Example of Education in Disaster Medicine in Sweden

Sweden has not been at war since 1809–1810, when we fought against Russia in Finland. Lyrics by Runeberg are among the few documentations about the wounded in that war. Life-saving first aid was not very good at that time, and most of the wounded died. Modern Sweden is a technically advanced community. We have had some mass casualty situations, such as fires in restaurants and airplane accidents. Six months ago a train crashed just outside the fire brigade station, only five minutes running distance from the hospital. The result was one person dead, two severely injured and about 40 slightly injured. The same crash could have occurred elsewhere in Sweden where the situation might have been much worse, for much of Sweden is very deserted with large woods, and roads are scarce.

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Difference in First Aid Activity During Mass Casualty Training Based on Having Taken an Educational Course

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2017.99 ◽

2017 ◽

Vol 12 (4) ◽

pp. 437-440

Author(s):

Youichi Yanagawa ◽

Kazuhiko Omori ◽

Kouhei Ishikawa ◽

Ikuto Takeuchi ◽

Kei Jitsuiki ◽

...

Keyword(s):

Life Support ◽

Initial Period ◽

Fire Department ◽

First Aid ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Disaster Medicine ◽

Ambulance Service ◽

Medical Practitioners ◽

The Difference

ABSTRACTBackgroundThe Japanese Association for Disaster Medicine developed a mass casualty life support (MCLS) course to improve cooperation among medical practitioners during a disaster, which is essential for reducing the rates of preventable disaster death. We investigated whether there was difference in first aid activity among members of the ambulance service during mass casualty training based on having taken the MCLS course.MethodsMass casualty training was held at the fire department of Numazu City. Twenty-one ambulance service parties participated in this training. They first evaluated the mass casualty situation, performed the appropriate services at the scene during the initial period, and then provided START triage for mock wounded patients. Throughout the training, 5 examiners evaluated their performance.ResultsRegarding the difference in first aid activity based on MCLS course attendance among the ambulance service members, the cooperative management (scored on a scale of 1 to 5) among the members who had taken the MCLS course was significantly better than that among those who had not taken the course (median [interquartile range]: 5 [0.5] vs. 4 [1.75], P<0.05).ConclusionAttending an MCLS course may help to improve outcomes in the face of an actual mass casualty incident. (Disaster Med Public Health Preparedness. 2018;12:437–440)

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Disaster Day: A Simulation-Based Disaster Medicine Curriculum for Novice Learners

Journal of Medical Education and Curricular Development ◽

10.1177/23821205211020751 ◽

2021 ◽

Vol 8 ◽

pp. 238212052110207

Author(s):

Brad D Gable ◽

Asit Misra ◽

Devin M Doos ◽

Patrick G Hughes ◽

Lisa M Clayton ◽

...

Keyword(s):

Medical Students ◽

Disaster Management ◽

Disaster Preparedness ◽

Real Life ◽

Mass Casualty ◽

Disaster Medicine ◽

Incident Command ◽

Management Concepts ◽

Simulation Based ◽

Second Year

Background: Mass casualty and multi-victim incidents have increased in recent years due to a number of factors including natural disasters and terrorism. The Association of American Medical Colleges (AAMC) recommends that medical students be trained in disaster preparedness and response. However, a majority of United States medical students are not provided such education. Objective: The goal of this study was to evaluate the effectiveness of a 1 day, immersive, simulation-based Disaster Day curriculum. Settings and Design: Learners were first and second year medical students from a single institution. Materials and Methods: Our education provided learners with information on disaster management, allowed for application of this knowledge with hands-on skill stations, and culminated in near full-scale simulation where learners could evaluate the knowledge and skills they had acquired. Statistical analysis used: To study the effectiveness of our Disaster Day curriculum, we conducted a single-group pretest-posttest and paired analysis of self-reported confidence data. Results: A total of 40 first and second year medical students participated in Disaster Day as learners. Learners strongly agreed that this course provided new information or provided clarity on previous training, and they intended to use what they learned, 97.6% and 88.4%, respectively. Conclusions: Medical students’ self-reported confidence of key disaster management concepts including victim triage, tourniquet application, and incident command improved after a simulation-based disaster curriculum. This Disaster Day curriculum provides students the ability to apply concepts learned in the classroom and better understand the real-life difficulties experienced in a resource limited environment.

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Simple Emergency Triage (SET) – the new perspective on mass casualty incident triage

Emergency Medical Service ◽

10.36740/emems202002107 ◽

2020 ◽

Vol 7 (2) ◽

pp. 120-123

Author(s):

Jerzy Jaskuła ◽

Marek Siuta

Keyword(s):

Personal Experience ◽

Emergency Services ◽

Statistical Data ◽

First Aid ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Starting Point ◽

Analysis And Synthesis ◽

The Subject ◽

New Perspective

The aim: Incidents with large number of casualties present a major challenge for the emergency services. Incident witnesses are always the first on scene. Authors aim at giving them an algorithm arranging the widely known first aid rules in such way, that the number of potential fatalities before the services’ arrival may be decreased. Material and methods: The authors’ main aim was creating an algorithm for mass casualty incident action, comprising elements not exceeding first aid skill level. Proceedings have been systematized, which led to creation of mass casualty incident algorithm. The analysis was based on the subject matter literature, legal acts and regulations, statistical data and author’s personal experience. Results: The analysis and synthesis of data from various sources allowed for the creation of Simple Emergency Triage (SET) algorithm. It has been proven – on theoretical level – that introducing an organized way of proceeding in mass casualty incident on the first aid level is justified. Conclusions: The SET algorithm presented in the article is of an implemental character. It may be a supplement to basic first aid skills. Algorithm may also be the starting point for further empirical research aimed at verifying its effectiveness.

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Method for Teaching Life-Saving Combat First-Aid Skills With live–actor Patients Using a Wearable Training Apparatus

Military Medicine ◽

10.1093/milmed/usab286 ◽

2021 ◽

Author(s):

Minrui Lv ◽

Yijun Jia ◽

Zhaowen Zong ◽

Renqing Jiang ◽

Wenqiong Du ◽

...

Keyword(s):

Medical Students ◽

First Aid ◽

High Fidelity ◽

Simulation Methods ◽

Advantages And Disadvantages ◽

Life Saving ◽

Traditional Training ◽

Teaching Life ◽

Training Apparatus ◽

Medical Teachers

ABSTRACT Introduction Training combat personnel in combat first-aid skills has faced many challenges over time, such as the need to combine tactics with medicine and to overcome combat personnel’s lack of medical background knowledge. Therefore, many simulation methods are currently being developed, each of which has its advantages and disadvantages. In this study, a combined simulation method involving live–actor patients using a wearable training apparatus was developed, and the effects of this method were observed. Materials and Methods Focusing on the major causes of preventable deaths among victims killed in action, wearable training apparatuses simulating massive hemorrhage, airway obstruction, and tension pneumothorax were designed and produced. Methods of simulating these three injury types using live–actor patients with these training apparatuses were developed, and medical teachers evaluated the simulation effects. The live–actor patients were incorporated into a tactical scenario to train and test nonmedical and medical students in year 3, respectively. High-fidelity simulator-based training and traditional training without simulation served as the control. A post-training survey using a 7-point Likert scale evaluated the trainees’ feelings toward these training approaches. Results Three types of training apparatuses were developed to simulate three life-threatening injuries, and the simulation effects of the live–actor patients using these apparatuses were highly recognized by medical teachers. Both live–actor patients and high-fidelity simulator-based training improved performance significantly more than traditional training. However, the improvement due to training with live–actor patients was greater than that due to high-fidelity simulator-based training for nonmedical students, whereas there was no difference between these two simulation methods for medical students. A post-training survey revealed that all the trainees were confident in practicing first-aid skills after training, and they all agreed that live–actor patients could combine tactical situations with first aid better than high-fidelity simulators. The nonmedical students strongly agreed that live–actor patients were more helpful in the training of injury evaluation than high-fidelity simulators. Conclusions The method using wearable training apparatus-based live–actor patients was satisfying and effective for teaching life-saving combat first-aid skills, especially for nonmedical students.

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Telemedicine and Information Technology for Disaster Medical Scenarios

Encyclopedia of Healthcare Information Systems ◽

10.4018/978-1-59904-889-5.ch163 ◽

2008 ◽

pp. 1303-1310

Author(s):

John D. Haynes ◽

Mehnaz Saleem ◽

Moona Kanwal

Keyword(s):

Information Technology ◽

Health Services ◽

Preventive Health Services ◽

Mass Casualty ◽

Disaster Medicine ◽

Preventive Health ◽

Global Environment ◽

Health Response ◽

Major Disaster ◽

Response Capacity

Disasters constitute events which are catastrophic in nature. Such events critically threaten the health, safety, and lives of people and their environment (and even aspects of the global environment), and as a result, overwhelm the affected community’s emergency response capacity. Globally, a major disaster occurs almost daily. Consequently, disaster events are virtually an everyday fact of life. Emergency medical services constitute one important aspect of disaster responses. Those populations affected by disasters require a complete range of health services and the appropriate mechanism of delivery. In this respect, increasingly, information technology is playing a greater role. Disaster medicine has become more than merely a mass-casualty, and affected health response; the affected population’s needs are assessed, which range from medical requirements, to rapidly coordinating and providing casualty, routine, and preventive health services. These kinds of assessments are significantly more effective, given the appropriate deployment of current information technology.

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Needs of Patients in the Triage Category “Expectant” in Prehospital Disaster Settings: A Survey Among German Medical Incident Commanders and Palliative Care Physicians

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19003406 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s151-s152

Author(s):

Gerald Ripberger ◽

Michael Oppert ◽

Jens Werner Bickelmayer

Keyword(s):

Palliative Care ◽

Online Survey ◽

Disaster Medicine ◽

Care Physician ◽

List Type ◽

Bill Of Rights ◽

Human Right ◽

Dying Patients ◽

Triage Category ◽

Life Saving

Introduction:The treatment of patients in the triage category “expectant” is not in the focus of the prehospital disaster medicine. The aim is to save as many lives as possible in situations with very limited resources. It is necessary to allocate the life-saving interventions to those who have the chance to survive, but there is a human right of best assistance even for those who are expected to die.Aim:In Germany, it is possible to use the triage category “expectant” in overwhelming disasters, so there should be preparedness for those patients, who receive this categorization. A survey was conducted to find out what the needs are of those patients.Methods:An online-survey was submitted to German medical incident commanders and palliative care physician in function of expert groups via their national associations.Results:219 physicians participated. The majority confirmed a necessity to treat those patients and to be prepared. Currently, in most of the areas, there is no preparation. The main needs are the treatment of pain, dyspnoea, fear, and loneliness. Following the “Dying person’s bill of rights” (1), the most relevant rights are: To be treated as living human being until I dieTo be free from painTo express the feelings and emotionsTo die in peace and dignityDiscussion:Palliative care should be part of disaster medicine planning. It is not too difficult to prepare a special group of helper for the care of dying patients. Medical incident commanders and palliative care physicians agree in the majority about the necessity, so SOPs can be implemented to teach non-medics. The medics will be needed for the first aim of disaster medicine.

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Medical Measurement Against the Mega-Disaster: The Necessity of Systematization of the Disaster Medicine or the Disaster Medicine Compendium

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19003340 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s149-s150

Author(s):

Yoshikura Haraguchi ◽

Yozo Tomoyasu ◽

Tohru Tsubata ◽

Tetsu Ishihara ◽

Motohiro Sakai ◽

...

Keyword(s):

Hurricane Katrina ◽

John Rawls ◽

Global Scale ◽

Negative Influence ◽

Disaster Medicine ◽

Broad Perspective ◽

Care And Support ◽

Chemical Hazard ◽

Life Saving ◽

The Moment

Introduction:The large number of casualties during major or mega-disasters are a global problem.Aim:The role of medicine against mega-disasters is analyzed from a worldwide perspective.Methods:Chernobyl incident, the Tokyo Subway Sarin Attack, the 9-11 attack, the Indian Ocean earthquake/tsunami, Hurricane Katrina, the Flu pandemic, the Higashi Nihon Earthquake followed by the Fukushima nuclear plant incident, etc. are critically analyzed, based on the actual medical experiences.Results:These mega-disasters often have a wide, severe negative influence. Linked catastrophes often form catastrophic circulus vitiosus (CCV) or malignant cycles on a global scale. The typical example is the Chernobyl incident which caused not only many deaths by radiation exposure/thyroid cancer and world anxiety, but also is considered to have contributed to the end of the Eastern European Communism system in 1989 (East Germany) and 1991 (ESSR).Discussion:Many roles of medical doctors and staff were requested, including creating preventive life-saving systems, in addition to the prevention of mega-disaster measurement to minimize the unhappiness. Moreover, medical ethics and philosophy are important, which were often overlooked. It is necessary for medical care and support to have a broad perspective. Although the classical philosophy of utilitarianism is often accepted without suspicion, it comes with the risk of disregarding vulnerable/weak people. The concept of justice according to John Rawls (USA) and the Minimal Unhappiness Theory by Naoto Kan (Japanese politician) should be considered, too. From such viewpoints, it is our conclusion to urge the establishment of systematic disaster medicine or to compile a disaster medicine compendium. Although the tentative first version was compiled with 22 volumes in 2005, only one-fourth was available in English. The English part increased up to nearly three-fourths by adding several new versions in which the nuclear/biological/chemical hazard version, tsunami measurement, and psychological care version are included at the moment.

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Military-Civilian Collaboration for Disaster Medicine in Israel (Discussion Comment)

Journal of the World Association for Emergency and Disaster Medicine ◽

10.1017/s1049023x00032635 ◽

1985 ◽

Vol 1 (1) ◽

pp. 32-32

Author(s):

Yakov Adler

Keyword(s):

Mass Casualty ◽

Disaster Medicine ◽

Fire Fighting ◽

The Other ◽

State Of Emergency ◽

Major Earthquake ◽

Military Commander ◽

Trained Manpower ◽

The Military ◽

State Of Israel

The only organization presently capable of responding immediately to a mass casualty situation in peacetime in Israel would be the Israeli Defense Forces. They have available the necessary means, organization, trained manpower and equipment. If a state of emergency would be proclaimed in the state of Israel in case of a major earthquake or similar disaster, in any part of the country, the chief military commander would be in charge. His army would take command over that area. All the other civilian institutions concerned with the care of casualties, including fire fighting forces, police and hospitals, would come under his command. With the military in charge, the response would be much shorter. The chief military commander would proclaim a state of emergency if he feels that it is warranted.

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Editorial: Military-Civilian Collaboration in Disaster Medicine

Journal of the World Association for Emergency and Disaster Medicine ◽

10.1017/s1049023x00032453 ◽

1985 ◽

Vol 1 (1) ◽

pp. 4-4 ◽

Cited By ~ 2

Author(s):

Peter Safar

Keyword(s):

Editorial Comment ◽

Medical Care ◽

Emergency Medical Services ◽

Military Medicine ◽

Disaster Medicine ◽

Nuclear War ◽

World Regions ◽

Emergency Medical ◽

Life Saving ◽

Mass Disasters

This is an editorial comment for Volume 1, Number 1. Medical disasters are “events in which the number of acutely ill or injured persons exceeds the capacity of the local emergency medical services (EMS) system to provide basic and advanced medical care according to prevalent regional standards.” There are multi-casualty incidents, such as transportation accidents, in which the local EMS system is overwhelmed; mass disasters, such as major earthquakes and wars, in which the local EMS system is severely damaged; and endemic disasters, such as combinations of famine, epidemics and revolutions which often occur in world regions without EMS systems. Nuclear war has become recognized as the “ultimate disaster” which is beyond disaster medicine systems' capacities to save lives. Military medicine, however, which is organized for “conventional” war, offers the maximal life-saving potential for mass disasters in peace time.

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