Standard Community Assessment for Public Health Emergency Response (CASPER) methods, a type of rapid needs assessment (RNA) for collecting data on household needs and impacts following emergencies, are not always suitable for rural, destroyed, or severely damaged communities, or disasters affecting small geographical areas. The objectives of this modified RNA were to: (1) identify the strengths, limitations, and operational challenges for utilization of modified RNAs for post-disaster, quick response research; and (2) capture the acute mental and physical health impacts and lived experiences of communities affected by the 2024 Arbor Day tornado in Nebraska (USA). This field study tested modifications of the CASPER methodology in rural and inaccessible communities in Washington and Douglas County, Nebraska following the 2024 Arbor Day tornado. A 60-item survey was developed using validated questions, including on mental and physical health impacts. Survey completion rates for Washington and Douglas Counties were 57.3% and 89.3%, respectively. Exacerbation of existing conditions, worsening allergies, and stress were commonly reported following the tornado. Modified RNAs were useful and feasible approaches for capturing perishable data following the 2024 Arbor Day tornado outbreak. These findings can be used to inform not only public health response but also future planning and policy.

Peer review is an important step in supporting high-quality research publications. However, understanding the review process can be challenging for peer reviewers. The role of the peer reviewer varies from journal-to-journal. Furthermore, it is sometimes difficult for reviewers to understand how to structure and format their review. This article discusses the role of peer review in the Prehospital and Disaster Medicine (PDM) review process and provides guidance for creating a high-quality peer review report.

Rural communities face unique challenges after a disaster as a result of overlapping vulnerabilities related to limited housing and transportation infrastructure, employment or income loss, and fewer emergency response and recovery resources. Hurricane Helene (Southeast Coast, USA; 2024) made landfall in Florida as a Category-4 hurricane, later impacting Western North Carolina with severe flooding, landslides, and hurricane-force winds. Communications and transportation were interrupted for months, leading to disinformation, recovery disruptions, and a loss of trust. To assess household impacts and recovery from Hurricane Helene in two rural Western North Carolina counties, a 29-question survey was adapted from a Community Assessment for Public Health Emergency Response (CASPER) conducted in Buncombe County, a nearby urban county. Thirty clusters were selected with probability proportionate to population across the two counties. Survey teams completed 183 interviews (completion rate = 87.1%). More than 35% of households evacuated because of Hurricane Helene, with nearly 18% evacuating in the week after due to on-going communication and utility outages. Less than 10% of households experienced new or worsening environmental health or chronic diseases. However, 40% reported anxiety, 30% reported trouble sleeping and depression, and 60% reported worrying about another disaster affecting their home. Nearly one year after the direct impact of the hurricane, much work remained as part of continued long-term recovery and resilience building. Because of their small populations and limited infrastructure, restoration of services necessary for response and recovery can be hindered in rural areas which often lack options such as public transportation, affordable short-term housing, and broadband or Wi-Fi.

A chemical explosion and fire erupted in Conakry, Guinea, West Africa on December 18, 2023, destroying Guinea's main fuel depot and resulting in 25 dead and 459 injured. Fifteen of the deaths occurred directly at the explosion site. Firefighters initiated efforts to control the blaze and transported injured, non-ambulatory victims to local hospitals with assistance from the military, Red Cross, and mining companies. Thirteen clinical facilities within an eight-mile radius of the explosion received burn and non-burn victims, with only one of these, Donka National Hospital, capable of handling burn victims. Many less seriously injured victims self-selected where they sought care, although anecdotal information indicates that an unknown number of injured did not seek care or chose to leave the city. The disaster marked the first time stakeholders from various sectors in the Guinean society (from first responders to mining companies) came together in a concerted response. Ranked 179th of 193 countries on the Human Development Index (HDI), the disaster rapidly outstripped Guinea's response and health care capabilities, leaving behind economic shocks affecting livelihoods and the local economy. These experiences underscore the need for improved capabilities and coordination in disaster planning, warning and communication systems, and prehospital and hospital response in developing countries.

Unfortunately, P value multiplicity continues to be a pervasive threat to statistical validity in medical research. Performing many hypothesis tests, and treating them each as if they were a single hypothesis, leads to a dramatic increase in the risk of false research claims. This editorial describes a simple method for authors to avoid P value multiplicity while improving clarity of the findings for the reader.

On March 28, 2025, a 7.7-magnitude earthquake struck the Sagaing region of Myanmar, resulting in 3,816 deaths and 5,104 injured, with Mandalay Region sustaining the most severe damage. Singapore Emergency Medical Team (SGEMT), verified by the World Health Organization (WHO) in 2024 as a Type-1 fixed Emergency Medical Team (EMT), was deployed in response. This mixed-methods study reports on the patient case mix and operational challenges encountered during the deployment. Data were derived from daily situation reports, clinical health records consistent with the WHO minimum data set (MDS), post-deployment review proceedings, and unstructured interviews with administrative, clinical, and logistics leads.Deployment was delayed by diplomatic complexities and logistical challenges in freight transport. Clinical operations commenced on April 8, 2025 at Bahtoo Stadium, Mandalay, where SGEMT managed 1,803 patients over eight days. Quantitatively, 21.6% presented with direct earthquake-related injuries, 7.9% with conditions indirectly related to displacement, and 70.5% with chronic or unrelated conditions, reflecting patterns observed in other post-earthquake responses. Acute respiratory infections were the predominant infectious disease. Most patients were female, underscoring the importance of gender-sensitive approaches. The integration of a physiotherapist in a Type-1 facility, beyond WHO EMT minimum standards, enhanced clinical efficacy and rehabilitative capacity.Qualitatively, thematic analysis guided by the 4Cs of disaster partnering -coordination, cooperation, communication, and collaboration - revealed critical enablers and constraints within the Association of Southeast Asian Nations (ASEAN) humanitarian framework. Findings highlight the need to reinforce regional coordination mechanisms to strengthen future disaster response in complex geopolitical situations.

In Jishishan County, Linxia Prefecture, Gansu Province, China, the altitude ranges from 1,787 meters to 4,308 meters. At 23:59 Beijing time on December 18, 2023, a magnitude 6.2 earthquake struck Jishishan County. The objective is to report the injury characteristics and medical treatments of those injured in the earthquake.

On April 28, 2025, a large-scale blackout affected mainland Spain and Portugal for over ten hours, severely impacting Emergency Medical Services (EMS). Although the cause remains uncertain and initially cyberattack was a concern, it has most probably been related to infrastructure failure. This event exposed critical vulnerabilities in EMS preparedness, as no region had a specific contingency plan for power outages.The blackout led to wide-spread disruption, including traffic signal failures that caused accidents and delayed emergency response, and the collapse of communication networks that affected 1-1-2 emergency calls. Fuel shortages also emerged as gas stations became non-operational. Patients using home medical devices faced life-threatening situations, with at least one death reported due to a ventilator failure. The reliance on technology proved to be a major weakness, as many EMS systems lacked backup communication tools like satellite phones or analog radios, and many hospitals and ambulance bases were not prepared with stable generators and adequate fuel access.Coordination between EMS, hospitals, and other emergency services was challenged by incompatible protocols and equipment. Despite these difficulties, EMS demonstrated adaptability by prioritizing urgent care and reallocating resources. The event exposed systemic fragilities and underscored the need for robust emergency planning, interagency drills, technological redundancy, and investment in resilient infrastructure. This incident serves as a global wake-up call, emphasizing that health systems must be prepared for increasing risks from climate change, cyber threats, and energy insecurity. Emergency preparedness should shift from being reactive to proactive, focusing on flexible systems, coordinated action, and workforce training to ensure continuity of health care during future blackouts.