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 by number of followers
Studies in Conflict & Terrorism     Hybrid Journal   (Followers: 365)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 347)
Canadian Journal of Remote Sensing     Full-text available via subscription   (Followers: 55)
Disasters     Hybrid Journal   (Followers: 20)
International Journal of Emergency Services     Hybrid Journal   (Followers: 20)
International Journal of Emergency Management     Hybrid Journal   (Followers: 11)
Evolution, Medicine, and Public Health     Open Access   (Followers: 9)
Prehospital and Disaster Medicine     Full-text available via subscription   (Followers: 8)
Strategic Analysis     Hybrid Journal   (Followers: 7)
Risk, Hazards & Crisis in Public Policy     Hybrid Journal   (Followers: 5)
International Journal of Intelligent Defence Support Systems     Hybrid Journal   (Followers: 4)
International Journal of Critical Infrastructure Protection     Hybrid Journal   (Followers: 4)
Disaster Recovery Journal     Full-text available via subscription   (Followers: 4)
Journal of Applied Security Research     Hybrid Journal   (Followers: 3)
Journal of Health Care Law and Policy     Open Access   (Followers: 3)
International Journal of Forensic Engineering     Hybrid Journal   (Followers: 2)
Global & Regional Health Technology Assessment     Open Access   (Followers: 2)
Korean Journal of Defense Analysis     Hybrid Journal  
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Journal Cover
Prehospital and Disaster Medicine
Journal Prestige (SJR): 0.462
Citation Impact (citeScore): 1
Number of Followers: 8  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 1049-023X - ISSN (Online) 1945-1938
Published by Cambridge University Press Homepage  [353 journals]
  • PDM volume 38 issue 6 Cover and Front matter

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      Pages: 1 - 6
      PubDate: 2023-11-30
      DOI: 10.1017/S1049023X23006659
       
  • PDM volume 38 issue 6 Cover and Back matter

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      Pages: 1 - 6
      PubDate: 2023-11-30
      DOI: 10.1017/S1049023X23006660
       
  • Editorial Comments: The 2023 Model Core Content of Disaster Medicine

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      Authors: Franc; Jeffrey Michael, Stratton, Samuel J.
      Pages: 697 - 698
      Abstract: The recently published Model Core Content of Disaster Medicine introduces proposed curriculum elements for specialized education and training in Disaster Medicine. This editorial comments on the publishing decision for the manuscript.
      PubDate: 2023-11-16
      DOI: 10.1017/S1049023X23006581
       
  • The 2023 Model Core Content of Disaster Medicine

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      Authors: Wexler; Bryan J., Schultz, Carl, Biddinger, Paul D., Ciottone, Gregory, Cornelius, Angela, Fuller, Robert, Lefort, Roxanna, Milsten, Andrew, Phillips, James, Nemeth, Ira
      Pages: 699 - 706
      Abstract: Introduction:Disaster Medicine (DM) is the clinical specialty whose expertise includes the care and management of patients and populations outside conventional care protocols. While traditional standards of care assume the availability of adequate resources, DM practitioners operate in situations where resources are not adequate, necessitating a modification in practice. While prior academic efforts have succeeded in developing a list of core disaster competencies for emergency medicine residency programs, international fellowships, and affiliated health care providers, no official standardized curriculum or consensus has yet been published to date for DM fellowship programs based in the United States.Study Objective:The objective of this work is to define the core curriculum for DM physician fellowships in the United States, drawing consensus among existing DM fellowship directors.Methods:A panel of DM experts was created from the members of the Council of Disaster Medicine Fellowship Directors. This council is an independent group of DM fellowship directors in the United States that have met annually at the American College of Emergency Physicians (ACEP)’s Scientific Assembly for the last eight years with meeting support from the Disaster Preparedness and Response Committee. Using a modified Delphi technique, the panel members revised and expanded on the existing Society of Academic Emergency Medicine (SAEM) DM fellowship curriculum, with the final draft being ratified by an anonymous vote. Multiple publications were reviewed during the process to ensure all potential topics were identified.Results:The results of this effort produced the foundational curriculum, the 2023 Model Core Content of Disaster Medicine.Conclusion:Members from the Council of Disaster Medicine Fellowship Directors have developed the 2023 Model Core Content for Disaster Medicine in the United States. This living document defines the foundational curriculum for DM fellowships, providing the basis of a standardized experience, contributing to the development of a board-certified subspecialty, and informing fellowship directors and DM practitioners of content and topics that may appear on future certification examinations.
      PubDate: 2023-10-23
      DOI: 10.1017/S1049023X23006556
       
  • Demographic and Clinical Characteristics of Earthquake Victims Presented
           to the Emergency Department with and without Crush Injury upon the 2023
           Kahramanmaraş (Turkey) Earthquake

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      Authors: Buyurgan; Çağrı Safa, Bozkurt Babuş, Seyran, Yarkaç, Akif, Köse, Ataman, Usluer, Halil Oktay, Ayrık, Cüneyt, Narcı, Hüseyin, Orekici Temel, Gülhan
      Pages: 707 - 715
      Abstract: Introduction:Earthquakes are sudden-onset natural disasters that are associated with substantial material damage, resulting in the collapse of built environment with a high rate of mortality, injury, and disability. Crush syndrome, which can be seen after devastating earthquakes, can lead to acute kidney injury (AKI) and patients may require amputation, fasciotomy, and dialysis. Supportive treatment has an important role in the prognosis of these patients.Study Objective:The aim of this study was to investigate the demographic and clinical characteristics of traumatic earthquake survivors admitted to the emergency department (ED) of a hospital, which was close to the earthquake zone but not affected by the earthquake, after the February 6, 2023 Kahramanmaraş (Turkey) earthquakes.Materials and Methods:This study was conducted by retrospectively analyzing the data of 1,110 traumatized earthquake survivors admitted to the ED of a tertiary care university hospital from February 6th through February 20th, 2023. Age; gender; time of presentation; presence of comorbid diseases; ED triage category; duration of stay under debris; presence of additional trauma; laboratory tests; presence of AKI; presence of crush injury and injury sites; supportive treatment (fluid replacement and intravenous [IV] sodium bicarbonate); need for amputation, dialysis, and fasciotomy; duration of hospitalization; and outcome of ED were evaluated.Results:Of the 1,110 traumatic victims in this study, 55.5% were female patients. The mean age of the patients was 45.94 (SD = 16.7) years; the youngest was 18 years old and the oldest was 95 years old. Crush injury was detected in 18.8% and AKI in 3.0% of the patients. Dialysis, amputation, and fasciotomy were required in 1.6%, 2.8%, and 1.4% of the patients, respectively. In total, 29.2% of patients were hospitalized, including 2.9% admitted to the intensive care unit (ICU) and 26.3% to the relevant ward. In total, 0.3% of the patients included in the study died at ED.Conclusion:Post-earthquake patients may present with crush injury, AKI may develop, and fasciotomy, amputation, and dialysis may be needed, so hospitals and EDs should be prepared for natural disasters such as earthquakes.
      PubDate: 2023-09-27
      DOI: 10.1017/S1049023X23006416
       
  • Enhancing Triage and Management in Earthquake-Related Injuries: The
           SAFE-QUAKE Scoring System for Predicting Dialysis Requirements

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      Authors: Yılmaz; Sarper, Cetinkaya, Remzi, Ozel, Mehmet, Tatliparmak, Ali Cankut, Ak, Rohat
      Pages: 716 - 724
      Abstract: Objectives:Identifying early predictors of dialysis requirements in earthquake-related injuries is crucial for optimal resource allocation and timely intervention. This study aimed to develop a predictive scoring system, named SAFE-QUAKE (Seismic Assessment of Kidney Function to Rule Out Dialysis Requirement), to identify patients at high risk of developing acute kidney injury (AKI) and requiring dialysis.Methods:A retrospective analysis was conducted on a cohort of 205 patients presenting with earthquake-related injuries. Patients were divided into two groups based on their need for dialysis: the no dialysis group (n = 170) and the dialysis group (n = 35). Demographic, clinical, and laboratory data were collected and compared between the two groups to identify significant predictors of dialysis requirements. The parameters that would form the score were determined by conducting an importance analysis using artificial neural networks (ANNs) to identify parameters that exhibited statistically significant differences in univariate analysis.Results:The dialysis group had a significantly longer median duration of being trapped under debris (48 hours) compared to the no dialysis group (eight hours). Blood gas and laboratory analyses revealed significant differences in pH levels, lactate values, creatinine levels, lactate dehydrogenase (LDH) levels, and aspartate transaminase (AST)-to-alanine transaminase (ALT) ratio between the two groups. Based on these findings, the SAFE-QUAKE rule-out scoring system was developed, incorporating entrapment duration (7.31), creatinine levels (
      PubDate: 2023-10-04
      DOI: 10.1017/S1049023X23006453
       
  • Development and Validation of a New Tool to Improve the Accuracy of the
           Hospital Mass-Casualty Incident Response Plan Activation: The PEMAAF Score
           

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      Authors: Ruffini; Claudia, Trentin, Monica, Corona, Alberto, Caviglia, Marta, Sechi, Giuseppe Maria, Migliari, Maurizio, Stucchi, Riccardo, Ragazzoni, Luca, Fumagalli, Roberto
      Pages: 725 - 734
      Abstract: Introduction:Effective response to a mass-casualty incident (MCI) entails the activation of hospital MCI plans. Unfortunately, there are no tools available in the literature to support hospital responders in predicting the proper level of MCI plan activation. This manuscript describes the scientific-based approach used to develop, test, and validate the PEMAAF score (Proximity, Event, Multitude, Overcrowding, Temporary Ward Reduction Capacity, Time Shift Slot [Prossimità, Evento, Moltitudine, Affollamento, Accorpamento, Fascia Oraria], a tool able to predict the required level of hospital MCI plan activation and to facilitate a coordinated activation of a multi-hospital network.Methods:Three study phases were performed within the Metropolitan City of Milan, Italy: (1) retrospective analysis of past MCI after action reports (AARs); (2) PEMAAF score development; and (3) PEMAAF score validation. The validation phase entailed a multi-step process including two retrospective analyses of past MCIs using the score, a focus group discussion (FGD), and a prospective simulation-based study. Sensitivity and specificity of the score were analyzed using a regression model, Spearman’s Rho test, and receiver operating characteristic/ROC analysis curves.Results:Results of the retrospective analysis and FGD were used to refine the PEMAAF score, which included six items–Proximity, Event, Multitude, Emergency Department (ED) Overcrowding, Temporary Ward Reduction Capacity, and Time Shift Slot–allowing for the identification of three priority levels (score of 5-6: green alert; score of 7-9: yellow alert; and score of 10-12: red alert). When prospectively analyzed, the PEMAAF score determined most frequent hospital MCI plan activation (>10) during night and holiday shifts, with a score of 11 being associated with a higher sensitivity system and a score of 12 with higher specificity.Conclusions:The PEMAAF score allowed for a balanced and adequately distributed response in case of MCI, prompting hospital MCI plan activation according to real needs, taking into consideration the whole hospital response network.
      PubDate: 2023-11-24
      DOI: 10.1017/S1049023X23006593
       
  • Impact of Smart Glasses on Patient Care Time in Emergency Medical Services
           Ambulance

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      Authors: Apiratwarakul; Korakot, Cheung, Lap Woon, Ienghong, Kamonwon
      Pages: 735 - 739
      Abstract: Introduction:The smart glasses were implemented as an innovative communication tool to enhance effectiveness in the field. The traditional mode of communication for Emergency Medical Services (EMS) was radio, which had significant restrictions, primarily that they were unable to transmit any visual data. To enhance efficiency, the smart glasses were used for a more accurate assessment of the condition of patients during transportation. At this time, however, no prior study has shown significant benefits of employing smart glasses into EMS.Study Objective:The primary objective of this study is to compare the duration of patient care in an ambulance between the use and non-use of smart glasses. The secondary objective is to identify the characteristics of data communication between the ambulance and the hospital.Methods:This retrospective study utilized data gathered from closed-circuit television (CCTV) in ambulances at Srinagarind Hospital, Thailand. The data were collected over a six-month period, specifically from July through December 2021. The study included two groups: the smart glasses group and no smart glasses groups, both used during EMS operations. The primary data collected focused on the duration of patient care in the ambulance. Additionally, the type and characteristics of data transfers via smart glasses during EMS operations were also recorded.Results:Out of the 256 EMS operations included in this study, 53.1% (N = 68) of the participants in the smart glasses group were male. The majority of operations were performed during the afternoon shift in both groups. The average patient care time in the smart glasses group was 10.07 minutes, while it was 5.10 minutes in the no smart glasses group (P
      PubDate: 2023-10-05
      DOI: 10.1017/S1049023X23006489
       
  • Comparing TIMI, HEART, and GRACE Risk Scores to Predict Angiographic
           Severity of Coronary Artery Disease and 30-Day Major Adverse Cardiac
           Events in Emergency Department Patients with NSTEACS

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      Authors: Yalcin Ocak; Necmiye, Yesilaras, Murat, Kilicaslan, Baris, Eyler, Yesim, Mutlu, İnan, Kutlu, Murat
      Pages: 740 - 748
      Abstract: Background:Acute coronary syndromes (ACS) are hard to diagnose because their clinical presentation is broad. Current guidelines suggest early clinical risk stratification to the optimal site of care. The aim of this study was to investigate the ability of Thrombolysis in Myocardial Infarction (TIMI); History, Electrocardiogram, Age, Risk Factors, Troponin (HEART); and Global Registry of Acute Coronary Events (GRACE) risk scores to predict the development of major adverse cardiac events (MACE) and the angiographic severity of coronary artery disease (CAD) in patients diagnosed with non-ST-segment elevation acute coronary syndrome (NSTEACS) in the emergency department (ED). In addition, independent variables associated with the development of MACE were also examined.Methods:This study is a prospective, observational, single-center study. All patients over 18 years of age who were planned to be hospitalized for pre-diagnosed NSTEACS (NSTEMI + UAP) were included in the study consecutively. Patients’ demographic information and all variables necessary for calculating risk scores (TIMI, HEART, and GRACE) were recorded. Two experienced cardiologists evaluated all coronary angiograms and calculated the Gensini score.Results:The median age was 60 (IQR: 18) years, and 220 (61.6%) were male of the 357 patients included in the study. In this study, 91 MACE (52 percutaneous coronary interventions [PCI], 28 coronary artery bypass graft [CABG], three cerebrovascular disease [CVD], and eight deaths) occurred. The 30-day MACE rate was 25.5%. The low-risk group constituted 40.0%, 1.4%, and 68.0% of the population, respectively, in TIMI, HEART, and GRACE scores. Multiple logistic regression models for predicting MACE, age (P = .005), mean arterial pressure (MAP; P = .015), and High-Sensitive Troponin I (P = .004) were statistically significant.Conclusion:The ability of the GRACE, HEART, and TIMI risk scores to predict severe CAD in patients with NSTEACS is similar. In patients with NSTEACS, the HEART and GRACE risk scores can better predict the development of MACE than the TIMI risk score. When low-risk groups are evaluated according to the three risk scores, the HEART score is more reliable to exclude the diagnosis of NSTEACS.
      PubDate: 2023-10-13
      DOI: 10.1017/S1049023X23006490
       
  • 9-1-1 Activations from Ambulatory Care Centers: A Sicker Pediatric
           Population

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      Authors: Heyming; Theodore W., Knudsen-Robbins, Chloe, Shelton, Shelby K., Pham, Phung K., Brukman, Shelley, Wickens, Maxwell, Valdez, Brooke, Bacon, Kellie, Thorpe, Jonathan, Kwon, Kenneth T., Schultz, Carl
      Pages: 749 - 756
      Abstract: Background:Pediatric patients transferred by Emergency Medical Services (EMS) from urgent care (UC) and office-based physician practices to the emergency department (ED) following activation of the 9-1-1 EMS system are an under-studied population with scarce literature regarding outcomes for these children. The objectives of this study were to describe this population, explore EMS level-of-care transport decisions, and examine ED outcomes.Methods:This was a retrospective review of patients zero to
      PubDate: 2023-10-25
      DOI: 10.1017/S1049023X23006544
       
  • Large Language Model (LLM)-Powered Chatbots Fail to Generate
           Guideline-Consistent Content on Resuscitation and May Provide Potentially
           Harmful Advice

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      Authors: Birkun; Alexei A., Gautam, Adhish
      Pages: 757 - 763
      Abstract: Introduction:Innovative large language model (LLM)-powered chatbots, which are extremely popular nowadays, represent potential sources of information on resuscitation for the general public. For instance, the chatbot-generated advice could be used for purposes of community resuscitation education or for just-in-time informational support of untrained lay rescuers in a real-life emergency.Study Objective:This study focused on assessing performance of two prominent LLM-based chatbots, particularly in terms of quality of the chatbot-generated advice on how to give help to a non-breathing victim.Methods:In May 2023, the new Bing (Microsoft Corporation, USA) and Bard (Google LLC, USA) chatbots were inquired (n = 20 each): “What to do if someone is not breathing'” Content of the chatbots’ responses was evaluated for compliance with the 2021 Resuscitation Council United Kingdom guidelines using a pre-developed checklist.Results:Both chatbots provided context-dependent textual responses to the query. However, coverage of the guideline-consistent instructions on help to a non-breathing victim within the responses was poor: mean percentage of the responses completely satisfying the checklist criteria was 9.5% for Bing and 11.4% for Bard (P>.05). Essential elements of the bystander action, including early start and uninterrupted performance of chest compressions with adequate depth, rate, and chest recoil, as well as request for and use of an automated external defibrillator (AED), were missing as a rule. Moreover, 55.0% of Bard’s responses contained plausible sounding, but nonsensical guidance, called artificial hallucinations, that create risk for inadequate care and harm to a victim.Conclusion:The LLM-powered chatbots’ advice on help to a non-breathing victim omits essential details of resuscitation technique and occasionally contains deceptive, potentially harmful directives. Further research and regulatory measures are required to mitigate risks related to the chatbot-generated misinformation of public on resuscitation.
      PubDate: 2023-11-06
      DOI: 10.1017/S1049023X23006568
       
  • Alcohol-Related Presentations to Emergency Departments on Days with
           Holidays, Social, and Sporting Events: An Integrative Literature Review

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      Authors: Hagan; Stephanie Rae, Crilly, Julia, Ranse, Jamie
      Pages: 764 - 773
      Abstract: Introduction:Events, specifically those where excessive alcohol consumption is common, pose a risk to increase alcohol-related presentations to emergency departments (EDs). Limited evidence exists that synthesizes the impact from events on alcohol-related presentations to EDs.Study Objective:This integrative review aimed to synthesize the literature regarding the impact events have on alcohol-related presentations to EDs.Methods:An integrative literature review methodology was guided by the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) Guidelines for data collection, and Whittemore and Knafl’s framework for data analysis. Information sources used to identify studies were MEDLINE, CINAHL, and EMBASE, last searched May 26, 2021.Results:In total, 23 articles describing 46 events met criteria for inclusion. There was a noted increase in alcohol-related presentations to EDs from 27 events, decrease from eight events, and no change from 25 events. Public holidays, music festivals, and sporting events resulted in the majority of increased alcohol-related presentations to EDs. Few articles focused on ED length-of-stay (LOS), treatment, and disposition.Conclusion:An increase in the consumption of alcohol from holiday, social, and sporting events pose the risk for an influx of presentations to EDs and as a result may negatively impact departmental flow. Further research examining health service outcomes is required that considers the impact of events from a local, national, and global perspective.
      PubDate: 2023-10-25
      DOI: 10.1017/S1049023X23006507
       
  • Application of Telemedicine in the Ambulance for Stroke Patients: A
           Systematic Review

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      Authors: Sarpourian; Fatemeh, Ahmadi Marzaleh, Milad, Fatemi Aghda, Seyed Ali, Zare, Zahra
      Pages: 774 - 779
      Abstract: Introduction:The use of telemedicine for the prehospital management of emergency conditions, especially stroke, is increasing day by day. Few studies have investigated the applications of telemedicine in Emergency Medical Services (EMS). A comprehensive study of the applications of this technology in stroke patients in ambulances can help to build a better understanding. Therefore, this systematic review was conducted to investigate the use of telemedicine in ambulances for stroke patients in 2023.Methods:A systematic search was conducted in PubMed, Cochrane, Scopus, ProQuest, Science Direct, and Web of Science from 2013 through March 1, 2023. The authors selected the articles based on keywords and criteria and reviewed them in terms of title, abstract, and full text. Finally, the articles that were related to the study aim were evaluated.Results:The initial search resulted in the extraction of 2,795 articles. After review of the articles, and applying the inclusion and exclusion criteria, seven articles were selected for the final analysis. Three (42.85%) studies were on the feasibility and intervention types. Also, randomized trials, feasibility, feasibility and prospective-observational, and feasibility and retrospective-interventional studies were each one (14.28%). Six (85.71%) of the studies were conducted in the United States. The National Institutes of Health Stroke Scale (NIHSS) and RP-Xpress were the most commonly used tools for neurological evaluations and teleconsultations.Conclusion:Remote prehospital consultations, triage, and sending patient data before they go to the emergency department can be provided through telemedicine in ambulances. Neurological evaluations via telemedicine are reliable and accurate, and they are almost equal to in-person evaluations by a neurologist.
      PubDate: 2023-10-25
      DOI: 10.1017/S1049023X23006519
       
  • Epidemiology of Trauma-Related Hemorrhage and Time to Definitive Care
           Across North America: Making the Case for Bleeding Control Education

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      Authors: Jones; Allison R., Miller, Justin, Brown, Michelle
      Pages: 780 - 783
      Abstract: Introduction:Uncontrolled trauma-related hemorrhage remains the primary preventable cause of death among those with critical injury.Study Objective:The purpose of this investigation was to evaluate the types of trauma associated with critical injury and trauma-related hemorrhage, and to determine the time to definitive care among patients treated at major trauma centers who were predicted to require massive transfusion.Methods:A secondary analysis was performed of the Pragmatic, Randomized, Optimal Platelet and Plasma Ratios (PROPPR) trial data (N = 680). All patients included were predicted to require massive transfusion and admitted to one of 12 North American trauma centers. Descriptive statistics were used to characterize patients, including demographics, type and mechanism of injury, source of bleeding, and receipt of prehospital interventions. Patient time to definitive care was determined using the time from activation of emergency services to responder arrival on scene, and time from scene departure to emergency department (ED) arrival. Each interval was calculated and then summed for a total time to definitive care.Results:Patients were primarily white (63.8%), male (80.3%), with a median age of 34 (IQR 24-51) years. Roughly one-half of patients experienced blunt (49.0%) versus penetrating (48.2%) injury. The most common types of blunt trauma were motor vehicle injuries (83.5%), followed by falls (9.3%), other (3.6%), assaults (1.8%), and incidents due to machinery (1.8%). The most common types of penetrating injuries were gunshot wounds (72.3%), stabbings (24.1%), other (2.1%), and impalements (1.5%). One-third of patients (34.5%) required some prehospital intervention, including intubation (77.4%), chest or needle decompression (18.8%), tourniquet (18.4%), and cardiopulmonary resuscitation (CPR; 5.6%). Sources of bleeding included the abdomen (44.3%), chest (20.4%), limb/extremity (18.2%), pelvis (11.4%), and other (5.7%). Patients waited for a median of six (IQR4-10) minutes for emergency responders to arrive at the scene of injury and traveled a median of 27 (IQR 19-42) minutes to an ED. Time to definitive care was a median of 57 (IQR 44-77) minutes, with a range of 12-232 minutes. Twenty-four-hour mortality was 15% (n = 100) with 81 patients dying due to exsanguination or hemorrhage.Conclusion:Patients who experience critical injury may experience lengthy times to receipt of definitive care and may benefit from bystander action for hemorrhage control to improve patient outcomes.
      PubDate: 2023-10-02
      DOI: 10.1017/S1049023X23006428
       
  • EMS Responses for Pediatric Behavioral Health Emergencies in the United
           States: A 4-Year Descriptive Evaluation

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      Authors: Boland; Lori L., Anderson, Morgan K., Powell, Jonathan R., Patock, Michael T., Panchal, Ashish R.
      Pages: 784 - 791
      Abstract: Background:The occurrence of behavioral health emergencies (BHEs) in children is increasing in the United States, with patient presentations to Emergency Medical Services (EMS) behaving similarly. However, detailed evaluations of EMS encounters for pediatric BHEs at the national level have not been reported.Methods:This was a secondary analysis of a national convenience sample of EMS electronic patient care records (ePCRs) collected from January 1, 2018 through December 31, 2021. Inclusion criteria were all EMS activations documented as 9-1-1 responses involving patients < 18 years of age with a primary or secondary provider impression of a BHE. Patient demographics, incident characteristics, and clinical variables including administration of sedation medications, use of physical restraint, and transport status were examined overall and by calendar year.Results:A total of 1,079,406 pediatric EMS encounters were present in the dataset, of which 102,014 (9.5%) had behavioral health provider impressions. Just over one-half of BHEs occurred in females (56.2%), and 68.1% occurred in patients aged 14-17 years. Telecommunicators managing the 9-1-1 calls for these events reported non-BHE patient complaints in 34.7%. Patients were transported by EMS 68.9% of the time, while treatment and/or transport by EMS was refused in 12.5%. Prehospital clinicians administered sedation medications in 1.9% of encounters and applied physical restraints in 1.7%. Naloxone was administered for overdose rescue in 1.5% of encounters.Conclusion:Approximately one in ten pediatric EMS encounters occurring in the United States involve a BHE, and the majority of pediatric BHEs attended by EMS result in transport of the child. Use of sedation medications and physical restraints by prehospital clinicians in these events is rare. National EMS data from a variety of sources should continue to be examined to monitor trends in EMS encounters for BHEs in children.
      PubDate: 2023-11-30
      DOI: 10.1017/S1049023X2300657X
       
  • Use of Simulation in Full-Scale Exercises for Response to Disasters and
           Mass-Casualty Incidents: A Scoping Review

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      Authors: Pek; Jen Heng, Quah, Li Juan Joy, Valente, Martina, Ragazzoni, Luca, Della Corte, Francesco
      Pages: 792 - 806
      Abstract: Disasters or mass-casualty incidents are uncommon events. The use of simulation is an ideal training modality in full-scale exercises as it immerses the participants in a replication of the actual environment where they can respond to simulated casualties in accordance with existing protocols.The objective of this scoping review is to answer the research question: “How effective is simulation, as assessed in full-scale exercises, for response to disasters and mass-casualty incidents world-wide'” Studies on full-scale exercises, as defined in World Health Organization (WHO) simulation exercise toolbox, that were published in peer-reviewed journals using the English language from 2001 through 2021 were included. Twenty studies were included from searching PubMed, Embase, and Web of Science. Simulated casualties were the most common simulation modality. Using Kirkpatrick’s levels of evaluation to synthesize the data, simulation was reported to be generally effective and mostly demonstrated at the levels of learning of individuals and/or systems, as well as reaction of individuals. Evaluations at levels of behavior and results were limited due to the uncommon nature of disasters and mass-casualty incidents. However, evaluation outcomes across the full-scale exercises were varied, leading to the inability to consolidate effectiveness of simulation into a single measure. It is recommended for best evidence-based practices for simulation to be adhered to in full-scale exercises so that the trainings could translate into better outcomes for casualties during an actual disaster or mass-casualty incident. In addition, the reporting of simulation use in full-scale exercises should be standardized using a framework, and the evaluation process should be rigorous so that effectiveness could be determined and compared across full-scale exercises.
      PubDate: 2023-11-24
      DOI: 10.1017/S1049023X2300660X
       
  • Medical Assistance in the De-Occupied Ukrainian Territory

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      Authors: Mazurenko; Oleg V., Roshchin, Georgiy G., Slychko, Ivan Yo
      Pages: 807 - 812
      Abstract: Introduction:The Russian invasion of Ukraine in 2022 has affected more people and destroyed a local public health facility. When some territories in Ukraine were de-occupied, national and international mobile clinics (MCs) were involved for medical assistance to local inhabitants. Knowledge about population health, medical, and humanitarian needs after they have been de-occupied has to improve planning for health system response.Objective:The aim of this study was to summarized the MC experience at the first month after the area was de-occupied, as well as to show out-patient visits and to identify a need for medicines and medical equipment in the MC.Methods:The information related to the missions was obtained by direct observation and estimation on empirical data gathering in the field during a twelve-day mission in April-May 2022. All patients were divided by age, sex, and diseases according to the International Classification of Diseases-10 (ICD-10). During the twelve-day MC mission, medical assistance was provided for 478 out-patients. Descriptive statistical methods were undertaken using Microsoft Office 2019, Excel with data analysis.Interventions:All out-patients were evaluated clinically. Personal medical cards were completed for each patient. Glucose testing as well as tests for coronavirus disease 2019/COVID-19 had been done, if it was necessary. All sick persons were treated for their disease.Results:The priority needs for emergency and primary medical care, medicines, and hygienic and sanitation supplies after the area was de-occupied were fixed. The most frequent reasons for visiting the МС were: hypertension (27.6%), musculoskeletal-related (arthritis) diseases (26.9%), heart and peripheral vascular diseases (12.1%), upper gastrointestinal disorder (5.4%), upper respiratory infection (5.0%), and diabetes Type-2 (3.7%). Other diagnoses such as lower respiratory tract infection, diagnoses of the digestive system (hemorrhoids and perianal venous thrombosis), chronic obstructive pulmonary disease/COPD or asthma, eye diseases, gynecology-related condition, menstrual condition, and urinary tract disorder were distributed almost equally (0.21%-2.51%) among the patient population.Conclusions:In the de-occupied territories, a health responder could be ready for medical assistance to patients with noncommunicable diseases (NCDs) as well as to support a person with psychological reactions who asked for sedatives and sleep-inducing medicines. These data clearly demonstrate that MCs must be equipped by blood pressure (BP) monitor, stethoscope, pulse oximeter, and diabetes testing kit glucose with essential medicines. This study improves health response planning for local civilian populations in de-occupied territory.
      PubDate: 2023-09-29
      DOI: 10.1017/S1049023X23006398
       
  • Health System Response to the 2023 Floods in Emilia-Romagna, Italy: A
           Field Report

    • Free pre-print version: Loading...

      Authors: Valente; Martina, Zanellati, Maicol, Facci, Giulia, Zanna, Nicola, Petrone, Emilio, Moretti, Erika, Barone-Adesi, Francesco, Ragazzoni, Luca
      Pages: 813 - 817
      Abstract: In May 2023, the Italian region Emilia-Romagna was hit by intense rainfall, which caused extensive floods in densely populated areas. On May 4, 2023, a 12-month state of emergency was declared in the region with the activation of response and recovery plans. This field report provides an overview of the health response to the floods, paying particular attention to the measures put in place to ensure care for displaced populations and raising interesting points of discussion regarding the role of the health system during extreme weather events (EWEs). The considerations that emerge from this report underline the need for a primary care approach to disasters, especially when these occur in areas with a high prevalence of elderly resident population, and underscore the importance of integration of different levels of care.
      PubDate: 2023-09-27
      DOI: 10.1017/S1049023X23006404
       
  • Reply to: “Response to: Long-Term Mortality in Patients Transferred by
           Emergency Medical Services: Prospective Cohort Study”

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      Authors: Martín-Rodríguez; Francisco, Enríquez de Salamanca Gambara, Rodrigo, López-Izquierdo, Raúl, Sanz-García, Ancor
      Pages: 818 - 819
      PubDate: 2023-10-25
      DOI: 10.1017/S1049023X23006532
       
  • The Importance of Prehospital and Disaster Medicine in Rural Areas in the
           Philippines

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      Authors: Corpuz; Jeff Clyde G.
      Pages: 820 - 821
      PubDate: 2023-11-08
      DOI: 10.1017/S1049023X23006520
       
 
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Studies in Conflict & Terrorism     Hybrid Journal   (Followers: 365)
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Canadian Journal of Remote Sensing     Full-text available via subscription   (Followers: 55)
Disasters     Hybrid Journal   (Followers: 20)
International Journal of Emergency Services     Hybrid Journal   (Followers: 20)
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Evolution, Medicine, and Public Health     Open Access   (Followers: 9)
Prehospital and Disaster Medicine     Full-text available via subscription   (Followers: 8)
Strategic Analysis     Hybrid Journal   (Followers: 7)
Risk, Hazards & Crisis in Public Policy     Hybrid Journal   (Followers: 5)
International Journal of Intelligent Defence Support Systems     Hybrid Journal   (Followers: 4)
International Journal of Critical Infrastructure Protection     Hybrid Journal   (Followers: 4)
Disaster Recovery Journal     Full-text available via subscription   (Followers: 4)
Journal of Applied Security Research     Hybrid Journal   (Followers: 3)
Journal of Health Care Law and Policy     Open Access   (Followers: 3)
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