Disaster Response Teams Research Articles

Board Game: An Effective Way for Novice Trainees to Learn Incident Command System

The incident command system (ICS) is widely used in disaster management, but it is hard for novice learners to apply what they learn in actual practice. Considering these aspects, we developed a board game for novice learners to learn ICS and conducted a study to evaluate the effectiveness of the board game method compared with that of traditional lectures.
 Two sessions of ICS training were conducted using only board games and lectures for each session. In the board game session, the participants played the board game for 1.5 hours without receiving any teaching. The game participants played as disaster response teams based on ICS principles. In the lecture session, a didactic lecture on ICS concepts and their applications in disaster medical assistance team (DMAT) work was taught for 1.5 hours by a disaster medicine expert. Before and after each session, a test comprising 20 multiple-choice questions (5 points for each question) was conducted. In the test, participants were evaluated on how to apply the ICS principle to DMAT work. Participants who had not previously received any disaster medicine education were defined as novice learners and were included to compare the learning effects of the two methods. A paired t-test was used to compare the results within each group, and an analysis of variance (ANOVA) was used to compare the results between the two groups.
 The study included 17 participants in the board game group and 25 participants in the lecture group. The mean test score was significantly higher after the game and the lecture (pre-game score = 56 versus post-game score = 75, p-value = .001; pre-lecture score = 58 versus post-lecture score = 74, p-value = .002). No significant difference was found in the score improvement between the two groups (p-value = .6). Hence, we can concluded that learning ICS through board games was as effective as using the traditional lecture method for novice disaster medicine trainees. The board game is an useful tool of disaster medicine education.

Implementation of a unique mass casualty and emergency preparedness longitudinal learning experience for postgraduate year 2 pharmacy residents

Background and purposeThe American Society of Health-System Pharmacists (ASHP) postgraduate year 2 (PGY2) critical care pharmacy residency program offers an elective competency area, E3: Mass Casualty. Similar elective competencies are also available for PGY2 emergency medicine and postgraduate year 1/2 pharmacotherapy programs. Because of the COVID-19 pandemic, pharmacist proficiency in the management of disasters is even more urgent. However, few residency programs require or include a specific learning experience to achieve this competency. This article provides examples of opportunities that residency programs can implement to offer an Emergency Preparedness/Mass Casualty (EP/MC) learning experience. Educational activity and settingA longitudinal EP/MC learning experience was integrated into a PGY2 critical care program. FindingsA longitudinal EP/MC learning experience within the PGY2 critical care, emergency medicine, and pharmacotherapy residency program curricula is achievable and promotes resident development. Learning experience components included topic discussions, participation on local and state-level emergency preparedness (EP) committees, completion of certification programs, projects, and participation on statewide emergency response teams. SummaryImplementation of a longitudinal EP/MC learning experience formalizes topics and activities that support achievement of the ASHP elective competency area of Mass Casualty for PGY2 residency programs. EP/MC goals and objectives should be a requirement for critical care, emergency medicine, pharmacotherapy, and health-system pharmacy administration and leadership PGY2 programs. By formalizing training, pharmacists can be better prepared for EP and more integrated into multidisciplinary disaster response teams.

Disaster Nursing Competency of Intensive Care Nurses in Jinan, China: A Multicenter Cross-Sectional Study.

Patients in disaster areas require the most urgent assistance. In recent large-scale natural disasters, intensive care nurses have served as an important reserve component of disaster response teams. In disaster nursing, ability and attitude directly affect the quality and effectiveness of disaster rescues. However, few studies have examined the disaster nursing competency of intensive care nurses in China. This study was designed to describe the current status of disaster nursing competency among intensive care nurses, analyze the related factors affecting the disaster response effectiveness, and evaluate the values of disaster nursing continuing education and training in cultivating professional personnel with disaster emergency rescue competence. This cross-sectional study was conducted at six tertiary general government hospitals in Jinan, Shandong Province, China. A convenience sampling method was adopted, and the Wenjuanxing website was used to compile the network questionnaire, which participants completed via a WeChat group. Descriptive, correlation, and regression analyses were performed using SPSS software. The participants in this study included 285 registered intensive care nurses employed at six hospitals in Jinan. Most were female (77.9%), and the mean age was 29.9 years. The mean total disaster nursing ability score was 122.98 (SD = 31.70), and the average scores for each item ranged from 2.78 to 3.70. The incident command system item earned the highest mean score (3.70, SD = 1.22), followed by triage (3.24, SD = 0.93). The biological preparedness item earned the lowest mean score (2.78, SD = 1.04). Being male, being < 30 years old, having an understanding of disaster nursing, having previously participated in disaster emergency simulation drills or training, and having a higher self-evaluation of rescue competence were all associated with higher disaster-nursing knowledge scores. Multiple linear regression analyses indicated that understanding of disaster nursing and experience participating in disaster emergency rescue drills or training had the most significant influence on the disaster nursing emergency knowledge score, followed by positive self-evaluation of disaster nursing ability and demand for training. The findings of this study indicate that the participants had a moderate disaster-nursing competency and that this competency may be improved through disaster-related continuing education and training. The cognitive attitude of disaster nursing was found to correlate positively with self-efficacy. Simulated emergency drills may effectively improve the disaster nursing competency of critical care nurses. The findings emphasize that experiences other than direct clinical practice such as specialized simulated emergency drills and training as well as willingness for such training are stronger factors for identifying and developing overall disaster nursing competency.

Adaptive Staffing Models and their Translation to Future Disaster Response: What Can Be Learned from COVID Unit Staffing?

Background: As much as hospital organizations like to be prepared for worst-case scenarios, situations inevitably arise that are unanticipated for which no amount of preparation would ever suffice. One such scenario was the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). Hospitals had to use their existing staff in order to meet the onslaught of patients presenting with COVID-19. Purpose: The aim of this paper is to review the various COVID unit hospital staffing models that were implemented during the influx of patients with COVID-19 and then to examine their sustainability and adaptability to response models for future disasters. Hospitals are equipped with rapid response teams and some with disaster response teams, but neither is designed to be on a massive scale or for an extended duration. Which teams worked well, and can any be used in future disaster response staffing models? Conclusions: An adaptive and sustainable disaster response team is more about the members who make up the team, than it is about the response. The training and knowledge of health care providers determines staffing model adaptability and these characteristics can be targeted when making decisions on hiring, training, ongoing education, and staff assignments.

Domestic application of lessons learned by Canadian health care professionals working in international disaster settings: a qualitative research study.

Background:Individuals with prior experience in international disaster response represent an essential source of expertise to support disaster response in their home countries. Our objective was to explore the experiences of personnel involved in international emergency health response regarding their perceptions of essential disaster response attributes and capacities and determine how these competencies apply to the Canadian context.Methods:For this qualitative study, we conducted semistructured interviews with key informants in person or over the telephone from May to December 2018. Participants were delegates deployed as part of the Canadian Red Cross medical response team in a clinical or technical, or administrative role within the last 5 years. Interviews were audio-recorded and transcribed. Conventional content analysis was performed on the transcripts, and themes were developed.Results:Eighteen key informants from 4 Canadian provinces provided perspectives on individual attributes acquired during international deployments, such as agility and stress management, and team capacities developed, including collaboration and conflict management. Key informants, including administrators (n = 5), technicians (n = 4), nurses (n = 4), physicians (n = 3) and psychosocial support workers (n = 2), described these experiences as highly relevant to the Canadian domestic context.Interpretation:Canadian physicians and health care workers involved with international disaster response have already acquired essential capacities, and this experience can be vital to building efficient disaster response teams in Canada. These findings complement the Canadian Medical Education Directives for Specialists (CanMEDS) roles and can inform course design, competency and curriculum development for physician and professional training programs related to disaster response and preparedness.

Phenomenology of Australian civilian hospital nurses’ lived experiences of the out-of-hospital environment following a disaster

Background Disasters disrupt the fabric of communities. This includes disruption to the healthcare system that supports a disaster-affected community. Nurses are important members of disaster response teams. However, there is limited literature that describes nurses’ roles or experience in responding to disasters. Aim This paper employs a phenomenological approach to uncover moments of being an Australian civilian hospital nurse in the out-of-hospital environment following a disaster. Method This study uncovers moments of what it is like being an Australian civilian hospital nurse deployed to the out-of-hospital environment following a disaster. Individual interviews were undertaken at two points in time with each participant. Audio-recorded interviews were transcribed to textual narratives, which was then analysed. Several activities were undertaken to uncover moments and provide exemplars of moments, from the narrative. Findings Eight hospital nurses participated in this study. Five moments were uncovered: ‘on the way to a disaster’, ‘prior to starting work’, ‘working a shift in a disaster’, ‘end of a shift’, and ‘returning home’. Each moment has its uniqueness and singularity exemplifying an experience of nurses in the out-of-hospital disaster environment. Discussion When compared to a hospital context, assisting during and/or following a disaster in the out-of-hospital environment is challenging. For example, nurses may need to do more with less resources, provide more frequent psychosocial support for more extenuating circumstances, and experience an unsettling return home at the end of the deployment. Conclusions This paper has provided new insights into what it may be like being an Australian civilian hospital nurse in the out-of-hospital disaster environment as part of a disaster medical assistance teams. Strategies to support nurses who assist during and/or following a disaster are important, so nurses can in turn provide care to people in disaster-affected communities.

Location-Based Game Platform for Behavioral Data Collection in Disaster Rescue Scenarios

Location-based games are an emerging paradigm for training, simulation, entertainment, health and many other domains. In this paper, we consider the role of location-based games as a platform for data collection and analysis of human behavior. We also examine how human teams perform in a disaster scenario when such a scenario is mapped to a game environment conducted as a location-based augmented reality game. We use a pilot experiment to study human behavior between simulated disaster rescue teams and an integrated commander for the purpose of future research into improving exploitation of local tasks versus exploration of assigned objectives by disaster response teams. We show the results of our pilot experiment, analyze the effectiveness of this game as a data collection platform and then investigate how additional experiments may be conducted to formalize this problem further.

Establishment of the Psychometric Properties of a Disaster Resilience Measuring Tool for Healthcare Rescuers in China: A Cross-Sectional Study

The aim of this study was to test the validity and reliability of a tool for measuring the disaster resilience of healthcare disaster rescuers. A cross-sectional study involving 936 healthcare disaster rescuers of the Sichuan Disaster Response Team was conducted to establish the psychometric properties of the disaster resilience measuring tool (DRMT). Item analysis, exploratory factor analysis, confirmatory factor analysis, and correlation analysis were adopted to analyze the data. Item analysis showed that all but three items had the critical ratio over 3, which indicates adequate discriminability for inclusion in the measuring tool. The exploratory factor analysis showed that 65.93% of the total variance was explained by four factors—self-efficacy, social support, positive growth, and altruism. The confirmatory factor analysis showed goodness of fit for the four-factor model: CMIN/DF (2.846), GFI (0.916 ≥ 0.90), CFI (0.949 ≥ 0.90), AGFI (0.891 ≥ 0.80), and RMSEA (0.063 ≤ 0.08). Criterion validity demonstrated significant associations of the DRMT and the Connor-Davidson Resilience Scale (P < 0.01, r = 0.566). Convergent validity was established by correlation with stress (P < 0.05, r = − 0.095), depression (P < 0.01, r = − 0.127), posttraumatic stress disorder-PCL-C (P < 0.05, r = − 0.100), compassion satisfaction (P < 0.01, r = 0.536), and burnout (P < 0.01, r = − 0.330). The DRMT demonstrated adequate internal consistency (Cronbach’s alpha > 0.84) and stability over the two-week study period (intraclass correlation coefficient > 0.85), and a cut-off point of 61 was suggested. The disaster resilience measuring tool has satisfactory psychometric properties and is a valid, reliable, and valuable instrument for assessing disaster resilience in healthcare rescue workers. The scale needs to be tested further among other populations and those from other cultures.

Provision of the Continuum of Care to Noncommunicable Diseases Post-Floods in Kerala, India 2018.

Integrating noncommunicable disease (NCD) in health care delivery during emergency response posed a major challenge post-floods in Kerala. Kerala experienced an abnormally high rainfall during mid-2018 where more than 400 people lost their lives. State health officials and the Disaster Response Team were sensitized about the importance of including NCDs in the response action. More than 80% of patients with hypertension and diabetes were not under control in Kerala. Under the state NCD cell, an NCD expert group was consulted for drafting the treatment and referral strategies. Steps to tackle NCDs during the disaster response were formulated. The state NCD cell decided to integrate NCDs in the response measures. The technical guidance document by the World Health Organization South-East Asia Region was consulted to formulate actions. The activities were implemented in 6 steps: prioritizing of major NCDS, patient estimation and drug stock preparation, standard treatment protocol, mapping of referral facilities, public engagement, and daily reporting of NCD consultations. Prioritizing the continuum of care of NCDs during floods among the program managers and care providers was crucial. The health education and communication campaign was done to sensitize the known NCD patients to seek early care. Daily reporting of consultations was established.

The role of Community-Based Disaster Preparedness and Response Team in building community resilience

The community and government of Kalipancur Village have realised and implemented the landslide disaster mitigation efforts known as Community-Based Disaster Preparedness and Response Team (SIBAT Team) as a part of the Disaster Risk Reduction Forums (FPRB) in Kalipancur Village. The purpose of this study was to determine the role of the SIBAT Team in implementing the resilience of the community of Kalipancur, especially the residents of RW 1, who live in landslide-prone areas. The sample in this study consisted of the SIBAT Team and residence of Kalipancur Village from RW I that were chosen using proportional random sampling. Data collection techniques used were observation, tests, questionnaires, and interviews. The data analysis techniques used consisted of qualitative data analysis technique with interactive methods and quantitative data analysis with descriptive analysis technique. The results showed that the SIBAT Team has a big role in building community resilience in Kalipancur Village in disaster mitigation education and emergency response efforts. The magnitude of the role of the SIBAT Team is directly proportional to the high level of community resilience in all aspects of the Kalipancur community. This research exemplifies that the Community-Based Disaster Risk Reduction (CBDRR) program is a strategic effort in building community resilience. Therefore, the sustainability of the CBDRR program is a necessity, and collaboration between the government, NGOs, and communities that combines bottom-up and top-down approaches will be an effective effort to build community resilience. Keywords: community resilience, disaster, Kalipancur village, landslide, SIBAT Team

After the Blast

UK disaster response team SARAID is helping Beirut find stability

Philippines braces for the typhoon season amidst COVID-19

Philippines braces for the typhoon season amidst COVID-19

Survey of awareness of radiation disasters among firefighters in a Japanese prefecture without nuclear power plants.

Japanese firefighting organisations are essentially run as village, town, or city units. The Great Hanshin Earthquake of 1995 led to the establishment of emergency support teams to ensure rapid action in response to disasters beyond the capacities of local fire departments. The 2011 Great East Japan Earthquake involved both a tsunami and a radiation disaster caused by a nuclear reactor meltdown, underscoring the need for responses in complex disasters. This study aimed to assess Nagasaki Prefecture firefighters' preparedness for, awareness of, and anxiety regarding radiation disaster response with the aim of elucidating the factors affecting individuals' decisions to accept or reject assignment to a radiation disaster response team. A questionnaire survey was carried out with 1,122 firefighters in three firefighting departments in Nagasaki Prefecture, which does not have nuclear power plants. In total, 920 questionnaires were returned, and the 784 that were valid were analysed. Among the participants, 39% replied that they would have no difficulty accepting assignment to a radiation disaster response team; most of them were under 30 years old and unmarried. This group also included significantly higher percentages of participants who were confident about radiation disaster response or, if anxious, believed things would turn out fine, as well as those who replied that they were able to use the necessary equipment. Furthermore, this group had significantly higher percentages of participants who replied that they would definitely participate in seminars and those who replied that their level of preparedness for radiation disasters was sufficient. The willingness to be assigned to a radiation disaster response team was linked to confidence about radiation disaster response and about handling materials and/or equipment. Therefore, it is considered that measures to increase firefighters' confidence regarding response to radiation disasters will be linked to more proactive measures if and when such disasters occur.

A grounded theory for the performance of temporary disaster response teams

PurposeThe purpose of this study is to identify and determine the most prevalent factors influencing the performance of temporary disaster response teams.Design/methodology/approachAfter a literature review on team performance and temporary organizations, this study uses the grounded theory approach, based on 13 years of United Nations Disaster Assessment and Coordination mission data.FindingsGeneric individual skills and a heterogeneous team composition are key. Speed of deployment trumps thoroughness of preparation. Partner organizations should contribute supporting capacities. Necessary leadership skills are simple rather than arcane. Uncontrollable factors must be accepted. Creativity plays only a small role.Practical implicationsPrioritize transferable competencies when selecting team members. Compose teams with regional, but not global, diversity. Reduce team leader training to basic leadership skills.Originality/valueThe intersection between temporary organizations and the performance of multinational disaster response teams is unexplored. Research aimed at increasing disaster response performance can contribute to human lives saved and advance general management and organization studies.

Low-cost UAV surveys of hurricane damage in Dominica: automated processing with co-registration of pre-hurricane imagery for change analysis

In 2017, hurricane Maria caused unprecedented damage and fatalities on the Caribbean island of Dominica. In order to ‘build back better’ and to learn from the processes causing the damage, it is important to quickly document, evaluate and map changes, both in Dominica and in other high-risk countries. This paper presents an innovative and relatively low-cost and rapid workflow for accurately quantifying geomorphological changes in the aftermath of a natural disaster. We used unmanned aerial vehicle (UAV) surveys to collect aerial imagery from 44 hurricane-affected key sites on Dominica. We processed the imagery using structure from motion (SfM) as well as a purpose-built Python script for automated processing, enabling rapid data turnaround. We also compared the data to an earlier UAV survey undertaken shortly before hurricane Maria and established ways to co-register the imagery, in order to provide accurate change detection data sets. Consequently, our approach has had to differ considerably from the previous studies that have assessed the accuracy of UAV-derived data in relatively undisturbed settings. This study therefore provides an original contribution to UAV-based research, outlining a robust aerial methodology that is potentially of great value to post-disaster damage surveys and geomorphological change analysis. Our findings can be used (1) to utilise UAV in post-disaster change assessments; (2) to establish ground control points that enable before-and-after change analysis; and (3) to provide baseline data reference points in areas that might undergo future change. We recommend that countries which are at high risk from natural disasters develop capacity for low-cost UAV surveys, building teams that can create pre-disaster baseline surveys, respond within a few hours of a local disaster event and provide aerial photography of use for the damage assessments carried out by local and incoming disaster response teams.

Roles of Public Health Disaster Response Team within the National Disaster Response System in South Korea

In South Korea, Public Health Disaster Response Team (PHDRT) has been organized by every Community Health Center since 2016. When a disaster or accident with heavy casualties is expected to occur, PHDRT is dispatched. This study shed light on the role of PHDRT within the Korean National Disaster Response System by analyzing the related law and regulations, their activities, and interviews with disaster medical professionals. PHDRT is the part of the national disaster management system in Korea, organized under the Framework Act on the Management of Disasters and Safety. As of 2018, there was a total of 468 teams and 2,557 members, mostly consisting of physicians, nurses and administrators. The roles of PHDRT in disaster medical response include early triage, medical resource planning, patient transportation, support of on-site emergency care, and media relations and communications. To facilitate the activities of PHDRT, their roles need to be well defined and supported by legal and institutional frameworks, along with individual and organizational efforts to strengthen capacity.

Localizing and quantifying infrastructure damage using class activation mapping approaches

Traditional post-disaster assessment of damage heavily relies on expensive geographic information system (GIS) data, especially remote sensing image data. In recent years, social media have become a rich source of disaster information that may be useful in assessing damage at a lower cost. Such information includes text (e.g., tweets) or images posted by eyewitnesses of a disaster. Most of the existing research explores the use of text in identifying situational awareness information useful for disaster response teams. The use of social media images to assess disaster damage is limited. We have recently proposed a novel approach, based on convolutional neural networks and class activation mapping, to locate building damage in a disaster image and to quantify the degree of the damage. In this paper, we study the usefulness of the proposed approach for other categories of infrastructure damage, specifically bridge and road damage, and compare two-class activation mapping approaches in this context. Experimental results show that our proposed approach enables the use of social network images for post-disaster infrastructure damage assessment and provides an inexpensive and feasible alternative to the more expensive GIS approach.

Just-in-Time Training for Disaster Response in the Austere Environment

Healthcare providers are critical to disaster response throughout the world. Increasingly, there are government and nongovernment sponsored opportunities for providers to participate in disaster response as members of disaster response teams. Training regarding principles and practices of disaster response should begin long before ever deploying for a disaster. Training opportunities on-line and in-person are readily available, but not usually for a specific disaster at the time it occurs. Just-in-time disaster specific training prepares providers for imminent deployment for a real-time disaster. Particularly for disaster response in an austere environment, just-in-time disaster specific training optimizes preparation and response. This manuscript offers topics, strategies, and modalities for just-in-time pediatric-focused disaster training regarding situational awareness, personal preparation and resiliency, and delivery of patient care for austere environments.

Upaya Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan Universitas Gadjah Mada dalam penanggulangan banjir di Kota Bima dengan teknologi pemanen air hujan

Flood disaster in Bima Town, West Nusa Tenggara Province, Indonesia at the end of 2016 affected 105,753 people. For the period of the disaster, water flooding whole area of the town. Universitas Gadjah Mada (UGM) represented by Faculty of Medicine, Public Health, and Nursing supported by the Faculty of Medicine Alumni Association (KAGAMADOK) sent two response teams to the disaster area with the aims to assess health status of the refugees and to create rainwater harvesting tool. There were two teams assigned to the flood management in Bima. First team assigned to establish database and health cluster information analysis, performed needs assessment at refugee camp and affected area, and sent the patient to emergency health service. Regarding to the first team assessment results, second team assigned to create rainwater harvesting tool. First UGM team discovered that communities experiencing high prevalence of dermatology disease, meanwhile the medicine livestock diminished. Escalation of diarrhea cases especially in children and limited community health surveillance in Bima Town were also identified by the team. The second team was in a mission to accomplish environmental studies associated with flood disaster and implement rainwater harvesting technology. Rainwater harvesting technology implemented based on data collection and analysis from the first team. Rainwater harvesting technology used to supply community water necessities since the groundwater in disaster area remain muddy and smells. Application of rainwater harvesting equipment completed at Penanae and Mpunda Primary Health Care. Deployment of the UGM Bima disaster response team expected to spring positive benefits to the flood affected communities, and in addition expected that the assistance from UGM established sustainably.

Lessons from the Brussels Terrorist Attack

Introduction:On March 22, 2016, the capital of Europe was hit by two terrorist attacks. As terrorism becomes more and more violent, it is critical to learn and share experiences in order to enhance effectiveness in saving lives.Methods:A field perspective and experience feedback from the Emergency Medical Response.Results:The first attack hit the departure hall of the airport, which, due to its strategic role, relies upon a dedicated emergency plan. However, it focuses on airplane crashes and not on explosions in a crowded terminal. The second attack hit the subway at rush hour. An attack in such a confined environment is particularly challenging for the rescue teams, as injuries are worsened, access hindered, and exits numerous.Eleven medical teams were sent in order to perform triage and provide vital care. The medical response was organized by two disaster response teams. Advanced Medical Posts were set up and the mass casualty plans of all hospitals were activated. Managing war injuries for civilian teams was challenging. On-site care consisted essentially in prehospital damage control and burn care in order to ensure rapid evacuations for haemostatic surgery. 313 victims were dispatched to thirty hospitals. Another challenge was safety. Several threats were apparent and explosives were found on both sites. Lessons from Paris had prompted a review of our multiple sites Emergency Plan. One single way of communication was used and the evacuations were managed centrally. Finally, the key factor that helped limit the number of casualties was the acquaintanceship between emergency workers and non-medical teams built during exercises, allowing them to adapt and blend in as one team.Discussion:Lessons from previous attacks were crucial to improve our management of the medical response. These should be shared around, as another attack may always occur anywhere and at any time.