Subjects -> HEALTH AND SAFETY (Total: 1464 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (686 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (358 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (112 journals)
    - PHYSICAL FITNESS AND HYGIENE (117 journals)
    - WOMEN'S HEALTH (82 journals)

CIVIL DEFENSE (22 journals)

Showing 1 - 18 of 18 Journals sorted alphabetically
Aggression and Violent Behavior     Hybrid Journal   (Followers: 371)
Canadian Journal of Remote Sensing     Full-text available via subscription   (Followers: 55)
Disaster Recovery Journal     Full-text available via subscription   (Followers: 4)
Disasters     Hybrid Journal   (Followers: 19)
Evolution, Medicine, and Public Health     Open Access   (Followers: 9)
Global & Regional Health Technology Assessment     Open Access   (Followers: 2)
International Journal of Critical Infrastructure Protection     Hybrid Journal   (Followers: 4)
International Journal of Emergency Management     Hybrid Journal   (Followers: 11)
International Journal of Emergency Services     Hybrid Journal   (Followers: 22)
International Journal of Forensic Engineering     Hybrid Journal   (Followers: 2)
International Journal of Intelligent Defence Support Systems     Hybrid Journal   (Followers: 4)
Journal of Applied Security Research     Hybrid Journal   (Followers: 3)
Journal of Health Care Law and Policy     Open Access   (Followers: 4)
Korean Journal of Defense Analysis     Hybrid Journal  
Prehospital and Disaster Medicine     Full-text available via subscription   (Followers: 7)
Risk, Hazards & Crisis in Public Policy     Hybrid Journal   (Followers: 5)
Strategic Analysis     Hybrid Journal   (Followers: 7)
Studies in Conflict & Terrorism     Hybrid Journal   (Followers: 378)
Similar Journals
Journal Cover
Prehospital and Disaster Medicine
Journal Prestige (SJR): 0.462
Citation Impact (citeScore): 1
Number of Followers: 7  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 1049-023X - ISSN (Online) 1945-1938
Published by Cambridge University Press Homepage  [352 journals]
  • PDM volume 37 issue 6 Cover and Front matter

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      Pages: 1 - 6
      PubDate: 2022-12-06
      DOI: 10.1017/S1049023X22002217
       
  • PDM volume 37 issue 6 Cover and Back matter

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      Pages: 1 - 5
      PubDate: 2022-12-06
      DOI: 10.1017/S1049023X22002205
       
  • The Difficult Airway Redefined

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      Authors: Burgess; Matthew B., Schauer, Steven G., Hood, R. Lyle, De Lorenzo, Robert A.
      Pages: 723 - 726
      Abstract: There is no all-encompassing or universally accepted definition of the difficult airway, and it has traditionally been approached as a problem chiefly rooted in anesthesiology. However, with airway obstruction reported as the second leading cause of mortality on the battlefield and first-pass success (FPS) rates for out-of-hospital endotracheal intubation (ETI) as low as 46.4%, the need to better understand the difficult airway in the context of the prehospital setting is clear. In this review, we seek to redefine the concept of the “difficult airway” so that future research can target solutions better tailored for prehospital, and more specifically, combat casualty care. Contrasting the most common definitions, which narrow the scope of practice to physicians and a handful of interventions, we propose that the difficult airway is simply one that cannot be quickly obtained. This implies that it is a situation arrived at through a multitude of factors, namely the Patient, Operator, Setting, and Technology (POST), but also more importantly, the interplay between these elements. Using this amended definition and approach to the difficult to manage airway, we outline a target-specific approach to new research questions rooted in this system-based approach to better address the difficult airway in the prehospital and combat casualty care settings.
      PubDate: 2022-11-09
      DOI: 10.1017/S1049023X22001455
       
  • First Activation of the WHO Emergency Medical Team Minimum Data Set in the
           2019 Response to Tropical Cyclone Idai in Mozambique

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      Authors: Kubo; Tatsuhiko, Chimed-Ochir, Odgerel, Cossa, Matchecane, Ussene, Isse, Toyokuni, Yoshiki, Yumiya, Yui, Kayano, Ryoma, Salio, Flavio
      Pages: 727 - 734
      Abstract: Introduction:During a disaster, comprehensive, accurate, timely, and standardized health data collection is needed to improve patient care and support effective responses. In 2017, the World Health Organization (WHO) developed the Emergency Medical Team (EMT) Minimum Data Set (MDS) as an international standard for data collection in the context of disasters and public health emergencies. The EMT MDS was formally activated for the first time in 2019 during the response to Cyclone Idai in Mozambique.Study Objective:The aim of this study was to analyze data collected through the EMT MDS during Cyclone Idai of 2019 and to identify the benefits of and opportunities for its future use.Methods:The EMT MDS was used for data collection. All 13 international EMTs deployed from March 27 through July 12 reported data in accordance with the EMT MDS form. The collected data were analyzed descriptively.Results:A total of 18,468 consultations, including delivery of 94 live births, were recorded. For children under-five and those five-years and older, the top five reasons for consultation were minor injuries (4.5% and 10.8%, respectively), acute respiratory infections ([ARI] 12.6% and 4.8%, respectively), acute watery diarrhea (18.7% and 7.7%, respectively), malaria (9.2% and 6.1%, respectively), and skin diseases (5.1% and 3.1%, respectively). Non-disaster-related health events accounted for 84.7% of the total health problems recorded. Obstetric care was among the core services provided by EMTs during the response.Conclusion:Despite of challenges, the EMT MDS reporting system was found to support the responses and coordination of EMTs. The role of the Mozambican Ministry of Health (MOH), its cooperation with EMTs, and the dedicated technical support of international organizations enabled its successful implementation.
      PubDate: 2022-11-03
      DOI: 10.1017/S1049023X22001406
       
  • Health Emergency and Disaster Risk Management Workforce Development
           Strategies: Delphi Consensus Study

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      Authors: Hung; Kevin K.C., MacDermot, Makiko K., Chan, Emily Y.Y., Mashino, Sonoe, Balsari, Satchit, Ciottone, Gregory R., Della Corte, Francesco, Dell’Aringa, Marcelo F., Egawa, Shinichi, Evio, Bettina D., Hart, Alexander, Ishii, Tadashi, Ragazzoni, Luca, Sasaki, Hiroyuki, Walline, Joseph Harold, Wong, Chi S., Dalal, Saurabh, Kayano, Ryoma, Abrahams, Jonathan, Huda, Qudsia, Graham, Colin A.
      Pages: 735 - 748
      Abstract: Introduction:Health workforce development is essential for achieving the goals of an effective health system, as well as establishing national Health Emergency and Disaster Risk Management (Health EDRM).Study Objective:The objective of this Delphi consensus study was to identify strategic recommendations for strengthening the workforce for Health EDRM in low- and middle-income countries (LMIC) and high-income countries (HIC).Methods:A total of 31 international experts were asked to rate the level of importance (one being strongly unimportant to seven being strongly important) for 46 statements that contain recommendations for strengthening the workforce for Health EDRM. The experts were divided into a LMIC group and an HIC group. There were three rounds of rating, and statements that did not reach consensus (SD ≥ 1.0) proceeded to the next round for further ranking.Results:In total, 44 statements from the LMIC group and 34 statements from the HIC group attained consensus and achieved high mean scores for importance (higher than five out of seven). The components of the World Health Organization (WHO) Health EDRM Framework with the highest number of recommendations were “Human Resources” (n = 15), “Planning and Coordination” (n = 7), and “Community Capacities for Health EDRM” (n = 6) in the LMIC group. “Policies, Strategies, and Legislation” (n = 7) and “Human Resources” (n = 7) were the components with the most recommendations for the HIC group.Conclusion:The expert panel provided a comprehensive list of important and actionable strategic recommendations on workforce development for Health EDRM.
      PubDate: 2022-11-03
      DOI: 10.1017/S1049023X22001467
       
  • Emergency Medical Services Preparedness in Dual Disasters: War in the Era
           of COVID-19 in Armenia

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      Authors: Woodward; Christina A., Hertelendy, Attila J., Hart, Alexander, Voskanyan, Amalia, Harutyunyan, Hakob, Virabyan, Anushavan, Mukhaelyan, Artak, Mahon, Selwyn E., Issa, Fadi S., Adnan, Mohd Syafwan, Stepanyan, Taguhi, Ciottone, Gregory R.
      Pages: 749 - 754
      Abstract: Introduction:Emergency Medical Services (EMS) is a critical part of Disaster Medicine and has the ability to limit morbidity and mortality in a disaster event with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training in the country. As a result, EMS physicians are trained in a variety of specialties.Armenia is also a country prone to disasters, and recently, the Armenian EMS system was challenged by two concurrent disasters when the 2020 Nagorno-Karabakh War broke out in the midst of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic.Study Objective:This study aims to assess the current state of disaster preparedness of the Armenian EMS system and the effects of the simultaneous pandemic and war on EMS providers.Methods:This was a cross-sectional study conducted by anonymous survey distributed to physicians still working in the Yerevan EMS system who provided care to war casualties and COVID-19 patients.Results:Survey response rate was 70.6%. Most participants had been a physician (52.1%) or EMS physician (66.7%) for three or less years. The majority were still in residency (64.6%). Experience in battlefield medicine was limited prior to the war, with the majority reporting no experience in treating mass casualties (52.1%), wounds from explosives (52.1%), or performing surgical procedures (52.1%), and many reporting minimal to no experience in treating gunshot wounds (62.5%), severe burns (64.6%), and severe orthopedic injuries (64.6%). Participants had moderate experience in humanitarian medicine prior to war. Greater experience in battlefield medicine was found in participants with more than three years of experience as a physician (z-score −3.26; P value
      PubDate: 2022-11-04
      DOI: 10.1017/S1049023X22002163
       
  • Short-Term Psychological Support for Civilians Exposed to the January 2015
           Terrorist Attacks in France

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      Authors: Vuillermoz; Cécile, Prieto, Nathalie, Pirard, Philippe, Baubet, Thierry, Stene, Lise Eilin, Vandentorren, Stéphanie
      Pages: 755 - 764
      Abstract: Introduction:Following a terrorist attack, responses to a psychosocial disaster range from low-intensity initiatives to high-intensity treatment. Some studies described post-disaster psychosocial services and planning across Europe. However, little is known about the psychosocial support (PS) actually delivered after terrorist attacks.Study Objective:This study assesses prevalence and the factors associated with not receiving short-term PS among terror-exposed people with probable mental health disorders following the January 2015 terrorist attacks in France.Methods:This study used data from the first wave of a longitudinal survey conducted six months after the attacks. Prevalence and factors associated with not receiving PS were described in the immediate period (48 hours), the early post-immediate period (48 hours-one week), and the medium-term (over one week) using a robust Poisson regression for each of the three periods.Results:Nearly one-half of the participants (N = 189) did not receive PS in any period (46.6% in the immediate period, 45.5% in the early post-immediate period, and 54.5% in the medium-term). In each period, not receiving PS was associated with not being very close to the attack sites. Not receiving PS in the immediate period was also associated with being a direct witness (DW) rather than being directly threatened (DT) and not having support in daily life; in the early post-immediate period, not receiving PS was associated with not having a peri-traumatic dissociation experience and being followed for a psychological problem before the attacks; and in the medium-term period, it was associated with perceived social isolation.Conclusion:The characteristics of the terror exposure and social support seemed to influence presence or absence of PS after the terrorist attack and highlight the need for strategies to reach out to people regardless of the type of exposure.
      PubDate: 2022-12-06
      DOI: 10.1017/S1049023X22002175
       
  • The Involvement of the European Master in Disaster Medicine (EMDM) Alumni
           in the COVID-19 Pandemic Response: An Example of the Perceived Relevance
           of Disaster Medicine Education during Disasters

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      Authors: Bahattab; Awsan A.S., Linty, Monica, Hubloue, Ives, Debacker, Michel, Della Corte, Francesco, Ragazzoni, Luca
      Pages: 765 - 771
      Abstract: Introduction:The coronavirus disease 2019 (COVID-19) pandemic has revealed a gap in disaster preparedness of health workers globally. Disaster medicine education is a key element to fill this gap.Objectives:This study evaluated the involvement of the European Master in Disaster Medicine (EMDM) Alumni in the current COVID-19 pandemic response and their self-perceived value of the EMDM educational program in accomplishing their tasks during the disaster.Methods:An online survey targeting the EMDM Alumni was conducted from January through March 2021. Quantitative data were described using percentages or means, as appropriate, while qualitative data were categorized using deductive thematic analysis.Results:In total, 259 Alumni completed the survey. Most of the Alumni (88.03%; standard error of the proportion [SEp] = 0.02) participated directly in the COVID-19 pandemic response – nationally or internationally – with different roles and responsibilities at different levels and sectors. Around 25% of the Alumni reported an increase in their tasks and responsibilities due to COVID-19 response, but few worked beyond their main specialization (5.26%) or expertise (2.19%). Moreover, Alumni shifted their role from clinical practice to managerial, public health, education and training, and policymaking roles during COVID-19 (P
      PubDate: 2022-09-15
      DOI: 10.1017/S1049023X22001340
       
  • Precise Limb Tourniquet Arterial Occlusion Pressure Determination using
           Real-Time Ultrasonography and a Capacitive-Based Force Sensor

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      Authors: Wood; Jeffrey N., Krippendorf, Benjamin S., Blakeney, Craig A., Kummer, Tobias, Hooke, Alexander W., Mullan, Aidan F., Sztajnkrycer, Matthew D.
      Pages: 772 - 777
      Abstract: Background:Hemorrhage control prior to shock onset is increasingly recognized as a time-critical intervention. Although tourniquets (TQs) have been demonstrated to save lives, less is known about the physiologic parameters underlying successful TQ application beyond palpation of distal pulses. The current study directly visualized distal arterial occlusion via ultrasonography and measured associated pressure and contact force.Methods:Fifteen tactical officers participated as live models for the study. Arterial occlusion was performed using a standard adult blood pressure (BP) cuff and a Combat Application Tourniquet Generation 7 (CAT7) TQ, applied sequentially to the left mid-bicep. Arterial flow cessation was determined by radial artery palpation and brachial artery pulsed wave doppler ultrasound (US) evaluation. Steady state maximal generated force was measured using a thin-film force sensor.Results:The mean (95% CI) systolic blood pressure (SBP) required to occlude palpable distal pulse was 112.9mmHg (109-117); contact force was 23.8N [Newton] (22.0-25.6). Arterial flow was visible via US in 100% of subjects despite lack of palpable pulse. The mean (95% CI) SBP and contact force to eliminate US flow were 132mmHg (127-137) and 27.7N (25.1-30.3). The mean (95% CI) number of windlass turns to eliminate a palpable pulse was 1.3 (1.0-1.6) while 1.6 (1.2-1.9) turns were required to eliminate US flow.Conclusions:Loss of distal radial pulse does not indicate lack of arterial flow distal to upper extremity TQ. On average, an additional one-quarter windlass turn was required to eliminate distal flow. Blood pressure and force measurements derived in this study may provide data to guide future TQ designs and inexpensive, physiologically accurate TQ training models.
      PubDate: 2022-10-18
      DOI: 10.1017/S1049023X2200142X
       
  • Emergency Service Assistance for Injuries on Alpine Ski Slopes: A
           Cross-Sectional Study

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      Authors: Wagner; Moritz, Pfurtscheller, Simon, Dammerer, Dietmar, Nardelli, Paul, Kaufmann, Gerhard, Brunner, Alexander
      Pages: 778 - 782
      Abstract: Objectives:Injuries on alpine ski slopes have been described in cohorts of a reasonable sample size, but constant improvements in safety gear, increased use of airborne rescue, and safety measures during the coronavirus disease 2019 (COVID-19) pandemic mandate re-evaluation. Therefore, the purpose of this study was to evaluate skiing and snowboarding injuries, effectiveness of airborne rescue, and impact of the COVID-19 pandemic on a large sample size.Methods:Data on alpine injuries were prospectively collected from the state emergency services dispatch center in the state of Tyrol (Austria). A total of 10,143 patients were identified, with an average age of 33.5 years (SD = 20.36). The ski patrol was involved in 8,606 cases (84.9%) and some patients (n = 1,536; 15.1%) required helicopter rescue.Results:A total of 10,143 patients were identified from the dataset of the emergency dispatch center. The most frequently injured region was the knee (30.2%), and it was followed by the shoulder (12.9%), the lower leg (9.5%), and the head/skull (9.5%).Conclusion:The present findings indicate that the most frequent site of injuries on alpine slopes is the knee, and life-threatening injuries are rare. Airborne rescue is very time-effective, however clinical studies with patient follow-up should be emphasized to determine the impact of airborne rescue on patient outcome. The present findings indicate that the duration of all rescue operations has been prolonged as a result of the introduction of safety measures during the COVID-19 pandemic.
      PubDate: 2022-10-06
      DOI: 10.1017/S1049023X22001364
       
  • Maintaining Prehospital Intubation Success with COVID-19 Personal
           Protective Precautions

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      Authors: Avery; Pascale, McAleer, Sam, Rawlinson, David, Gill, Stuart, Lockey, David
      Pages: 783 - 787
      Abstract: Background:Tracheal intubation is a high-risk intervention for exposure to airborne infective pathogens, including the novel coronavirus disease 2019 (COVID-19). During the recent pandemic, personal protective equipment (PPE) was essential to protect staff during intubation but is recognized to make the practical conduct of anesthesia and intubation more difficult. In the early phase of the coronavirus pandemic, some simple alterations were made to the emergency anesthesia standard operating procedure (SOP) of a prehospital critical care service to attempt to maintain high intubation success rates despite the challenges posed by wearing PPE. This retrospective observational cohort study aims to compare first-pass intubation success rates before and after the introduction of PPE and an altered SOP.Methodology:A retrospective observational cohort study was conducted from January 1, 2019 through August 30, 2021. The retrospective analysis used prospectively collected data using prehospital electronic patient records. Anonymized data were held in Excel (v16.54) and analyzed using IBM SPSS Statistics (v28). Patient inclusion criteria were those of all ages who received a primary tracheal intubation attempt outside the hospital by critical care teams. March 27, 2020 was the date from which the SOP changed to mandatory COVID-19 SOP including Level 3 PPE – this date is used to separate the cohort groups.Results:Data were analyzed from 1,266 patients who received primary intubations by the service. The overall first-pass intubation success rate was 89.7% and the overall intubation success rate was 99.9%. There was no statistically significant difference in first-pass success rate between the two groups: 90.3% in the pre-COVID-19 group (n = 546) and 89.3% in the COVID-19 group (n = 720); Pearson chi-square 0.329; P = .566. In addition, there was no statistical difference in overall intubation success rate between groups: 99.8% in the pre-COVID-19 group and 100.0% in the COVID-19 group; Pearson chi-square 1.32; P = .251.Non-drug-assisted intubations were more than twice as likely to require multiple attempts in both the pre-COVID-19 group (n = 546; OR = 2.15; 95% CI, 1.19-3.90; P = .01) and in the COVID-19 group (n = 720; OR = 2.5; 95% CI, 1.5-4.1; P =
      PubDate: 2022-09-12
      DOI: 10.1017/S1049023X22001273
       
  • Learning Success and Influencing Factors in Out-of-Hospital Placement of
           Intravenous Catheters

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      Authors: Häske; David, Dorau, Wolfgang, Eppler, Fabian, Heinemann, Niklas, Hochgreve, Bernd, Schempf, Benjamin
      Pages: 788 - 793
      Abstract: Introduction:Placing peripheral intravenous catheters (“IV lines”) is a standard procedure for health care professionals in acute and emergency medicine. The study aimed to determine the learning curve and success rates in applying IV lines during a three-year paramedic training and the factors influencing successful placement.Methods:This was a prospective and noninterventional observational study to determine the influencing factors, learning outcomes, and performance in the placement of IV lines by trainees and experienced paramedics. Trial registration: German Clinical Trials Register, ID DRKS00024631.Results:From February 1, 2016 through December 31, 2021, a total of 3,547 peripheral venous accesses attempts were performed: 76.5% (n = 2,712) by trainees and 23.5% (n = 835) by experienced practitioners. The trainee group had one-to-three years of training and the experienced group had 11 (SD = 11) years of work experience after training (one-to-35 years). The learning or success curve in the successful placement of peripheral venous accesses was 85.2% in the first year of training, 88.5% in the second year of training, and 92.5% in the third year (and the end of training). It was then 94.3% in the fourth year (first year of being experienced). Successful insertion of peripheral venous accesses in the experienced group was up to 97.0%. The first-attempt success rate was 90.4% across the entire trainee group versus 95.9% in the experienced group (P
      PubDate: 2022-09-26
      DOI: 10.1017/S1049023X22001327
       
  • A Geographical Analysis of Access to Trauma Centers from US National Parks
           in 2018

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      Authors: Lu; Lily Y., Robichaud, Sabrina N., Boggs, Krislyn M., Bedell, Brandon R., Cash, Rebecca E., Sullivan, Ashley F., Harris, N. Stuart, Camargo, Carlos A.
      Pages: 794 - 799
      Abstract: Introduction:Millions of people visit US national parks annually to engage in recreational wilderness activities, which can occasionally result in traumatic injuries that require timely, high-level care. However, no study to date has specifically examined timely access to trauma centers from national parks. This study aimed to examine the accessibility of trauma care from national parks by calculating the travel time by ground and air from each park to its nearest trauma center. Using these calculations, the percentage of parks by census region with timely access to a trauma center was determined.Methods:This was a cross-sectional study analyzing travel times by ground and air transport between national parks and their closest adult advanced trauma center (ATC) in 2018. A list of parks was compiled from the National Parks Service (NPS) website, and the location of trauma centers from the 2018 National Emergency Department Inventory (NEDI)-USA database. Ground and air transport times were calculated using Google Maps and ArcGIS, with medians and interquartile ranges reported by US census region. Percentage of parks by region with timely trauma center access—defined as access within 60 minutes of travel time—were determined based on these calculated travel times.Results:In 2018, 83% of national parks had access to an adult ATC within 60 minutes of air travel, while only 26% had timely access by ground. Trauma center access varied by region, with median travel times highest in the West for both air and ground transport. At a national level, national parks were unequally distributed, with the West housing the most parks of all regions.Conclusion:While most national parks had timely access to a trauma center by air travel, significant gaps in access remain for ground, the extent of which varies greatly by region. To improve the accessibility of trauma center expertise from national parks, the study highlights the potential that increased implementation of trauma telehealth in emergency departments (EDs) may have in bridging these gaps.
      PubDate: 2022-10-20
      DOI: 10.1017/S1049023X22001431
       
  • Wilderness Medicine Curricula in United States EMS Fellowship, Emergency
           Medicine Residency, and Wilderness Medicine Programs

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      Authors: Holstrom-Mercader; Maria, Kass, Daniel, Corsetti, Monica, Flamm, Avram
      Pages: 800 - 805
      Abstract: Objective:Wilderness Medicine (WM) focuses on care delivered in austere or resource-scarce environments. The Accreditation Council for Graduate Medical Education (ACGME) requirements and core content for Emergency Medicine (EM) residency and Emergency Medical Services (EMS) fellowship in the United States (US) include some WM topics that are covered to varying degrees in these programs. Furthermore, there are no ACGME-approved WM fellowships or specific curricula. Different training programs may develop WM content and curricula that differ significantly, leading to variations in WM competencies and training. In 2009, the American College of Emergency Physicians (ACEP) Wilderness Medicine Section created a Fellowship Subcommittee and Taskforce to develop a standardized curriculum and core content for EM-based WM fellowships. However, to date, EMS fellowship and EM residency WM curricula in the US content have not been analyzed for consistency with the ACEP WM fellowship curriculum.Methods:In this study, the WM curricula components of EM residency and EMS fellowship were evaluated using the ACEP WM fellowship curriculum as a control. Potential curriculum gaps for each program type were identified.Results:Of the 19 WM competencies developed by the ACEP Wilderness Medicine Section Fellowship Subcommittee and Taskforce, EMS fellowship covers more WM topics (16 topics, or 84%) than EM residency (12 topics, or 63%), and combined, they cover 89% of these topics.Conclusions:By expanding to cover two additional WM topics, all WM curricula topics recommended by the ACEP WM fellowship curriculum could potentially be covered in EM residency + EMS fellowship; however, the depth of education in each topic may vary. It may be beneficial for Graduate Medical Education (GME)-level learners for programs to implement hands-on educational experiences in WM topics.
      PubDate: 2022-10-10
      DOI: 10.1017/S1049023X22001388
       
  • Pooled Urine Analysis at a Belgian Music Festival: Trends in Alcohol
           Consumption and Recreational Drug Use

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      Authors: Geuens; Marjolein, Van Hoofstadt, Kathleen, Hoogmartens, Olivier, Van den Eede, Nele, Sabbe, Marc
      Pages: 806 - 809
      Abstract: Background:Recreational drug use has become more and more accepted in society. Availability and purity are rising and new psychoactive substances (NPS) are popping up.The aim of this study was to provide objective data on illicit drug use at a Belgian festival in order to report on arising trends. This may provide additional information to help develop preventive strategies.Methods:A cross-sectional study took place during a music festival in the summer of 2019, where 43 samples of pooled urine were collected at four different locations and at different moments of the day. Analysis was performed using gas chromatography with a flame ionization detector (GC-FID) to determine ethanol concentrations. Drugs of abuse were quantified using liquid chromatography-tandem mass spectrometry. A qualitative analysis was performed using high-resolution mass spectrometry.Results:Median ethanol concentration was 0.88g/L. Cocaine, 3,4-methylenedioxymethamphetamine (MDMA), amphetamines, ketamine, and cannabis were detected in almost every sample and often in high concentrations. Furthermore, two NPS were detected and a variety of over-the-counter medication and adulterants were also found.Discussion:The findings were largely in-line with trends outlined in the European Drug Report. Striking were the relatively high concentrations of MDMA and ketamine and detection of two synthetic cathinones. Two possible adulterants of cocaine were detected, namely flecainide and amlodipine.Conclusion:Music festivals are considered a high-risk setting for alcohol consumption and illicit drug use. Analysis of pooled urine samples at a festival therefore provides a valuable method to evaluate trends and to screen for new substances. Wide-spread use of classical drugs and identification of two NPS were observed during a major international music festival in Belgium. Results need to be interpreted carefully, taking into account the possibilities and limitations of the used techniques and a standardized sampling is required.
      PubDate: 2022-09-23
      DOI: 10.1017/S1049023X22001285
       
  • Coping Strategies for Exposure to Trauma Situations in First Responders: A
           Systematic Review

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      Authors: Díaz-Tamayo; Alejandra María, Escobar-Morantes, Jorge Reinerio, García-Perdomo, Herney Andrés
      Pages: 810 - 818
      Abstract: Objective:The objective of the present work was to characterize the coping strategies used by first responders to emergencies in the face of exposure to traumatic events.Methods:A systematic search was performed in the databases MEDLINE (Ovid), EMBASE, LILACS (Latin American and Caribbean Literature in Health Sciences), and the Cochrane Central Registry of Controlled Clinical Trials (CENTRAL) from their inception through February 2022. First responders to emergencies with training in the prehospital area and who used validated measurement instruments for coping strategies were included.Results:First responders to emergencies frequently used nonadaptive coping strategies, with avoidance or disconnection being one of the main strategies, as a tool to avoid confronting difficult situations and to downplay the perceived stressful event. The nonadaptive coping strategies used by these personnel showed a strong relationship with posttraumatic stress disorder (PTSD) symptoms, burnout syndrome, psychiatric morbidity, and chronic stress. As part of the adaptive strategies, active coping was found, which includes acceptance, positive reinterpretation, focusing on the problem, self-efficacy, and emotional support, either social or instrumental, as protective strategies for these personnel.Conclusions:Developing adaptive coping strategies, whether focused on problems or seeking emotional support, can benefit emergency personnel in coping with stressful situations. These coping strategies should be strengthened to help prevent people from experiencing long-term negative effects that could arise from the traumatic events to which they are exposed. Active coping strategies instead of avoidance strategies should be promoted.
      PubDate: 2022-11-03
      DOI: 10.1017/S1049023X22001479
       
  • Video Emergency Calls in Medical Dispatching: A Scoping Review

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      Authors: Sýkora; Roman, Peřan, David, Renza, Metoděj, Bradna, Jan, Smetana, Jiří, Duška, František
      Pages: 819 - 826
      Abstract: Background:Video emergency calls (VCs) represent a feasible future trend in medical dispatching. Acceptance among callers and dispatchers seems to be good. Indications, potential problems, limitations, and directions of research of adding a live video from smartphones to an emergency call have not been reviewed outside the context of out-of-hospital cardiac arrest (OHCA).Objective:The main objective of this study is to examine the scope and nature of research publications on the topic of VC. The secondary goal is to identify research gaps and discuss the potential directions of research efforts of VC.Design:Following PRISMA-ScR guidelines, online bibliographic databases PubMed, Web of Science, SCOPUS, Google Scholar, ClinicalTrials.gov, and gray literature were searched from the period of January 1, 2012 through March 1, 2022 in English. Only studies focusing on video transfer via mobile phone to emergency medical dispatch centers (EMDCs) were included.Results:Twelve articles were included in the qualitative synthesis and six main themes were identified: (1) cardiopulmonary resuscitation (CPR) guided by VC; (2) indications of VCs; (3) dispatchers’ feedback and perception; (4) technical aspects of VCs; (5) callers’ acceptance; and (6) confidentiality and legal issues.Conclusion:Video emergency calls are feasible and seem to be a well-accepted auxiliary method among dispatchers and callers. Some promising clinical results exist, especially for video-assisted CPR. On the other hand, there are still enormous knowledge gaps in the vast majority of implementation aspects of VC into practice.
      PubDate: 2022-09-23
      DOI: 10.1017/S1049023X22001297
       
  • Pandemics and Other Health Crises: A Special Report from a European
           Parliament Workshop

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      Authors: Quaglio; Gianluca, Ragazzoni, Luca, De la Mata, Isabel, Arafat, Raed, De Muynck, Sabine, Vlieghe, Erika, Claes, Petra
      Pages: 827 - 831
      Abstract: Once an emergency has passed, general attention typically returns to dealing with day-to-day system management, and the opportunity to learn from the crisis and improve is missed. Lessons from the coronavirus disease 2019 (COVID-19) crisis must be learned, and the necessary changes made at all levels, both in terms of improving collaboration and strengthening health systems. This special report provides the conclusion of a workshop held in the European Parliament (EP) in Brussels, Belgium. The event explored the modalities of response and preparation to the COVID-19 pandemic, and to health crises in general. The workshop considered actions at different levels: international organizations (global level), European Union (EU) Member States ([MS] national level), and health services (local level). It provided an opportunity to look back at several initiatives taken during the pandemic, and to draw inspiration from them.
      PubDate: 2022-10-03
      DOI: 10.1017/S1049023X22001376
       
  • Temporal Changes in Epinephrine Dosing in Out-of-Hospital Cardiac Arrest:
           A Review of EMS Protocols across the United States

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      Authors: Garfinkel; Eric, Michelsen, Katelyn, Johnson, Benjamin, Margolis, Asa, Levy, Matthew
      Pages: 832 - 835
      Abstract: Background:Administration of epinephrine has been associated with worse neurological outcomes for survivors of out-of-hospital cardiac arrest. The publication of the 2018 PARAMEDIC-2 trial, a randomized and double-blind study of epinephrine in out-of-hospital cardiac arrest, provides the strongest evidence to date that epinephrine increases return of spontaneous circulation (ROSC) but not neurologically intact survival. This study aims to determine if Emergency Medical Services (EMS) cardiac arrest protocols have changed since the publication of PARAMEDIC-2.Methods:States in the US utilizing mandatory or model state-wide EMS protocols, including Washington DC, were included in this study. The nontraumatic cardiac arrest protocol as of January 1, 2018 was compared to the protocol in effect on January 1, 2021 to determine if there was a change in the administration of epinephrine. Protocols were downloaded from the relevant state EMS website. If a protocol could not be obtained, the state medical director was contacted.Results:A 2021 state-wide protocol was found for 32/51 (62.7%) states. Data from 2018 were available for 21/51 (41.2%) states. Of the 11 states without data from 2018, all follow Advanced Cardiac Life Support (ACLS) guidelines in the 2021 protocol. Five (15.6%) of the states with a state-wide protocol made a change in the cardiac arrest protocols. Maximum cumulative epinephrine dose was limited to 4mg in Maryland and 3mg in Vermont. Rhode Island changed epinephrine in shockable rhythms to be administered after three cycles of cardiopulmonary resuscitation (CPR) and an anti-arrhythmic. Rhode Island also added an epinephrine infusion as an option. No states removed epinephrine administration from their cardiac arrest protocol. Simple statistical analysis was performed with Microsoft Excel.Conclusion:Several states have adjusted cardiac arrest protocols since 2018. The most frequent change was limiting the maximum cumulative dosage of epinephrine. One state changed timing of epinephrine dosing depending on the rhythm and also provided an option of an epinephrine infusion in place of bolus dosing. While the sample size is small, these changes may reflect the future direction of prehospital cardiac arrest protocols. Significant limitations apply, including the exclusion of local and regional protocols which are more capable of quickly adjusting to new research. Additionally, this study is only focused on EMS in the United States.
      PubDate: 2022-10-21
      DOI: 10.1017/S1049023X22001418
       
  • Malaysian Disaster Medicine Research: A Bibliographic Study of Publication
           Trends

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      Authors: Adnan; Mohd Syafwan Bin, Hart, Alexander, Hertelendy, Attila J., Tin, Derrick, Abelanes, Sally-Mae, Issa, Fadi, Ciottone, Gregory R.
      Pages: 836 - 842
      Abstract: Introduction:Despite the increasing risks and complexity of disasters, education for Malaysian health care providers in this domain is limited. This study aims to assess scholarly publications by Malaysian scholars on Disaster Medicine (DM)-related topics.Methodology:An electronic search of five selected journals from 1991 through 2021 utilizing multiple keywords relevant to DM was conducted for review and analysis.Results:A total of 154 articles were included for analysis. The mean number of publications per year from 1991 through 2021 was 5.1 publications. Short reports were the most common research type (53.2%), followed by original research (32.4%) and case reports (12.3%). Mean citations among the included articles were 12.4 citations. Most author collaborations were within the same agency or institution, and there was no correlation between the type of collaboration and the number of citations (P = .942). While a few clusters of scholars could build a strong network across institutions, most research currently conducted in DM was within small, isolated clusters.Conclusion:Disaster Medicine in Malaysia is a growing medical subspecialty with a significant recent surge in research activity, likely due to the SARS-CoV-2/coronavirus disease 2019 (COVID-19) global pandemic. Since most publications in DM have been on infectious diseases, the need to expand DM-related research on other topics is essential.
      PubDate: 2022-11-14
      DOI: 10.1017/S1049023X22002187
       
  • A Successful Case of Cardiac Arrest due to Acute Myocarditis with
           COVID-19: 120 Minutes on Manual Cardiopulmonary Resuscitation then
           Veno-Arterial Extracorporeal Membrane Oxygenation

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      Authors: Hoang; Bui Hai, Tran, Huyen Trang, Nguyen, Tat Thanh, Nguyen, Minh Nguyen, Nguyen, Anh Dung, Do, Giang Phuc, Vu, Ngoc Tu, Nguyen, Mai, Nguyen, Lan Hieu, Nakahara, Shinji
      Pages: 843 - 846
      Abstract: Acute myocarditis is one of the common complications of coronavirus disease 2019 (COVID-19) with a relatively high case fatality. Here reported is a fulminant case of a 42-year-old previously healthy woman with cardiogenic shock and refractory cardiac arrest due to COVID-19-induced myocarditis who received veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) after 120 minutes of cardiopulmonary resuscitation (CPR). This is the first adult case of cardiac arrest due to COVID-19-induced myocarditis supported by ECMO that fully recovered with normal neurological functions. The success of the treatment course with full recovery emphasized the potential role of ECMO in treating these patients.
      PubDate: 2022-10-04
      DOI: 10.1017/S1049023X2200139X
       
  • Health Care Management during a Major Planned Event in Italy

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      Authors: Melegari; Gabriele, Giuliani, Enrico, Fornaciari, Davide, Cremonini, Claudia, Di Pietro, Giulia, Barbieri, Alberto
      Pages: 847 - 852
      Abstract: Events involving a high number of participants should be planned and implemented with the primary objective of guaranteeing the highest possible level of safety, which is ever more essential in the recent years due to the risk of terrorism, violence, and highly transmissible pathogens like coronavirus disease 2019 (COVID-19).The aim of this study was describing health care management of the Vasco Modena Park July 1, 2017 concert by the artist Vasco Rossi that involved 220,000 participants, more than doubling the population of Modena (Italy), the city hosting the event.Data were retrospectively collected from all health care registers used during the concert. Descriptive data regarding the event were recorded, as well as the medical records generated by the advanced medical posts.For analysis, patients were divided into two groups: the LOW-Severity (admission code green) and HIGH-Severity (admission codes yellow and red). The number of patients within the inclusion period was 1,088; there were 953 green discharge codes (97.74%), 16 yellow (1.64%), and six red (0.61%). Patients who needed a second-level assessment were 5.85% (57 events). HIGH-Severity patients needed to be further evaluated in 45.45% of the cases versus 4.93% of the LOW-Severity patient group (P value
      PubDate: 2022-10-03
      DOI: 10.1017/S1049023X22001352
       
  • COVID-19 Pandemic: An Opportunity for Using Tele-Dentistry for a Better
           Dental Care

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      Authors: Shaygani; Fatemeh, Ahmadi Marzaleh, Milad
      Pages: 853 - 855
      PubDate: 2022-09-15
      DOI: 10.1017/S1049023X22001339
       
  • Dissemination of Water-Mediated Infections due to Torrential Rainfalls
           Leading to Havoc Floods: A Dreadful Curve for Pakistan

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      Authors: Shabbir; Muhammad Aqib, Naveed, Muhammad, Asif, Muhammad Farrukh, Shahid, Amna, Ain, Noor-ul-, Mahmood, Sarmad, Laila, Umm-e-, Iftikhar, Muhammad Junaid
      Pages: 856 - 857
      PubDate: 2022-10-21
      DOI: 10.1017/S1049023X22001443
       
  • Dispatcher Telephone Assistance on First Aid: An Important but Unexplored
           Area for Research

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      Authors: Birkun; Alexei A.
      Pages: 858 - 859
      PubDate: 2022-11-08
      DOI: 10.1017/S1049023X22001492
       
  • The Outbreak of the Ebola Virus: Sudan Strain in Uganda and its Clinical
           Management

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      Authors: Ali; Urooj, Naveed, Muhammad, Ijaz, Adil, Jabeen, Khizra, Mughal, Muhammad Saad, ul Hasan, Jawad
      Pages: 860 - 862
      PubDate: 2022-11-15
      DOI: 10.1017/S1049023X22002199
       
 
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