scholarly journals Tracking Patients in an Earthquake Response: The Bad, the Better, and the Best

2019 ◽  
Vol 34 (s1) ◽  
pp. s88-s88
Author(s):  
Paula Grainger
Keyword(s):  
Human Resources ◽  
Mass Casualty ◽  
Care Provision ◽  
Coordinated Care ◽  
Patient Tracking ◽  
Digital Paper ◽  
Number Systems ◽  
Minimum Data ◽  
Mass Casualty Event ◽  
National Implementation

Introduction:Tracking patients through health systems is fundamental to coordinated care provision. However, it is an inconsistent element of emergency preparedness. This presentation presents findings of a study undertaken after the 2011 Christchurch Earthquake, and the resultant nationally implemented changes.Aim:The intent was to investigate options to improve patient tracking in a mass casualty event. By looking at one scenario involving a mass casualty presentation with the central responder disabled by electricity loss, standards of practice were outlined and made scalable to meet the needs of various events.Methods:Clinical and clerical staff involved in the event’s patient tracking were interviewed. Data were analyzed using thematic analysis and reported using the structure, process, and outcomes framework.1Results:Structures were material and human resources. Material resources were identification number systems, technological requirements, disaster-specific documents, minimum data for entry, digital/paper/hybrid registration systems, and digital-paper integration. Human resources were role allocation, and familiarity of plans, roles, processes, tools, and facilities. Process identified the activities to manage unidentified patients, triage, registration, and ongoing tracking processes. Outcomes were management of patient flow, patient-care provision, and patient-family reunification.Initial implementation was local. Structures and processes were agreed upon, with varying response levels according to the incident scope, while staying as close to business as usual for familiarity. National implementation followed via a Ministry of Health working group involving different district health boards. The group developed a consensus on the minimum data to be entered and the process to merge patient identities of initially unidentified patients. Written tools were shared for standardization.Discussion:With inter-agency and inter-organization emergency response, standardized processes and information are required. Collaboration prior to events can mitigate issues when an event occurs.

Non-Pediatric Nurses’ Willingness to Provide Care to Pediatric Patients during a Disaster: An Assessment of Pediatric Surge Capacity in Four Midwestern Hospitals

2021 ◽  
pp. 1-6
Author(s):  
Terri Rebmann ◽  
Rachel L. Charney ◽  
Rebecca L. Eschmann ◽  
M. Colleen Fitzpatrick
Keyword(s):  
Pediatric Patients ◽  
Response Rate ◽  
Mass Casualty ◽  
Pediatric Care ◽  
Pediatric Nurses ◽  
Surge Capacity ◽  
Factors Associated ◽  
Pediatric Hospitals ◽  
Survey Response Rate ◽  
Mass Casualty Event

Abstract Objective: To assess non-pediatric nurses’ willingness to provide care to pediatric patients during a mass casualty event (MCE). Methods: Nurses from 4 non-pediatric hospitals in a major metropolitan Midwestern region were surveyed in the fall of 2018. Participants were asked about their willingness to provide MCE pediatric care. Hierarchical logistical regression was used to describe factors associated with nurses’ willingness to provide MCE pediatric care. Results: In total, 313 nurses were approached and 289 completed a survey (response rate = 92%). A quarter (25.3%, n = 73) would be willing to provide MCE care to a child of any age; 12% (n = 35) would provide care only to newborns in the labor and delivery area, and 16.6% (n = 48) would only provide care to adults. Predictors of willingness to provide care to a patient of any age during an MCE included providing care to the youngest-age children during routine duties, reporting confidence in calculating doses and administering pediatric medications, working in the emergency department, being currently or previously certified in PALS, and having access to pediatric-sized equipment in the unit or hospital. Conclusion: Pediatric surge capacity is lacking among nurses. Increasing nurses’ pediatric care self-efficacy could improve pediatric surge capacity and minimize morbidity and mortality during MCEs.

Postexposure Interventions to Prevent Infection With HBV, HCV, or HIV, and Tetanus in People Wounded During Bombings and Other Mass Casualty Events—United States, 2008: Recommendations of the Centers for Disease Control and Prevention and Disaster Medicine and Public Health Preparedness

2008 ◽  
Vol 2 (3) ◽  
pp. 150-165 ◽  
Author(s):  
Louisa E. Chapman ◽  
Ernest E. Sullivent ◽  
Lisa A. Grohskopf ◽  
Elise M. Beltrami ◽  
Joseph F. Perz ◽  
...  
Keyword(s):  
Public Health ◽  
Disease Control ◽  
Emergency Response ◽  
Mass Casualty ◽  
Acute Injury ◽  
Mass Casualties ◽  
Public Health Preparedness ◽  
Mass Casualty Event ◽  
Public Health Officials ◽  
Centers For Disease Control

ABSTRACTPeople wounded during bombings or other events resulting in mass casualties or in conjunction with the resulting emergency response may be exposed to blood, body fluids, or tissue from other injured people and thus be at risk for bloodborne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass casualty event. Decisions regarding the implementation of prophylaxis are complex, and drawing parallels from existing guidelines is difficult. For any prophylactic intervention to be implemented effectively, guidance must be simple, straightforward, and logistically undemanding. Critical review during development of this guidance was provided by representatives of the National Association of County and City Health Officials, the Council of State and Territorial Epidemiologists, and representatives of the acute injury care, trauma, and emergency response medical communities participating in the Centers for Disease Control and Prevention’s Terrorism Injuries: Information, Dissemination and Exchange project. The recommendations contained in this report represent the consensus of US federal public health officials and reflect the experience and input of public health officials at all levels of government and the acute injury response community. (Disaster Med Public Health Preparedness. 2008;2:150–165)

Computerization of patient tracking and tracing during mass casualty incidents

2000 ◽  
Vol 7 (3) ◽  
pp. 211-216 ◽  
Author(s):  
J. H. BOUMAN ◽  
R. J. SCHOUWERWOU ◽  
K. J. VAN DER EIJK ◽  
A. J. VAN LEUSDEN ◽  
T. J.F. SAVELKOUL
Keyword(s):  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Patient Tracking

Analysis of Emergency Health Care Workforce and Service Readiness for a Mass Casualty Event in the Republic of Ireland

2018 ◽  
Vol 13 (02) ◽  
pp. 243-255 ◽  
Author(s):  
Tener Goodwin Veenema ◽  
Fiona Boland ◽  
Declan Patton ◽  
Tom O’Connor ◽  
Zena Moore ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Response ◽  
Large Scale ◽  
Mass Casualty ◽  
Republic Of Ireland ◽  
Emergency Responders ◽  
Mass Casualty Event ◽  
Service Readiness ◽  
The Republic ◽  
Professional Disciplines

ABSTRACTObjectiveUltimately, a country’s capacity for a large-scale major emergency response will be directly related to the competence of its health care provider (HCP) workforce and communication between emergency responders and hospitals. The purpose of this study was to assess HCP preparedness and service readiness for a major emergency involving mass casualties (mass casualty event or MCE) in Ireland.MethodsA cross-sectional study using a 53-item survey was administered to a purposive sample of emergency responders and HCPs in the Republic of Ireland. Data collection was achieved using the Qualtrics® Research Suite. Descriptive statistics and appropriate tests of comparison between professional disciplines were conducted using Stata 13.ResultsA total of 385 respondents, registered nurses (43.4%), paramedics (37.9%), medical doctors (10.1%), and administrators/managers (8.6%), participated in the study. In general, a level of knowledge of MCEs and knowledge of clinical response activities and self-assessed clinical competence varied drastically across many aspects of the survey. Knowledge and confidence also varied across professional disciplines (P<0.05) with nurses, in general, reporting the least knowledge and/or confidence.ConclusionsThe results demonstrate that serious deficits exist in HCP knowledge, skills, and self-perceived abilities to participate in a large-scale MCE. Results also suggest a poor knowledge base of existing major emergency response plans. (Disaster Med Public Health Preparedness. 2019;13:243–255)

scholarly journals (A284) Improving Hospital Mass Casualty Preparedness through Ongoing Readiness Evaluation

2011 ◽  
Vol 26 (S1) ◽  
pp. s79-s79
Author(s):  
B. Adini ◽  
D. Laor ◽  
T. Hornik-Luria ◽  
A. Goldberg ◽  
D. Schwartz ◽  
...  
Keyword(s):  
Acute Care ◽  
Emergency Preparedness ◽  
Life Experience ◽  
Real Life ◽  
High Standard ◽  
Acute Care Hospitals ◽  
Mass Casualty ◽  
Evaluation Tool ◽  
Effective Response ◽  
Mass Casualty Event

BackgroundIsraeli Hospitals are required to maintain a high level of emergency preparedness.ObjectivesTo investigate the effect of on-going use of an evaluation tool on acute-care hospitals' emergency preparedness for mass casualty events (MCE).MethodsEvaluation of emergency preparedness for MCE was carried out in all acute-care hospitals, based on an evaluation tool consisting of 306 objective and measurable parameters. Two cycles of evaluations were conducted in 2005 to 2009 and the scores were calculated to detect differences.ResultsA significant increase was found in the mean total scores of emergency preparedness between the two cycles of evaluations (from 77.1 to 88.5). An increase was found in scores for standard operating procedures, training and equipment, but the change was significant only in the training category. The relative increase was highest in hospitals that did not experience real MCE.DiscussionThis study offers a structured and practical approach for ongoing improvement of emergency preparedness, based on validated measurable benchmarks. An ongoing assessment of the level of emergency preparedness motivates hospitals' management and staff to improve their capabilities and thus results in a more effective response mechanism for emergency scenarios.ConclusionsUtilization of predetermined and measurable benchmarks allows the institutions being assessed to improve their level of performance in the evaluated areas. The expectation is that these benchmarks will allow for a better response to actual MCEs. The study further demonstrated that even hospitals without “real-life” experience can gear up using preset benchmarks and reach a high standard of mass casualty event preparedness.

scholarly journals Is definitive vascular reconstruction of carotid arteries justified during a mass casualty event?

Injury Extra ◽  
2007 ◽  
Vol 38 (5) ◽  
pp. 182-186
Author(s):  
Yair Edden ◽  
Anat Globerman ◽  
Amir Elami ◽  
Jean-Yves Sichel ◽  
Chen Rubinstein ◽  
...  
Keyword(s):  
Carotid Arteries ◽  
Vascular Reconstruction ◽  
Mass Casualty ◽  
Mass Casualty Event

A Burn Mass Casualty Event Due to Boiler Room Explosion on a Cruise Ship: Preparedness and Outcomes

2005 ◽  
Vol 71 (3) ◽  
pp. 210-215 ◽  
Author(s):  
Akin Tekin ◽  
Nicholas Namias ◽  
Terence O'Keeffe ◽  
Louis Pizano ◽  
Mauricio Lynn ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Mass Casualty ◽  
Cruise Ship ◽  
Post Traumatic Stress ◽  
Trauma Resuscitation ◽  
Burn Center ◽  
Mass Casualty Event ◽  
Boiler Room ◽  
Abdominal Compartment

The purpose of this study was to review our experience with a mass casualty incident resulting from a boiler room steam explosion aboard a cruise ship. Experience with major, moderate, and minor burns, steam inhalation, mass casualty response systems, and psychological sequelae will be discussed. Fifteen cruise ship employees were brought to the burn center after a boiler room explosion on a cruise ship. Eleven were triaged to the trauma resuscitation area and four to the surgical emergency room. Seven patients were intubated for respiratory distress or airway protection. Six patients had >80 per cent burns with steam inhalation, and all of these died. One of the 6 patients had 99 per cent burns with steam inhalation and died after withdrawal of support within the first several hours. All patients with major burns required escharotomy on arrival to trauma resuscitation. One patient died in the operating room, despite decompression by laparotomy for abdominal compartment syndrome and pericardiotomy via thoracotomy for cardiac tamponade. Four patients required crystalloid, 20,000 mls/m2–27,000 ml/m2 body surface area (BSA) in the first 48 hours to maintain blood pressure and urine output. Three of these four patients subsequently developed abdominal compartment syndrome and died in the first few days. The fourth patient of this group died after 26 days due to sepsis. Five patients had 13–20 per cent burns and four patients had less than 10 per cent burns. Two of the patients with 20 per cent burns developed edema of the vocal cords with mild hoarseness. They improved and recovered without intubation. The facility was prepared for the mass casualty event, having just completed a mass casualty drill several days earlier. Twenty-six beds were made available in 50 minutes for anticipated casualties. Fifteen physicians reported immediately to the trauma resuscitation area to assist in initial stabilization. The event occurred at shift change; thus, adequate support personnel were instantaneously to hand. Our mass casualty preparation proved useful in managing this event. Most of the patients who survived showed signs of post-traumatic stress syndrome, which was diagnosed and treated by the burn center psychology team. Despite our efforts at treating large burns (>80%) with steam inhalation, mortality was 100 per cent. Fluid requirements far exceeded those predicted by the Parkland (Baxter) formula. Abdominal compartment syndrome proved to be a significant complication of this fluid resuscitation. A coordinated effort by the facility and preparation for mass casualty events are needed to respond to such events.

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