Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Prehosp Disaster Med [journal]
- Response to the Bam Earthquake: A Qualitative Study on the Experiences of the Top and Middle Level Health Managers in Kerman, Iran. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jul 22.:1-4.
Introduction The 2003 Bam, Iran earthquake resulted in high casualties and required international and national assistance. This study explored local top and middle level managers' disaster relief experiences in the aftermath of the Bam earthquake.Using qualitative interview methodology, top and middle level health managers employed during the Bam earthquake were identified. Data were collected via in-depth interviews with participants. Data were analysed using thematic analysis.Results showed that the managers interviewed experienced two main problems. First, inadequacy of preparation of local health organisations, which was due to lack of familiarity of the needs, unavailability of essential needs, and also increasing demands, which were above the participants' expectations. Second, inappropriateness of delivered donations was perceived as a problem; for example, foods and sanitary materials were either poor quality or expired by date recommended for use. Participants also found international teams to be more well-equipped and organised.During the disaster relief period of the response to the Bam earthquake, local health organizations were ill prepared for the event. In addition, donations delivered for relief were often poor quality or expired beyond a usable date. Moosazadeh M , Zolala F , Sheikhzadeh K , Safiri S , Amiresmaili M . Response to the Bam earthquake: a qualitative study on the experiences of the top and middle level health managers in Kerman, Iran. Prehosp Disaster Med. 2014;29(4):1-4 .
- Emergency Preparedness Law and Willingness to Respond in the EMS Workforce. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jul 21.:1-6.
Introduction For effective responses to emergencies, individuals must have the ability to respond and also be willing to participate in the response. A growing body of research points to gaps in response willingness among several occupational cohorts with response duties, including the Emergency Medical Services (EMS) workforce. Willingness to respond is particularly important during an influenza or other pandemic, due to increased demands on EMS workers and the potential for workforces to be depleted if responders contract influenza or stay home to care for sick dependents. State emergency preparedness laws are one possible avenue to improve willingness to respond. Hypothesis Presence of certain state-level emergency preparedness laws (ie, ability to declare a public health emergency; requirement to create a public health emergency plan; priority access to health resources for responders) is associated with willingness to respond among EMS workers.Four hundred twenty-one EMS workers from the National Registry of Emergency Medical Technicians' (NREMT's) mid-year Longitudinal EMT Attributes and Demographics Study (LEADS) were studied. The survey, which included questions about willingness to respond during an influenza pandemic, was fielded from May through June 2009. Survey data were merged with data about the presence or absence of the three emergency preparedness laws of interest in each of the 50 US states. Unadjusted logistic regression analyses were performed with the presence/absence of each law and were adjusted for respondents' demographic/locale characteristics.Compared to EMS workers in states that did not allow the government to declare a public health emergency, those in states that permitted such declarations were more likely to report that they were willing to respond during an influenza pandemic. In adjusted and unadjusted analyses, this difference was not statistically significant. Similar results were found for the other state-level emergency preparedness laws of interest.While state-level emergency preparedness laws are not associated with willingness to respond, recent research suggests that inconsistencies between the perceived and objective legal environments for EMS workers could be an alternative explanation for this study's findings. Educational efforts within the EMS workforce and more prominent state-level implementation of emergency preparedness laws should be considered as a means to raise awareness of these laws. These types of actions are important steps toward determining whether state-level emergency preparedness laws have the potential to promote response willingness among EMS workers. Rutkow L , Vernick JS , Thompson CB , Pirrallo RG , Barnett DJ . Emergency preparedness law and willingness to respond in the EMS workforce. Prehosp Disaster Med. 2014;29(4):1-6 .
- The Prehospital Management of Suspected Spinal Cord Injury: An Update. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jul 21.:1-4.
Introduction Spinal cord injury (SCI) is a serious condition that may lead to long-term disabilities placing financial and social burden on patients and their families, as well as their communities. Spinal immobilization has been considered the standard prehospital care for suspected SCI patients. However, there is a lack of consensus on its beneficial impact on patients' outcome.This paper reviews the current literature on the epidemiology of traumatic SCI and the practice of prehospital spinal immobilization.A search of literature was undertaken utilizing the online databases Ovid Medline, PubMed, CINAHL, and the Cochrane Library. The search included English language publications from January 2000 through November 2012.The reported annual incidence of SCI ranges from 12.7 to 52.2 per 1 million and occurs more commonly among males than females. Motor vehicle collisions (MVCs) are the major reported causes of traumatic SCI among young and middle-aged patients, and falls are the major reported causes among patients older than 55. There is little evidence regarding the relationship between prehospital spinal immobilization and patient neurological outcomes. However, early patient transfer (8-24 hours) to spinal care units and effective resuscitation have been demonstrated to lead to better neurological outcomes.This review reaffirms the need for further research to validate the advantages, disadvantages, and the effects of spinal immobilization on patients' neurological outcomes. Oteir AO , Smith K , Jennings PA , Stoelwinder JU . The prehospital management of suspected spinal cord injury: an update. Prehosp Disaster Med. 2014;29(4):1-4 .
- Global Uptake of the Humanitarian Accountability Partnership Over Its First Ten Years. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jul 21.:1-4.
Introduction Accountability in the delivery of humanitarian aid has become increasingly important and emphasized by the humanitarian community. The Humanitarian Accountability Partnership (HAP) was created in 2003 in order to improve accountability in the humanitarian sector. HAP acts as a self-regulatory body to the humanitarian system. One of the main goals of HAP is the promotion of accountability through self-regulation by members. Humanitarian nongovernmental organizations (NGOs) can become members by meeting standards of accountability and quality management set by HAP. This report describes the growth of HAP membership by the humanitarian community from its inception until present. Hypothesis/Problem The hypothesis for this study was that HAP membership has grown substantially since inception, both in terms of number of member organizations and annual budgets of member organizations, but that near universal membership has not yet been achieved.A retrospective study was conducted to determine the total number and percentage of humanitarian NGOs that are members of HAP. Total expenditures of HAP members in 2010 also was measured and compared with the total humanitarian expenditure by all humanitarian NGOs for the same year. The reference year of 2010 was chosen in order to be able to compile accurate budgets for the largest possible number of HAP members. The total number of HAP members for the years 2005 through 2012 was divided by the estimated number of humanitarian NGOs active in 2010. The total budgets for HAP members in 2010 were divided by the estimated total humanitarian expenditure of all NGOs for 2010.As of the beginning of 2012, the percentage of humanitarian NGOs that were members of HAP was 1.6% (68 members out of 4400 organizations). The combined budgets of the member organizations of HAP in 2010 made up 62.9% of the total humanitarian expenditure for the year 2010 (US $4.65 billion/7.4 billion).A very small proportion of humanitarian NGOs have adopted HAP membership. However, HAP members account for almost two-thirds of all humanitarian expenditures. The humanitarian sector, therefore, remains without a universal regulatory and accountability structure, although progress has been made. Efforts should be made to increase the membership within HAP of more small to medium sized organizations. Foran MP , Williams AR . Global uptake of the Humanitarian Accountability Partnership over its first ten years. Prehosp Disaster Med. 2014;29(4):1-4 .
- Willingness of International Delegations to be Deployed to Areas With High Risk of Radiation. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jul 9.:1-5.
An earthquake of 9.0 magnitude, followed by a tsunami, hit Japan in 2011 causing widespread destruction. Fukushima Nuclear Power Plant had been damaged, causing a spread of radioactive materials.The aim of this study was to assess personal willingness to respond to a disaster as a part of an international delegation, to an area with unknown and unclear risk of radioactive materials. The Israeli delegation to the Japan 2011 earthquake had been chosen as a case study.The survey was conducted during the first two weeks after the tsunami in Japan. The population was selected randomly. After distributing the survey form, 94 anonymous answers were received, which give a 69% participation rate. The sample was divided into two groups (participated or didn't participate in an international delegation in the past).It was found that as the situation on the ground became worse, the willingness to be deployed dropped dramatically, although no significant difference was found in willingness between the two study groups. When both groups were combined into one group, significant differences were found in their willingness to be deployed in a delegation between the three levels (no radioactive leak, possible radioactive leak, and uncontrolled leak).The willingness to serve on a delegation that responds to a scene with a potential radioactive leak will be dramatically influenced by the risk at the site. Shenhar G , Radomislensky I , Rosenfeld M , Peleg K . Willingness of international delegations to be deployed to areas with high risk of radiation. Prehosp Disaster Med. 2014;29(4):1-5 .
- Hospital Preparedness in Advance of the 2014 FIFA World Cup in Brazil. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jul 9.:1-4.
Introduction Regardless of the capacity of the health care system of the host nation, mass gatherings require special planning and preparedness efforts within the health system. Brazil will host the 2014 Fédération Internationale de Football Association (FIFA) World Cup and the 2016 Olympics. This paper represents the first results from Project "Prepara Brasil," which is investigating the preparedness of the health sector and pharmaceutical services for these events. Hypothesis/Problem This study was designed to identify the efforts engaged in to prepare the health sector in Brazil for the FIFA World Cup 2014 event, as well as the 2016 Summer Olympics.Key informant interviews were conducted with representatives of both the municipality and hospital sectors in each of the 12 host cities where matches will be played. A semi-structured key informant interview guide was developed, with sections for each type of participant. One of each municipality's reference hospitals was identified and seven additional general hospitals were randomly selected from all of the inpatient facilities in each municipality. The interviewers were instructed to contact a reference hospital, and two of the other hospitals, in the jurisdiction for participation in the study. Questions were asked about plans for mass-gathering events, the interaction between hospitals and government officials in preparation for the World Cup, and their perceptions of their surge capacity to meet the potential demands generated by the presence of the World Cup events in their municipalities.In all, 11 representatives of the sampled reference hospitals, and 24 representatives of other general private and public hospitals in the municipalities, were interviewed. Most of the hospitals had some interaction with government officials in preparation for the World Cup 2014. Approximately one-third (34%) received training activities from the government. Fifty-four percent (54%) of hospitals had no specific plans for communicating with the government or other agencies during the World Cup. Approximately half (51%) had plans for surge capacity during the event, but only 27% had any surge capacity for isolation of potentially infectious patients.Overall, although there has been mention of a great deal of planning on the part of the government officials for the World Cup 2014, hospital surge to meet the potential increase in demand still falls short. Shoaf K , Osorio de Castro CGS , Miranda ES . Hospital preparedness in advance of the 2014 FIFA World Cup in Brazil. Prehosp Disaster Med. 2014;29(4):1-4 .
- Emergency Medical Services Response to Active Shooter Incidents: Provider Comfort Level and Attitudes Before and After Participation in a Focused Response Training Program. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jul 9.:1-8.
Introduction Emergency Medical Services (EMS) routinely stage in a secure area in response to active shooter incidents until the scene is declared safe by law enforcement. Due to the time-sensitive nature of injuries at these incidents, some EMS systems have adopted response tactics utilizing law enforcement protection to expedite life-saving medical care.Describe EMS provider perceptions of preparedness, adequacy of training, and general attitudes toward active shooter incident response after completing a tactical awareness training program.An unmatched, anonymous, closed-format survey utilizing a five-point Likert scale was distributed to participating EMS providers before and after a focused training session on joint EMS/police active shooter rescue team response. Descriptive statistics were used to compare survey results. Secondary analysis of responses based on prior military or tactical medicine training was performed using a chi-squared analysis.Two hundred fifty-six providers participated with 88% (225/256) pretraining and 88% (224/256) post-training surveys completed. Post-training, provider agreement that they felt adequately prepared to respond to an active shooter incident changed from 41% (92/225) to 89% (199/224), while agreement they felt adequately trained to provide medical care during an active shooter incident changed from 36% (82/225) to 87% (194/224). Post-training provider agreement that they should never enter a building with an active shooter changed from 73% (165/225) to 61% (137/224). Among the pretraining surveys, significantly more providers without prior military or tactical experience agreed they should never enter a building with an active shooter until the scene was declared safe (78% vs 50%, P = .002), while significantly more providers with prior experience felt both adequately trained to provide medical care in an active shooter environment (56% vs 31%, P = .007) and comfortable working jointly with law enforcement within a building if a shooter were still inside (76% vs 56%, P = .014). There was no difference in response to these questions in the post-training survey.Attitudes and perceptions regarding EMS active shooter incident response appear to change among providers after participation in a focused active shooter response training program. Further studies are needed to determine if these changes are significant and whether early EMS response during an active shooter incident improves patient outcomes. Jones J , Kue R , Mitchell P , Eblan G , Dyer KS . Emergency Medical Services response to active shooter incidents: provider comfort level and attitudes before and after participation in a focused response training program. Prehosp Disaster Med. 2014;29(4):1-7 .
- The Impact of Adaptive Capacity on Disaster Response and Recovery: Evidence Supporting Core Community Capabilities. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jul 1.:1-8.
Introduction The aim of this study was to determine if a relationship exists between the development of adaptive capacity and disaster response and recovery outcomes. Hospitals and health care systems are a critical element in community planning for all phases of the disaster cycle. There is a lack of research, however, to validate the relationship between the development of these capabilities and improved response and recovery outcomes. Hypothesis/Problem Two hypotheses were formulated to address the research question. The first hypothesis argued that counties or parishes that developed adaptive capacity through pre-event planning, community engagement, training, and the use of national response frameworks would have improved response and recovery performance outcomes. The second hypothesis argued that adaptive capacity, along with response and recovery performance outcomes, predicts the trajectory of recovery progression.This study employed a quantitative cross-sectional survey methodology and existing community demographic data to explore the development of adaptive capacity and its ability to predict disaster response and recovery outcomes in communities affected by major disaster in 2011. A total of 333 counties and parishes were included in the final sample, providing a 95% confidence interval with a 5% margin of error. Data were analyzed using both descriptive and inferential statistics. Multiple, hierarchical, and robust regression were used to find the best fitting model. Multi-level modeling with random intercepts was used to control for the nesting effects associated with county, state, and the Federal Emergency Management Agency (FEMA) region sampling.Descriptive results provide a baseline assessment of adaptive capacity development at the community level. While controlling for other variables, hypothesis testing revealed that pre-event planning, community engagement, full-scale exercises, and use of national frameworks predicated overall response and recovery performance outcomes (R 2 = .43; F 13,303 = 13.34; P < .001). In terms of recovery progression, pre-event planning, overall response and recovery performance outcome, total time of disruption, and percent of people below poverty were significant (R 2 = .15; F14,302 = 4.53; P < .001).Establishment of empirical data provides communities with reinforcement to continue resilience-building activities at the local level. However, findings from this study suggest that only full-scale exercises were significant in improving response and recovery outcomes. Implications for re-evaluation of disaster training warrant further exploration. Zukowski RS . The impact of adaptive capacity on disaster response and recovery: evidence supporting core community capabilities. Prehosp Disaster Med. 2014;29(4):1-8 .
- Implementation of a Titrated Oxygen Protocol in the Out-of-Hospital Setting. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jul 1.:1-6.
Oxygen is one of the most frequently-used therapeutic agents in medicine and the most commonly administered drug by prehospital personnel. There is increasing evidence of harm with too much supplemental oxygen in certain conditions, including stroke, chronic obstructive pulmonary disease (COPD), neonatal resuscitations, and in postresuscitation care. Recent guidelines published by the British Thoracic Society (BTS) advocate titrated oxygen therapy, but these guidelines have not been widely adapted in the out-of-hospital setting where high-flow oxygen is the standard. This report is a description of the implementation of a titrated oxygen protocol in a large urban-suburban Emergency Medical Services (EMS) system and a discussion of the practical application of this out-of-hospital protocol. Bosson N , Gausche-Hill M , Koenig W . Implementation of a titrated oxygen protocol in the out-of-hospital setting. Prehosp Disaster Med. 2014;28(4):1-6 .
- Iranian EMS System. [JOURNAL ARTICLE]
- Prehosp Disaster Med 2014 Jun 30.:1.