Integrated Emergency Management Research Articles

Validation of an emergency triage scale for obstetrics and gynaecology: a prospective study.

To evaluate the reliability of a four-level triage scale for obstetrics and gynaecology emergencies and to explore the factors associated with an optimal triage. Thirty clinical vignettes presenting the most frequent indications for obstetrics and gynaecology emergency consultations were evaluated twice using a computerised simulator. The study was performed at the emergency unit of obstetrics and gynaecology at the Geneva University Hospitals. The vignettes were submitted to nurses and midwives. We assessed inter- and intra-rater reliability and agreement using a two-way mixed-effects intra-class correlation (ICC). We also performed a generalised linear mixed model to evaluate factors associated triage correctness. Triage acuity. We obtained a total of 1191 evaluations. Inter-rater reliability was good (ICC 0.748; 95% CI 0.633-0.858) and intra-rater reliability was almost perfect (ICC 0.812; 95% CI 0.726-0.889). We observed a wide variability: the mean number of questions varied from 6.9 to 18.9 across individuals and from 8.4 to 16.9 across vignettes. Triage acuity was underestimated in 12.4% of cases and overestimated in 9.3%. Undertriage occurred less frequently for gynaecology compared with obstetric vignettes [odds ratio (OR) 0.45; 95% CI 0.23-0.91; P = 0.035] and decreased with the number of questions asked (OR 0.94; 95% CI 0.88-0.99; P = 0.047). Certification in obstetrics and gynaecology emergencies was an independent factor for the avoidance of undertriage (OR 0.35; 95% CI 0.17-0.70; P = 0.003). The four-level triage scale is a valid and reliable tool for the integrated emergency management of obstetrics and gynaecology patients. The Swiss Emergency Triage Scale is a valid and reliable tool for obstetrics and gynaecology emergency triage.

Statistic Methods for Assessments of Risks and Damages at Nuclear Power Plants

Many high development countries have not the natural hydrocarbon deposits. That is why NPP energy production is constantly and intensive increases. For example, in France. The corresponding treats under NPP exploitation also are increasing, that caused by different natural and manmade factors, including as attractive objects for possible directed terrorist attacks. Correct assessments of corresponding risks and damages are necessary for any NPP at all periods: its projecting, building and exploitation under its complex integrated emergency management. Here we try to analyze some possible methods of NPP risk assessments. Early we predicted the irradiation doses and corresponded risks for population under implementation of Russian Federal Program:” Development of Russian atomic energy industrial complex on 2007-2020 years at 10 homeland NPP, that operated in normal non disasters regimes during two last decades. But such data are absent for NPP, that have been or will be under non prognostic emergencies. It is connected with the following facts. The part or total of needed information may be obtained only after NPP disasters. Some NPP are located in the dangerous regions and exposed to intense negative natural responses (earthquakes, tsunami, etc.) and manmade ones, when NPP are located in some dangerous conflicts zones with high level of possible terrorism threats. Here the using of classic methods of expertise risk NPP assessments are not correct and often impossible at all. Some needed thematic data may be obtained from primary virtual computer tests of individual NPP with imitation of possible disasters. It allows to plan the actions for NPP operators and special services under serious NPP disasters or may be to prevent them at all. These thematic problems, connected with the following NPP: Fukusima, Seversk in Tomsk region, Armenian, the future NPP in Kazakhstan and nuclear terrorism are also under consideration in this article.

Towards an integrated approach to emergency management: interdisciplinary challenges for research and practice

This article presents an interdisciplinary vision for large-scale integrated emergency management that has been inspired by the transition from platform centric to integrated operations in the oil and gas fields, which uses remote emergency control centres collaborating virtually with local responders. The article discusses some of the most salient research challenges for integrated emergency management, including the role of mobile technology, human-centred sensing, citizen participation and social media, and the socio-cultural determinants of disaster management. The purpose of this article is to frame an integrated emergency management approach that adopts a multi-disciplinary approach, including human computer interaction, information systems, computer science, development studies and organization science employing different methodologies.Most importantly, we need to better understand the socio-cultural determinants of how people prepare to, respond and perceive disasters, in order to evaluate whether and what kind of information and communication technology (ICT) support is appropriate. There is need for more research as to why in some regions local people ignore official orders to evacuate, and rather follow the advice of local leaders, elders or religious leaders. In other instances, disasters are seen as ‘acts of God’ thus shaping disaster preparedness and response.

119 긴급구조시스템 교육훈련 시뮬레이터 개발

119 Integrated Emergency Management System, 119 IEMS hereinafter, is specialized command and control system for fire H.Q., that supports effective response activity at Fire, Rescue, and First Aids; it covers the emergency call taking, dispatch command delivery and situation control after dispatch command. While the efficiency of emergency response activity of call-taker and dispatcher is directly linked to the capability of qualified response in protecting the life and properties at real-time emergency condition, there is not any similar simulator system that can be used for training purposes for newly allocated personnel or beginner of emergency call taking and dispatch activity - 119 IEMS in fire H.Q. is the operation system that cannot be shared with other purposes, and they`re highly expensive ICT system and infrastructure to be used as training and education. 119 Integrated Emergency Management Simulator System, 119 IEMS Simulator, was developed to be utilized in low cost for the training of 119 emergency call taker and dispatcher, and it can be used in training of various types of disaster and emergency handling, spans to emergency call taking, dispatch command, and field report and situation control after dispatch command.

The specific characteristics of the modern integrated system of management in the state of emergency

Until early 1980s, the main aim of the existing system for the management in the state of emergency was the Continuity of Government (CoG). A few years later a new program of Comprehensive Emergency Management (CEM), which was conceptually clearer and wider, was adopted. This program indicated that government and the state had reoriented their relation to different dangerous situations which may endanger the civilians and the entire society. In the theoretical and practical sense, a different course was taken with respect to natural, industrial and other dangers. The lack of the precise formulation of the role of each subject in the comprehensive emergency management demanded the definition of the new program. This was the reason for the greatest number of states to determine a more precise and original model of the Integrated Emergency Management System (IEMS). This program should put the emphasis on the civil readiness of the state, in regard to all potential risks and threats, but at the same time it should have ensure that the states subjects at each level achieve the integrated cooperation in the sense of the coordination regardless of the danger in question. Bearing in mind In regard to the changed security environment, and the efforts which the national states were making to create the integrated response to the states of emergency, the EU has developed a large number of instruments to make an integrated response to the emergency situations. The establishment of European Emergency Response Capacity on the basis of the property of the member states and the development of the European Emergency Response Centre (EERC) were proposed as the base of the response strategy in emergency situations. The main component in the integrated security sector and the management of the states of emergency in Bulgaria is the command and control system C-2. The crucial element is the integration of the horizontal and vertical services on the national, regional and international levels and the factor which shows their mutual functioning and networking.

Advanced simulation and management software for nuclear emergency training and response

Abstract The importance of training of safety personnel to deal with real world scenarios is prevalent amongst nuclear emergency preparedness and response organizations. For the development of training tools we have committed to ensure that field procedures, data collection software and decision making tools be identical during training sessions as they would be during a real emergency. By identifying the importance of a fully integrated tool, we have developed a safety support system capable of both functioning in training mode and real mode, enabling emergency response organizations to train more efficiently and effectively. This new fully integrated emergency management tool is called S3-FAST also known as Safety Support Systems – Field Assessment Survey Tool.

Resilience and civil contingencies: tensions in northeast and northwest UK (2000–2008)

This paper draws on research funded by the ESRC New Security Challenges Programme1 covering a period between 2000 and 2008. The paper reflects on restructuring under the resilience agenda for all-hazards approaches to disaster and civil contingencies. The broad context of increased natural disasters and a perceived heightening of the threat of terrorism contributed to a widespread overhaul of the formal structures of emergency planning and a shift towards integrated emergency management (IEM). However, this process of step-change towards a more resilient structure was fraught with tensions between competing interests at national, regional, and local levels. This paper expands upon these tensions, explaining the national strategic platform, the regional agenda and context of civil contingencies and tensions between the push for regionalisation, and the local practice of ‘blue-light’ agencies in the northeast and the northwest of the UK (focused on Tyne and Wear and Greater Manchester). It concludes that despite the tensions these have been overcome to offer a more comprehensive approach to all-hazards management of disaster.

Testimony on Needed Emergency Management Reforms

In addition to causing death, injury, and destruction on a massive scale, Hurricane Katrina also revealed critical flaws in the entire U. S. emergency management system. Some of those deficiencies were of long standing, while others were the result of poor policy and decision making following the terrorist attacks of September 11, 2001.In the aftermath of Katrina, many critical reports were issued, and the executive and legislative branches of the U. S. government took steps to address some Katrina-related problems. Such efforts include the passage of the Post-Katrina Emergency Management Reform Act and the revision of the National Response Plan.It is too soon to tell whether new initiatives will actually improve the ability of the U.S. to respond to extreme and catastrophic events. It may be that measures undertaken following Katrina will make little difference in the long run. To effectively reduce disaster losses, significant advances must be made in several areas, including: the development of a fully-functional and integrated emergency management system; a return to an all-hazards and comprehensive emergency management philosophy; the de-politicization of top emergency management positions; reforms aimed at increasing the resilience of civil society institutions in the face of disasters; strategies to address existing and future deficiencies in the emergency management work force; and initiatives aimed at strengthening emergency management oversight, accountability, and program evaluation. These broad lessons are applicable both to the U.S. context and to other nations.

Information and Services Integrating and Scheduling Model for Event Handling

Around city applications such as E-Government, E-Business, etc, event handling becomes a common activity. When handling an event in a city, people should focus on the task of integrating, conforming and scheduling heterogeneous, distributed resources from multi-domains, as well as sharing knowledge among different organizations. This paper proposes a rule-based distributed resources integrating and scheduling model for event handling. The model has a hierarchical structure with four levels: resource layer, knowledge layer, business layer and representation layer. Detail work on the knowledge layer is explored, which includes the definition of formal business rule, reference to resources in a rule, as well as the design and implementation of the rule system. Finally, an event handling prototype system of unitive alarm taking in for iEMS (integrated emergency management system) is implemented to validate the model.

Chemical and bioterrorism: An integrated emergency management approach at the undergraduate level

The accredited Environmental Health Science BS degree program at Salisbury University, a member institution of the University System of Maryland, has developed an integrated chemical and bioterrorism course for undergraduate students and emergency management professionals. The one-credit class meets once a week. Course design is adapted from the Federal Emergency Management Agency’s (FEMA) integrated approach to chemical and bioterrorist defensive training strategies. Course objectives are to gain knowledge of specific chemical and biological agents; become familiar with peacetime equivalents and surrogate agents; understand biomedical and environmental factors related to agent exposures; become familiar with integrated response strategies; and gain understanding of government policy issues, agency coordination, and field operations.Student input is based on specific discipline group response and participation in a simulated bioagent release. Discipline groups include public and emergency health, media, critical incident stress analysis, and conflict resolution. Student evaluations of the first course offered in the fall semester of 2002 indicated that the simulated release exercise gave each student an increased awareness of multiagency response necessary to mitigate bioterrorist-initiated events. Evaluation results also suggested the following modifications: include at least one community professional in each discipline group, extend the course to two credits, and schedule the class in late afternoon to accommodate working professionals.

Emergency and Disaster: Pervasive Risk and Public Bureaucracy in Developing Nations

Developing nations experience pervasive risk of devastation, human and property loss resulting from human and natural disasters. This level of risk is attributable to socioeconomic stress, aging and inadequate physical infrastructure, weak education and preparedness for disaster and insufficient fiscal and economic resources to carefully implement the preparedness, response, mitigation and recovery components of integrated emergency management. This article examines these dynamics using a conceptual framework derived from chaos theory and emergency management theory and raises several critical methodological issues related to inquiries into disaster and emergency management dynamics in developing nations.

Developing disaster management capability: an assessment centre approach

Fundamental to disaster readiness planning is developing training strategies to compensate for the limited opportunities available for acquiring actual disaster response experience. With regard to communication, decision making and integrated emergency management response, the need to develop mental models capable of reconciling knowledge of multiple goals with the collective expertise of those responding represents a significant challenge for training. This paper explores the utility of the assessment centre as a developmental resource capable of achieving this goal. In addition to providing multiple, expertly evaluated simulations to facilitate the development and practice of specific skills, the ability of assessment centre methodology to promote tacit knowledge and self‐efficacy renders it an appropriate vehicle for developing the mental models that underpin the core disaster management competencies of situational awareness and naturalistic and team decision making.

Designing Paper Disasters: An Authoring Environment for Developing Training Exercises in Integrated Emergency Management

Discussion-based exercises are a prevalent form of training in emergency management, aimed at improving coordinative decision making between the various agencies involved in disaster response. In each exercise, small multi-agency groups of decision makers discuss potential courses of action within a fictitious disaster scenario presented as a textual narrative supported by visual materials. We present a cognitive engineering analysis of the problem of designing disaster scenarios for effective discussion-based exercises. The analysis was carried out through the development of a pilot authoring environment to establish and address the requirements of a training organisation in the UK. The pilot authoring environment embodies a simple theoretical model of the exercise process in which facts of a disaster scenario afford discussion of pertinent issues which are elicited by considerations fed to trainees. This representational scheme allows the authoring environment to complement and extend authors’ mental models of exercises, and thereby enhance five aspects of authoring: rationalisation; continuity of rationale; evolution; adaptability; and the integration of evaluation feedback.

Organisational response to a volcanic eruption

This paper reports on the findings of a survey of organisational responses to the 1995 eruptions at Ruapehu volcano, New Zealand. The survey identified co‐ordination, communication, training and management issues that had implications for the quality and effectiveness of an integrated organisational response to hazard impacts. This paper explores the implications of organisational structure and social (professional) identity for developing and sustaining integrated emergency management capability. It also discusses the implications of decision‐making processes and group dynamics for response effectiveness. These issues are used to illustrate the nature and origin of the problems observed in the survey and to define strategies for their resolution and for promoting effective inter‐organisational relationships and integrated emergency management capability.

An integrated emergency management decision support system for hurricane emergencies

Hurricane Andrew has taught Florida a deadly and expensive lesson. Once again, we have been reminded how unprepared we are for natural disasters. In this paper we present a conceptual framework for an effective, integrated, and modular decision support system (DSS) for hurricane emergency management. As an important component of this decision support system, we have been developing a PC-based emergency hurricane evacuation planning module, Regional Evacuation Modeling System (REMS), at the University of Florida since 1990. The software uses simulation as well as several network optimization models in estimating the evacuation time and the traffic flow on a given transportation road network. The system is very robust and user friendly. One of the important features of REMS is its ability to be used in real time.

Adopting Integrated Emergency Management in the United States: Political and Organizational Challenges

U.S. Federal Emergency Management Agency (FEMA) officials have promoted the Integrated Emergency Management System (IEMS) since 1981. IEMS has many components intended to serve all levels of government in developing, maintaining, and managing an efficient and cost-effective emergency management capability. This study analyzes the implementation of IEMS, and based upon interviews, and primary and secondary source information, reports what U.S. local emergency managers think of FEMA's IEMS initiative and how far local governments have gone in adopting IEMS. The author concludes that a variety of factors, which are separate from the IEMS concept itself have impeded FEMA's ability to successfully promote local government implementation of the IEMS approach to emergency management, but that IEMS remains an important move away from narrow purpose, single hazard program orientations of the past, to a broader, functional, and multi-hazard method of emergency management.

Computer Aided Emergency Response Systems

Over the past years several, less or more integrated emergency management support and information systems have been developed and implemented. After a short review of the larger, mainly governmentally sponsored systems and of a selection from the smaller commercially available systems, the computer aided emergency response system (CAERS) of the Belgian Nuclear Energy Research Centre is highlighted.

The Federal Emergency Management Agency's alert and notification systems review program

Nuclear power plants throughout the United States are required by the Nuclear Regulatory Commission (NRC) to provide the means for early notification and clear instruction of the populace within the 10‐mile radius Emergency Planning Zone (EPZ) around each plant. The regulations and the Federal Emergency Management Agency's (FEMA) technical program for reviewing and approving alert and notification systems are discussed in this paper. The FEMA program consists of an acoustical/engineering review of the system design, coupled with a telephone survey of residents of the EPZ following activation of the system to determine its effectiveness. To date, system designs have been submitted for every nuclear power plant in the nation. The engineering design review has been completed at 68 sites, and a telephone survey has been completed at 63 sites. Recently, the technical standards against which alert and notification systems are reviewed have come under scrutiny in Atomic Safety and Licensing Board litigation and FEMA has defended the adequacy of the current standards. Efforts are underway to place the Outdoor Sound Propagation Model used in the alert and notification system reviews into FEMA's Integrated Emergency Management Information System for application to civil defense programs, hazardous materials program, and other programs in and outside of FEMA.

Mitigation Strategies and Integrated Emergency Management

Most public officials in the United States are familiar with procedures for reducing risks from single hazards, such as floods, due to the hazard mitigation requirements for obtaining federal flood insurance. Few, however, have thought about devising integrated strategies for reducing risks from multiple hazards, such as floods, earthquakes, and nuclear accidents. This is not doomsday thinking, but a new and more efficient allhazards approach to emergency management encouraged by the National Governors' Association and the Association of State Floodplain Managers, and recently adopted by the Federal Emergency Management Agency (FEMA) under the title Integrated Emergency Management System (IEMS). As described by FEMA, the IEMS concept applies to all levels of government, all relevant hazards, and all phases of preparedness, mitigation, response, and recovery.' It stresses an integrated approach to management of the full spectrum of emergencies, including natural disasters, technological disasters, and possible attack. Like all institutional innovations, IEMS faces a long adoption process, which is likely to be especially difficult at the local level due to its technical demands and organizational complexities, uncertain incentives, and, in the case of mitigation, long-standing political constraints. This article examines present hazard mitigation practices of local agencies in terms of their potential for developing effective integrated emergency management systems. It reviews the basic concepts involved in such systems, mitigation tools available to hazard managers, and multiple hazard analysis techniques. It argues for packaging mitigation measures with development management programs into coordinated strategies in order to address effectively the opportunities and problems of integrated hazard mitigation.

Managing the Emergency Response

The first few hours following any large-scale disaster present a complex array of organizational demands that constitute a unique managerial problem. As the disaster agent changes from tornado or hurricane to toxic chemical spill or terrorist threat so, too, does the set of responding organizations and the specific tasks they confront. Despite obvious differences in the demand structures generated by such large-scale emergencies, research studies completed during the last two decades have validated the utility of a generalized approach. Initially referred to as a dual-use orientation, the concept of Comprehensive Emergency Management (CEM)' has emerged as a partial response to a long-recognized need -improved hazard and disaster management, including emergency responses.2 Fiscal year 1984 marks the initial implementation of the Integrated Emergency Management System (IEMS) at all levels of government nationwide.3 CEM is the long-term objective, IEMS is the current implementation strategy.4 The thesis of this article is that efforts to promote IEMS, or any other disaster management tool, require explicit recognition of fundamental structural qualities that characterize emergency responses within American society. The presentation is divided into four sections: (1) the American scene; (2) who actually responds?; (3) strategies for enhancing intergovernmental coordination; and (4) implications for managing emergency responses.