Emergency Response Center Research Articles

Correlation between the accuracy of the emergency response centre’s urgency assessment and emergency medical services non-conveyance: a retrospective register-based study in Finland

BackgroundIn modern emergency medical services (EMS), ambulances increasingly focus on examining and treating the patient at the scene. This has led to increased levels of non-conveyance. In Finland, for instance, approximately 40% of EMS dispatches end up in non-conveyance. As EMS systems evolve, the proportion of non-conveyance could serve as a cost-effective measure to assess the quality of the dispatch criteria, if a link to the performance of urgency assessment would be established. The purpose of this study was to investigate whether the proportion of non-conveyance is associated with the test performance levels of the urgency assessment. This investigation was done separately within each dispatch category.MethodsA retrospective evaluation of the data was conducted on all EMS dispatches in the Pirkanmaa Hospital District from 1 August 2021 through 31 August 2021. There were a total of 7,245 EMS dispatches during the study period of which 829 were excluded. This study was conducted by comparing the existing test performance levels (sensitivity, specificity and under- or overestimation) of the emergency response centre’s urgency assessment with the non-conveyance rate (%) of each dispatch category. The relationships between the variables were measured using Spearman’s rank correlation coefficient.ResultsThe proportion of over-triage was the only urgency assessment’s test performance variable that had a statistically significant correlation with the proportion of non-conveyance (r = 0.568; p = 0.003). Other test performance variables of the urgency assessment had no or little correlation to the proportion of non-conveyance. Of the 6,416 EMS dispatches in the study period, 42% (2,672) resulted in non-conveyance of the patient. In nine dispatch categories, at least half (51–69%) of the dispatches ended in non-conveyance.ConclusionsBased on this study, it seems that the percentage of non-conveyance in the dispatch category could be used, with certain limitations, to assess the proportion of over-triage in the dispatch category. The method is particularly applicable in scenarios where the dispatch criteria have undergone modifications and there is a need to monitor the effect of the changes on the level of over-triage.

Advancing Road Safety Through Intelligent Vehicle Accident Detection and Reporting Enabled by IoT Innovation

The escalating incidence of road accidents poses a significant challenge to public safety, often exacerbated by delays in emergency response. This research introduces an IoT-based intelligent system designed to revolutionize accident management by providing real-time data and critical information to emergency services. By seamlessly integrating Raspberry Pi and Arduino microcontrollers with advanced sensors such as force-sensitive resistors (FSRs), GPS, and potentially additional sensors like accelerometers and gyroscopes, the system accurately detects accidents, assesses their severity, and captures comprehensive data, including passenger images, vehicle details, and precise accident location. Upon impact, the system rapidly transmits this data, along with pre and post-accident images, to a designated emergency response center via a secure and reliable communication network. This swift dissemination of critical information empowers emergency responders to make informed decisions, optimize resource allocation, and prioritize response efforts, ultimately saving lives and minimizing the impact of accidents. The system's intelligence lies in its ability to not only detect accidents but also to assess their severity based on sensor data analysis, enabling a more targeted and efficient emergency response. Furthermore, the system's potential to collect valuable data on accident patterns and causes can contribute to the development of preventive measures and road safety strategies. By leveraging the power of IoT technology, this research aims to significantly enhance road safety and transform accident management practices.

Reducing the severity of incidents or emergency in Estonian emergency calls

Abstract The aim of the article is to analyze the calls to the Estonian Emergency Response Centre, focusing on instances where callers reduce the severity of incident or emergency in their first turn. The data comprise 39 calls from the Corpus of Emergency Calls of the University of Tartu. The analysis reveals that callers employ mitigating words and negative turn-initial utterances to reduce the severity. These words indicate the caller’s uncertainty about the information provided or suggest that the reported incident or emergency is minor. The utterances are syntactically and semantically (but not prosodically) completed clauses followed by a second part of the clause construction containing specific information about the caller’s issue. Functionally, these utterances serve as assessments falling into three groups based on the information they project. Some assessments project uncertain information, explicitly expressing uncertainty about the information or using the epistemic marker ma=i=tea ‘I don’t know’. The second group of assessments project information about an incident that the caller does not qualify as an emergency. The last group projects a potential incident or emergency using variants of the utterance ei juhtund midagi ‘nothing happened’. In addition, we offer explanations for why callers reduce the severity of the incident or emergency and demonstrate that reducing severity does not lower the probability of sending assistance. This indicates that call-takers do not rely on callers’ assessments when deciding whether the help is needed.

Lessons learned while planning for advanced air mobility

Historically aviation has gone through periods of immense innovative growth. Today the air transport industry is in the midst of yet another revolutionary period. Advanced Air Mobility (AAM) includes technological advancements in electric and hydrogen propulsion, battery capacity and autonomy, resulting in the development of a new generation of electric and hybrid-electric aircraft. These emerging technologies and new aircraft show promise in addressing historical concerns such as noise, safety, and negative environmental impacts. AAM has the potential to revolutionise the way we live by serving as the catalyst to robust, sustainable transport systems for people and goods. AAM can assist with emergency response, medical transport, reduced travel times, improve accessibility and reduce harmful emissions. Airports are an essential part of the transport infrastructure, serving as hubs for air travel, cargo shipments and emergency response centres in the wake of natural disasters. With the rise of AAM technologies, airports will need to adapt and prepare to accommodate these new types of aircraft. Each airport is unique and airport management will need to understand not only the potential of AAM but the capabilities of the airport itself. This paper aims to capture what the aviation industry has been, what it could be through AAM, lessons learned while planning for AAM, and how airports can use critical success factors to evaluate their readiness and plan for this innovative era.

Can the Emergency Medical Service (EMS) System Help in Improving the Healthcare Access - Evidence from Maharashtra EMS.

For many people in the remote regions of India, medical help is inaccessible as 66% of rural Indians do not have access to critical medicine and 31% of the population travel more than 30 km seeking health care in rural India. Timely non-availability of doctors in healthcare facilities, especially in primary health centers (PHCs), leads to more dependency on the private healthcare practitioners for the out-patient department services. This needs immediate attention. The healthcare authority in Maharashtra has allowed doctors in 108 emergency ambulances to provide consulting services. The current study is based on the total consultations managed by the doctors on-board on the 108 ambulances in the state of Maharashtra in the years 2020, 2021, and 2022. The data are procured from the state-run Emergency Response Centre, and the analysis is done by using the basic statistical technique in MS Excel and SPSS16.0. More than 9.35 lakh medical consultations were provided with an average 856 consultations per ambulance in the year 2022, showing a significant growth of 452% over the consultations in 2020. The base location of the 32% ambulance (298) in the PHCs has improved the round the clock accessibility in 16% of the total PHCs in the state of Maharashtra. The availability of the doctors in the state-run emergency ambulances for general healthcare services has improved the adherence of Indian Public Health Standards, and such practice must be examined for implementation in other states.

Foreign experience in training operators of the Emergency Assistance System for the population via a single telephone number 112

For a person who finds himself in a situation where there is a threat to his life or health, or the life or health of his relatives, the time within which the competent authorities will come to his aid is critically important. In order to respond to emergencies in a timely manner, Ukraine has established a mechanism for responding to citizens' appeals. This mechanism includes the State Emergency Service of Ukraine, the National Police of Ukraine, emergency (ambulance) medical care, emergency gas service and other emergency services. However, it is not entirely convenient to call these services for help, as the call is made by different phone numbers and in situations where a variety of phone numbers will lead to a loss of time and serious consequences.
 Ukraine's integration into the European community requires our country to review the mechanisms for protecting a person in an emergency situation. It is established that the main purpose of implementing the system of emergency assistance to the single telephone number 112 in Ukraine is to provide timely assistance to European level with the ability to communicate in foreign languages, prompt involvement of necessary emergency services, which is a decisive factor in providing assistance, emergency response.
 The article also considers the issues of training employees who receive calls to the single emergency number «112», their interaction with each other during the performance of duties at emergency response centers, as well as their interaction with employees who directly provide assistance to scene. It is established that the training of operators who organize the rescue operation is carried out at the police academy.
 The training system for 112 Centre operators in Estonia is one of the best in the world and can be borrowed for implementation in Ukraine. At the same time, the «Emergency Assistance System for the Population via a Single Phone Number 112» is a rather complex mechanism for the implementation of which, in addition to analysing positive foreign experience, it is necessary to involve a fairly wide range of specialists from various fields, and therefore to create an appropriate regulatory framework to regulate the interaction between different response services.

Satellite imagery in evaluating oil spill modelling scenarios for the Syrian oil spill crisis, summer 2021

The second-largest oil pollution incident in the Eastern Mediterranean Levantine basin, following the oil pollution crisis in Lebanon in 2006, is considered to be the oil leakage from the Syrian Baniyas power plant (summer 2021), during which 12,000 tons of oil were released. At the operational phase, the everyday predictions of oil drift were provided using the MEDSLIK and MEDSLIK-II models in the framework of an agreement between the Mediterranean Operational Network for Global Ocean Observing System (MONGOOS) and the Regional Marine Pollution Emergency Response Centre for the Mediterranean (REMPEC). In this work, we present a novel post-operational comprehensive model-based analysis, conducting a SAR validation in two model outputs: the MEDSLIK and the OpenDrift models. Each simulation is initiated with the operationally acquired EMSA-CSN and ESA SAR images. Moreover, the high-resolution met-ocean fields (CYCOFOS, SKIRON) are used to force the oil drift and transformation in both models. The spill was developed under the calm-wind conditions that prevailed during the incident. We found that the boundary sea currents developed on the periphery of the Lattakia eddies (anticyclonic and cyclonic) were responsible for the fast westward spreading of the oil spill offshore in the NE Levantine, the north-south pathway bifurcation, and re-landing of oil in the extended coastal area of Lattakia. Model outputs were validated against Synthetic-aperture radar (SAR) images with appropriate performance metrics, used for the first time, to assess the capacity of a reliable representation of oil spill drift. The intercomparison between the two oil spill models indicated that both models produce almost similar results, while their validation against the satellite SAR observations illustrates moderate accuracy.

Parental knowledge attitude and practices about chemical and medicinal poisons: A hospital based study from Karachi, Pakistan

BackgroundUnintentional poisoning is among the leading cause of death in children less than 20 years age. The incidence of unintentional poisoning in Low-income countries LMICs is four times higher compared to high-income countries (HICs). In Pakistan a 10% (25/211) incidence of unintentional poisonings among 0–15-year-old children has been reported. Most of the poisoning occur because of household chemical and medicines. This study aimed to assess the knowledge, attitude, and practices (KAP) of parents in Karachi regarding poisonous household chemicals and medicines. MethodsThis KAP study was conducted at Aga Khan University Hospital, Karachi from May to August 2019. A maximum sample of 384 was calculated using a 50% knowledge about household chemicals. Data were collected about parental knowledge, attitude and practices about poisons and chemicals at home and presented as frequency and percentages. Chi-square test of independence (or Fisher's exact test) was used. Data were analyzed using SPSS version 20. ResultsA total of 364 parents of 0–16-year-old children completed the survey out of which 229 were mothers and 127 were fathers (eight had missing data). We had 70% of parents that kept chemicals and medicines locked in cabinets and 80% chose to never leave medicines unattended, there are still 20–30% parents that need improvement in the parental knowledge and practices for storing chemicals and medicines. A general lack of knowledge regarding poisoning first aid and emergency response centers was noted. ConclusionsTwo-pronged approach for future interventions could be useful; (1) Improving the knowledge and practice among the remaining 20–30% through repeated awareness’ sessions for the community. (2) Information regarding PCCS needs to be made readily available to the parents which is a measure useful in cases a child poisoning occurs.

Wireless Network Safety Status Prediction Based on Fuzzy Logic

In WN environment, network safety status means to state of information managing in various WN environments, WN transmission information safety status assessment is one of primary research directions in this territory. Existing network safety status awareness methods are difficult to adapt to real-time changes of network structure, and WN environment is complex and changeable, and they can only analyze the current network safety status, and it is difficult to predict and analyze overall tendency of WN safety status. In order to resist potential attacks, evaluate safety of network and detect attack means in network in a timely manner, this paper introduces fuzzy logic to propose a safety status prediction model for wireless sensor networks, which can help administrators to timely perceive and comprehensively grasp the real-time status of network and predict future advancement direction. In order to assess current network status, a safety status evaluation model for wireless network (WN) depended on fuzzy logic is presented. In cluster head node, neighborhood rough set is used for feature extraction to reduce energy consumption of redundant data on the node. Balance data by synthesizing a few over-sampling techniques, and then use random forest to detect attacks on the network to identify attack types. Combined with the status element acquisition mechanism, three status indicators, namely attack frequency, total number of attacks and threat factor, are extracted. According to the status indicators and status calculation method, the network safety status value is calculated, and current network safety status is evaluated by referring to network safety level divided by National Internet Emergency Response Center. Neighborhood rough set is applied to complete attribute reduction, which can effectively deal with underwater mixed data and obtain feature subsets with same classification capability as initial data. Safety status of WSN is predicted based on random forest. The risk degree of WN status is divided into fuzzy subsets, and the process of dynamic prediction of safety status is designed. Based on test values, highest input signal spectrum of the system is 30 mV, and the lowest input signal spectrum is -15 mV, which is consistent with the selected 120 groups of status data sequence diagram, the fluctuation amplitude of the input signal under 40~62 groups of samples is small, basically unchanged, consistent with the selected 120 groups of status data sequence diagram. Fuzzy logic model represented by star broken line has higher precision than decision tree and the limit learning machine in all five different attack types. mapped network safety status grade can also effectively express the actual network safety status. indicating that the prediction results of the system are accurate.

Situation awareness of emergency response centre personnel during chemical incidents: an interview study in a Swedish context

ObjectivesIf a chemical incident occurs, the emergency response centre (ERC) personnel are the first that are notified. They need to quickly attain situation awareness, based on the information from the...

Automated external defibrillator delivery by a drone in a mountainous region to treat sudden cardiac arrest

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): ZOLL Introduction Out-of-hospital cardiac arrest (OHCA) poses a tough medical challenge with poor survival rates. Factors that may enable survival include resuscitation measures initiated by a bystander, early use of an automated external defibrillator (AED), and further performance of advanced life support. The latter will arrive on scene with an inevitable time-delay due to logistics challenges and potential AED unavailability, especially in rural areas. Here, drones might deliver an AED in order to increase the probability of survival. Methods Ten paramedics and nineteen medical laypersons were confronted with a person suffering from OHCA within a field test scenario in a mountainous region (Bodental, Carinthia, Austria) without detailed information. The scenario included a mock-call to the emergency response center responsible for the Austrian State Carinthia that dispatched a semi-autonomously flying drone towards the caller’s GPS coordinates. During the emergency call, participants should perform cardiopulmonary resuscitation (CPR) measures and were informed that a drone delivers a training-AED. Various timepoints (time to (tt) emergency call, tt start CPR, tt drone start, tt first shock, hands-off times) as well as CPR quality were subject of analysis. Results The paramedics realized the cardiac arrest after 21 ± 11 seconds, the emergency call was performed after 40 ±43 seconds, the drone started after 5:15 ± 2:11 minutes and dropped off the AED after 10:52 ± 2:06 minutes, and the first shock was delivered after 12:15 ± 2:03 minutes. 70 % performed adequate chest compressions and 50 % provided sufficient mouth-to-mouth ventilation. Hands-off times were 50 ± 22 seconds. Only 37 % of the medical laypersons reported to know the algorithms for basic life support while 32 % performed adequate chest compressions and 68 % performed adequate mouth-to-mouth ventilation. In this group, the cardiac arrest was realized after 51 ±40 seconds, the emergency call was performed after 53 ±43 seconds, the drone started after 6:15 ± 1:33 minutes and dropped off the AED after 10:54 ± 1:56 minutes, and the first shock was delivered after 14:04 ± 2:10 minutes. Hands-off times were 2:11 ± 0:39 minutes. Conclusion The delivery and usage of an AED via a semi-autonomously flying drone in a remote region is feasible and safe. The drone delivery of an AED in mountainous regions can lead to early application of shocks. CPR quality performed by medical laypersons is suboptimal and emphasises the need for regular trainings.

Automated external defibrillator delivery by drone in mountainous regions to support basic life support – A simulation study

BackgroundOut-of-hospital cardiac arrest (OHCA) is associated with poor survival rates. Factors that may enable survival include cardiopulmonary resuscitation (CPR) initiated by bystanders and early use of an automated external defibrillator (AED). This explorative simulation study was conceptualized to test the feasibility of a semi-autonomously operating drone that delivers an AED to a remote emergency location and its bystander-use. MethodsTen paramedics and nineteen laypersons were confronted with a manikin simulating an OHCA as single bystanders within a field test located in a mountainous region between Austria and Slovenia. The scenario included a mock-call to the local emergency response center that dispatched a drone towards the caller’s GPS coordinates and supported the ongoing CPR. The outcomes were the successful delivery of the AED, the time to the first shock, hands-off times, and the overall performance of the CPR. ResultsThe AED was delivered by drone and used in all 29 scenarios without serious adverse events. The flight time of the drone was in median 5:20 (range: 1:35–8:19) minutes. The paramedics delivered the first shock after a mean of 12:15 ± 2:03 min and hands-off times were 50 ± 22 s. The laypersons delivered the first shock after 14:04 ± 2:10 min and hands-off times were 2:11 ± 0:39 min. All participants felt confident in the handling of the delivered AED. ConclusionThe delivery and usage of an AED via a semi-autonomously flying drone in a remote region is feasible. This approach can lead to early administration of shocks.

Differences between the dispatch priority assessments of emergency medical dispatchers and emergency medical services: a prospective register-based study in Finland

BackgroundResponsive and efficient emergency medical services (EMS) require accurate telephone triage. In Finland, such services are provided by Emergency Response Centre Agency (ERC Agency). In 2018, a new Finnish computer-assisted emergency dispatch system was introduced: the Emergency Response Integrated Common Authorities (ERICA). After the introduction of ERICA, the appropriateness of EMS dispatch has not been investigated yet. The study´s objective is to determine the consistency between the priority triage of the emergency medical dispatcher (EMD) and the on-scene priority assessment of the EMS, and whether the priority assessment consistency varied among the dispatch categories.MethodsThis was a prospective register-based study. All EMS dispatches registered in the Tampere University Hospital area from 1 August 2021 to 31 August 2021 were analysed. The EMD’s mission priority triaged during the emergency call was compared with the on-scene EMS’s assessment of the priority, derived from the pre-set criteria. The test performance levels were measured from the crosstabulation of true or false positive and negative values of the priority assessment. Statistical significance was analysed using the chi-square test and the Kruskal–Wallis H test, and p-values < 0.05 were considered significant.ResultsOf the 6416 EMS dispatches analysed in this study, 36% (2341) were urgent according to the EMD’s dispatch priority, and of these, only 29% (688) were urgent according to the EMS criteria. On the other hand, 64% (4075) of the dispatches were non-urgent according to the EMD’s dispatch priority, of which 97% (3949) were non-urgent according to the EMS criteria. Moreover, there were differences between the EMD and EMS priority assessments among the dispatch categories (p < 0.001). The overall efficiency was 72%, sensitivity 85%, specificity 71%, positive predictive value 29%, and negative predictive value 97%.ConclusionWhile the EMD recognised the non-urgent dispatches with high consistency with the EMS criteria, most of the EMD’s urgent dispatches were not urgent according to the same criteria. This may diminish the availability of the EMS for more urgent missions. Thus, measures are needed to ensure more accurate and therefore, more efficient use of EMS resources in the future.

Mitigating Sustainability Risks in a Road Hazardous Materials Transport Network

Many materials which are important for a sustainable society are hazardous materials (hazmat), and there is the risk of potential threats with undesirable impacts on the sustainability of transport systems. The goal of this study is the mitigation of sustainability risks associated with hazmat transport processes. Moreover, it is necessary to design reliable road hazmat transport networks based on risk mitigation. This research combines route planning of hazmat shipments with location for emergency response centers in a road hazmat transport network. In addition, a new subsidy policy is also proposed. Hazmat carriers are able to choose routes for shipments in accordance with minimum transport costs. As a game scenario, a bi-level programming model is established to describe the problem. A genetic algorithm is developed to solve the problem, and computational experiments are made to testify the effectiveness of the proposed method. The results show the reasonableness of the model and the effectiveness of the algorithm, calibrating the influence of the parameters and the optimization characteristics of certain practical scenarios. Overall, the purpose of this paper is to develop a complete optimization approach for the design of road hazmat transport networks with sustainable risk as the key innovation.

CHARACTERISTICS OF PROFESSIONAL AND TECHNICAL EDUCATIONAL ESTABLISHMENTS OF CIVIL PROTECTION OF UKRAINE

The article describes the contents of the concepts of professional training of the personnel of theunits of Civil Protection Emergency Rescue Service, primary professional training, professional (vocational) training.The structure of vocational education of the civil protection sphere is considered.The description of the training centers of the emergency rescue units of the special purpose (specializededucational institutions of the first attestation level), the list of working professions by which vocational training,retraining, advanced training are carried out is presented. The training centers of the Civil Rescue Service (trainingcenter of the Main Department of the State Emergency Service in Kyiv, the training center of the Civil Rescue Service,the Interregional Emergency Response Center of the operational and rescue service) the list of proffessions for whichpreparation, retraining, advanced training, vocational training are carried out, their main purpose is given. The activityof the Higher Vocational School of Lviv State University of Life Safety and the State Paramilitary Mining and RescueSquad is described, the working professions under which vocational training, initial vocational training, retraining andadvanced training are carried out.

AUTOMATED ACCIDENTS ON ROAD ANALYSIS: AN OVERVIEW OF STATE OF THE INSIGHTS

Nowadays, people’s lives are becoming more and more luxurious with the use of technologies. Everyone wants ease and comfort. The trend of having personal vehicles for daily-based usage is increasing rapidly. As more and more people are buying vehicles, the traffic burden is increasing on the roads, causing accidents. When an accident happens, people get injured, and if the emergency services like medical aid are not given on time, then it may cause death. In the upcoming era, the idea of smart cities would be utilized, where every facility and service would be centralized and connected to a server; therefore, devices will be used to send a signal to the nearest emergency response center when an accident is detected on CCTV footage. This work reviews accident and accidental vehicle analysis through automated approaches. The areas of applications are highlighted along with the recent trends and practices discussed in this article.

On the functioning of the «System of emergency assistance to the population on a single telephone number 112»: foreign experience and opportunities for its use in Ukraine.

The article analyzes the positive foreign experience of the emergency assistance system to the single telephone number 112. It has been established that the main purpose of implementing the system of emergency assistance to the single telephone number 112 in Ukraine is to provide timely assistance to European level with the ability to communicate in foreign languages, prompt involvement of necessary emergency services, which is a decisive factor in providing assistance, emergency response. The study examines the structure of emergency response centers and their main powers. The main function of any emergency response center is to receive calls to the emergency number 112 and to refer the relevant units to assist the applicant or other persons who find themselves in an emergency. The functions of regional centers also include providing information to the public on issues that are not classified as emergency. The article also considers the issues of training employees who receive calls to the single emergency number 112, their interaction with each other during the performance of duties at emergency response centers, as well as their interaction with employees who directly provide assistance to scene. It is established that the training of operators who organize the rescue operation is carried out at the police academy. An appropriate operator training center has been set up for their training at the academy. According to the results of the study, it is concluded that the use of positive foreign experience allows to quickly and effectively achieve international standards of emergency care.

UAV-Based Intelligent Transportation System for Emergency Reporting in Coverage Holes of Wireless Networks.

During critical moments, disaster and accident victims may not be able to request help from the emergency response center. This may happen when the victim’s vehicle is located within a coverage hole in a wireless network. In this paper, we adopt an unmanned aerial vehicle (UAV) to work as an automatic emergency dispatcher for a user in a vehicle facing a critical condition. Given that the UAV is located within a coverage hole and a predetermined critical condition is detected, the UAV becomes airborne and dispatches distress messages to a communication network. We propose to use a path loss map for UAV trajectory design, and we formulate our problem mathematically as an Integer Linear Program (ILP). Our goals are to minimize the distress messages delivery time and the UAV’s mission completion time. Due to the difficulty of obtaining the optimal solution when the scale of the problem is large, we proposed an efficient algorithm that reduces the computational time significantly. We simulate our problem under different scenarios and settings, and study the performance of our proposed algorithm.

Converting an Under-Construction Healthcare Facility into a COVID-19 Screening and Emergency Response Centre During Complete Lockdown in India.

In view of the COVID-19 surge, the construction of the Burns and Plastic Surgery Block at AIIMS, New Delhi was expedited at war footing level and converted into a COVID-19 Emergency response Centre (ERC). Engineering works were completed in a speedy manner and various patient care areas were equipped as deemed necessary for providing tertiary care to COVID-19 patients. A highly spirited team comprising of Emergency Medicine Specialists, Anesthesia and Critical Care specialist, Hospital Administrators and Nursing Officers was formed. Effective segregation of patient care areas into clean, contaminated, and intermediate zones was done using physical barriers and air conditioning modifications. The screening area for patients suspected of having COVID-19 was created in addition to a 2-step process i.e., Triage 1 and Triage 2, thereafter, patients requiring admission would be referred to the emergency area. An in-house designed and fabricated sampling booth was created to bring down the use of PPEs and for better infection control. The ERC has a general ward and state of the art intensive care units. Mobilizing resources (machinery, manpower, consumables etc.) during the lockdown required commitment from top leadership, motivated teams, expeditious procurement, coordination with multiple agencies working on site, expediting statutory clearances, coordination with police services, transportation of labor etc.

Developing COVID-19 emergency response centres in geographically challenged areas of Pakistan: A case study of the Aga Khan Development Network.

The inevitable COVID‐19 global pandemic has severely affected Pakistan’s fragile healthcare system. The system was already facing a significant burden of noncommunicable and other infectious diseases, and the pandemic further exacerbated the disease and the healthcare burden in Pakistan. In such a situation, people who live in geographically challenged areas with limited healthcare infrastructure and resources are more vulnerable to the impacts of a pandemic. The authors share the experience of the development of emergency response centres (ERCs) in the rural remote mountainous regions of Pakistan–Chitral, an initiative that the Government of Pakistan and Aga Khan Health Service Pakistan (AKHSP) implemented to manage the increasing rates of COVID‐19 cases in these areas. The authors outline the processes that need to be undertaken to develop such healthcare facilities in a short period of time and discusses the challenges of establishing and operating these centres and the lessons learnt during and after the development of these centres in the remote mountainous regions of Pakistan.