scholarly journals How to Surge to Face the SARS-CoV-2 Outbreak: Lessons Learned From Lombardy, Italy

2020 ◽  
Vol 14 (5) ◽  
pp. e39-e41 ◽  
Author(s):  
Roberto Faccincani ◽  
Federico Pascucci ◽  
Sten Lennquist
Keyword(s):  
Sudden Onset ◽  
Lessons Learned ◽  
Medical Emergency ◽  
Case Scenario ◽  
Surge Capacity ◽  
Probable Case ◽  
Major Incidents ◽  
Spanish Flu ◽  
Disaster Trauma ◽  
Official Data

ABSTRACTItaly is fighting against one of the worst medical emergency since the 1918 Spanish Flu. Pressure on the hospitals is tremendous. As for official data on March 14th: 8372 admitted in hospitals, 1518 in intensive care units, 1441 deaths (175 more than the day before). Unfortunately, hospitals are not prepared: even where a plan for massive influx of patients is present, it usually focuses on sudden onset disaster trauma victims (the most probable case scenario), and it has not been tested, validated, or propagated to the staff. Despite this, the All Hazards Approach for management of major incidents and disasters is still valid and the “4S” theory (staff, stuff, structure, systems) for surge capacity can be guidance to respond to this disaster.

Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy
Keyword(s):  
College Students ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sense Of Self ◽  
Scientific Evidence ◽  
Sudden Onset ◽  
Lessons Learned ◽  
Speech Language Pathologists ◽  
The Brain ◽  
Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

scholarly journals Four pandemics: lessons learned, lessons lost

2020 ◽  
Keyword(s):  
Public Health ◽  
Lessons Learned ◽  
World Health ◽  
Swine Flu ◽  
Global Public Health ◽  
Health Crisis ◽  
The World ◽  
Spanish Flu ◽  
Future Events ◽  
Health Organization

In the past 100 years, the world has faced four distinctly different pandemics: the Spanish flu of 1918-1919, the SARS pandemic of 2003, the H1N1 or “swine flu” pandemic of 2012, and the ongoing COVID-19 pandemic. Each public health crisis exposed specific systemic shortfalls and provided public health lessons for future events. The Spanish flu revealed a nursing shortage and led to a great appreciation of nursing as a profession. SARS showed the importance of having frontline clinicians be able to work with regulators and those producing guidelines. H1N1 raised questions about the nature of a global organization such as the World Health Organization in terms of the benefits and potential disadvantages of leading the fight against a long-term global public health threat. In the era of COVID-19, it seems apparent that we are learning about both the blessing and curse of social media.

scholarly journals Regional Flexible Surge Capacity—A Flexible Response System

2020 ◽  
Vol 12 (15) ◽  
pp. 5984 ◽  
Author(s):  
Viktor Glantz ◽  
Phatthranit Phattharapornjaroen ◽  
Eric Carlström ◽  
Amir Khorram-Manesh
Keyword(s):  
Sudden Onset ◽  
Community Resources ◽  
Surge Capacity ◽  
Response System ◽  
Dental Clinics ◽  
Medical Responsibility ◽  
Flexible Response ◽  
Potential Alternative ◽  
Main Components ◽  
Injured Patients

Surge capacity is the ability to manage the increased influx of critically ill or injured patients during a sudden onset crisis. During such an event, all ordinary resources are activated and used in a systematic, structured, and planned way to cope with the situation. There are, however, occasions where conventional healthcare means are insufficient, and additional resources must be summoned. In such an event, the activation of existing capabilities within community resources can increase regional surge capacity in a flexible manner. These additional resources together represent the concept of Flexible Surge Capacity. This study aims to investigate the possibility of establishing a Flexible Surge Capacity response system to emergencies by examining the main components of surge capacity (Staff, Stuff, Structure, System) within facilities of interest present in the Western Region of Sweden. Through a mixed-method and use of (A) questionnaires and (B) semi-structured key-informant interviews, data was collected from potential alternative care facilities to determine capacities and capabilities and barriers and limitations as well as interest to be included in a flexible surge capacity response system. Both interest and ability were found in the investigated primary healthcare centers, veterinary and dental clinics, schools, and sports and hotel facilities to participate in such a system, either by receiving resources and/or drills and exercises. Barriers limiting the potential participation in this response system consisted of a varying lack of space, beds, healthcare materials, and competencies along with a need for clear organizational structure and medical responsibility. These results indicate that the concept of flexible surge capacity is a feasible approach to emergency management. Educational initiatives, drills and exercises, layperson empowerment, organizational and legal changes and sufficient funding are needed to realize the concept.

scholarly journals Aortic Dissection Presenting as Acute Pancreatitis: Suspecting the Unexpected

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Adam Hafeez ◽  
Dillon Karmo ◽  
Adrian Mercado-Alamo ◽  
Alexandra Halalau
Keyword(s):  
Blood Pressure ◽  
Acute Pancreatitis ◽  
Aortic Dissection ◽  
Epigastric Pain ◽  
Pressure Control ◽  
Sudden Onset ◽  
Medical Emergency ◽  
Threatening Condition ◽  
Life Threatening ◽  
Normal Triglyceride

Aortic dissection is a life-threatening condition in which the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). It is considered a medical emergency. We report a case of a healthy 56-year-old male who presented to the emergency room with sudden onset of epigastric pain radiating to his back. His blood pressure was 167/91 mmHg, equal in both arms. His lipase was elevated at 1258 U/L, and he was clinically diagnosed with acute pancreatitis (AP). He denied any alcohol consumption, had no evidence for gallstones, and had normal triglyceride level. Two days later, he endorsed new suprapubic tenderness radiating to his scrotum, along with worsening epigastric pain. A MRCP demonstrated evidence of an aortic dissection (AD). CT angiography demonstrated a Stanford type B AD extending into the proximal common iliac arteries. His aortic dissection was managed medically with rapid blood pressure control. The patient had excellent recovery and was discharged home without any surgical intervention.

scholarly journals Alternative Leadership in Flexible Surge Capacity—The Perceived Impact of Tabletop Simulation Exercises on Thai Emergency Physicians Capability to Manage a Major Incident

2020 ◽  
Vol 12 (15) ◽  
pp. 6216 ◽  
Author(s):  
Phatthranit Phattharapornjaroen ◽  
Viktor Glantz ◽  
Eric Carlström ◽  
Lina Dahlén Holmqvist ◽  
Amir Khorram-Manesh
Keyword(s):  
Emergency Management ◽  
Major Incident ◽  
Emergency Physicians ◽  
Surge Capacity ◽  
Incident Command ◽  
Perceived Ability ◽  
Major Incidents ◽  
Knowledge And Attitude ◽  
And Control ◽  
Simulation Exercises

Flexible surge capacity aims to activate and utilize other resources than normally are surged in a community during the primary and secondary surge capacity. The presence of alternative leadership, skilled and knowledgeable in hospital and prehospital emergency management, is invaluable. Thai emergency physicians work at both levels, emphasizing their important role in emergency management of any source in a disaster-prone country. We aimed to investigate Thai emergency physicians’ ability in terms of knowledge and preparedness to manage potential emergencies using tabletop simulation exercises. Using an established method for training collaboration, two training courses were arranged for over 50 Thai emergency physicians, who were divided into three teams of prehospital, hospital, and incident command groups. Three scenarios of a terror attack along with a bomb explosion, riot, and shooting, and high building fire were presented, and the participants’ performance was evaluated regarding their preparedness, response and gained knowledge. Two senior observers followed the leadership characteristic in particular. Thai physicians’ perceived ability in command and control, communication, collaboration, coordination, and situation assessment improved in all groups systematically. New perspectives and innovative measures were presented by participants, which improved the overall management on the final day. Tabletop simulation exercise increased the perceived ability, knowledge, and attitude of Thai emergency physicians in managing major incidents and disasters. It also enabled them to lead emergency management in a situation when alternative leadership is a necessity as part of the concept of a flexible surge capacity response system.

Global Dispersant Stockpile: Part of the Industry Solution to Worst Case Scenario Readiness

2014 ◽  
Vol 2014 (1) ◽  
pp. 504-515 ◽  
Author(s):  
Melany Carter-Groves
Keyword(s):  
Raw Materials ◽  
Oil Industry ◽  
Project Manager ◽  
Lessons Learned ◽  
Contingency Planning ◽  
Case Scenario ◽  
Worst Case ◽  
Legal Implications ◽  
Oil Spill Response ◽  
Ongoing Project

ABSTRACT Within the oil industry, the lessons learned from the Macondo incident, have prompted an in depth look into readiness for worst case scenarios in the future, giving rise to a number of Joint Industry Projects. One such project was the development of response-ready subsea well capping devices. Another initiative highlighted the need for an available stockpile of dispersant. The needs for this dispersant stock stems from the unprecedented amounts of dispersant called on during the Macondo incident, for use on the surface and through the new subsea injector systems. Dispersant suppliers need several weeks to begin production, and ongoing supply flagged up limitations in acquiring some of the raw materials for manufacture. Oil Spill Response Ltd was given the responsibility of procuring and managing the stockpile for our member companies, as the project manager in charge of procurement and implementation. It made sense to utilize and expand on the logistics already in place for the dispersant stockpile. The dispersant purchased was 5000 cu.m. of the 3 dispersants with the widest global approval for use. The figure of 5000m3 was based on what was needed 30 days of subsea and aerial dispersant use during the Macondo incident. Unfortunately, following the incident, there were a number of 3rd party claims against the manufacturers of the dispersant. This prompted the dispersant suppliers to seek protection from the legal implications of dispersant use. Achieving this protection had to be practical for those purchasing dispersants , as well as robust enough that the dispersant suppliers were comfortable supplying their product. This resulted in a significant amount of months spent on legal negotiations. Once an agreement was reached on these issues were settled, and after the initial 30 days of dispersant for response is in place, the ongoing project will look at working with suppliers to establish stocks of raw materials and making production more reliable during an incident, as well as working with members of the industry on contingency planning and logistical considerations surrounding the stock. Companies who subscribed to the stockpile will have 5,000 cu.m. of dispersant, split into various locations around the globe, available for both small and large incidents. Future scope for the stockpile includes tabletop and mobilization exercises to test the speed and logistics of response in preparation for an incident, which the hope is, will never happen.

Major Incident Experience and Preparedness in a Developing Country

2013 ◽  
Vol 7 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Hesam Seyedin ◽  
Rouhollah Zaboli ◽  
Hamid Ravaghi
Keyword(s):  
Public Health ◽  
Positive Impact ◽  
Lessons Learned ◽  
Major Incident ◽  
Incident Management ◽  
Semistructured Interview ◽  
Framework Analysis ◽  
Health Organizations ◽  
Research Software ◽  
Major Incidents

AbstractBackgroundResearch shows that having previous experience of major incidents has a positive impact on awareness and preparedness of organizations. We investigated the effects of major incident experience on preparedness of health organizations on future disasters in Iran.MethodsA qualitative study using a semistructured interview technique was conducted with 65 public health and therapeutic affairs managers. Analysis of the data was performed used the framework analysis technique, which was supported by qualitative research software.ResultsThe study found that prior experience of major incidents results in better performance, coordination, and cooperation in response to future events. There was a positive effect on policy making and resource distribution and an increase in (1) preparedness activities, (2) raising population awareness, and (3) improving knowledge. However, the preparedness actions were predominantly individual-dependent.ConclusionsOur findings showed that to increase system efficiency and effectiveness within health organizations, an appropriate major incident management system is needed. The new system can use lessons learned from previous major incidents to better equip health organizations to cope with similar events in the future. (Disaster Med Public Health Preparedness. 2013;7:313-318)

Lessons Learned During an In‐Flight Medical Emergency: Case Report and Discussion

2014 ◽  
Vol 21 (2) ◽  
pp. 130-132
Author(s):  
Melissa D. Stone ◽  
David A. Lubarsky ◽  
Gauri G. Agarwal
Keyword(s):  
Case Report ◽  
Lessons Learned ◽  
Medical Emergency ◽  
Emergency Case

scholarly journals Clonidine Toxicity: One or More Tablets can be Dangerous in Toddlers

2019 ◽  
Vol 39 (1) ◽  
pp. 53-55 ◽  
Author(s):  
Sandesh Kini ◽  
Ramesh Bhat Y ◽  
Phalguna Kousika ◽  
Chennakeshava Thunga
Keyword(s):  
Respiratory Failure ◽  
Attention Deficit ◽  
Healthy Child ◽  
Ventilatory Support ◽  
Sudden Onset ◽  
High Index ◽  
Case Scenario ◽  
Attention Deficit Hyperactive Disorder ◽  
Hypertensive Drug ◽  
High Index Of Suspicion

Clonidine was a popular anti-hypertensive drug during the 1970s but is less commonly used now. In children clonidine is used to treat attention deficit hyperactive disorder (ADHD). We report a toddler who accidentally ingested 0.3 mg of clonidine and developed respiratory failure with hypotension requiring ventilatory support and inotropes but recovered completely within one week. In any case scenario, when a previously healthy child presents with sudden onset respiratory failure, we should keep a high index of suspicion of clonidine use by anyone at home and its easy accessibility to the child.   

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