scholarly journals Acute Chemical Incidents With Injured First Responders, 2002-2012

2017 ◽  
Vol 12 (2) ◽  
pp. 211-221 ◽  
Author(s):  
Natalia Melnikova ◽  
Jennifer Wu ◽  
Alice Yang ◽  
Maureen Orr
Keyword(s):  
Police Officers ◽  
Human Error ◽  
Descriptive Analysis ◽  
First Responders ◽  
Toxic Substances ◽  
Limited Information ◽  
Hazardous Material ◽  
Hazardous Chemical ◽  
Chemical Incidents ◽  
Awareness Level

AbstractIntroductionFirst responders, including firefighters, police officers, emergency medical services, and company emergency response team members, have dangerous jobs that can bring them in contact with hazardous chemicals among other dangers. Limited information is available on responder injuries that occur during hazardous chemical incidents.MethodsWe analyzed 2002-2012 data on acute chemical incidents with injured responders from 2 Agency for Toxic Substances and Disease Registry chemical incident surveillance programs. To learn more about such injuries, we performed descriptive analysis and looked for trends.ResultsThe percentage of responders among all injured people in chemical incidents has not changed over the years. Firefighters were the most frequently injured group of responders, followed by police officers. Respiratory system problems were the most often reported injury, and the respiratory irritants, ammonia, methamphetamine-related chemicals, and carbon monoxide were the chemicals more often associated with injuries. Most of the incidents with responder injuries were caused by human error or equipment failure. Firefighters wore personal protective equipment (PPE) most frequently and police officers did so rarely. Police officers’ injuries were mostly associated with exposure to ammonia and methamphetamine-related chemicals. Most responders did not receive basic awareness-level hazardous material training.ConclusionAll responders should have at least basic awareness-level hazardous material training to recognize and avoid exposure. Research on improving firefighter PPE should continue. (Disaster Med Public Health Preparedness. 2018;12:211–221)

Secondary Contamination of Medical Personnel, Equipment, and Facilities Resulting From Hazardous Materials Events, 2003–2006

2008 ◽  
Vol 2 (2) ◽  
pp. 104-113 ◽  
Author(s):  
D. Kevin Horton ◽  
Maureen Orr ◽  
Theodora Tsongas ◽  
Richard Leiker ◽  
Vikas Kapil
Keyword(s):  
Medical Personnel ◽  
Hazardous Substances ◽  
Medical Attention ◽  
Toxic Substances ◽  
Hazardous Material ◽  
Medical Facilities ◽  
Initial Release ◽  
Emergency Events ◽  
Contamination Events ◽  
Secondary Contamination

ABSTRACTBackground: When not managed properly, a hazardous material event can quickly extend beyond the boundaries of the initial release, creating the potential for secondary contamination of medical personnel, equipment, and facilities. Secondary contamination generally occurs when primary victims are not decontaminated or are inadequately decontaminated before receiving medical attention. This article examines the secondary contamination events reported to the Agency for Toxic Substances and Disease Registry (ATSDR) and offers suggestions for preventing such events.Methods: Data from the ATSDR Hazardous Substances Emergency Events Surveillance system were used to conduct a retrospective analysis of hazardous material events occurring in 17 states during 2003 through 2006 involving secondary contamination of medical personnel, equipment, and facilities.Results: Fifteen (0.05%) Hazardous Substances Emergency Events Surveillance events were identified in which secondary contamination occurred. At least 17 medical personnel were injured as a result of secondary contamination while they were treating contaminated victims. Of the medical personnel injured, 12 were emergency medical technicians and 5 were hospital personnel. Respiratory irritation was the most common injury sustained.Conclusions: Adequate preplanning and drills, proper decontamination procedures, good field-to-hospital communication, appropriate use of personal protective equipment, and effective training can help prevent injuries of medical personnel and contamination of transport vehicles and medical facilities. (Disaster Med Public Health Preparedness. 2008;2:104–113)

scholarly journals Working with catatonia: a qualitative exploration of inpatient team emotional responses

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S347-S347
Author(s):  
Emma Salter ◽  
Linda Pow ◽  
Emma Stacey ◽  
Victoria Stephens ◽  
Paul Beckley ◽  
...  
Keyword(s):  
Mental Health ◽  
Focus Group ◽  
Descriptive Analysis ◽  
Emotional Responses ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Service Improvement ◽  
Limited Information ◽  
Impact Patient Care ◽  
Teaching Learning

AimsChild and adolescent mental health (CAMHS) wards treat patients with variable presentations. During diagnosis and treatment, psychiatric professionals use structured criteria, but also honed awareness of countertransference. Unacknowledged emotional responses can produce powerful dynamics and impact patient care.Limited information exists on possible emotional responses and team dynamics when working with catatonia.This project aimed to establish common themes relating to staff felt-experience of working with a specific case of catatonia on a Child and Adolescent Mental Health (CAMHS) ward. A secondary aim was to establish potential areas for future training and service improvement.MethodTrust Research and Development department approved this work. Inpatient professionals working with the specified patient during admission were eligible. Participants were invited via email and face-face discussion with one of the authors. Participants, patient and mother provided written consent.A questionnaire was created and disseminated via email to eligible staff (n = 33). 27 questions asked individuals to rate responses on Likert scales, plus space for further comments. Questions involved emotional responses to different catatonic states, feelings towards self, patient, colleagues and plans. Descriptive analysis was completed on this anonymised data.Qualitative data were gathered via 1-hour recorded focus group, led by a systemic psychotherapist and psychologist. The session was transcribed anonymously. Two clinicians, using Thematic Analysis, reviewed the transcript independently.Result16 (48.5%) questionnaires were completed. Participants felt negatively about themselves and colleagues more frequently than about the patient. Participants felt positively about themselves less frequently than about colleagues and the patient. Participants identified with more feelings during immobile patient states than lucid states. During immobile states, participants identified with abusive, guilt, hopeless and neglectful responses; during lucid states, with helpful, caring, happy responsesEight (50%) participants felt they sometimes did not understand their feelings towards colleagues/plans. Nine (57%) participants felt they sometimes did not understand their feelings towards themselves. Ten (66%) participants felt they sometimes did not understand their feelings towards the patient.Ten (62.5%) participants felt confused by their emotions at least some of the time. Two (12.5%) frequently felt confused by their emotions.Four participants attended the focus group. Themes included confusion, internal and team conflict.ConclusionWorking with catatonia involved confusion and team splitting. Staff conflict between plans and morals resulted in painful emotions. Prompt psycho-education within teams working with uncommon presentations was identified as a focus for improvement. The authors plan to explore possible avenues for future teaching, learning and team support.

Professional responsibilities versus familial responsibilities: An examination of role conflict among first responders during the Hurricane Katrina disaster

2014 ◽  
Vol 12 (1) ◽  
pp. 45 ◽  
Author(s):  
Terri Adams, PhD ◽  
Mila Turner, MA
Keyword(s):  
Hurricane Katrina ◽  
Natural Disaster ◽  
Role Conflict ◽  
Police Officers ◽  
First Responders ◽  
Police Departments ◽  
Front Line ◽  
Efficient Manner ◽  
Critical Response ◽  
Professional Responsibilities

In the event of a human-caused or natural disaster, the police are essential front-line first responders. The ability of police departments to provide adequate services is contingent upon critical response personnel working and functioning in an efficient manner. Currently, it is assumed that first responders will continue to work in the event of a disaster, even if they are personally impacted by the disaster to which they are expected to respond. This study examines role conflict among police officers who served as first responders during the Hurricane Katrina disaster.

The Relation Between Mindfulness and Posttraumatic Growth: A Study of First Responders to Trauma-Inducing Incidents

2009 ◽  
Vol 31 (4) ◽  
pp. 363-376 ◽  
Author(s):  
Brian Chopko ◽  
Robert Schwartz
Keyword(s):  
Mental Health ◽  
Posttraumatic Growth ◽  
Police Officers ◽  
Spiritual Growth ◽  
Negative Symptoms ◽  
Stress Disorder ◽  
First Responders ◽  
Health Counseling ◽  
Mindfulness Skills ◽  
Posttraumatic Growth Inventory

Research on the reactions of first responders (e.g., police officers, fire fighters) to traumatic incidents has largely focused on negative symptoms (e.g., posttraumatic stress disorder) rather than aspects promoting mental health. Consistent with the counseling profession's focus on growth and development, this study investigated the relation between mindfulness (using the Kentucky Inventory of Mindfulness Skills) and posttraumatic growth (using the Posttraumatic Growth Inventory) among 183 police officers. Results of multiple regression analyses showed that effort toward spiritual growth was positively correlated, and accepting events without judgment was negatively correlated, with posttraumatic growth. Implications for mental health counseling are discussed.

Treatment patterns and clinical outcomes among patients (pts) with HER2+ advanced breast cancer (ABC) and germline BRCA1/2 mutation(s) (gBRCA1/2mut): Results from a US real-world study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13076-e13076
Author(s):  
Elias Obeid ◽  
Rohan Parikh ◽  
Elizabeth Esterberg ◽  
Bhakti Arondekar ◽  
Abigail Hitchens ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Clinical Outcomes ◽  
Real World ◽  
Descriptive Analysis ◽  
Parp Inhibitors ◽  
Limited Information ◽  
Kaplan Meier ◽  
Additional Data Collection ◽  
Line Setting

e13076 Background: g BRCA1/2mut ABC represents ~5% of all breast cancer (BC) including pts with HER2+ BC. While HER2-targeted therapy remains an effective tx for those pts, limited information is available on the use and effectiveness of PARP inhibitors (PARPi) for pts with HER2+ g BRCA1/2mut ABC. Recently, NCCN updated its guidelines (v1.2020) to support the use of PARPi in pts with g BRCA1/2mut metastatic BC regardless of subtype. In order to establish a baseline reference point, we assessed real-world tx patterns and clinical outcomes among pts with g BRCA1/2mut HER2+. Methods: Oncologists retrospectively reviewed charts (July-Oct 2019) of randomly selected pts ≥18 y, with g BRCA1/2mut HER2+ABC who received ≥1 cytotoxic chemotherapy (CT) regimen(s) for ABC between Jan 2013-April 2018. Descriptive analysis was performed for 1st line ABC tx patterns. Clinical outcomes (1st line ABC PFS rates) were estimated using the Kaplan-Meier method. PARPi clinical outcomes data was immature given its recent launch. Additional analyses evaluating outcomes in pts receiving PARPi are planned. Results: Of the 225 pts with g BRCA1/2mut ABC included in the study, 48 (21%) female pts had HER2+ disease. Of the g BRCA1/2mut HER2+ pts, 77% were white with a median age of 58 y. Clinical characteristics: 42% HR+/HER2+, 56% HR-/HER2+, 2% had unknown HR/HER2+ ABC. Txs in the 1st line setting for HR+/HER2+ ABC pts (n = 20) included: CT (75%), CT + HER2-targeted therapy (25%) (Table). First-line txs used for HR-/HER2+ ABC pts (n = 27) included: CT + HER2-targeted therapy (78%), CT (15%), other (7%) (Table). 12-month PFS for 1st line HR+/HER2+ pts was 73% and for HR-/HER2+ pts was 69% (Table). Later line tx patterns will be presented. Conclusions: In this analysis of pts with g BRCA1/2mut HR+/HER2+, unexpectedly low rates of HER2-targeted therapy were observed. As expected, high rates of HER2-targeted therapy with CT were observed among g BRCA1/2mut HR-/HER2+ pts. Clinical outcome findings demonstrate the need for more efficacious tx options. Studies assessing clinical outcomes among g BRCA1/2mut HER2+ ABC pts receiving PARPi +/- HER2-targeted tx are warranted. This is a limited sample size; additional data collection including median PFS is ongoing. [Table: see text]

scholarly journals Medication errors involving intravenous patient-controlled analgesia: results from the 2005–2015 MEDMARX database

2018 ◽  
Vol 9 (8) ◽  
pp. 389-404 ◽  
Author(s):  
Maitreyee Mohanty ◽  
Oluwadolapo D. Lawal ◽  
Margie Skeer ◽  
Ryan Lanier ◽  
Nathalie Erpelding ◽  
...  
Keyword(s):  
Medication Errors ◽  
Human Error ◽  
Human Performance ◽  
Descriptive Analysis ◽  
Clinical Intervention ◽  
Patient Controlled Analgesia ◽  
Error Type ◽  
Medication Error Reporting ◽  
Improper Use ◽  
Cause Of Error

Background: The aim of this study was to determine the current magnitude and characteristics of intravenous patient-controlled analgesia (IV-PCA) errors, and to identify opportunities for improving the PCA modality. Methods: We conducted a descriptive analysis of IV-PCA medication errors submitted to the MEDMARX database. Events were restricted to those occurring in inpatient hospital settings between 1 January 2005 and 31 December 2015. IV-PCA errors were classified by error category, cause of error, error type, level of care rendered, and actions taken. Results: A total of 1948 IV-PCA errors were identified as potential errors (3.9%), nonharmful errors (89.5%), or harmful errors (6.7%) based on the National Coordinating Council for Medication Error Reporting and Prevention taxonomy for categorizing medication errors. Of these, 19.1% required a clinical intervention to address the deleterious effects of the error, indicating an underestimation of the risks associated with IV-PCA errors. The most frequent types of errors were improper dose/quantity (43.2%) and omission errors (19.9%). While human performance deficit was the leading cause of error (50.2%), other common causes included failure to follow procedure and protocol (42.2%) and improper use of the pump (22.7%). Although remedial actions were often taken to prevent error recurrence, actions were taken to rectify the systemic deficits that led to errors in only a minority of cases (11.8%). Conclusion: Preventable errors continue to pose unnecessary risks to patients receiving IV-PCA. Multimodal analgesic regimens and novel PCA systems that reduce human error are needed to prevent errors while preserving the advantages of PCA for the management of acute pain.

scholarly journals Impact of a Postcrash First Aid Educational Program on Knowledge, Perceived Skills Confidence, and Skills Utilization Among Traffic Police Officers: A Single-Arm Before-After Intervention Study

2019 ◽  
Author(s):  
Menti Lastone Ndile ◽  
Gift G. Lukumay ◽  
Karin Bolenius ◽  
Anne H. Outwater ◽  
Britt-Inger Saveman ◽  
...  
Keyword(s):  
Police Officers ◽  
Educational Program ◽  
Road Traffic ◽  
Effective Means ◽  
First Responders ◽  
Knowledge Score ◽  
First Aid ◽  
Nonparametric Tests ◽  
Basic Knowledge ◽  
The Mean

Abstract Background An overwhelming proportion of road traffic deaths and injuries in low- and middle-income countries (LMICs) occur in prehospital environments. Lay first responders such as police officers play an important role in providing initial assistance to victims of road traffic injuries either alone or in collaboration with others. The present study evaluated a postcrash first aid (PFA) educational program developed for police officers in Tanzania.Method A 16-hour PFA educational program was conducted in Dar es Salaam, Tanzania, for 135 police officers. Participants completed training surveys before, immediately and six months after the training (before, N = 135; immediately after, N = 135; after six months, N = 102). The primary outcome measures were PFA knowledge, perceived skills confidence, and skills utilization. Parametric and nonparametric tests were used to analyse changes in outcome.Results The mean PFA knowledge score increased from 44.73% before training ( SD = 20.70) to 72.92% six months after training ( SD = 18.12), p ˂ .001, N = 102. The mean PFA perceived skills confidence score (measured on a 1–5 Likert scale) increased from 1.96 before training ( SD = 0.74) to 3.78 six months after training ( SD = 0.70), p ˂ .001, N = 102. Following training, application of the recovery position skill ( n = 42, 46%) and application of the bleeding control skill ( n = 45, 49%) were reported by nearly half of the responding officers. Less than a quarter of officers reported applying head and neck immobilization skills ( n = 20, 22%) following training.Conclusion A PFA educational program may be an effective means of imparting basic knowledge and skills for prehospital trauma care to lay first responders in contexts where resources are limited. Furthermore, the likelihood of applying such skills can be enhanced by the availability of the necessary resources.

scholarly journals The response of law enforcement agencies and police officers' experiences under the Covid-19 state of alarm in Catalonia, Spain

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ana Martínez-Catena ◽  
Montse Subirana-Malaret ◽  
Falgars Subirana-Malaret
Keyword(s):  
Law Enforcement ◽  
Police Officers ◽  
Online Survey ◽  
Descriptive Analysis ◽  
Communication Channels ◽  
Emotional Impact ◽  
Main Concern ◽  
Law Enforcement Agencies ◽  
Content Type ◽  
General Terms

PurposeLaw enforcement agencies and police officers' efforts were crucial to oversee the public health measures and legal regulations introduced during the Covid-19 pandemic. The study had two objectives: to examine the strategies implemented by law enforcement agencies in Catalonia (Spain) to monitor the pandemic and to explore the adverse working conditions of police officers and their personal difficulties during the state of alarm.Design/methodology/approachA total of 96 experienced police officers completed a closed-ended, anonymous online survey. In addition, complementary information was collected about the management of law enforcement agencies through open interviews. A descriptive analysis was carried out and the association between variables was explored.FindingsIn general terms, law enforcement agencies managed the uncertainty of the situation, with a focus on official information and communication channels between officers. However, many difficulties were reported by the police officers, such us inconsistency between rules, lack of preventive material or changes in work schedules. Besides, the officers' main concern, beyond the emotional impact suffered during this period, was the possibility of being infected or infecting others.Practical implicationsThe congruence between the job requirements and resources, as well as the increase of communication channels during situations of high risk are important variables to assure good job development and personal satisfaction of police officers.Originality/valueTo the knowledge of the authors, at the time of writing this paper, this is the first study in Spain to explore the management of law enforcement agencies and police officers' personal experiences during the Covid-19.

scholarly journals Some problems of investigating street fraud and the ways to solve them

2018 ◽  
Vol 71 (4) ◽  
pp. 55-59
Author(s):  
K. D. Zaiats
Keyword(s):  
Police Officers ◽  
Educational Process ◽  
Practical Significance ◽  
Limited Information ◽  
Criminal Proceedings ◽  
Scientific Methods ◽  
Initial Stage ◽  
General Scientific ◽  
The Individual ◽  
High Level

The subjects of the study are the problems that arise at the initial stage of the investigation of street fraud, the study is the individual problems of pre-trial investigation of street fraud and the ways of their solution. The study aims to highlight the most common problems in practice at the initial stage of the investigation of this group of fraud, and presents recommendations for their solution. In the course of time, general scientific methods of cognition were used. The relevance of the research topic is that the main problems of investigators arise at the stage of the decision to open criminal proceedings. Difficulties are related to the fact that the investigator needs to take a key procedural decision based on the analysis of very limited information about the event. In addition, in the context of open criminal proceedings, it is very difficult to form a system of evidence of the existence of a criminal intention in the actions of a fraudsters. Indeed, unlike other crimes, they are reflected not so much in material traces as in acts of intellectual nature: the reporting of false information, the use of fictitious documents, specific attributes, and many others. Gathering evidence of such an order requires an extraordinary level of professionalism. The investigator should not only have a high level of knowledge of the existing criminal and criminal procedural legislation, but also be aware of ways to overcome the main difficulties encountered in criminal proceedings on fraud. The novelty of the results is that the research in this direction was conducted for the first time. The main results of the study are given a number of typical problems of investigation of street fraud, as well as recommendations for their overcoming. The results of the study can be used in the field of the criminal law cycle. The practical significance lies in the possibility of introducing the results of the research into the educational process in the presentation of the discipline “The method of investigation of crimes”, special courses, as well as in raising the skills of practical police officers. As a result of the study, conclusions were drawn in the form of concrete proposals for addressing typical problems arising in the investigation of street fraud.

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