Characteristics of Effective Disaster Responders and Leaders: A Survey of Disaster Medical Practitioners

2016 ◽  
Vol 10 (5) ◽  
pp. 720-723 ◽  
Author(s):  
Richard V. King ◽  
Gregory Luke Larkin ◽  
Raymond L. Fowler ◽  
Dana L. Downs ◽  
Carol S. North
Keyword(s):  
Cognitive Abilities ◽  
Disaster Response ◽  
First Responders ◽  
Mass Casualty ◽  
Medical Practitioners ◽  
Incident Command ◽  
Effective Performance ◽  
Competency Models ◽  
Disaster Training ◽  
State Of The Science

AbstractObjectiveTo identify key attributes of effective disaster/mass casualty first responders and leaders, thereby informing the ongoing development of a capable disaster health workforce.MethodsWe surveyed emergency response practitioners attending a conference session, the EMS State of the Science: A Gathering of Eagles. We used open-ended questions to ask participants to describe key characteristics of successful disaster/mass casualty first responders and leaders.ResultsOf the 140 session attendees, 132 (94%) participated in the survey. All responses were categorized by using a previously developed framework. The most frequently mentioned characteristics were related to incident command/disaster knowledge, teamwork/interpersonal skills, performing one’s role, and cognitive abilities. Other identified characteristics were related to communication skills, adaptability/flexibility, problem solving/decision-making, staying calm and cool under stress, personal character, and overall knowledge.ConclusionsThe survey findings support our prior focus group conclusion that important characteristics of disaster responders and leaders are not limited to the knowledge and skills typically included in disaster training. Further research should examine the extent to which these characteristics are consistently associated with actual effective performance of disaster response personnel and determine how best to incorporate these attributes into competency models, processes, and tools for the development of an effective disaster response workforce. (Disaster Med Public Health Preparedness. 2016;page 1 of 4)

Development and Implementation of a Disaster Medicine Certificate Series (DMCS) for Medical Students

2019 ◽  
Vol 34 (02) ◽  
pp. 197-202 ◽  
Author(s):  
Madison B. Kommor ◽  
Bethany Hodge ◽  
Gregory Ciottone
Keyword(s):  
Medical Students ◽  
Disaster Response ◽  
Effective Means ◽  
Extreme Environments ◽  
The United States ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Mass Shootings ◽  
Student Opinions ◽  
Incident Command

Introduction:The recent increase in natural disasters and mass shootings highlights the need for medical providers to be prepared to provide care in extreme environments. However, while physicians of all specialties may respond in emergencies, disaster medicine training is minimal or absent from most medical school curricula in the United States. A voluntary Disaster Medicine Certificate Series (DMCS) was piloted to fill this gap in undergraduate medical education.Report:Beginning in August of 2017, second- and third-year medical students voluntarily enrolled in DMCS. Students earned points toward the certificate through participation in activities and membership in community organizations in a flexible format that caters to variable schedules and interests. Topics covered included active shooter training, decontamination procedures, mass-casualty triage, Incident Command System (ICS) training, and more. At the conclusion of the pilot year, demographic information was collected and a survey was conducted to evaluate student opinions regarding the program.Results:Sixty-eight second- and third-year medical students participated in the pilot year, with five multi-hour skills trainings and five didactic lectures made available to students. Forty-eight of those 68 enrolled in DMCS completed the retrospective survey. Student responses indicated that community partners serve as effective means for providing lectures (overall mean rating 4.50/5.0) and skills sessions (rating 4.58/5.0), and that the program created avenues for real-world disaster response in their local communities (rating 4.40/5.0).Conclusions:The DMCS voluntary certificate series model served as an innovative method for providing disaster medicine education to medical students.Kommor MB, Hodge B, Ciottone G. Development and implementation of a Disaster Medicine Certificate Series (DMCS) for medical students.Prehosp Disaster Med. 2019;34(2):197–202

scholarly journals Training Emergency Department Charge Nurses Through Tabletop Exercises

2019 ◽  
Vol 34 (s1) ◽  
pp. s19-s19
Author(s):  
Beth Weeks
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Training Program ◽  
Disaster Response ◽  
Mass Casualty ◽  
Full Scale ◽  
Leadership Role ◽  
Mass Casualty Incidents ◽  
Charge Nurses ◽  
Incident Command

Introduction:In a disaster or mass casualty incident, the Emergency Department (ED) charge nurse is thrust into an expanded leadership role, expected to not only manage the department but also organize a disaster response. Hospital emergency preparedness training programs typically focus on high-level leadership, while frontline decision-making staff get experience only through online training and infrequent full-scale exercises. Financial and time limitations of full-scale exercises have been identified as major barriers to frontline training.Aim:To discuss a cost-effective approach to training ED charge nurses and informal leaders in disaster response.Methods:A formal training program was implemented in the ED. All permanent and relief charge nurses are required to attend one four-hour Hospital ICS course within their first year in their position, as well as participate in a minimum of one two-hour ED-based tabletop exercise per year. The tabletop exercises are offered bimonthly, covering various mass casualty scenarios such as apartment complex fires, riots, and a tornado strike. Full-scale exercises involving the ED occur annually.Results:ED permanent and relief charge nurses expressed increased skills and knowledge in areas such as initiation of disaster processes, implementation of hospital incident command, and familiarization with protocols and available resources. Furthermore, ED charge nurses have demonstrated strong leadership, decision-making, and improved response to actual mass casualty incidents since implementing ICS training and tabletop exercises.Discussion:Limitations of relying on full-scale disaster exercises to provide experience to frontline leaders can be overcome by the inclusion of ICS training and tabletop exercises for ED charge nurses in a hospital training and exercise plan. Implementing a structured training program for ED charge nurses focusing on leadership in mass casualty incidents is one step to building a more resilient and prepared ED, hospital, and community.

First responder and physician liability during an emergency

2013 ◽  
Vol 11 (6) ◽  
pp. 405
Author(s):  
Amanda Eddy, BA
Keyword(s):  
Disaster Response ◽  
First Responders ◽  
Standard Of Care ◽  
Population Based ◽  
Mass Casualty ◽  
Emergency Medical Technicians ◽  
First Responder ◽  
Adequate Care ◽  
Mass Casualty Event ◽  
Physician Liability

First responders, especially emergency medical technicians and paramedics, along with physicians, will be expected to render care during a mass casualty event. It is highly likely that these medical first responders and physicians will be rendering care in suboptimal conditions due to the mass casualty event. Furthermore, these individuals are expected to shift their focus from individually based care to community- or population-based care when assisting disaster response. As a result, patients may feel they have not received adequate care and may seek to hold the medical first responder or physician liable, even if they did everything they could given the emergency circumstances. Therefore, it is important to protect medical first responders and physicians rendering care during a mass casualty event so that their efforts are not unnecessarily impeded by concerns about civil liability. In this article, the author looks at the standard of care for medical first responders and physicians and describes the current framework of laws limiting liability for these persons during an emergency. The author concludes that the standard of care and current laws fail to offer adequate liability protection for medical first responders and physicians, especially those in the private sector, and recommends that states adopt clear laws offering liability protection for all medical first responders and physicians who render assistance during a mass casualty event.

Attributes of Effective Disaster Responders: Focus Group Discussions With Key Emergency Response Leaders

2010 ◽  
Vol 4 (4) ◽  
pp. 332-338 ◽  
Author(s):  
Richard V. King ◽  
Carol S. North ◽  
Gregory L. Larkin ◽  
Dana L. Downs ◽  
Kelly R. Klein ◽  
...  
Keyword(s):  
Focus Group ◽  
Focus Groups ◽  
Interpersonal Communication ◽  
Disaster Response ◽  
Personal Characteristics ◽  
Training Experience ◽  
Group Discussions ◽  
Incident Command ◽  
General Training ◽  
Disaster Training

ABSTRACTMethods: An effective disaster response requires competent responders and leaders. The purpose of this study was to ask experts to identify attributes that distinguish effective from ineffective responders and leaders in a disaster. In this qualitative study, focus groups were held with jurisdictional medical directors for the 9-1-1 emergency medical services systems of the majority of the nation's largest cities. These sessions were recorded with audio equipment and later transcribed.Results: The researchers identified themes within the transcriptions, created categories, and coded passages into these categories. Overall interrater reliability was excellent (κ = .8). The focus group transcripts yielded 138 codable passages. Ten categories were developed from analysis of the content: Incident Command System/Disaster Training/Experience, General Training/Experience, Teamwork/Interpersonal, Communication, Cognition, Problem Solving/Decision Making, Adaptable/Flexible, Calm/Cool, Character, and Performs Role. The contents of these categories included knowledge, skills, attitudes, behaviors, and personal characteristics.Conclusions: Experts in focus groups identified a variety of competencies for disaster responders and leaders. These competencies will require validation through further research that involves input from the disaster response community at large.(Disaster Med Public Health Preparedness. 2010;4:332-338)

Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil

2014 ◽  
Vol 30 (1) ◽  
pp. 93-96 ◽  
Author(s):  
Silvana T. Dal Ponte ◽  
Carlos F. D. Dornelles ◽  
Bonnie Arquilla ◽  
Christina Bloem ◽  
Patricia Roblin
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
The State ◽  
Capital City ◽  
Smoke Inhalation ◽  
Publication Type ◽  
Incident Command ◽  
Santa Maria

AbstractOn January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.Dal PonteST, DornellesCFD, ArquillaB, BloemC, RoblinP. Mass-casualty response to the Kiss Nightclub in Santa Maria, Brazil. Prehosp Disaster Med. 2015;30(1):1-4.

Development of evaluation modules for use in hospital disaster drills

2007 ◽  
Vol 2 (2) ◽  
pp. 87-95 ◽  
Author(s):  
Mollie W. Jenckes, MHSc, BSN ◽  
Christina L. Catlett, MD ◽  
Edbert B. Hsu, MD, MPH ◽  
Karen Kohri ◽  
Gary B. Green, MD, MPH ◽  
...  
Keyword(s):  
Disaster Response ◽  
Healthcare Providers ◽  
Physical Space ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Evaluation Tool ◽  
General Observation ◽  
Incident Command ◽  
Structure Communication ◽  
Command Center

Introduction: Disaster drills are a valuable means of training healthcare providers to respond to mass casualty incidents resulting from acts of terrorism or public health crises. We present here a proposed hospital-based disaster drill evaluation tool that is designed to identify strengths and weaknesses of hospital disaster drill response, provide a learning opportunity for disaster drill participants, and promote integration of lessons learned into future responses. Methods: Clinical specialists, experienced disaster drill coordinators and evaluators, and experts in questionnaire design developed the evaluation mod-ules based upon a comprehensive review of the litera-ture, including evaluations of disaster drills. The tool comprises six evaluation modules designed to capture strengths and weaknesses of different aspects of hospital disaster response. The Predrill Module is completed by the hospital during drill planning and is used to define the scope of the exercise. The Incident Command Center Module assesses command structure, communication between response areas and the command center, and communication to outside agencies. The Triage Zone Module captures the effect of a physical space on triage activities, efficiency of triage operations, and victim flow. The Treatment Zone Module assesses the relation of the zone’s physical characteristics to treatment activities, efficacy of treatment operations, adequacy of supplies, and victim flow. A Decontamination Zone Module is available for evaluating decontamination operations and the use of decontamination and/or personal protective equipment in drills that involve biological or radiological hazardous materials. The Group Debriefing Module provides sample discussion points for drill participants in all types of drills. The tool also has addenda to evaluate specifics for 1) general observation and documentation, 2) victim tracking, 3) biological incidents, and 4) radiological incidents. Conclusion: This evaluation tool will help meet the need for standardized evaluation of disaster drills. The modular approach offers flexibility and could be used by hospitals to evaluate staff training on response to natural or man-made disasters.

Effectiveness of Hospital Staff Mass-Casualty Incident Training Methods: A Systematic Literature Review

2004 ◽  
Vol 19 (3) ◽  
pp. 191-199 ◽  
Author(s):  
Edbert B. Hsu ◽  
Mollie W. Jenckes ◽  
Christina L. Catlett ◽  
Karen A. Robinson ◽  
Carolyn Feuerstein ◽  
...  
Keyword(s):  
Literature Review ◽  
Hospital Staff ◽  
Mass Casualty Incident ◽  
Evaluation Methods ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Current Evidence ◽  
Training Methods ◽  
Incident Command ◽  
Disaster Training

AbstractIntroduction:Recently, mass-casualty incident (MCI) preparedness and training has received increasing attention at the hospital level.Objectives:To review the existing evidence on the effectiveness of disaster drills, technology-based interventions and tabletop exercises in training hospital staff to respond to an MCI.Methods:A systematic, evidence-based process was conducted incorporating expert panel input and a literature review with the key terms: “mass casualty”, “disaster”, “disaster planning”, and “drill”. Paired investigators reviewed citation abstracts to identify articles that included evaluation of disaster training for hospital staff. Data were abstracted from the studies (e.g., MCI type, training intervention, staff targeted, objectives, evaluation methods, and results). Study quality was reviewed using standardized criteria.Results:Of 243 potentially relevant citations, twenty-one met the defined criteria. Studies varied in terms of targeted staff, learning objectives, outcomes, and evaluation methods. Most were characterized by significant limitations in design and evaluation methods. Seventeen addressed the effectiveness of disaster drills in training hospital staff in responding to an MCI, four addressed technology-based interventions, and none addressed tabletop exercises. The existing evidence suggests that hospital disaster drills are effective in allowing hospital employees to become familiar with disaster procedures, identify problems in different components of response (e.g., incident command, communications, triage, patient flow, materials and resources, and security) and provide the opportunity to apply lessons learned to disaster response. The strength of evidence on other training methods is insufficient to draw valid recommendations.Conclusions:Current evidence on the effectiveness of MCI training for hospital staff is limited. A number of studies suggest that disaster drills can be effective in training hospital staff. However, more attention should be directed to evaluating the effectiveness of disaster training activities in a scientifically rigorous manner.

First responder and physician liability during an emergency

2013 ◽  
Vol 8 (4) ◽  
pp. 267-272
Author(s):  
Amanda Eddy, BA
Keyword(s):  
Disaster Response ◽  
First Responders ◽  
Standard Of Care ◽  
Population Based ◽  
Mass Casualty ◽  
Emergency Medical Technicians ◽  
First Responder ◽  
Adequate Care ◽  
Mass Casualty Event ◽  
Physician Liability

First responders, especially emergency medical technicians and paramedics, along with physicians, will be expected to render care during a mass casualty event. It is highly likely that these medical first responders and physicians will be rendering care in suboptimal conditions due to the mass casualty event. Furthermore, these individuals are expected to shift their focus from individually based care to community- or population-based care when assisting disaster response. As a result, patients may feel they have not received adequate care and may seek to hold the medical first responder or physician liable, even if they did everything they could given the emergency circumstances. Therefore, it is important to protect medical first responders and physicians rendering care during a mass casualty event so that their efforts are not unnecessarily impeded by concerns about civil liability. In this article, the author looks at the standard of care for medical first responders and physicians and describes the current framework of laws limiting liability for these persons during an emergency.The author concludes that the standard of care and current laws fail to offer adequate liability protection for medical first responders and physicians, especially those in the private sector, and recommends that states adopt clear laws offering liability protection for all medical first responders and physicians who render assistance during a mass casualty event.

Model for Pre-Hospital Disaster Response

1986 ◽  
Vol 2 (1-4) ◽  
pp. 80-82
Author(s):  
Thomas J. Schwartz
Keyword(s):  
Los Angeles ◽  
Emergency Medical Services ◽  
Disaster Response ◽  
Planning Process ◽  
Mass Casualty ◽  
Task Group ◽  
Medical Services ◽  
Mutual Aid ◽  
Incident Command ◽  
Emergency Medical

I will present a process by which many of the prehospital providers in this country are trying to organize effective and efficient response plans for major medical incidents which could in fact include a disaster response.Many people in the emergency medical services community, including myself, have been involved in a planning process for voluntary national EMS standards, the program being coordinated by the American Society of Testing & Materials (ASTM) F30 Emergency Medical Services Standards Committee. I chair a subtask group on Disaster Management. The committee has prepared a document containing elements, suggestions, processes and procedures from MCI/disaster response plans from EMS agencies around the country. These places include the cities of Los Angeles, New York, Chicago, Washington, D.C. area, Phoenix, Arizona and other urban places. The intent of this task group is not to prepare a document as a rigid standard to cover every detail on an individual task response plan. Instead, the intent of our task group is to provide an overview of expectations of what an individual mass casualty plan should include; focusing on such topical areas as Incident Command Management, communications, triage, transportation, logistical support issues, mutual aid and ancillary support services and many other topical areas that agency planners must address in developing their respective operational response plans.

Improving Skills in Senior Secondary Schools for Effective Performance in Computer Based Test and Security.

2019 ◽  
pp. 167-174
Author(s):  
Agu B.G. ◽  
Eya G.M.
Keyword(s):  
Cognitive Abilities ◽  
Computer Literacy ◽  
Literacy Skills ◽  
School Students ◽  
Effective Performance ◽  
Information And Communication ◽  
Computer Based ◽  
Senior Secondary Schools ◽  
Matriculation Examination ◽  
Senior Secondary

Students are accessed using paper and pen on cognitive abilities in Nigeria. This method of assessment encourages different forms of examination malpractices. The threat of examination malpractices on the validity of examination outcomes has resulted in some examination bodies adopting different methods of examination. One of such methods is the computer based test (CBT). Using survey research method, this study investigated the levels of competency in computer literacy skills possessed by senior secondary school students. Three research questions and one hypothesis guided the study. Problems encountered by the students and prospective methods of enhancing computer based test (CBT) acceptance in Nigeria were also documented. A total of 310 copies of the questionnaire were administered to students who participated in the 2015 Unified Tertiary Matriculation Examination (UTME) at Afrihub Information and Communication Technology (CBT) centre, Institution of Management and Technology (IMT), Enugu and Godfrey Okoye University, Enugu and 237 representing 76% were adequately completed and found usable. The findings revealed among others that majority of the respondents confirmed that CBT can curb examination malpractice. Majority of candidates were also found to prefer CBT to the paper and pencil test (PPT). The mean, standard deviation and Pearson‟s Correlation Analysis showed that the respondent is preference for CBT were sensitive across gender. While improving electricity was identified as critical in enhancing CBT examinations, poor ICT skills on the part of students and the invigilators were also identified as the major problems facing the implementation of JAMB CBT examination in Nigeria.

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