Ethical perspectives and attitudes of disaster workers throughout the disaster management cycle in the Middle East

Space technology plays important role during emergency as well as non-emergency situation to provide the information that is relevant for disaster preparedness and to the rescue and emergency medical teams. During emergency situation, first and immediate information rescue and medical teams like to have is the area impacted, severity of the disaster and the population at risk. Such information is of critical nature for emergency medical teams in order to plan and mobilize the medical personnel, resources and infrastructure needed to provide effective medical services. Space based observation is the most efficient way to provide this preliminary information. Often emergency maps generated based on the space based observations are useful to the medical and rescue teams during emergency situation while detailed information from the field is still awaited. UN-SPDIER offers the platform for providing such services effectively by connecting with the end users the international and regional mechanism that provides such information. During non-emergency phase, the space technology contributes in strengthening disaster risk reduction (DRR) efforts, especially through telemedicines and Global Positioning System (GPS) technologies. These tools integrated with Geographical Information System (GIS) provide effective mechanism for predicting risks (risk mapping) and early warning. It also ensures the rapid distribution of information during catastrophic events. In recognition of these needs the United Nations General Assembly established the United Nations Platform for Space-based Information for Disaster Management and Emergency Response (UN-SPIDER). The programme aims at providing universal access to all types of space-based information by: being a Gateway to space information for disaster management support; serving as a Bridge to connect the disaster management and space communities; and being a Facilitator of capacity-building and institutional strengthening.

In recent years, with the increasingly frequent variety of large-scale disasters that have happened in China, the Chinese People's Armed Police Forces (PAP) has undertaken increasingly frequent and diversified tasks, which has led to greater requirements for the construction of emergency medical rescue equipment. Therefore, as determined by the characteristics of the PAP's tasks and based on the construction of special boxes and frame tent equipment, a new PAP mobile rescue hospital system was successfully developed, and all PAP provincial-level medical rescue teams have been equipped with this system. In the present article, we describe this mobile rescue hospital system, which is mainly composed of professional emergency vehicles, frame-type tents, and advanced medical equipment. The system has the following characteristics: significant integration, a fast response, flexibility, and practicability. The mobile rescue system is generally used as the army's own health service support system and to provide certain emergency medical rescue services to disaster-stricken people. The successful construction and further application of this system have significance in terms of accelerating the response of rescue teams and the emergency treatment ability of the PAP's provincial-level emergency medical rescue teams. (Disaster Med Public Health Preparedness. 2018;12:455-459).

Accurate medical evaluation of victims injured during confined space rescues poses significant operational, medical, and logistical challenges for medical providers of all disciplines and experience levels. The Federal Emergency Management Agency (FEMA) teaches rescuers to begin their assessment as soon as verbal contact is obtained with the victim. While a significant amount of information can be obtained by talking to the victim, an accurate assessment of the victim's condition is often limited or impossible. Many professional rescue agencies currently use cameras to locate a victim's position or visualize obstacles that prevent the successful extraction of casualties. However, there is no published literature describing the use of a camera to complete a medical evaluation. The authors describe their use of a fiber optic camera to complete a limited but accurate primary and secondary trauma evaluation of a patient trapped inside an 18 in water pipe for a prolonged period of time. The providers' assessment provided critical information to the rescue team and assisted in the planning and eventual extrication of the patient from the confined space. Moreover, there was very little variation between the findings obtained during the assessment at the scene and the assessment in the receiving facility's trauma bay. When evaluating a trauma patient, there is no substitution for visual inspection and physical diagnosis. The use of a fiber optic camera can assist rescuers and medical providers in obtaining the information they desire, and enable the completion of an accurate patient assessment. The camera may also provide psychological reassurance and ease anxiety, as well as generate prehospital images that can be transmitted to the receiving facility for use in preparation of the casualty. Emergency medical service providers, urban search & rescue teams, fire departments, and other professional rescuers should be trained on the use and limitations of fiber optic cameras during confined space rescues. Furthermore, regulatory agencies such as FEMA should consider integrating the use of fiber optic camera and audiovisual devices into the current training courses offered to professional rescuers.

As Hurricane Katrina demonstrated, federalism can impede the government's ability to plan for and respond to emergencies. Many emergencies transcend federalist divisions of power and responsibility, rendering unclear which level of government should respond. In addition, while emergencies may require a coordinated response by local, state, and national government, getting different levels of government to work together in times of crises is difficult. Further, even when states and localities call for outside assistance, they tend to resist undue federal interference in their affairs; a national government that lacks experience working with local actors on the ground can find it difficult to implement relief programs. Given the widely recognized failures of the government's response to Katrina and the urgent need for reform, some federal officials have proposed that, in a future emergency, rather than try to work with state and local response personnel, the federal government should simply deploy the military to take over the relief effort. This Article presents an alternative solution: emergency commandeering. This solution would allow the federal government, when it responds to certain kinds of emergencies, to call into periods of mandatory federal service the emergency response personnel of the state in which the emergency occurs, and, if necessary, emergency response personnel from other states. These state employees - police, firefighters, emergency medical technicians, urban search and rescue teams, and public health specialists - would serve with compensation under the command of the President. Emergency commandeering allows the national government to mount an effective response, one that draws upon the skills and experiences of state and local personnel, without the hindrance of multiple command structures or other forms of state and local resistance. Emergency commandeering is authorized by the Constitution, consistent with federalism, and, compared to the alternative of sending the military into our streets, good for democracy.

Dental trauma is common in patients assisted by rescue teams at sites of accidents and by emergency teams in hospitals. However, these professionals are given little or no information about taking care of the injured teeth and mouth. The aim of this study was to evaluate the level of knowledge of rescue and emergency teams’ professionals (physicians, Nurses, and Paramedics) concerning dental trauma first management. Material and methods: 196 professionals of rescue and emergency units had received a standard questionnaire of 5 questions concerning dental trauma first management and reserving avulsed dental tissue (tooth or its fragment). The results showed high level of attendance of dental trauma patients by paramedics, nurses, and physicians, with very low-level knowledge about dealing with such cases, and with moderate results about the best medium to reserve the avulsed tooth, and the actions taken during the rescue process. Conclusions: Our results show a high occurrence of cases of dental trauma attended by rescue and emergency medical teams, with a lack of knowledge. This suggests a need for more educational campaigns for these professionals with a long-term follow-up.Keywords: Traumatic dental injury, Tooth Avulsion, Emergence rescue teams.

To discuss health assessment and epidemic prevention in earthquake rescue, to establish emergency health and epidemic prevention mode for the national earthquake emergency medical rescue team scientifically, and to provide references and consultations for emergency hygiene and epidemic prevention measures in disaster medicine. China National Earthquake Disaster Emergency Search and Rescue Team gathered and evaluated environment, food, drinking water and other health related information around more than 2000 earthquake victims in Baoxing County, Shuangshi Town and Qingren Township from 20th April 2013 to 27th by using methods such as field epidemiological investigations. The national earthquake emergency medical rescue team spread comprehensive evaluation focusing on the local epidemics, find out the starting point of epidemic prevention, and then built reporting system in disaster area. The team also formulated the emergency detection system of food and drinking water and carried out health education. After the golden 72 hours, by comprehensive evaluation the establishment of early response in disaster area and spreading epidemic prevention, this team achieved the full coverage of three in the earthquake area, the resettlement of residents and families in that area and gradually formed a disaster medical rescue hygiene and epidemic prevention mode.

Background: An objective, comprehensive and scientific evaluation of emergency medical rescue capability (EMRC) is of great realistic significance in assisting the health administrative department to grasp the overall response capability of all emergency medical rescue teams, enabling each team to have a full understanding of its own strengths and weakness and improve itself accordingly. At present, the research on the evaluation of EMRC in Hazardous Chemicals Accidents (HCA) is not systematic and in-depth, and the existing research results also have some shortcomings, such as, the lack of strong theoretical support for the evaluation index system, the relatively single function of evaluation methods, and so on. Objectives: The objective of this article is to research the evaluation index system and a new evaluation method of EMRC in HCA to overcome the above shortcomings. Methods: It establishes an emergency medical rescue capability model by employing the competency model and then constructs the evaluation index system on the basis of the analysis of all the factors of emergency medical rescue capability in hazardous chemical accidents and sets up an evaluation model based on the theory of connection numbers and partial connection numbers. It determines the competence ranking of several emergency medical rescue teams and the competence state of an individual emergency medical rescue team by calculating the connection principal value, and it also predicts how the emergency medical rescue capability will develop based on the values of partial connection numbers. Results: The example shows that the calculation process of this model is relatively simple, and its assessment results are objective and authentic, and moreover, its multi-functions can make up for the deficiency of the simplified function of other evaluation models. Conclusion: This method is scientific and rational to some extent and can provide reference for evaluation problems of the same kind.

Due to rapid development of biocybernetics and technical computer science, dispatching ofmedical emergency services can be significantly improved. Thus the effectiveness of conductingrescue operations during mass casualty incidents (MCI) can be increased. Selected optimizationmethods and the expert system have been used to develop an Intelligent Medical Rescue OperationsManagement System (IMROMS). This system is the basis for the real emergency medical supportsystem that could be implemented in the emergency units. In the current paper IMROMS hardwareand software implementation problems have been discussed, including the analysis of the currentstate of information-telecommunication technologies (ICT) support for the rescue system inprovinces of Poland. The IMROMS consists of computer support for the following emergencyworkstations: Data Communication System of Provincial Emergency System (DCSPES), MedicalEmergency Coordinator (MEC) and Medical Emergency Dispatcher (MED) workstations,Medical Emergency Supervisor (MES) workstation, Casualty Health Monitor (CHM) mobiledevices, Hospital Emergency Department (HED) workstations and Medical Rescue Teams (MRTs)workstations. Computer software implements the following modules: optimization module(IMROMS-OM), expert system (IMROMS-ES), geographical information system – (IMROMSGIS).Optimization module has been developed on the basis of the computer simulator for optimaldecision-making in medical rescue operations (CSMRO). The IMROMS software was developed tocarry out hypothetical rescue operations with the support of a computer, the operation of which wastested under near-real conditions during the 14th Warmia and Mazury Championship in MedicalRescue, held in Olsztyn, Poland, in 2016. The Championships were attended by 20 medical rescueteams from all over Poland. The competition scenario assumed a specific post-accident conditionof the victims, their injuries and the status of their basic vital signs. Participants performed initialsegregation according to the START algorithm, first without computer support – in the traditionalway - and then using IMROMS. Identification took place at the scene and involved entering healthdata such as the status of basic vital functions, including respiratory characteristics, blood pressure,respiratory effort and capillary return and the type of injury suffered by the victim. Data was entered by paramedics using the Casualty Health Monitor (CHM) mobile device. A MED/MEC computersupport station using the CSMRO optimization module provided a solution based on this to assignHED and MRT to MCI victims. The time spent by rescuers at the scene of an MCI incident duringinitial segregation was significantly reduced and, consequently, the time taken to carry out actionsin the subsequent individual stages of the rescue operation was also shorter.

Background The main task of the State Medical Rescue System is to provide assistance to every person who faces a sudden health emergency or threat to life. This is provided through Medical Rescue Teams, the analysis of which will allow us to take a closer look at their characteristics and indicate possible areas for improvement. Objectives The purpose of this study is to research the functioning of Medical Rescue Teams in Łódź in 2020, including determining the number, type, reasons and legitimacy of interventions, and detailing the characteristics of patients, place of events, time of departure, time of arrival at the scene and the number and type of trips. Material and methods The material consists of 72,749 trips carried out by Medical Rescue Teams in Łódź in 2020. The obtained results were statistically analyzed using the Statistica v. 13.3 program, where the χ2 test was used to determine the relationship between the variables. A significance level of p<0.05 was assumed. The statistical analysis shows that 72,749 trips were carried out by Medical Rescue Teams in Łódź in 2020, 89% of which were “P” type, and 11% “S” type. Results Most of the interventions (emergency callouts) were visits to women and to the elderly (those in the 60+ age category). Teams were usually dispatched in the departure urgency code “1”. The most common places to which emergency teams were sent were patients’ homes and public places. Ambulances were more often called for patients who were not in a state of emergency than for those who were. The most common reasons for requesting help were symptoms, disease features, cardiovascular diseases, injuries and poisonings. Conclusions Noting the high percentage of calls to patients who did not have a sudden threat to life or health – educational activities should be carried out to promote and increase awareness of the reasons for calling emergency medical teams.

Disaster has great destructiveness and a wide influence on urban and rural construction, and more than one place is affected by disaster. Thus, it needs to take multiple disaster points into account. In view of different rescue missions, both medical rescue teams and search rescue teams also need to be dispatched. That is the multi-sided matching among medical rescue teams, search rescue teams and disaster points. Firstly, we describe the matching process, including the related symbols used in the process, and define a concept called multi-sided matching. Then, we aim to solve two problems: determining the competency degree of rescuers and calculating the time reliability of rescue teams arriving at disaster points. For the first one, we invite experts to evaluate pending rescue teams in terms of professional ability and collaboration ability using probabilistic linguistic term sets (PLTSs) because PLTSs not only keep original linguistic information but also give distributed expressions. For the second one, we determine the arriving time and calculating the time reliability by using the improved Bureau of Public Road (BPR) function. After that, we construct the two-stage multi-sided matching programming models based on the improved BPR function and PLTSs. Finally, a case study is used to demonstrate the proposed matching process, some comparative analyses and discussions are also conducted to validate the proposed models.

Indonesia contributed to the 2023 Turkiye earthquake response with a 181-member urban search and rescue team, an emergency medical team, and 140 tons of relief supplies. Multistakeholder international humanitarian assistance improves regional collaboration and human capital development of disaster response professionals. Additionally, humanitarian diplomacy nurtures our global community and aids in reducing disaster risks from impacts of disaster, climate change, and conflict. Indonesia and Turkiye collaborated excellently during the 2004 Aceh tsunami response to ensure marginalized communities had access to essential humanitarian relief. Both Indonesia and Turkiye as well as the United States (US) are vital partners. The three countries comprise close to a tenth of the global population, representing the West, Middle East, and Asia. The Federal Emergency Management Agency of the US, the Turkiye Disaster and Emergency Management Presidency (Afet ve Acil Durum Yonetimi Bas，kanlıǧı), and Indonesia’s National Disaster Management Agency (Badan Nasional Penanggulangan Bencana) have been collaborating in knowledge exchange for disaster risk reduction. The humanitarian assistance to the Turkiye earthquake response provided lessons on international emergency response operations and integrated technical and cultural knowledge in emergency management. The experience demonstrated how to leverage education and training to build capabilities. This case is also about forging regional collaboration to support and serve marginalized, at-risk communities.

Personal injuries and traffic hold‐ups caused by such incidents as crashes, collisions, fires and falling trees demand fast action by medical and emergency rescue teams. Given the volume of traffic flow in most cities and urban centres today, getting to trouble spots in time with the right equipment calls for compact, powerful and versatile vehicles manned by quick‐thinking, capable rescue teams.

Review Question: This review aims to answer the following specific question: What are nurses’ experiences of preparing for and managing the ethical challenges posed by catastrophic public health emergencies and health care disasters? Review Purpose/Objectives: The purpose of this systematic review is to systematically review and synthesise research literature reporting nurses’ experiences of ethical preparedness for dealing with catastrophic public health emergencies and health care disasters and the ethical quandaries that may arise during such events. INCLUSION CRITERIA: Types of Participants: The review will consider publications that include nurses registered or authorised under a given country’s state of emergency provisions to practice in jurisdictions in which a public health emergency (e.g. pandemic influenza) or sudden‐onset mass casualty health care disaster (e.g. flood, hurricane, earthquake, tsunami, volcanic eruption, terrorist attack) have occurred, or may occur. Phenomena of interest: This review will examine the phenomenon of nurses’ experiences of preparing for and/or managing ethical issues arising during a public health emergency or health care disaster. Consideration will be given to, but not be limited to nurse preparation for and management of ethical issues associated with: development of local public health emergency (including pandemic influenza) and sudden‐onset health care disaster plans provision of first health care contact for the general public personal protection and correct use of safety equipment providing front line clinical care providing community and primary health care assistance with containment measures triaging in a range of settings, including general practices, community health centres, and local hospitals maintaining infection control vaccinations informing the public work attendance.

For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People's Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.

Medical and epidemiological documentation in disasters is pivotal: the former for recording patient care and the latter for providing real-time information to the host country. Furthermore, documentation informs post-hoc analysis to improve the effectiveness of future deployments.Although documentation is considered important and indeed integral to health care response, there are many barriers and challenges. Some of these challenges include: working without well-established standards for medical documentation; and working with international guidelines which provide minimal guidance as to how health data should be managed practically to ensure accuracy and completion. Furthermore, there is a shift in mindset in disaster contexts wherein most health care focus shifts to direct clinical care and diverts almost all attention from quality documentation.This report distinguishes between the tasks of the epidemiologist and the data manager (DM) in an emergency medical team (EMT) and discusses the importance of data collection in the specific case of an EMT deployment. While combining these roles is sometimes possible if resources are limited, it is better to separate them, as the two are quite distinct. Although there is overlap, to achieve the goals of either role, preferentially they should be carried out by two people working closely together with complementary skill sets. The main objective of this report is to provide guidance and task descriptions to EMTs and field hospitals when training, recruiting, and preparing DMs and epidemiologists to work within their teams. Clear delineation of tasks will lead to better quality data, as it commits DMs to being concerned with the provision of real-time documentation from patient arrival through to compiling daily reports. It also commits epidemiologists to providing enhanced disease surveillance; outbreak investigation; and a source of reliable and actionable information for decision makers and stakeholders in the disaster management cycle.