Emergency Response Experience Research Articles

Support for Ukrainian refugees after Russia's invasion of Ukraine: aid structure and resilience factors. Case studies of Lublin and Lutsk

ABSTRACT Russia's invasion of Ukraine in February 2022 triggered forced migration on a scale not seen in Europe since World War II. The city of Lublin (Poland), as the capital of the border region, has become both a destination and transit point for refugees, generating the need for both emergency and long-term assistance. Lublin Voivodeship is adjacent to the Volyn region with its capital in Lutsk, where the situation has also changed rapidly (an influx of internally displaced persons). The purpose of this article is to capture the overall picture of the response to war in regional urban centres with similar demographic, absorption and adaptation potential and to identify social resilience factors. We begin by describing the aid structure based on the concept of multilevel governance. We then identify three groups of social resilience factors in both cities: past experience in emergency response, the diversity of actors involved, and the way the work is managed (with professionalisation of volunteer phenomena). The article is based on data resulting from qualitative research in Lublin and Lutsk with the actors of the humanitarian aid.

Pharmacy residency training program increases residents' confidence in inpatient medical emergency response.

The benefits of pharmacists' involvement in medical emergencies are well established, but optimal methods of training pharmacists for emergency response are unknown. The primary objective of this report is to describe the design and evaluation of a pharmacy resident medical emergency response training (PR-MERT) program for preparing trainees to respond to hospital medical emergencies, including cardiac arrest and rapid sequence intubation (RSI). The PR-MERT program was a year-long longitudinal experience designed to prepare postgraduate year 1 pharmacy residents for medical emergency response. During the first month, the residents completed an orientation session that encompassed several lectures, certification by the American Heart Association in basic life support and advanced cardiovascular life support, standardized simulation scenarios, and mock medical emergencies. The trainees continued to utilize these skills and clinical knowledge through a longitudinal didactic lecture series, resident case conferences, and practice-based application by responding to real-life medical emergencies. Residents were assessed and coached throughout the program by clinical pharmacy preceptors and a "code coach" with extensive medical emergency response experience. After the year-long training, residents completed an anonymous survey assessing self-confidence and the structure of the program. The results showed improved confidence in medication selection and dosing, as well as anticipating the needs of the team and speaking up in cardiac arrest and RSI situations. Residents were satisfied with the training offered and structure of the program. The development of a PR-MERT program at an academic medical center was successful in achieving longitudinal learning objectives and improving residents' confidence in responding to medical emergencies. The implementation of a similar medical emergency training curriculum in inpatient pharmacy residency programs may be beneficial.

The cycle of disparity: A gap analysis of emergency management and information technology.

Emergency management (EM) requires an appropriate understanding of its situational context in real time. This involves constant communication between emergency operations and administration, so that informed, coordinated decisions can be made in a constantly changing environment using the most critical and updated information. Challenges in EM include adapting to rapidly changing technologies, adoption, and communication. The goal of this needs assessment is to examine how the effective collection and communication of information has been affected by the technology developed to support it, to identify critical disconnects between emergency management professionals and information technology and telecommunications (ITT) professionals, and to identify opportunities for improved application and user interface development. The methods for this qualitative analysis enumerate and categorize some of the communication challenges faced by the EM community as identified by interviews conducted with subject matter experts using the strengths, weaknesses, opportunities, and threats technique. This study finds that the absence of ITT professionals with experience in emergency response and, conversely, the absence of EM professionals working in EM application development create a "cycle of disparity," where the key findings of this study both arise from one central input and feed into to each of the other key findings in a continuous cycle, reinforcing what threats and weaknesses already exist.

What motivates and demotivates emergency response volunteers? A survey-based factor analysis study

BackgroundOrganized volunteer initiatives can reduce response times and improve outcomes in emergencies such as cardiac arrests or fires. Retention of volunteers is important to maintain good coverage and capabilities. The current study explores factors underlying volunteers’ motivation to continue as volunteers.MethodsData from 5347 active volunteers were collected through an online survey. An exploratory factor analysis was used to identify underlying factors that were then used in a regression analysis to predict intention to continue as a volunteer. Group differences based on, among others, number of alarms and prior professional experience in emergency response were explored.ResultsThe results showed that the factors community, self-image, and competence were the strongest positive predictors for the motivation to continue, whereas alarm fatigue and negative experience were the strongest negative predictors. Volunteers with professional background had higher competence and lower Alarm fatigue. Volunteers from rural areas and small cities had higher community than those in large cities.ConclusionsAlarm fatigue can make it hard to retain volunteers, which could be addressed using improved dispatch algorithms. Support after dispatch is important to prevent negative experiences. Finally, increased competence, e.g. through education and training, can improve volunteer’s motivation to continue.

Emergency response of medical forces at cross-departmental exercises “Safe Arctic-2023”

Relevance. On April 6, 2023 large-scale cross-departmental experimental and research exercises took place for the forces of the Common Public System of Emergency Prevention and Response in the Russian Arctic, called ‘Safe Arctic - 2023’. The exercises focused on elimination of medical and sanitary consequences of man-made accidents at the Kostomuksha Mining and Treatment facility (Republic of Karelia).The objective is to analyse and summarise emergency response experience of rescuers and medical forces within the framework of cross-departmental exercises in the Russian Arctic, to assess first aid and emergency medical responses, provided to victims in emergency scenarios.Methods. The exercises were participated by over 100 rescuers, workers and volunteers, with 17 units of emergency and fire rescue equipment, 4 emergency response ambulances, and a MI-8 helicopter with medevac units available for medical evacuation of 12 injured patients. Seven top professional experts assessed medical response and evacuation on a 5-score scale (with 5 as the highest score). We studied medical documents (patient medical records, medical triage tags, expert scoring), verified statistic distribution and validated calculations using Student’s t-test for discrete unrelated samples.Results and discussion. Experts highly appreciated the quality of first aid with rescuers scoring (4.6 ± 0.3) points, while medical triage scored (4.7 ± 0.2) points, emergency pre-medical, medical and specialised medical treatment of the injured scored (4.6 ± 0.2) points. Patient triage demonstrated high-quality, with life-threatening injuries and traumas accurately identified; patients were accurately diagnosed and triaged for evacuation. During medical evacuation, emergency medical care was provided to all the injured in a comprehensive and timely manner, with no discrepancies in diagnoses.Conclusion. The resulting xpert assessments of the cross-departmental experimental and research exercises ‘Safe Arctic – 2023’ showed significantly high quality of first aid, medical triage and emergency medical care during evacuation, though not without imperfections. The organising committee received recommendations regarding ways to improve cross-departmental cooperation in first aid and medical care in emergency scenarios; these recommendations were formulated in the final report.

Experience in emergency response to 2019-nCoV positive cases in an international test competition

Objective: To analyze the performance of emergency response to 2019 novel coronavirus (2019-nCoV) positive cases in an international test competition in an Winter Olympic Game venue and provide evidences for the COVID-19 prevention and control in similar competitions. Methods: A retrospective analysis on the epidemiological investigation and nucleic acid test results of the cases, the implementation of prevention and control measures, including the communication with sport teams and others, was conducted. Results: The positive cases of 2019-nCoV among entering people were detected before entry, at airport, hotel and venue. Two positive cases were reported before entry, 2 positive cases infected previously and 3 asymptomatic cases were reported after the entry. The venue public health team and local CDC conducted epidemiological investigation and contact assessment jointly in a timely and efficient manner. No local secondary transmission occurred, but the nucleic acid test results of positive persons fluctuated, posing serious challenges to the implementation of prevention and control measures. Conclusion: In large scale international competition, there is high risk of imported COVID-19. It is necessary to fully consider the fluctuation of nucleic acid test results, the criteria for determination and cancellation of positive results and give warm care to positive cases in the emergency response.

Leadership, politics, and communication: challenges of the epidemiology workforce during emergency response

BackgroundImproving the epidemiological response to emergencies requires an understanding of who the responders are, their role and skills, and the challenges they face during responses. In this paper, we explore the role of the epidemiologist and identify challenges they face during emergency response.MethodsWe conducted a cross-sectional survey to learn more about epidemiologists who respond to public health emergencies. The online survey included open and closed-ended questions on challenges faced while responding, the roles of epidemiology responders, self-rating of skills, and support needed and received. We used purposive sampling to identify participants and a snowballing approach thereafter. We compared data by a number of characteristics, including national or international responder on their last response prior to the survey. We analysed the data using descriptive, content, and exploratory factor analysis.ResultsWe received 166 responses from individuals with experience in emergency response. The most frequently reported challenge was navigating the political dynamics of a response, which was more common for international responders than national. National responders experienced fewer challenges related to culture, language, and communication. Epidemiology responders reported a lack of response role clarity, limited knowledge sharing, and communication issues during emergency response. Sixty-seven percent of participants reported they needed support to do their job well; males who requested support were statistically more likely to receive it than females who asked.ConclusionsOur study identified that national responders have additional strengths, such as better understanding of the local political environment, language, and culture, which may in turn support identification of local needs and priorities. Although this research was conducted prior to the COVID-19 pandemic, the results are even more relevant now. This research builds on emerging evidence on how to strengthen public health emergency response and provides a platform to begin a global conversation to address operational issues and the role of the international epidemiology responder.

Application of Artificial Intelligence to Social Governance Capabilities under Public Health Emergencies

Due to the high complexity, high destructive power, and comprehensive governance characteristics of public health emergencies, the ability of social governance has been distorted and alienated under intensive pressure, and the subjects of social governance have become lazy, professional, and politicized. There are obvious problems, such as system information leakage and information asymmetry. Based on the above background, the purpose of this article is to study the application of artificial intelligence to social governance capabilities under public health emergencies. This article focuses on the relevant concepts and content of emergency management of public health emergencies and in-depth analysis of the actual application of big data technology in epidemic traceability and prediction, medical diagnosis and vaccine research and development, people’s livelihood services, and government advice and suggestions, combined with investigations. The questionnaire analysis sorted out the problems in the social emergency management of public health emergencies in China. The results showed that 87.7% of the people simply sorted out laws and regulations and higher-level documents or even repeated content and lacked summary and reflection on emergency response experience, which led to the operability of emergency plans being generally even poor. In response to the shortcomings, countermeasures and suggestions were put forward, including establishing a standard data collection mechanism, establishing a data sharing mechanism, establishing a personal privacy security protection mechanism, and promoting the breadth and depth of big data applications.

Investigating Anxiety, Depression and Obsessive-Compulsive Disorders (OCD) among healthcare workersin COVID-19 unit and the control group

To investigate anxiety, depression, and Obsessive-Compulsive Disorders (OCDs) among the healthcare workers (HCWs) to compare the healthcare workers in COVID positive services with the control group. This cross-sectional study was conducted on 198 subjects participating in the study. To test the difference between the two groups involved in COVID-19 hospitalization section and normal section in Anxiety, Depression, and Obsessive-Compulsive Disorders Scale, two sample independent t-tests, however, Welch–Satterthwaite P Values were considered for test significance. The categorical variables (sex, branch type, etc.) were also tested using the Chi-Square test to make sure that the two samples were not influenced by the demographics of the population. 198 subjectspartici pated in the study, among whom 72% were female and 28.3% were male. 130 participants (66%) worked in COVID and 68 participants (35%) worked in other sections.The mean age of the two samples was close to 35 and most of them (~45%) were nurses. 57% of the pooled samples had Emergency Response Experience (ERE).There was no significant difference between the two groups regarding sex, education, marital status, and ERE, however, the branch type showed major differences between the two groups(P-value < 0.08). The age difference between the two groups was also insignificant. Working in the COVID-19 section significantly increased anxiety scores from 9.62 to 13.15 with a P-value of

Rapid Generation of Emergency Response Plans for Unconventional Emergencies

Unconventional emergencies can lead to unforeseen disastrous penalties. Due to their unrepeatable, complex, and unpredictable nature, it is generally hard to establish high-quality Emergency Response Plans (ERPs) for unconventional emergencies, thus posing great challenges for unconventional emergency response. This work proposes a rapid ERP generation approach for unconventional emergencies so as to provide support for emergency decision-making. The generation of ERPs is achieved by exploitation of existing ERPs that contain much emergency response experience. First, a number of ERPs are collected and structurally organized to construct an ERP repository. Then, the applicability of each ERP segment in the repository to a given unconventional emergency is evaluated by a proposed ERP similarity measure and emergency scenario matching mechanism, in which the semantic relevance and the scenario consistency of an ERP segment are taken into account, respectively. Applicable ERP segments are obtained for each section of ERPs, and combined to form a new ERP with the guidance of pre-defined ERP structure. Furthermore, we design an ERP assessment method and perform a case study on the proposed approach which presents encouraging experimental results.

Gambaran Kesiapan Tenaga Kesehatan dalam Manajemen Bencana di Puskesmas Wilayah Rawan Bencana

Introduction: Disaster management is a very important factor in reducing the impact of a disaster. So far, the readiness of health workers in disaster management in disaster-prone health centers in West Sumbawa district has never been evaluated. This study intends to explore sociodemographic factors and illustrate the readiness of health workers in disaster management.Method: This study used a cross-sectional design. The population of this study is health workers, namely doctors, nurses, and midwives in health centers in West Sumbawa Regency. The sample size was 211 samples (doctors, nurses, midwives) who were randomly selected in 9 health centers, by taking paper containing the serial number according to the list of names of health workers in each PHC. The dependent variable is knowledge in disaster management, while the independent variable is a sociodemographic factor. Data were collected using an electronic questionnaire that included seven questions related to sociodemographic data and 17 questions related to knowledge about disaster management. Data were analyzed using Chi-Square statistical tests.Result: Most health workers have good knowledge in disaster management. Among the sociodemographic factors studied, level of education, place of work, and experience in emergency response to disaster significantly related to knowledge in disaster managementConclusion: Diversity of backgrounds of respondents showed good knowledge. Improving education related to disaster management and increasing the capacity of workplaces need to be improved to improve the knowledge of health workers in health centers

A model for the representation of emergency cases

An emergency case contains important information and knowledge for emergency management, such as the evolution law of incidents, the vulnerability of hazard-affected carriers and the practice of emergency response. To respond effectively, we should learn from these valuable kinds of information and knowledge and utilize them. Most models of emergency cases are established based on ontology methodology. Important emergency information is semantically expressed and then analyzed by the text mining or cluster analysis methods. This type of methodology is at a disadvantage for obtaining the knowledge contained in the cases. In addition, some emergency case representation models are established using the event tree method or state chart method. However, not all the important information for emergencies can be integrated into these diagrams. The knowledge elements are not expressed with good structure, which results in a disadvantage to case-based reasoning and knowledge mining. In this paper, a comprehensive model for the representation of emergency cases is established. The proposed model combines the advantages of several conventional methods, including event tree, Bayesian conditional probability and information structured expression. Hazard-affected carrier properties, incident evolution laws and emergency response experience can be integrated and represented, which provides a good basis to employ data mining technology. With the proposed model, the general laws and successful emergency response experience contained in massive emergency cases can be obtained. Furthermore, the case-based reasoning and knowledge mining models for risk assessment, emergency preparedness and prevention, and decision-making can be developed based on effectively represented emergency cases.

Building a professional global disaster response team at an academic health-care institution: the professionalisation of humanitarian health-care workers

Abstract Background The numbers of individuals affected by disasters and conflict are on the rise, similarly are the numbers of clinicans who seek to help. Although health-care workers want to provide immediate clinical care—as in field hospitals—disaster response requires a comprehensive set of knowledge, skills, and behaviour not taught in medical and nursing schools. With competency-based training and a vetted and credentialed workforce, academic medical institutions have the opportunity to augment emergency response for humanitiarian aid organisations. We aim to describe the minimum standards for building a professional disaster response team within an academic medical institution. Methods Through literature review and key informant interviews, we built a database to describe emergency response experience in 21 countries within 25 national and international aid organisations, governments, and academic universities. We created a checklist and applied this to responses for sudden onset and chronic crises. Key variables included deployment parameters, credentialing procedures, competency or skillset requirements, predeployment and postdeployment preparation, and types of organisational support. Findings We found large variation between organisations for emergency response, including the credentialling process, definition of competency or skillsets, implementation of deployment, and the extent of organisational support. From this analysis, we created a set of minimum standards for deployment, including physical and mental fitness, previous professional experience, team-based response, appropriate flexible skillset, approval or vetting by direct supervisors, initial or duration of availability, cultural or language competency, self reliance in austere conditions, communication skills, briefing and debriefing participation, and support from organisation. Interpretation Minimum standards and guidelines for institutions deploying health-care workers to disasters is a key step in professionalisation. Funding None.

Modeling the risk assessment of landslide-dammed lakes based on the emergency response measures in Wenchuan earthquake, 2008, China

With the rapid development of urbanization and climate change, the frequency and degree of the natural hazards and extreme weather events have increased, such as the earthquake, flood, and torrential rain. And the landslide-dammed lake as the secondary disaster of these hazards has become a major threat to many countries. So from twentieth century, many countries have begun to explore the effective emergency response method to reduce the danger of the landslide-dammed lake to the surrounded environment and people. Particularly in China, with successfully dealing with three high-risk landslide-dammed lakes in recent 10 years, the Chinese government has accumulated a great deal of experience in managing the landslide-dammed lakes. So in this paper, based on the Chinese and many other countries’ emergency response experience of successfully managing the landslide-dammed lakes, we build an outburst time–predicted model which can use the Dimensionless blockage index value to predict the outburst time of the landslide-dammed lakes. Based on the urgent time in the process of emergency response to the landslide-dammed lake, we build an integrated risk assessment model with the gray relational analysis and Technique for order preference by similarity to an ideal solution approach to evaluate the risk value and judge the risk level of the landslide-dammed lake from three aspects (the stability of the landslide-dammed lake, the hydrological environment, and the vulnerability factor of the surrounding environment). These two models can quickly and accurately determine the risk level of landslide-dammed lake in case of lack of complete and detailed data. So it would provide an important reference for government to make the scientific and effective emergency response plan to deal with the extremely high-risk landslide-dammed lake disasters in the future.

Disasters and public health: planning and response

From the San Diego wildfires to multi-drug-resistant strains of bacteria, communities are facing an ever-growing list of potential disasters. Some events, like pandemic flu or anthrax attacks, are public health emergencies first and foremost. Hurricane Katrina taught us, however, that lack of planning for the frail, elderly, and impoverished population can turn a natural disaster into a healthcare nightmare and lead to needless death and suffering. Emergency managers and public health professionals must integrate their prevention and response efforts to serve their communities most effectively. The structure of each chapter offers an innovative approach to organizing key information: Case Study or Historical Example; Disaster-specific Terms Defined; Disaster Description; Threat (Morbidity and Mortality); Prevention; Immediate Actions; Recovery or Managing the Aftermath; and, Summary. Disasters and Public Health is a crucial tool in planning for and responding to the health impact of any crisis situation. Bruce Clements served over 20 years in the U.S. Air Force and Air National Guard as a Public Officer and a Nuclear, Biological, and Chemical Warfare Defense Instructor, a Hazardous Materials Specialist with an Urban Search and Rescue Team, and as a Safety Officer with a Disaster Medical Assistance Team. He also served as the Public Preparedness Director of Missouri in 2006, when the state experienced a record number of disaster declarations. Throughout his years of experience, he frequently needed to track down a variety of references to quickly understand what was needed for an effective public health response in various situations. He has researched and compiled this information on the health impact of a wide range of disasters into one quick reference. Emergency managers can also no longer afford to be surprised by the next crisis that erupts. This book guides planners in both disciplines in preventing tragedies by most effectively preparing and responding when disaster strikes. This title helps to: prevent or respond to disasters from terrorism to pandemic flu; examine the critical intersection of emergency management and public health; and, benefit from the author's years of experience in emergency response.

Evaluation Tools in Simulation Learning: Performance and Self-Efficacy in Emergency Response

Introduction High performance in emergency response is critical for high-quality patient outcomes but is not assessed in some traditional critical care nurse internships. Recognition of the opportunity to assess these skills in a simulated environment is growing, but validated measurement tools are needed. This study develops and evaluates two tools to assess confidence in emergency response and psychomotor performance during a simulated emergency response experience. Method Using constructs from basic life support and advanced cardiac life support, an emergency response performance tool (ERPT) and a confidence tool were developed. The ERPT consisted of 11 categorical items and six timed tasks. The confidence tool comprised 17 items and required participants to rate their confidence on a scale from 0% to 100%. A total of 41 registered nurses were assigned to one of three groups: (a) those experienced in critical care without formal training, (b) those with < 13 months experience with formal training, and (c) those with no critical care experience or training. All participants completed the knowledge test and confidence tool. From the 41 participants, 12 were selected randomly and scheduled to participate in one simulation event and then rate their confidence a second time. Trained raters viewed video recordings of the participants' performance and rated them using the ERPT. Results The statistical findings from this study support reliability and validity for the ERPT performance measure and reliability and internal consistency of the confidence tool. Interrater reliability on the ERPT was high for the majority of items. Comparisons among the three groups found significant differences in knowledge and confidence among the groups. Conclusions The confidence tool and the ERPT show a basic level of validity, reliability, and usability. Findings from the study have guided the development of more-robust performance and confidence instruments to use in a future comparison study to examine three different simulation teaching methodologies.

The relationship of subjective distress and emergency response experience to the effective use of protective equipment

Abstract A total of 11 1 chernical emergency response team members were evaluated on the effective use ofpersonal protective equipment (PPE) and self-contained breathing apparatus (SCBA) whde participating in a series of simulated hazardous material accidents. Performance ratings of PPE and SCBA use were conducted via behaviourally anchored rating scales (BARS), self-estimates of effectiveness, and cohort ratings. Subjective distress was assessed via the Subjective State Change Measure (SSCM), State-Trait Anxiety Inventory, and the Framingham Type A Behaviour Scale. Results indicated that effective use ofprotective breathing apparatus was correlated with prior emergency response experience and state anxiety. BARS scores were negatively related to state anxiety when controlling for experience. Self-ratings for effectiveness was positively related to both type A behaviour pattern and state anxiety.

The role of psychological stress and prior experience in the use of personal protective equipment

This study examines the relationship of emergency response experience and psychological stress with personal protective equipment (PPE) use. Effective PPE use was assessed by behaviorally anchored rating scales (BARS) and by a subjective state change measure (SSCM) of PPE use. Participants, consisting of 141 emergency response team members of a chemical manufacturing organization, were evaluated in a series of field simulations where PPE was used. Subjects completed a series of paper and pencil questionnaires measuring anxiety, type A behavior, anger expression, and a knowledge test concerning chemical emergency response. Results indicated that self-estimates of PPE skill were better predictors of observed BARS performance than knowledge scores, the amount of formal training, or emergency response experience. Effective performance scores were related to knowledge and experience in PPE use and negatively related to the outward expression of anger. Discomfort in using PPE was significantly correlated with experience using protective gear, positive teamwork-effectiveness ratings, and lower levels of anxiety symptoms.