals were more likely to be triggered by disasters which killed more people (OR 1.29 [95% confidence interval (CI) 1.02-1.64] log10 persons), affected more people (OR 1.85 [95%CI 1.57-2.18] / log10 persons), and occurred in Africa (OR 1.67 [95%CI 1.06-2.62). Earthquakes (OR 4.07 [95%CI 2.16-7.67]), volcanic activity (OR 6.23 [95%CI 2.50-15.53]), and insect infestations (OR 12.14 [95%CI 3.05-48.35]) were more likely to trigger international aid appeals. International aid appeals were less likely to be triggered by disasters which occurred in Asia (OR 0.46 [95%CI 0.29-0.73]) and which were transport accidents (OR 0.12 [95%CI 0.02-0.89]).

International aid appeal during disasters was associated with greater magnitude of damage, disasters in Africa, and specific types of disasters such as earthquakes, volcanic activity, and insect infestations. Humanitarian aid providers can focus preparation on these identified factors.

Following humanitarian crises (e.g. armed conflict), reliable population health metrics are vital to establish health needs and priorities. However, the challenges associated with accurate health information and research in conflict zones are well documented. Often working within conflict settings are authorities and non-government organizations (NGOs) who frequently collect data under the context of operations. This operational data is a potentially untapped source of hard-to-reach data that could be utilized to provide a better insight into conflict affected populations. The Hard to Reach Data (HaRD) framework highlights the process of identifying and engaging with these stakeholders collaboratively to develop research capacity.

The HaRD framework was developed from literature searches of health and social sciences databases. The framework which provides a structure to gain access to data in hard-to-reach settings was applied to humanitarian mine action to identify and collect existing but underutilized data.

Guided by the HaRD framework we compiled the world’s first global casualty dataset for casualties of landmines and explosive remnants of war. The framework provided a structured approach to identify and engage with key stakeholders. An adaptive approach was needed for stakeholder engagement with trust building and transparency important factors in developing a collaborative partnership. Appropriate communication of research findings is important to ensure reciprocity.

The HaRD framework can identify potential data sources and guide access in hard-to-reach data settings. Operational data is often available but hidden; a systematic approach to identifying and engaging with stakeholders can assist in developing successful research partnerships between academia and humanitarian organizations.

To understand the role of medical providers in general and the radiology community in the prevention, management, and aftermath of a radiological or nuclear event.

Using a power point presentation, the author will describe in detail the role diagnostic medical imagers can play in responding to the radiological or nuclear MASCAL events.

The purpose is to educate the civilian radiology audience about their role amidst the changing nature of current nuclear threats and asymmetric and hybrid warfare in urban settings. It is very likely that in the future the civilian radiology community may be involved and respond to a nuclear crisis or a radiation accident or its aftermath before the military gets involved because it will most likely be initially a MASCAL event in a civilian setting, not immediately under the purview of the military.

Radiologists and nuclear medicine physicians will play a very critical and central role in the event of a nuclear detonation or a radiation dispersal device detonation due to their inherent knowledge of the principles of radiation, contamination, exposure and radiation protection.

Accurate triage is crucial for pediatric patients because their physiological differences make them more vulnerable to traumatic injury and mortality. However, pediatric trauma patients are challenging for EMS personnel for several reasons including infrequent clinical encounters and inadequate training. Despite the need for increased training, little is known about EMS readiness to perform triage and lifesaving interventions during pediatric mass casualty incidents (MCIs). Simulation skills assessment correlates with EMS performance in the field and can be used to determine MCI readiness.Pediatric patients are often omitted from MCI training and protocols. Feedback from EMS clinicians who participate in pediatric MCI simulations may be useful for educators seeking to optimize pediatric mass shooting triage training.

This was an observational study assessing EMS clinician accuracy in triaging eight children and two adults in a mass shooting simulation involving intimate partner violence (IPV) set at a private residence. Participating EMS clinicians were attendees of continuing education classes at Yale New Haven Health Centers for EMS. Participants worked in pairs, and triage decisions were documented during the simulation with an evaluation tool and video recording. After the simulation, pairs completed the demographic survey and completed a semi-structured debriefing. Facilitator prompts included correct triage level for each patient, the role IPV plays in mass shootings, and the participants feedback. Recordings of the debriefings were transcribed and analyzed using grounded theory. During the evaluation process, the major themes will be identified and coded. The transcriptions will be re-evaluated and any additional sub-themes will be identified and coded.

As of November 2022, eight paramedics have participated with more sessions scheduled for spring 2023. A preliminary review indicates potential themes will fall under the categories of simulation implementation and clinical approach to triage.

These findings may assist EMS agencies with their pediatric MCI training and response.

Handover is of big value in preserving continuity of the medical services chain when managing patients. Simulation is well accepted as a good learning method to acquire non-technical skills. Actual studies dealing with this issue are performed on paramedics. Studies involving physicians are rare and usually focus on interviews or questionnaires describing practical situations.

The aim of our study was to evaluate the utility of simulation in enhancing the quality of handover between both pre-hospital and intra-hospital physicians.

We conducted a prospective pre-test/post-test study in a regional Emergency Medical System (EMS) on the handover topic.

We included voluntary physicians who signed participation consent. The study was designed as a three-step project: theoretical training with pre-test and post-test, 1st simulation session, 2nd simulation session with post-test. The two simulation sessions were evaluated according to a specific score. We evaluated the progression of knowledge (tests means) and skills (percentages of good answers): before and after theoretical training and before and after simulation sessions.

Sixteen EMS physicians were enrolled. Thirteen were under 40 years old and ten were emergency medicine physician specialists. Theoretical training made progression in means and percentage good answers (post-test 1 vs. pré-test : 9.5±3.3 vs 6.9±2 ; p=0.008 et 22 vs. 10% ; p=0,001 respectively). Progression of means after simulation was noticed (2nd session vs. 1st session) (16.3±0.9 vs. 12.3±2.5 ; p<0.001). Simulation enhanced significant quality of handover. Means and percentage of good answers in tests was better after simulation sessions (post-test 2 vs. post-test 1 vs. pre-test : 10.7±2.8 vs. 9.5±3.3 vs. 6.9±2 ; p=0.01 et 29% vs. 22% vs. 10% ; p<0.001 respectively).

Our study showed the utility of simulation in enhancing handover between pre-hospital and intra-hospital physicians. Simulation as an active learning method, combined with theoretical training, can improve knowledge and enhance skills.

The mission of the medical department in the Home Front Command is to support the preparedness of Israel’s health system for emergencies, both in day-to-day routine and during wartime. This is achieved by practicing emergency scenarios in all general hospitals, including biological, chemical, and radiological mass-casualty events.

Implementing an annual drill plan in all general hospitals and practicing emergency scenarios, including non-conventional events such as mass toxicological events and radiological mass casualty events.

The presentation describes the hospital radiological and chemical mass casualty event doctrine and the drills performed in hospitals to achieve better preparedness.

The drills conducted in the general hospitals in Israel enable better preparation for CBRN emergency scenarios.