scholarly journals (A145) Simulation for the Assessment and Optimization of Medical Disaster Management

2011 ◽  
Vol 26 (S1) ◽  
pp. s41-s42
Author(s):  
E.L. Dhondt ◽  
F. Van utterbeek ◽  
C. Ullrich ◽  
M. Debacker
Keyword(s):  
Decision Making ◽  
Disaster Management ◽  
Disaster Response ◽  
Large Scale ◽  
Simulation Optimization ◽  
Mass Casualty ◽  
Optimization Techniques ◽  
Evidence Based ◽  
Outcome Indicators ◽  
Medical Response

BackgroundThe ultimate goal of medical disaster management must be to predictably orchestrate transition from “standard of care” to “sufficiency of care” using evidence-based methods. However, neither descriptive reports of disaster responses nor epidemiological studies investigating disaster risk factors have been able to provide validated outcome measures as to what constitutes a “good” disaster response. Moreover, it either has been considered impossible, ethically inappropriate, or both, to identify experimental and control groups essential for hypothesis testing for the conduct of scientific randomized controlled clinical trials.ObjectiveThe aim of this study was to identify a number of performance and outcome indicators and define optimal disaster response and management decision-making for various disaster scenarios using simulation optimization.Methods and ResultsA system model of medical disaster management was designed, and victim models and performance and outcome indicators were developed. Various mass-casualty and large-scale disaster scenarios were developed, including: (1) a hospital emergency incident/disaster; (2) a CBRNE incident; (3) an airplane crash and airport disaster; (4) a mass gathering; and (5) a military battlefield mass casualty. Using “Discrete Event Driven Simulation”, multiple replications were made for different decision-making modalities, different resource allocations, and different disaster response procedures. Statistical analysis and optimization techniques were applied to achieve the best available setting of parameters of the simulation model. In such a way, the “Medical Disaster Management Simulator” runs the “missing experimental studies” in a simplified artificial simulated disaster environment.ConclusionsSimulation optimization is an adequate tool for judging and evaluating the effectiveness and adequacy of health and relief services provided during disaster medical response. Evidence-based recommendations and codes of best practice were formulated for optimal medical disaster and military battlefield management in different large-scale event scenarios as well as for teaching, training, and research in medical disaster management.

scholarly journals The Role of Veterinarians in Mass Casualty Disasters: A Continuing Need for Integration to Disaster Management

2021 ◽  
Vol 9 ◽  
Author(s):  
Lindsey S. Holmquist ◽  
James Patrick O'Neal ◽  
Ray E. Swienton ◽  
Curtis A. Harris
Keyword(s):  
Disaster Management ◽  
Disaster Response ◽  
Clinical Skills ◽  
Healthcare Access ◽  
Mass Casualty ◽  
Effective Response ◽  
Medical Resources ◽  
Medical Response ◽  
Mass Casualty Events

The need to prepare veterinarians to serve as part of the disaster medical response for mass casualty incidents has been recognized since at least the 1960's. The potential value of incorporating veterinarians for mass casualty disaster response has been noted by organizations throughout the world. Clinical veterinarians are highly trained medical professionals with access to equipment, medications, and treatment capabilities that can be leveraged in times of crisis. The ongoing threat of disasters with the current widespread healthcare access barriers requires the disaster management community to address the ethical constraints, training deficiencies and legal limitations for veterinary medical response to mass casualty disasters. An ethical imperative exists for veterinarians with translatable clinical skills to provide care to humans in the event of a mass casualty disaster with insufficient alternative traditional medical resources. Though this imperative exists, there is no established training mechanism to prepare veterinarians for the provision of emergency medical care to humans. In addition, the lack of clear guidance regarding what legal protections exist for voluntary responders persists as a barrier to rapid and effective response of veterinarians to mass casualty disasters. Measures need to be undertaken at all levels of government to address and remove the barriers. Failure to do so reduces potentially available medical resources available to an already strained medical system during mass casualty events.

Disaster management mobile protocols: A technology that will save lives

2011 ◽  
Vol 6 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Hope M. Williamson, Major, USA, DNP, ACNP-BC, CCNS, CEN, NREMT
Keyword(s):  
Disaster Management ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Mobile Application ◽  
Healthcare Workers ◽  
Early Recognition ◽  
Diagnostic Procedures ◽  
Evidence Based ◽  
Medical Provider ◽  
Medical Response

Although training and education have long been accepted as integral to disaster preparedness, many currently taught practices are neither evidence based nor standardized.The need for effective evidence-based disaster education for healthcare workers at all levels in the multidisciplinary medical response to major events has been designated by the disaster response community as a high priority. This article describes a disaster management mobile application of systematic evidence-based practice. The application is interactive and comprises portable principles, algorithms, and emergency protocols that are agile, concise, comprehensive, and response relevant to all healthcare workers. Early recognition through clinical assessment versus laboratory and diagnostic procedures in chemical, biological, radiological, and nuclear (CBRNE) exposures grounded in an evidencebased skill set is especially important. During the immediate threat, the clinical diagnosis can get frustrating because CBRNE casualties can mimic everyday healthcare illnesses and initially present with nonspecific respiratory or flu-like symptoms. As there is minimal time in a catastrophic event for the medical provider to make accurate decisions, access to accurate, timely, and comprehensive information in these situations is critical. The CBRNE mobile application is intended to provide a credible source for treatment and management of numerous patients in an often intimidating environment with scarce resources and overwhelming tasks.

scholarly journals Code Orange: A Systematic Review of Psychosocial Disaster Response

2019 ◽  
Vol 34 (s1) ◽  
pp. s69-s70 ◽  
Author(s):  
Melissa B. Korman ◽  
Lauren Goldberg ◽  
Cailtin Klein ◽  
Marjan Khanjani ◽  
Gemma Cox ◽  
...  
Keyword(s):  
Disaster Response ◽  
Psychological Treatment ◽  
Data Extraction ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Free Text ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Mass Trauma ◽  
Disaster Situation

Introduction:Survivors of mass casualty incidents are vulnerable to both physical and psychological injuries. Hospitals need to triage the walking wounded victims, their loved ones, and witnesses for symptoms of emotional distress to ensure that those who are traumatized benefit from proactive psychological treatment. Hospitals must also manage the influx of searching family and friends, and be able to reunite them with their loved ones, to reduce chaos and prevent hospital skipping.Aim:To analyze previous research on institutional psychosocial disaster response, what has or has not worked, and lessons learned in order to develop evidence-based future planning suggestions.Methods:A literature search was conducted on the following electronic databases: (Medline 2007 to July 2018), (Embase 2007 to July 2018), (PsycInfo 2007 to July 2018). A combination of subject headings and free text keywords were used to perform the searches. After removing duplicates, abstracts were screened independently by two reviewers for the following inclusion criteria: 1) crisis intervention (in a disaster situation), 2) mention of psychosocial response or lack thereof and lessons learned, 3)relevant outcomes, 4) OECD countries, and 5) journal articles published 2007–Present. Review articles were excluded. Primary and secondary reviewers are in the process of discussing discrepancies. Data extraction will be conducted from all articles that meet the inclusion criteria. Key themes to be analyzed include psychological casualties, searching family and friends, and family reunification plans.Results:The initial search yielded 6,267 results. 5,294 articles remained after duplicates were removed. Of the 4,890 reviewed thus far, 269 articles met inclusion criteria.Discussion:Although a wealth of existing literature notes the need for an effective psychosocial response in mass trauma and disaster situations, no prior study has analyzed the efficacy of such interventions or laid out an evidence-based plan. This study will fill this much-needed gap in the literature.

scholarly journals Lessons from the Brussels Terrorist Attack

2019 ◽  
Vol 34 (s1) ◽  
pp. s91-s92
Author(s):  
Andreas Möhler
Keyword(s):  
Disaster Response ◽  
Terrorist Attack ◽  
Damage Control ◽  
Mass Casualty ◽  
Emergency Plan ◽  
War Injuries ◽  
Burn Care ◽  
Medical Response ◽  
Key Factor ◽  
Medical Teams

Introduction:On March 22, 2016, the capital of Europe was hit by two terrorist attacks. As terrorism becomes more and more violent, it is critical to learn and share experiences in order to enhance effectiveness in saving lives.Methods:A field perspective and experience feedback from the Emergency Medical Response.Results:The first attack hit the departure hall of the airport, which, due to its strategic role, relies upon a dedicated emergency plan. However, it focuses on airplane crashes and not on explosions in a crowded terminal. The second attack hit the subway at rush hour. An attack in such a confined environment is particularly challenging for the rescue teams, as injuries are worsened, access hindered, and exits numerous.Eleven medical teams were sent in order to perform triage and provide vital care. The medical response was organized by two disaster response teams. Advanced Medical Posts were set up and the mass casualty plans of all hospitals were activated. Managing war injuries for civilian teams was challenging. On-site care consisted essentially in prehospital damage control and burn care in order to ensure rapid evacuations for haemostatic surgery. 313 victims were dispatched to thirty hospitals. Another challenge was safety. Several threats were apparent and explosives were found on both sites. Lessons from Paris had prompted a review of our multiple sites Emergency Plan. One single way of communication was used and the evacuations were managed centrally. Finally, the key factor that helped limit the number of casualties was the acquaintanceship between emergency workers and non-medical teams built during exercises, allowing them to adapt and blend in as one team.Discussion:Lessons from previous attacks were crucial to improve our management of the medical response. These should be shared around, as another attack may always occur anywhere and at any time.

Mass-Casualty Triage: Time for an Evidence-Based Approach

2008 ◽  
Vol 23 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Jennifer Lee Jenkins ◽  
Melissa L. McCarthy ◽  
Lauren M. Sauer ◽  
Gary B. Green ◽  
Stephanie Stuart ◽  
...  
Keyword(s):  
Reliability And Validity ◽  
Mass Casualty ◽  
Ease Of Use ◽  
Future Research ◽  
Evidence Based ◽  
Infectious Agents ◽  
Research Priority ◽  
Medical Response ◽  
Rapid Transport ◽  
Triage Algorithm

AbstractMass-casualty triage has developed from a wartime necessity to a civilian tool to ensure that constrained medical resources are directed at achieving the greatest good for the most number of people. Several primary and secondary triage tools have been developed, including Simple Treatment and Rapid Transport (START), JumpSTART, Care Flight Triage, Triage Sieve, Sacco Triage Method, Secondary Assessment of Victim Endpoint (SAVE), and Pediatric Triage Tape. Evidence to support the use of one triage algorithm over another is limited, and the development of effective triage protocols is an important research priority. The most widely recognized mass-casualty triage algorithms in use today are not evidence-based, and no studies directly address these issues in the mass-casualty setting. Furthermore, no studies have evaluated existing mass-casualty triage algorithms regarding ease of use, reliability, and validity when biological, chemical, or radiological agents are introduced. Currently, the lack of a standardized mass-casualty triage system that is well validated, reliable, and uniformly accepted, remains an important gap. Future research directed at triage is recognized as a necessity, and the development of a practical, universal, triage algorithm that incorporates requirements for decontamination or special precautions for infectious agents would facilitate a more organized mass-casualty medical response.

scholarly journals A Framework for Evidence-Based Decision Making in Large-Scale Food Fortification Programs

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1802-1802
Author(s):  
Valerie Friesen ◽  
Mduduzi Mbuya ◽  
Lynnette Neufeld ◽  
Frank T Weiringa
Keyword(s):  
Decision Making ◽  
Large Scale ◽  
Program Design ◽  
Decision Makers ◽  
Evidence Based ◽  
Food Fortification ◽  
Impact Pathway ◽  
Gates Foundation ◽  
The Impact ◽  
Evidence Based Decision Making

Abstract Objectives The use of evidence on program performance and potential for impact for decision making in food fortification programs is limited and often done in isolation from other micronutrient interventions. We present a framework for fortification stakeholders responsible for making program recommendations and decisions to facilitate and document evidence-based decision making. Methods First, we reviewed the literature to define the key decision makers and decisions necessary for effective fortification program design and delivery, informed by a clear impact pathway. Then we classified decisions by domain, identified data sources and criteria for their assessment, and adapted the GRADE Evidence to Decision framework to summarize the results. Finally, we considered how the framework would apply to different country programs to test its utility. Results Policymakers, particularly government ministries, and the food producers themselves are the most important decision makers in a fortification program, while technical support agencies, donor agencies, and the research community play important roles in translating data and evidence into contextualized recommendations that meet the needs of different decision makers. The main fortification decision types were classified into five domains across the impact pathway: 1) program design (need, food vehicle(s)); 2) program delivery (compliance, quality, coverage); 3) program impact (nutrient intake and status); 4) overlapping micronutrient interventions and/or under-served populations; and 5) decisions to continue or stop programs. Important criteria for the assessment of each decision type included priority, benefits/risks, equity, acceptability, and feasibility among others. Country examples illustrated the importance of coordinating decision-making in the context of overlapping micronutrient interventions to ensure continued safety and impact over time. Conclusions This framework is a practical tool to enable evidence-based decision making by fortification stakeholders. Using evidence in a systematic and transparent way can enable more effective program design, delivery, and ultimately health impacts. Funding Sources Bill & Melinda Gates Foundation.

A Framework of Simulation and Gaming for Enhancing Community Resilience Against Large-Scale Earthquakes: Application for Achievements in Japan

2020 ◽  
Vol 51 (2) ◽  
pp. 180-211
Author(s):  
Yusuke Toyoda
Keyword(s):  
Decision Making ◽  
Adaptive Capacity ◽  
Disaster Management ◽  
Large Scale ◽  
Critical Reflection ◽  
Community Resilience ◽  
The Other ◽  
Community Based ◽  
Mutual Help ◽  
Disastrous Experience

Background. The significance of mutual-help in communities for disaster management is a fundamental important concept. However, the current societal state does not reflect this lesson. S&G (Simulation and Gaming) has the potential to overcome the challenges faced in promoting community-based disaster management. No scientific research is currently present that reviews their achievements in Japan. Aim. This paper analyzes the current achievements of S&G in enhancing community resilience against large-scale earthquakes in Japan. Method. The paper clarifies the theoretical advantages of S&G in enhancing community resilience in coping and adaptive capacity plus proposes a conceptual contribution framework of S&G in improving community resilience. Based on this framework, the paper analyzes some major games that tackle community resilience against earthquakes in Japan. Results. The paper demonstrates the achievements through the S&G spectrum that stresses the disastrous experience with specific resilience views on one side, while decision making for critical reflection from other players with more comprehensive resilience views on the other side. Conclusion. The paper showcases the current S&G achievements in enhancing community resilience against large-scale earthquakes in Japan using the proposed framework, which can be utilized by other disaster-prone countries to develop and evaluate applications of S&G for increasing community resilience against earthquakes.

scholarly journals Ethical Decision-Making in Humanitarian Medicine: How Best to Prepare?

2020 ◽  
pp. 1-5
Author(s):  
Kadri Simm
Keyword(s):  
Decision Making ◽  
Disaster Response ◽  
Ethical Decision ◽  
Time Pressure ◽  
Ethical Decision Making ◽  
Practical Importance ◽  
Ethics Training ◽  
Medical Professionals ◽  
Medical Response

ABSTRACT Ethical decision-making during humanitarian medical response is a topic of great moral as well as practical importance. The context of humanitarian disasters, often characterized by acute time-pressure, lack of resources, the unfamiliarity of circumstances, is stressful for medical professionals. The overall aim of this article is pragmatic, to introduce briefly the importance and context for preparing medical disaster response personnel for ethical decision-making and then to provide a discussion case and explain the particular value-reflection methodology. The focus of methodology is on providing space for the emotional and stressful aspects of ethics training for disasters.

Analysis of Description of Local Disaster Management Plan for Smooth and EffectiveWide-Area Support System During Large-Scale Disaster

2012 ◽  
Vol 7 (2) ◽  
pp. 147-159 ◽  
Author(s):  
Muneyoshi Numada ◽  
◽  
Shinya Kondo ◽  
Masashi Inoue ◽  
Kimiro Meguro ◽  
...  
Keyword(s):  
Disaster Management ◽  
Local Governments ◽  
Disaster Response ◽  
Large Scale ◽  
Management Plan ◽  
Wide Area ◽  
System A ◽  
Management Plans ◽  
Hyogo Prefecture ◽  
Cooperation System

This paper gives attention to the phase of safety of work in wide-area support and considers differences in description in local disaster management plans drafted by supporting local governments and supported ones, assuming that standardization of such descriptions could bring more smooth and effective implementation of plans. This paper targets desirable directions toward arrangement for a highly effective wide-area cooperation system. A framework is introduced in examining on what wide-area support should be like, referring to previous studies on actual situation of the support at the time of the 1995 Southern Hyogo Prefecture Earthquake and of the 2004Mid Niigata Prefecture Earthquake. Then the disaster response activities in wide-area support are examines and local disaster management plans among different local governments are compared and differences in descriptions in plans. Necessary information for supporting sides and introduces the exchange of opinions with Kawasaki City that stood on the supporting side after the 2011 Great East Japan Earthquake is discussed. To make cooperation among the Japanese Government, prefectures, and municipalities more effective, the description of local disaster management plans should be standardized to some degree.

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