Emergency Services Organization Research Articles

Emergency management decision-making in a changing world: 3 key challenges

Managing emergencies is taxing for individuals due to the stress of making decisions in dangerous, high-stakes and time-constrained environments. These complex, dynamic environments also make it difficult to coordinate as other responders perform different roles that may have conflicting goals. This study explored some of the challenges faced by emergency management decision-makers through a literature review of 70 papers identified from SCOPUS and EBSCO database searches. Three major challenges for emergency management were identified: stress and fatigue, interoperability and ethical decision-making. Each of these challenges is examined to explore their nature and how they are likely to evolve in the future. This paper provides helpful advice on how to mitigate these challenges. We argue that to better meet these challenges, emergency services organisations need to develop and maintain appropriate doctrine and training, develop a supportive organisational culture and effectively learn the lessons of previous critical incidents.

Migrant and refugee communities strengthening disaster resilience

This paper presents insights from a community-led initiative in South Australia aimed at enhancing disaster resilience in culturally and linguistically diverse (CALD) migrant and refugee communities. Anchored in the principles of community cohesion, empowerment and informed action, the project addresses socio-cultural dynamics and communication barriers. A series of workshops and forums, tailored to account for cultural sensitivity, showed strengthened community collaboration, skills development and increased awareness of the psychosocial effects of disasters, prompting proactive strategies that consider the unique vulnerabilities and strengths of CALD communities. Participant testimonials noted increased community spirit and practical application of acquired knowledge, including understanding local hazard risk profiles and trust-building with emergency services organisations. The findings demonstrate the importance of mitigating access challenges, integrating diverse community perspectives into resilience- building activities and ensuring the inclusivity of management policies. Highlighting the significance of strengths-based community-driven approaches in emergency and disaster management, particularly for marginalised groups, this initiative found that engaging communities as active contributors enables more resilient and self-efficacious populations that effectively bridge cultural and linguistic gaps in preparedness.

A longitudinal investigation of job demands‐resources theory in volunteer firefighters working for the nonprofit sector

AbstractMany nonprofit emergency service organizations rely heavily on volunteers. With the recent decline in volunteer numbers and the associated economic cost, it is important for nonprofit organizations to develop strategies aimed at improving volunteer retention. To this end, we applied job demands‐resources theory to examine how volunteer demands and resources explain volunteers' well‐being (i.e., exhaustion and engagement) and consequently, retention and mental health (i.e., depressive symptoms). Specifically, we hypothesized that: (1) exhaustion mediates the positive relationship between demands and depressive symptoms, and the negative relationship between demands and retention; (2) engagement mediates the positive relationship between resources and retention; (3) resources buffer the positive relationship between demands and exhaustion; and (4) demands boost the positive relationship between resources and engagement. Volunteer firefighters (N = 126) were asked to complete a self‐report questionnaire twice over a 1‐year period. Results showed that increases in engagement mediated the positive relationship between resources and retention over time. Contrary to expectations, volunteer resources boosted the positive relationship between volunteer demands and increases in exhaustion. Namely, demands related positively with exhaustion particularly when resources were high (instead of low). Collectively, the study results have important theoretical implications since they suggest that demands do not always have long‐term, unfavorable consequences for volunteer firefighters. In contrast, resources enhance volunteer engagement and consequently, promote retention in the long run. Therefore, it is important for volunteer organizations to provide relevant resources to their members to keep them engaged and enhance their willingness to remain in the force.

An operator’s guide to SPAR(CD): a model to support decision-making

In order to explore the commonalities and differences in decision-making across emergency services organisations, a systematic literature review of over 10,000 peer reviewed English-language studies was undertaken looking at sense-making and critical decision-making in police, military, ambulance and firefighting contexts. The insights gained and lessons learnt from this research enabled the development of the Situation, Context, Decision, Plan, Act, Review or S(CD)PAR framework. The new framework is hazard and service agnostic, not only incorporating complexity analysis and contextual factors but also being applicable to the full spectrum of emergency management operations. This paper presents the operational translation of the theoretical S(CD)PAR framework into a multi-sector end-user decision SPAR(CD) model that can guide operational decision-making as well as the development of policy, procedures and learning and assessment tools. While the S(CD)PAR framework and SPAR(CD) model have been developed based on research in high-consequence and low-time emergency services and military environments, they are equally applicable in other environments including business contexts and boardrooms wherever decisions are made. This research and subsequent model are important as it supports a common approach to decision-making and also provides a foundation for teaching and assessing evidence-based decision-making across multiple contexts.

Framework and Thematic Analysis of Historical After Action Review Reports from the Australian Capital Territory Emergency Services Agency

Introduction:Emergency services organizations routinely undertake internal quality improvement activities following training and operational activities. One form of a quality improvement activity is the After Action Review (AAR). An AAR is a facilitator-led post-event review where data is collected from individuals and groups of individuals using either surveys, focus group-like meetings, or individual interviews. Data is collected using a semi-structured data collection tool which is usually customized to the specific tasks being reviewed and the priorities and goals of the organization. The quality of AARs has been noted to vary significantly across organizations with reporting biases and differences between exercise or real event AARs and biases introduced by utilization of internal rather than external evaluators, and limited justification for data selection and collection rationales. The Australian Capital Territory Emergency Services Agency (ACT ESA) has identified that interoperability and integration between internal ACT ESA sub-agencies and externally with other agencies is a key problem. The aim of this study was to identify specific areas of consistent interoperability concern through the examination of historical AARs.Method:In this qualitative study a Framework Analysis of historical AAR text documents was conducted, following the standard five step process. This was followed by detailed thematic analysis in aggregate and examined longitudinally, with emergent themes undergoing further analysis.Results:AARs relating to major emergency response and training activities 2016-2022 were examined. There was a substantial variation in quality, level of detail, completeness and structure across the different AAR documents. Consistent themes emerging from the data highlighted concerns regarding inter-agency culture, uncertainty when conducting joint activities and its impact on decision making, logistics concerns, resourcing and breakdown of shared understanding and communication between teams.Conclusion:Despite a centralized command structure, historical AAR analysis shows ACT ESA has had persistent operationally impacting interoperability and integration problems within the organization and with external agencies.

Mixed Reality–Exploring the Requirements of Realism in the Context of Mass Casualty Incident Training

Introduction:The occurrence of mass casualty incidents is increasing globally. Training is an essential cornerstone in achieving disaster preparedness, yet studies show that medical first responders perceive their level of readiness to face disaster incidents as inadequate. As real-world disaster training exercises can be characterized as resource-intensive in terms of cost and time, virtual training environments have been highlighted as a potential alternative to mass casualty incident training. In order to increase the preparedness of medical first responders, a deeper understanding of their requirements in the context of disaster training exercises is needed.Method:Individual, contextual interviews were conducted with a total of 26 medical first responders from four European emergency service organizations: Hellenic Rescue Team (Greece), Summa 112 (Spain), Sanitätspolizei Bern (Switzerland), and Johanniter Österreich (Austria). The interviews were analyzed using qualitative content analysis.Results:The preliminary results indicate that real-world disaster training exercises have limitations regarding realism. The participants described a need to train in an environment that accurately represents what they might face amidst a real-world incident site. This included the recreation of potential environmental dangers that had to be taken into consideration before approaching the incident site. The participants also highlighted the importance of realistic representations of injuries and reactions from the victims during training. The limited possibilities to provide a realistic training environment that corresponds to the set requirements lead to the participants feeling less prepared to face a real-world mass casualty incident.Conclusion:Medical first responders’ need for increased realism in real-world disaster training exercises deserves attention. Training solutions that could potentially increase the level of preparedness needs to be taken into consideration. How the degree of realism in Virtual or Mixed Reality based training platforms affects the perception of preparedness among medical first responders warrant further research.

Leveraging ERP systems for improving ERP effectiveness in emergency service organizations: an empirical study

PurposeThe purpose of this paper is to examine the factors that influence enterprise resource planning (ERP) effectiveness within the context of emergency service organizations. Drawing on information systems (IS) effectiveness, ERP implementation and job satisfaction literature, the authors posit that user involvement, top management involvement and training satisfaction are the antecedents to perceived job satisfaction, and perceived job satisfaction leads to ERP effectiveness in emergency service organizations.Design/methodology/approachSurvey methodology is used for collecting data for this research, and the PLS-SEM technique is used for analysis.FindingsResults indicate users will be more satisfied with their training if their inputs are taken into account during their training and the top management is actively involved during the training process. Further, if the users perceive that they are adequately trained, they will be more satisfied with their jobs in using ERP, which will also lead to more effective ERP usage in emergency service operations.Research limitations/implicationsThe focus of this study is on a single emergency service organization and thus may not be generalizable to other sectors. The authors extend ERP research to the context of emergency service organizations and thus add to the literature on ERP and emergency services. They conceptualize perceived job satisfaction to integrate roles, teamwork, supervisor and their perception regarding their potential to grow in the organization.Practical implicationsThe managerial contribution of this research is to identify the motivational aspects and provide practical insights into the effective use of ERP systems for emergency service organizations. From a managerial perspective, the study provides a framework for both IS and emergency service providers/executives to understand and evaluate the factors that help them use ERP effectively in their firms.Originality/valueThis study extends the knowledge of ERP systems. While most of the ERP research focuses on implementation, the authors’ focus is on the effective use of ERP in emergency service organizations. They focus on identifying key factors that are important to using ERP effectively, specifically in emergency service organizations.

EVALUATION OF FALL RISK PREVENTION EDUCATION THROUGH AGE-FRIENDLY PARTNERSHIPS

Abstract Falls in the home and community environments are the leading cause of injuries and long-term disabilities for the aging population. This study examines the outcomes of a partnership among an academic institution, government agency, community nonprofit, and emergency services organization to expand access to a fall prevention training program by targeting delivery in postal codes identified as underserved with high rates of falls emergencies (hot spots) and non-high rates (non-hot spots). A total of 354 adults aged 50 and older participated in a fall prevention education program, with 188 (53%) participants completing at least five sessions (completers), of which 35% resided in hot spot areas. Descriptive statistics for frequency, percentage, mean, and standard deviations values were calculated for demographic variables. A paired t-test analysis was conducted to compare initial and final scores for self-assessed general health and fall efficacy programs. The paired sample t-test statistics revealed significant improvements in fall efficacy for completers in hot spots (t= -6.23; p < 0.001) and non-hot spots areas (t= - 11.17; p < 0.001). No statistical differences (p > 0.05) were observed between the initial and final scores of the self-assessed general health for completers in hot spots and non-hot spot areas. Cross-sector collaboration to deliver targeted falls prevention training at various community locations can effectively reach underserved, at-risk older adults, although additional retention strategies must be considered. In conclusion, identifying at-risk older adults to mobilize partnerships, limited resources can be allocated towards improving retention and program outcomes of community-based fall prevention education.

Building “common knowledge” when responding to major road tunnel incidents: an inter-organisational focus group study

PurposeMajor incidents in tunnel environment will pose several challenges for the emergency service organisations in terms of heat, visibility and lack of experiences from working in confined environments. These aspects, in turn, could pose challenges to establish collaboration. This study aims to contribute to the field of collaborative tunnel responses by exploring how “common knowledge” (Edwards, 2011) is built by the emergency services organisations, that is, what the organisations consider important while working on a potentially common problem, and their motives for the interpretations and actions if a major tunnel incident occurs.Design/methodology/approachParticipants from the road traffic control centre, emergency dispatch centre, emergency medical service, rescue service and police were included in the study. Data from four focus group sessions was analysed using thematic analysis.FindingsThe study revealed that the tunnel environment presents specific aspects of how common knowledge was produced related to lifesaving and safety. The themes structuring mechanisms to reduce uncertainty, managing information for initial priorities, aligning responsibilities without hampering each other's work and adjusting actions to manage distance, illustrated how common knowledge was produced as crucial aspects to a collaborative response. Organising management sites, grasping and communicating risks, accessing the injury victims, was challenged by the confined environment, physical distances and imbalance in access to information and preparedness activities in tunnel environments.Originality/valueThis study offers new insights of common knowledge, by illustrating a motive perspective on collaborative responses in tunnel incidents. Creating interoperability calls not just for readiness for action and tunnel safety, but also training activities acknowledging different interpretations and motives to further develop tunnel responses.

Clinical Severity Level Prediction Based Optimal Medical Resource Allocation at Mass Casualty Incident

Controlling the mortality rate at the Mass Casualty Incident presents an increasingly important challenge for Emergency service organizations. Preparation is required by any healthcare system to minimize the loss of life and maximize casualty recovery. The literature conjectures that casualty rates can be decreased by integrating technology with the emergency service management system. To develop a superior mortality rate-controlling plan it is critical to anticipate the clinical condition deterioration of the casualties and effectively serve a large number of casualties with an optimal number of medical resources. Thus, this research proposes a multi methodology approach that integrates a prediction model to forecast the worsening of the casualties’ clinical conditions with an optimization model to detect the number of medical resources needed to treat the casualties. The method incorporates the Gravitational Search based Back Propagation Neural Network-based prediction model together with the qSOFA medical score to produce an accurate casualty’ clinical condition prediction. The findings of the prediction model are then combined with methods to identify in advance the optimum number of medical resources needed to control the rate of incoming casualties. The proposed multi-methodological approach experimented on the MIMIC-II dataset results show that clinical condition prediction and allocation of the optimal number of medical resources supports reduction in mortality length. The prediction model has the Accuracy, Sensitivity, and Specificity values 91.9%, 94.7%, and 83.9% respectively. Further, the optimization model is compared with the literature work and the result shows the better performance with regard to mortality length and Queue length performance parameters. The proposed work involving the prediction model of clinical conditions and the optimization model of medical resources facilitates clinicians to serve the casualties with better health treatment, thus reducing the mortality length.

High reliability Human Resource Management (HRM): A system for high risk workplaces

AbstractHigh Performance Work Systems (HPWS) research is based on the search for the most suitable bundle of complementary practices appropriate for the organisation and its operating environment. We examine the contents of a HPWS in organisations seeking impeccable safety and reliability as their foremost ‘performance’ outcome. We propose a ‘High Reliability HRM’ framework, and examine the degree of implementation in a three case study of Australian state emergency services organisations. The findings highlight HRM practices inconsistent with the framework, and illustrated by rich interview accounts, we detail associated negative implications for employee behaviour and attitudes. We contribute to HPWS research by empirically examining how reliability‐seeking organisations conceptualise and implement HRM systems. This study emphasises how inconsistency in HRM practice bundles can pose a threat to reliable service provision, a critical finding for emergency services and reliability‐seeking organisations more broadly.

Encouraging evacuation: The role of behavioural message inputs in bushfire warnings

In catastrophic bushfires or wildfires, warnings are issued by emergency service organisations to inform communities about the hazard and provide guidance about protective actions. Long-form warnings are complemented by shorter social media warnings that preference content about hazard severity. Warnings that do not include clear behavioural guidance can challenge clarity and community uptake. However, there has been little research that examines and compares existing warnings with those constructed to encourage behavioural intentions. In this study, we follow the Protective Action Decision Model and first identify cues that predict evacuation intentions. Next, we compare existing long-form and social media warnings with those modified to include behavioural advice and instruction to examine their effect on clarity and ease of action and protective action intentions. Findings show how the inclusion of behavioural inputs into social media warnings enhances protective action intentions, offering evidence to specifically support changes to existing practice.

Understanding skill decay and skill maintenance in first responders

To carry out their roles, first responders need to have appropriate skills. It is important to identify and train in key skills appropriate for the tasks that first responders will perform. Once these skills have been acquired, they need to be maintained otherwise they will decay to the point where performance of the skill is no longer acceptable. This means that emergency services organisations need programs that appropriately maintain the skills of their volunteers and employees. To deliver cost-effective training, these organisations need a good understanding of what key skills are required for tasks that are regularly performed, why and how quickly these skills decay and how these skills can be maintained. To help emergency services organisations better understand these important concepts, this paper reviews relevant literature on skill decay and skill maintenance. Task decomposition methods and training needs analysis are introduced to assist organisations determine what key skills they require. This provides information to make sound, evidence-based decisions about recurrent training programs that can maintain the skills required by first responders and retain efficacy in the organisation.

Community-led disaster resilience in Nauiyu Aboriginal community


 
 
 There is a need for emergency management systems in Australia to shift to a more collaborative model that involves working with communities rather than simply delivering to communities. This research paper argues that in order to address this, emergency services organisations in Australia need to continue to shift from a service delivery approach to a more localised, participatory and consultative model that acknowledges and harnesses local leadership, knowledge, skills and experience creating opportunities for community driven and fit-for-purpose emergency management. The paper makes the case for why localised approaches are important in places with diverse populations such as the Northern Territory (NT). The NT Aboriginal community of Nauiyu’s experience of evacuations due to flooding in 2015 and 2018 will be used as a case study to offer an example of locally led approaches to disaster resilience.
 
 

Mobilisation of emergency services for chemical incidents in Sweden - a multi-agency focus group study

BackgroundIn chemical incidents, infrequent but potentially disastrous, the World Health Organization calls for inter-organizational coordination of actors involved. Multi-organizational studies of chemical response capacities are scarce. We aimed to describe chemical incident experiences and perceptions of Swedish fire and rescue services, emergency medical services, police services, and emergency dispatch services personnel.MethodsEight emergency service organizations in two distinct and dissimilar regions in Sweden participated in one organization-specific focus group interview each. The total number of respondents was 25 (7 females and 18 males). A qualitative inductive content analysis was performed.ResultsThree types of information processing were derived as emerging during acute-phase chemical incident mobilization: Unspecified (a caller communicating with an emergency medical dispatcher), specified (each emergency service obtaining organization-specific expert information), and aligned (continually updated information from the scene condensed and disseminated back to all parties at the scene). Improvable shortcomings were identified, e.g. randomness (unspecified information processing), inter-organizational reticence (specified information processing), and downprioritizing central information transmission while saving lives (aligned information processing).ConclusionsThe flow of information may be improved by automation, public education, revised dispatcher education, and use of technical resources in the field. Future studies should independently assess these mechanism’s degree of impact on mobilisation of emergency services in chemical incidents.

Lesbian and Bisexual Women’s Experience of Emergency Management

As climate change exacerbates exposure to disasters, a growing body of scholarship provides evidence that some groups experience significant barriers in accessing and participating in emergency services. This article reports on the findings of an exploratory, qualitative study involving in-depth interviews with four lesbian or bisexual women in Australia. The aim of the study is to better understand the degree to which emergency services’ policies, programs and procedures accommodate diversity and the needs of lesbian and bisexual women as ‘clients’ and paid staff or volunteers. Results are organised under five key categories: language; discrimination; sector acknowledgment; the role of faith-based organisations; and ways forward. The data is presented through the women’s voices and documents their lived experiences of discrimination. The study provides an opportunity to consider how discrimination against sexual and gender identity diverse minorities (LGBT people) intersects with, as it draws on, discrimination against women, increasing lesbian and bisexual women’s experiences of marginalisation as emergency sector clients, employees and volunteers. It also provides an opportunity to address the effects of systemic discrimination in the organisation and delivery of emergency services, promoting a more diverse and inclusive emergency sector.

Out of Hospital Cardiac Arrest: A Case Report

Introduction: Sudden OHCA (Out of hospital cardiac arrest) is the third leading cause of death in industrialized nations. With more than 60% of cardiovascular deaths resulting from cardiac arrest, it remains the leading cause of death worldwide. Heart rhythms associated with cardiac arrest are divided into two groups: shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) and non-shockable rhythms (asystole and pulseless electrical activity (PEA)). VF is the most commonly identified arrhythmia in cardiac arrest patients. Urgent medical treatment includes cardiopulmonary resuscitation and early defibrillation.
 Material and Methods: Materials for this case report are data collected from the medical records of the Emergency Medical Center of Sarajevo protocol of patients.
 Case report: Our case report is presented with 59 years old man who had OHCA in his apartment. The initial rhythm was VF, and cardiopulmonary resuscitation was provided due to the Advanced life support guidelines to shockable rhythms. It was delivered 3 DC Shock-s (200J, 300J, 360 J) with the biphasic defibrillator, it was administered 1mg Adrenalin and performed endotracheal intubation. After the third DC shock, we got the return of spontaneous circulation ROSC. The patient was transferred to the University hospital, were he was stabile, and PCI of the LAD was performed as per the standard protocol. Echocardiography performed in the CCU revealed hypokinesia of RV, with preserved systolic function. On hospital day 7 he had a full neurological recovery. He was conscious, oriented, with normal breathing, blood pressure 125/79mmHg, sPO2 99, ECG: sinus rhythm, fr 87/min, without pathological signs. Echocardiography revealed the reduced systolic function of the left ventricle, with mitral regurgitation MR+2.
 Discussion: Out-of-hospital cardiac arrest (OHCA) is a major health problem in Europe and in the United States. The numbers of patients who have OHCA annually in these two parts of the world have traditionally been reported to be 275,000 and 420,000 respectively. The success of resuscitation depends on many factors: well-organized health care, organization of outpatient emergency services, but primarily when it comes to OHCA, education of the population on Basic life support, and early Cardiopulmonary resuscitation and use of AED (automated external defibrillator).

Development of leading indicators for the assessment of occupational health performance using Reason's Swiss cheese model.

BACKGROUND:The Swiss cheese model of accident causation is a model used in risk analysis and risk management, including aviation safety, engineering, healthcare, and emergency service organizations, and as the principle behind layered security, as used in computer security and defense in-depth. This study aimed to develop and weight the occupational health leading indicators using the Swiss cheese model.MATERIALS AND METHODS:The present study was a descriptive, cross-sectional study; occupational health performance assessment indicators were classified into five main groups of chemical, physical, ergonomic, psychosocial, and biological harmful agents. In addition, potential hazards and their prevention methods were identified using the Swiss cheese model. The leading performance measurement indicators (n = 64) were developed based on preventive methods and were weighted and rated by fuzzy analytic hierarchy process.RESULTS:Thirty-six out of 64 indicators were related to the management measures, 25 indicators were related to exposure to harmful occupational agents, and the remaining indicators were occupational-related illnesses and diseases rate. Considering the importance and frequency of indicators, psychological agents were the most important indicators (40%) and physical agents had the greatest frequency (59%).CONCLUSIONS:Process of indicators' development has demonstrated that the major occupational health prevention measures in the oil and gas industry are concentrated on physical, psychological, and chemical agents, respectively. Thus, to provide protection for employees against occupational diseases and improve health performance indicators, paying special attention to mentioned agents is essential in the oil and gas industry.

COVID-19 and primary care: A critical need for strengthening emergency preparedness across health systems.

Sir, The coronavirus disease (COVID-19) pandemic has disrupted every frontier of human lives. When it comes to emergency care for any health emergency for individuals, or primary care where people make their first contact with the health system in a country, this pandemic has shown the lack of preparedness on delivering medical care in both settings. An integrative yet holistic perspective is needed to strengthen emergency medicine and primary care across health systems, which may enable us to save more lives during this pandemic and be better prepared for the next one. In this regard, the recent work of Kumar et al. appears to be a meaningful contribution to this emerging area of global health reform.[1] In their systematic review of reviews, the authors synthesized nine intertwined themes on emergency and primary care collaboration during COVID-19. We need to revisit how primary care is conceptualized and utilized alongside emergency management in care of public health emergencies. The authors rightly suggested inclusive health policymaking that may empower specialties such as family medicine and emergency medicine, which may improve health outcomes during this pandemic. Several domains should be investigated through primary research and evidence synthesis that may complement inclusive policymaking for pandemic preparedness. First, in recent years, digital health interventions have shown promising impacts in terms of increasing access to health services and improving health outcomes in different contexts.[23] More research is needed on COVID-19 that may inform how such technological advancements can facilitate potential strengthening efforts targeting emergency and primary care. Second, most reviews synthesized studies from high-income countries except China. Since the pandemic has impacted almost every nation globally, it is critical to promote emergency and primary care research in under-represented countries that share a higher disease burden but may have limited resources to investigate local health issues.[4] It is necessary to promote local and regional research assessing factors influencing the organization and delivery of emergency and primary care services. Third, socioeconomic disparities may impact the provision of and access to emergency and primary care in different countries. As a public health emergency such as COVID-19 is a common threat for individuals and populations, health services, irrespective of places and sociodemographic divides, should be made available for everyone. Therefore, the call for strengthening emergency and primary care during this pandemic aligns with the global vision of universal health coverage (UHC). Countries and global health agencies need to identify the barriers and facilitators of UHC to strengthen future pandemic preparedness. Lastly, capacity building across health systems is critical for preparing people and healthcare organizations to mitigate the current pandemic and future crises.[5] The current evidence informs how global knowledge domains can be evaluated to identify common domains of healthcare management and leadership. Strategies should be adopted, including the development of educational curricula for health sciences professionals, health promotion programs for patients and their caregivers, and targeted interventions enabling patient-centric care. Such multipronged efforts may empower emergency and primary care systems to address individual and community health problems during global health emergencies. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Emergency numbers accessibility for disabled peoples’: Case of the Islamic Republic of Iran

An emergency is a serious, unexpected situation which may lead to injury, loss of life and damage to property and often needs urgent interventions. Emergency calls can bring urgent life-saving intervention in such situations. Although access to emergency lines for all persons of a society is one of the effectiveness indexes of this critical service, in most countries, these lines are not accessible for disabled people. This study examined the issue of emergency number accessibility for disabled people in the I.R. of Iran. Two persons who had been poisoned by carbon monoxide died because their deaf-mute father could not communicate with the Emergency Medical Service Center (EMSC). This led to the Emergency Medical Service Management Center (EMSMC), in collaboration with Iranian Society of Deaf People Family (ISDPF), developing a system that is a combination of short message system (SMS) and location-based information (LBI) to facilitate the communication of such disabled persons with EMSMCs. The system did not receive any emergency message until this report is provided. Because emergency call service has not been available for disabled people in Iran until now, emergency service organizations should take a proactive approach in developing a reliable and easy to use a method with the current technologies. These organizations should also provide information about the installed systems for end-users.