Disaster Preparedness in Hospitals in the Middle East: An Integrative Literature Review

2019 ◽  
Vol 13 (4) ◽  
pp. 806-816 ◽  
Author(s):  
Abdullah Alruwaili ◽  
Shahidul Islam ◽  
Kim Usher
Keyword(s):  
Middle East ◽  
Emergency Response ◽  
Disaster Preparedness ◽  
Mass Casualty ◽  
Eligibility Criteria ◽  
Factors Affecting ◽  
Mass Casualty Events ◽  
Review Study ◽  
Meta Analyses ◽  
Key Terms

ABSTRACTDisasters occur rarely but have significant adverse consequences when they do. Recent statistics suggest that millions of lives and billions of US dollars have been lost in the last decade due to disaster events globally. It is crucial that hospitals are well prepared for disasters to minimize their effects. This integrative review study evaluates the preparedness level of hospitals in the Middle East for disasters using the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) guidelines. The key terms include disaster preparedness OR disaster management OR emergency response AND Middle East AND hospitals. The study reviews articles published between January 2005 and December 2015, which focused on the hospitals’ preparedness for disasters in the Middle East nations. Based on their meeting 5 eligibility criteria, 19 articles were included in the review. Twelve of the articles focused on both natural and man-made disasters, whereas 6 of them were based on mass casualty events and 1 on earthquake. Thirteen of the reviewed articles ranked the level of preparedness of hospitals for disasters to be generally “very poor,” “poor,” or “moderate,” whereas 6 reported that hospitals were “well” or “very well prepared” for disasters. Factors affecting preparedness level were identified as a lack of contingency plans and insufficient availability of resources, among others. (Disaster Med Public Health Preparedness. 2019;13:806–816).

Terrorism in France

2003 ◽  
Vol 18 (2) ◽  
pp. 92-99 ◽  
Author(s):  
Pierre Carli ◽  
Caroline Telion ◽  
David Baker
Keyword(s):  
Emergency Response ◽  
Life Support ◽  
Mass Casualty ◽  
Lessons Learned ◽  
National Plan ◽  
Medical Response ◽  
Emergency Medical ◽  
Mass Casualty Events ◽  
Psychological Assistance ◽  
Key Aspects

AbstractFrance has experienced two waves of major terrorist bombings since 1980. In the first wave (1985–1986), eight bombings occurred in Paris, killing 13 and injuring 281. In the second wave (1995–1996), six bombings occurred in Paris and Lyon, killing 10 and injuring 262. Based on lessons learned during these events, France has developed and improved a sophisticated national system for prehospital emergency response to conventional terrorist attacks based on its national emergency medical services (EMS) system, Service d' Aide Medicale Urgente (SAMU). According to the national plan for the emergency medical response to mass-casualty events (White Plan), the major phases of EMS response are: (1) alert; (2) search and rescue; (3) triage of victims and provision of critical care to first priority victims; (4) regulated dispatch of victims to hospitals; and (5) psychological assistance.Following the 1995 Tokyo subway sarin attack, a national plan for the emergency response to chemical and biological events (PIRATOX) was implemented. In 2002, the Ministries of Health and the Interior collaborated to produce a comprehensive national plan (BIOTOX) for the emergency response to chemical, biological, radiological, and nuclear events. Key aspects of BIOTOX are the prehospital provision of specialized advance life support for toxic injuries and the protection of responders in contaminated environments. BIOTOX was successfully used during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak in France.

Using Mixed Methods to Assess Pediatric Disaster Preparedness in the Hospital Setting

2014 ◽  
Vol 29 (6) ◽  
pp. 569-575 ◽  
Author(s):  
Rita V. Burke ◽  
Tae Y. Kim ◽  
Shelby L. Bachman ◽  
Ellen I. Iverson ◽  
Bridget M. Berg
Keyword(s):  
Mixed Methods ◽  
Emergency Response ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Hospital Setting ◽  
Mass Casualty ◽  
Disaster Victims ◽  
Qualitative Feedback ◽  
Disaster Exercise ◽  
Communication Equipment

AbstractIntroductionChildren are particularly vulnerable during disasters and mass-casualty incidents. Coordinated multi-hospital training exercises may help health care facilities prepare for pediatric disaster victims.ProblemThe purpose of this study was to use mixed methods to assess the disaster response of three hospitals, focusing on pediatric disaster victims.MethodsA full-functional disaster exercise involving a simulated 7.8-magnitude earthquake was conducted at three Los Angeles (California USA) hospitals, one of which is a freestanding designated Level I Pediatric Trauma Center. Exercise participants provided quantitative and qualitative feedback regarding their perceptions of pediatric disaster response during the exercise in the form of surveys and interviews. Additionally, trained observers provided qualitative feedback and recommendations regarding aspects of emergency response during the exercise, including communication, equipment and supplies, pediatric safety, security, and training.ResultsAccording to quantitative participant feedback, the disaster exercise enhanced respondents’ perceived preparedness to care for the pediatric population during a mass-casualty event. Further, qualitative feedback from exercise participants and observers revealed opportunities to improve multiple aspects of emergency response, such as communication, equipment availability, and physician participation. Additionally, participants and observers reported opportunities to improve safety and security of children, understanding of staff roles and responsibilities, and implementation of disaster triage exercises.ConclusionConsistent with previous investigations of pediatric disaster preparedness, evaluation of the exercise revealed several opportunities for all hospitals to improve their ability to respond to the needs of pediatric victims. Quantitative and qualitative feedback from both participants and observers was useful for comprehensively assessing the exercise's successes and obstacles. The present study has identified several opportunities to improve the current state of all hospitals’ pediatric disaster preparedness, through increased training on pediatric disaster triage methods and additional training on the safety and security of children. Regular assessment and evaluation of supplies, equipment, leadership assignments, and inter-hospital communication is also suggested to optimize the effectiveness and efficiency of response to pediatric victims in a disaster.BurkeRV, KimTY, BachmanSL, IversonEI, BergBM. Using mixed methods to assess pediatric disaster preparedness in the hospital setting. Prehosp Disaster Med. 2014;29(6): 1-7.

Tools and Checklists Used for the Evaluation of Hospital Disaster Preparedness: A Systematic Review

2016 ◽  
Vol 10 (5) ◽  
pp. 781-788 ◽  
Author(s):  
Mahmood Nekoie-Moghadam ◽  
Lisa Kurland ◽  
Mahmood Moosazadeh ◽  
Pier Luigi Ingrassia ◽  
Francesco Della Corte ◽  
...  
Keyword(s):  
Systematic Review ◽  
New York ◽  
Disaster Preparedness ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Evaluation Tool ◽  
Thomson Reuters ◽  
Hospital Preparedness ◽  
Meta Analyses ◽  
Hospital Disaster Preparedness

AbstractHospitals need to be fully operative during disasters. It is therefore essential to be able to evaluate hospital preparedness. However, there is no consensus of a standardized, comprehensive and reliable tool with which to measure hospital preparedness. The aim of the current study was to perform a systematic review of evaluation tools for hospital disaster preparedness. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words “crisis,” “disaster,” “disaster medicine,” “emergency,” “mass casualty,” “hospital preparedness,” “hospital readiness,” “hospital assessment,” “hospital evaluation,” “hospital appraisal,” “planning,” “checklist,” and “medical facility” were used in combination with the Boolean operators “OR” and “AND.” PubMed (National Library of Medicine, Bethesda, MD), ISI Web of Science (Thomson Reuters, New York, NY), and Scopus (Elsevier, New York, NY) were searched. A total of 51,809 publications were screened. The following themes were required for relevance: logistics, planning, human resources, triage, communication, command and control, structural and nonstructural preparedness, training, evacuation, recovery after disaster, coordination, transportation, surge capacity, and safety. The results from 15 publications are presented. Fifteen articles fulfilled the criteria of relevance and considered at least 1 of the 14 predetermined themes. None of the evaluated checklists and tools included all dimensions required for an appropriate hospital preparedness evaluation. The results of the current systematic review could be used as a basis for designing an evaluation tool for hospital disaster preparedness. (Disaster Med Public Health Preparedness. 2016;page 1 of 8)

Disaster management among pediatric surgeons: Preparedness, training and involvement

2008 ◽  
Vol 3 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Nikunj K. Chokshi, MD ◽  
Solomon Behar, MD ◽  
Alan L. Nager, MD, FAAP ◽  
Fred Dorey, PhD ◽  
Jeffrey S. Upperman, MD, FAAP, FACS
Keyword(s):  
Emergency Response ◽  
Disaster Response ◽  
Online Survey ◽  
The United States ◽  
Mass Casualty ◽  
Leadership Role ◽  
Training Methods ◽  
Disaster Victims ◽  
Disaster Experience ◽  
Mass Casualty Events

Introduction: Contemporary events in the United States (eg, September 2001, school shootings), Europe (eg, Madrid train bombings), and the Middle East have raised awareness of mass casualty events and the need for a capable disaster response. Recent natural disasters have highlighted the poor preparation and infrastructure in place to respond to mass casualty events. In response, public health policy makers and emergency planners developed plans and prepared emergency response systems. Emergency response providers include first responders, a subset of emergency professionals, including firemen, law enforcement, paramedics, who respond to the incident scene and first receivers, a set of healthcare workers who receive the disaster victims at hospital facilities. The role of pediatric surgeons in mass casualty emergency response plans remains undefined. The authors hypothesize that pediatric surgeons’ training and experience will predict their willingness and ability to be activated first receivers. The objective of our study was to determine the baseline experience, preparedness, willingness, and availability of pediatric surgeons to participate as activated first receivers.Methods: After institutional review board approval, the authors conducted an anonymous online survey of members of the American Pediatric Surgical Association in 2007. The authors explored four domains in this survey: (1) demographics, (2) disaster experience and perceived preparedness, (3) attitudes regarding responsibility and willingness to participate in a disaster response, and (4) availability to participate in a disaster response. The authors performed univariate and bivariate analyses to determine significance. Finally, the authors conducted a logistic regression to determine whether experience or preparedness factors affected the respondent’s availability or willingness to respond to a disaster as a first receiver.Results: The authors sent 725 invitations and received 265 (36.6 percent) completed surveys. Overall, the authors found that 77 percent of the respondents felt “definitely” responsible for helping out during a disaster but only 24 percent of respondents felt “definitely” prepared to respond to a disaster. Most felt they needed additional training, with 74 percent stating that they definitely or probably needed to do more training. Among experiential factors, the authors found that attendance at a national conference was associated with the highest sense of preparedness. The authors determined that subjects with actual disaster experience were about four times more likely to feel prepared than those with no disaster experience (p 0.001). The authors also demonstrated that individuals with a defined leadership position in a disaster response plan are twice as likely to feel prepared (p _ 0.002) and nearly five times more willing to respond to a disaster than those without a leadership role. The authors found other factors that predicted willingness including the following: a contractual agreement to respond (OR 2.3); combat experience (OR 2.1); and prior disaster experience (OR 2.0). Finally, the authors found that no experiential variables or training types were associated with an increased availability to respond to a disaster.Conclusions: A minority of pediatric surgeons feel prepared, and most feel they require more training. Current training methods may be ineffectual in building a prepared and willing pool of first receivers. Disaster planners must plan for healthcare worker related issues, such as transportation and communication. Further work and emphasis is needed to bolster participation in disaster preparedness training.

Specialized retrieval systems

2016 ◽  
Keyword(s):  
Critical Care ◽  
Medical Care ◽  
Emergency Response ◽  
Disaster Response ◽  
Country Of Origin ◽  
Mass Casualty ◽  
Medical Emergency ◽  
Retrieval Systems ◽  
Mass Casualty Events ◽  
Care Response

Civilian and military retrieval services commonly respond to mass casualty events and international disasters. It is necessary to adapt usual practices to achieve the most for many. The structures, systems, language, and discipline take on a military flavour in civilian disaster response. This brings some order to the chaos and facilitates multiagency cooperation. Triage, treatment, and transport must occur in unfavourable environments. This is exemplified in military scenarios where there is ongoing risk to casualties and retrieval teams. Medical care provided by retrieval teams will depend on risk and resources. Staged retrieval may be required. This is also the case with civilian international retrieval where the patient may be transferred to an intermediate destination facility for immediate care, before being repatriated to their country of origin. Also included, is a section on medical emergency response teams which provide a critical care response to deteriorating patients in a hospital ward setting.

scholarly journals Prehospital Tourniquets in Civilians: A Systematic Review

2020 ◽  
pp. 1-9
Author(s):  
Kenneth A. Eilertsen ◽  
Morten Winberg ◽  
Elisabeth Jeppesen ◽  
Gyri Hval ◽  
Torben Wisborg
Keyword(s):  
Blood Transfusion ◽  
Adverse Effects ◽  
Current Knowledge ◽  
Mass Casualty ◽  
Cochrane Library ◽  
Mass Casualty Events ◽  
Life Threatening ◽  
Secondary Outcomes ◽  
Meta Analyses ◽  
Without Tourniquet

Abstract Objectives: Terrorist attacks and civilian mass-casualty events are frequent, and some countries have implemented tourniquet use for uncontrollable extremity bleeding in civilian settings. The aim of this study was to summarize current knowledge on the use of prehospital tourniquets to assess whether their use increases the survival rate in civilian patients with life-threatening hemorrhages from the extremities. Design: Systematic literature review in Medline (Ovid), Embase (Ovid), Cochrane Library, and Epistemonikos was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. The search was performed in January 2019. Setting: All types of studies that examined use of tourniquets in a prehospital setting published after January 1, 2000 were included. Primary/Secondary Outcomes: The primary outcome was mortality with and without tourniquet, while adverse effects of tourniquet use were secondary outcomes. Results: Among 3,460 screened records, 55 studies were identified as relevant. The studies were highly heterogeneous with low quality of evidence. Most studies reported increased survival in the tourniquet group, but few had relevant comparators, and the survival benefit was difficult to estimate. Most studies reported a reduced need for blood transfusion, with few and mainly transient adverse effects from tourniquet use. Conclusion: Despite relatively low evidence, the studies consistently suggested that the use of commercial tourniquets in a civilian setting to control life-threatening extremity hemorrhage seemed to be associated with improved survival, reduced need for blood transfusion, and few and transient adverse effects.

scholarly journals The Health Impact of Smokeless Tobacco Products: A Systematic Review

2021 ◽  
Author(s):  
Cother Hajat ◽  
Emma Stein ◽  
Lars Ramstrom ◽  
Saran Shantikumar ◽  
Riccardo Polosa
Keyword(s):  
Middle East ◽  
Health Outcomes ◽  
Head And Neck ◽  
Smokeless Tobacco ◽  
Good Health ◽  
Health Impact ◽  
Eligibility Criteria ◽  
Colon Cancers ◽  
Meta Analyses ◽  
The Impact

IntroductionThe objective was to systematically review studies reporting on health outcomes from smokeless tobacco (SLT) products.MethodsWe included published literature on the health impact of SLT from 01/01/2015 until 01/02/2020 following the PRISMA protocol using PubMed, Embase, Scopus and Google Scholar. ResultsOf 321 studies identified, 53 met eligibility criteria; 23(43%) were rated as poor, 21(39%) fair and 9(17%) as good. Health outcomes differed starkly between SLT products and global regions. SLT products in Asia, Middle East and Africa were associated with higher mortality (overall, cancer, CHD, respiratory but not CVD), and morbidity (CVD, oral and head and neck cancers), with odds ratios as high as 39 (shammah use). European studies showed no excess mortality (overall, CVD, from cancers) or morbidity (IHD, stroke, oral, head and neck, pancreatic or colon cancers) from several meta-analyses but single studies reporting elevated risk of rectal cancer and respiratory disorders. Pooled studies showed a protective effect against developing Parkinson’s disease. US studies showed mixed results for mortality (raised overall, CHD, cancer and smoking-related cancer mortality; no excess risk of respiratory or CVD mortality). Morbidity outcomes were also mixed, with some evidence of increased IHD, stroke and cancer risk (oral, head and neck). No studies reported on the health impact of switching from cigarettes to SLT products. ConclusionOur review has demonstrated stark differences between different SLT products in different regions on health impact, ranging from no harm from European snus to greatly increased health risks from SLT products used in Asia, Middle East and Africa. The literature on the impact of SLT products for harm reduction is incomplete and potentially misinforming policy and regulation.

scholarly journals The Role of Health Systems in Emergency Response Planning

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Vladimir Dobricanin ◽  
Nebojsa Djokic ◽  
Sanja Dobricanin
Keyword(s):  
Emergency Response ◽  
National Health System ◽  
Mass Casualty ◽  
Response Planning ◽  
Mass Casualty Events ◽  
Emergency Response Planning ◽  
History Of ◽  
Further Development

Abstract The history of mankind is pervaded by many events that have had an incredible influence on the further development of civilization. Unfortunately, many historical milestones have also been marked by unimaginable disasters that have sometimes threatened the very existence of the human race. One of the most important links in the chain of readiness in emergencies and disasters is the national health system with all its institutions at the primary and secondary levels of healthcare. Their capacities and capabilities for adequate response can be significantly enhanced by the development and implementation of appropriate Emergency Response Plans (ERPs). The necessity of ERPs is considered for several important elements: to protect lives, property and the environment; to mitigate the consequences caused by emergencies and disasters and ensure the continuity of general health services; to create a system and network to respond to and recover from the consequences of emergencies and disasters; to use of available resources optimally; and to provide additional resources if needed and improve the cooperation between sectors and agencies. The overall quality of a healthcare system is also measured by its readiness to respond to mass casualty events, emergencies and disasters. The lack of an ERP, a poor ERP, or a nonunderstandable or inaccessible plans leads to partial preparedness that can cause unimaginable consequences to overall health and loss of life of the population.

Early Diagnosis and Intervention in Mass Casualty Events

2008 ◽  
Author(s):  
Ilan Kutz ◽  
Rachel Dekel ◽  
Shaul Schreiber ◽  
Victor Resnick ◽  
Ornah T. Dolberg ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Mass Casualty ◽  
Mass Casualty Events
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