scholarly journals Ensuring Emergency Preparedness through Systematic Evaluations

2019 ◽  
Vol 34 (s1) ◽  
pp. s76-s76
Author(s):  
Gila Margalit ◽  
Orna Rachaminov ◽  
Yuval Levy ◽  
Bruria Adini ◽  
Amir Grinberg
Keyword(s):  
Emergency Preparedness ◽  
Trauma Center ◽  
Mass Casualty ◽  
Home Front ◽  
Administrative Professionals ◽  
Emergency Scenarios ◽  
High Level ◽  
Relative Change ◽  
Chemical Incidents ◽  
The Impact

Introduction:Hospitals are required to maintain emergency preparedness 24/7. In order to maintain readiness, Israeli hospitals operate Emergency Committees comprised of medical, nursing, and administrative professionals who are responsible for capacity building including the development of plans, infrastructure, equipment, training, crisis management, and learning lessons. The Ministry of Health (MOH) and Home Front Command (HFC) conduct a comprehensive, structured evaluation of emergency preparedness in every hospital every two to three years.Aim:To assess the impact of a periodical evaluation on levels of emergency preparedness over time in a level one trauma center.Methods:Evaluation of emergency preparedness is conducted by approximately 12 evaluators from the MOH and HFC, encompassing mass casualty incidents (MCIs), mass toxicological/chemical incidents (MTEs), radiological and biological events, earthquakes and conflicts. Evaluations are based on objective parameters, relayed to hospitals prior to the evaluation. The hospital’s level of emergency preparedness is graded and improvements that must be implemented are delineated. The grades of four evaluations conducted from 2011 to 2018 were compared to identify trends in preparedness.Results:Mean levels of emergency preparedness in the 2018 versus 2011 evaluations presented an increase concerning all threats, including MCIs (92 vs. 90), MTEs (99 vs. 77, respectively), biological events (96 vs. 73, respectively), radiological events (91 vs. 79), earthquakes (87 vs. 60, respectively), and conflicts (95 vs. 74). The relative change in levels of preparedness was more noted concerning biological events and earthquakes.Discussion:A periodical evaluation by governing authorities seems to motivate the hospital’s administrations to invest efforts in building and maintain a high level of emergency preparedness. Systematic evaluations conducted bi-annually contributed to improved readiness for diverse emergency scenarios, including for threats that less frequently materialize.

Evaluating the impact of decontamination interventions performed in sequence for mass casualty chemical incidents

2021 ◽  
Author(s):  
Samuel Collins ◽  
Natalie Williams ◽  
Felicity Southworth ◽  
Thomas James ◽  
Louise Davidson ◽  
...  
Keyword(s):  
Vegetable Oil ◽  
Methyl Salicylate ◽  
Emergency Services ◽  
Mass Casualty ◽  
Human Volunteer ◽  
Additional Contribution ◽  
Uv Photography ◽  
Chemical Incidents ◽  
The Impact ◽  
Control Skin

Abstract The Initial Operational Response (IOR) to chemical incidents is a suite of rapid strategies including evacuation, disrobe and improvised and interim decontamination. IOR and Specialist Operational Response (SOR) decontamination protocols involving mass decontamination units would be conducted in sequence by UK emergency services following a chemical incident, to allow for safe onward transfer of casualties. As part of a series of human volunteer studies, we examined the effectiveness of IOR and SOR decontamination procedures alone and in sequence. Specifically, we evaluated the additional contribution of SOR, when following improvised and interim decontamination. Two simulants, methyl salicylate (MeS) with vegetable oil and benzyl salicylate (BeS), were applied to participants’ skin. Participants underwent improvised dry, improvised wet, interim wet, specialist decontamination and a no decontamination control. Skin analysis and UV photography indicated significantly lower levels of both simulants remaining following decontamination compared to controls. There were no significant differences in MeS levels recovered between decontamination conditions. Analysis of BeS, a more persistent simulant than MeS, showed that recovery from skin was significantly reduced following combined IOR with SOR than IOR alone. These results show modest additional benefits of decontamination interventions conducted in sequence, particularly for persistent chemicals, supporting current UK operational procedures.

scholarly journals (P2-82) Developing and Implementing an Emergency Preparedness and Trauma Research Program in a New Level One Trauma Center

2011 ◽  
Vol 26 (S1) ◽  
pp. s163-s163
Author(s):  
T.E. Rives ◽  
C. Hecht ◽  
A. Wallace ◽  
R. Gandhi
Keyword(s):  
Emergency Preparedness ◽  
Trauma Center ◽  
Emergency Services ◽  
Mass Casualty ◽  
Senior Executives ◽  
Research Administration ◽  
Trauma Research ◽  
Uninsured Patient ◽  
Research Relationship ◽  
Trauma Surgeons

Our level one trauma center with a service area covering a population of approximately four-million people treats approximately 80,000 patients per year. In 2010, we anticipate more than 23,000 patients admitted, and to experience more than 850,000 patient encounters within the network. Trauma research is an important component to any level one trauma center, as well as a requirement of the American College of Surgeons/Committee on Trauma (ACS/COT). Our trauma center has recently gained level one designation and began an emergency preparedness research and trauma research (EPR/TR) program in earnest. We are fortunate to have support from executive administrators. Stewardship is a necessary element of our planning, in part because we are a county hospital serving a large uninsured patient population. The following are a few of the necessary steps we took to build an (EPR/TR) department from the beginning, to the point of submitting abstracts, manuscripts, funding grants, and presentations to regional, national, and international conferences, journals, and agencies. Structure the Emergency Preparedness Office to be a component of Trauma Services, allowing a unique opportunity for real-time disaster and mass casualty research. Secure a commitment from senior executives. Secure an experienced researcher, capable of research administration. Ensure the (EPR/TR) director, trauma medical director, trauma services director, and emergency preparedness coordinator can be a cohesive team with complimentary skills. Encourage trauma surgeons to perform research with assistance from the (EPR/TR) Office. Seek federal and foundation funding. Seek alliances with appropriate consortiums and associations. Develop a research relationship with pre-hospital emergency services. The above steps represent only some of the components used to build our (EPR/TR) department. We anticipate the planned expansion of the above steps will take our EPR/TR to the next level and increase extramural funding.

scholarly journals Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

2020 ◽  
Vol 17 (7) ◽  
pp. 2385
Author(s):  
Maya Siman-Tov ◽  
Benny Davidson ◽  
Bruria Adini
Keyword(s):  
Emergency Preparedness ◽  
Geographical Location ◽  
Evaluation Process ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Medical Facilities ◽  
Potential Risks ◽  
The Impact ◽  
And Training ◽  
Secondary Contamination

Background: A mass casualty incident (MCI) caused by toxicological/chemical materials constitutes a potential though uncommon risk that may cause great devastation. Presentation of casualties exposed to such materials in hospitals, if not immediately identified, may cause secondary contamination resulting in dysfunction of the emergency department. The study examined the impact of a longitudinal evaluation process on the ongoing emergency preparedness of hospitals for toxicological MCIs, over a decade. Methods: Emergency preparedness for toxicological incidents of all Israeli hospitals were periodically evaluated, over ten years. The evaluation was based on a structured tool developed to encourage ongoing preparedness of Standard Operating Procedures (SOPs), equipment and infrastructure, knowledge of personnel, and training and exercises. The benchmarks were distributed to all hospitals, to be used as a foundation to build and improve emergency preparedness. Scores were compared within and between hospitals. Results: Overall mean scores of emergency preparedness increased over the five measurements from 88 to 95. A significant increase between T1 (first evaluation) and T5 (last evaluation) occurred in SOPs (p = 0.006), training and exercises (p = 0.003), and in the overall score (p = 0.004). No significant changes were found concerning equipment and infrastructure and knowledge; their scores were consistently very high throughout the decade. An interaction effect was found between the cycles of evaluation and the hospitals’ geographical location (F (1,20) = 3.0, p = 0.056), proximity to other medical facilities (F (1,20) = 10.0 p = 0.005), and type of area (Urban vs. Periphery) (F (1,20) = 13.1, p = 0.002). At T5, all hospitals achieved similar high scores of emergency preparedness. Conclusions: Use of accessible benchmarks, which clearly delineate what needs to be continually implemented, facilitates an ongoing sustenance of effective levels of emergency preparedness. As this was demonstrated for a risk that does not frequently occur, it may be assumed that it is possible and practical to achieve and maintain emergency preparedness for other potential risks.

scholarly journals Evaluating the impact of decontamination interventions performed in sequence for mass casualty chemical incidents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Samuel Collins ◽  
Natalie Williams ◽  
Felicity Southworth ◽  
Thomas James ◽  
Louise Davidson ◽  
...  
Keyword(s):  
Vegetable Oil ◽  
Methyl Salicylate ◽  
Emergency Services ◽  
Mass Casualty ◽  
Additional Contribution ◽  
Uv Photography ◽  
Chemical Incidents ◽  
The Impact ◽  
First Time ◽  
Control Skin

AbstractThe Initial Operational Response (IOR) to chemical incidents is a suite of rapid strategies including evacuation, disrobe and improvised and interim decontamination. IOR and Specialist Operational Response (SOR) decontamination protocols involving mass decontamination units would be conducted in sequence by UK emergency services following a chemical incident, to allow for safe onward transfer of casualties. As part of a series of human volunteer studies, we examined for the first time, the effectiveness of UK IOR and SOR decontamination procedures alone and in sequence. Specifically, we evaluated the additional contribution of SOR, when following improvised and interim decontamination. Two simulants, methyl salicylate (MeS) with vegetable oil and benzyl salicylate (BeS), were applied to participants’ skin. Participants underwent improvised dry, improvised wet, interim wet, specialist decontamination and a no decontamination control. Skin analysis and UV photography indicated significantly lower levels of both simulants remaining following decontamination compared to controls. There were no significant differences in MeS levels recovered between decontamination conditions. Analysis of BeS, a more persistent simulant than MeS, showed that recovery from skin was significantly reduced following combined IOR with SOR than IOR alone. These results show modest additional benefits of decontamination interventions conducted in sequence, particularly for persistent chemicals, supporting current UK operational procedures.

Mass Casualty following Unprecedented Tornadic Events in the Southeast: Natural Disaster Outcomes at a Level I Trauma Center

2012 ◽  
Vol 78 (7) ◽  
pp. 770-773 ◽  
Author(s):  
Elizabeth H. Hartmann ◽  
Nathan Creel ◽  
Jacob Lepard ◽  
Robert A. Maxwell
Keyword(s):  
Soft Tissue ◽  
Length Of Stay ◽  
Emergency Preparedness ◽  
Trauma Center ◽  
Average Length ◽  
Mass Casualty ◽  
Incident Command ◽  
Trauma Service ◽  
Large Patient ◽  
Level I

On April 27, 2011, an EF4 (enhanced Fujita scale) tornado struck a 48-mile path across northwest Georgia and southeast Tennessee. Traumatic injuries sustained during this tornado and others in one of the largest tornado outbreaks in history presented to the regional Level I trauma center, Erlanger Health System, in Chattanooga, TN. Patients were triaged per mass casualty protocols through an incident command center and triage officer. Medical staffing was increased to anticipate a large patient load. Records of patients admitted as a result of tornado-related injury were retrospectively reviewed and characterized by the injury patterns, demographics, procedures performed, length of stay, and complications. One hundred four adult patients were treated in the emergency department; of these, 28 (27%) patients required admission to the trauma service. Of those admitted, 16 (57%) were male with an age range of 21 to 87 years old and an average length of stay of 10.9 ± 11.8 days. Eleven (39%) patients required intensive care unit admissions. The most common injuries seen were those of soft tissue, bony fractures, and the chest. Interventions included tube thoracostomies, exploratory laparotomies, orthopedic fixations, soft tissue reconstructions, and craniotomy. All 28 patients admitted survived to discharge. Nineteen (68%) patients were discharged home, six (21%) went to a rehabilitation hospital, and three (11%) were transferred to skilled nursing facilities. Emergency preparedness and organization are key elements in effectively treating victims of natural disasters. Those victims who survive the initial tornadic event and present to a Level I trauma center have low mortality. Like in our experience, triage protocols need to be implemented to quickly and effectively manage mass injuries.

Assessing Levels of Hospital Emergency Preparedness

2006 ◽  
Vol 21 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Bruria Adini ◽  
Avishay Goldberg ◽  
Danny Laor ◽  
Robert Cohen ◽  
Roni Zadok ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Acute Stress ◽  
Objective Assessment ◽  
Mass Casualty ◽  
Assessment Tools ◽  
Stress Reactions ◽  
Emergency Plan ◽  
Effective Response ◽  
Contingency Plans ◽  
High Level

AbstractIntroduction:Emergency preparedness can be defined by the preparedness pyramid, which identifies planning, infrastructure, knowledge and capabilities, and training as the major components of maintaining a high level of preparedness.The aim of this article is to review the characteristics of contingency plans for mass-casualty incidents (MCIs) and models for assessing the emergency preparedness of hospitals.Characteristics of Contingency Plans:Emergency preparedness should focus on community preparedness, a personnel augmentation plan, and communications and public policies for funding the emergency preparedness. The capability to cope with a MCI serves as a basis for preparedness for non-conventional events. Coping with chemical casualties necessitates decontamination of casualties, treating victims with acute stress reactions, expanding surge capacities of hospitals, and integrating knowledge through drills. Risk communication also is important.Assessment of Emergency Preparedness:An annual assessment of the emergency plan is required in order to assure emergency preparedness. Preparedness assessments should include: (1) elements of disaster planning; (2) emergency coordination; (3) communication; (4) training; (5) expansion of hospital surge capacity; (6) personnel; (7) availability of equipment; (8) stockpiles of medical supplies; and (9) expansion of laboratory capacities. The assessment program must be based on valid criteria that are measurable, reliable, and enable conclusions to be drawn. There are several assessment tools that can be used, including surveys, parameters, capabilities evaluation, and self-assessment tools.Summary:Healthcare systems are required to prepare an effective response model to cope with MCIs. Planning should be envisioned as a process rather than a production of a tangible product. Assuring emergency preparedness requires a structured methodology that will enable an objective assessment of the level of readiness.

ПРАГМАТИЧНИЙ ПОТЕНЦІАЛ НАТИВНОЇ РЕКЛАМИ: ФОРМИ, ТРЕНДИ (НА ПРИКЛАДІ НАТИВНОГО КОНТЕНТУ В СОЦІАЛЬНІЙ МЕРЕЖІ FACEBOOK ЩОДО БРЕНДА ФАКУЛЬТЕТУ ЖУРНАЛІСТИКИ ЗНУ)

2020 ◽  
pp. 113
Author(s):  
V. Kovpak ◽  
N. Trotsenko
Keyword(s):  
Social Network ◽  
Professional Training ◽  
Educational Process ◽  
Communication Strategy ◽  
Student Centered ◽  
Teacher Student ◽  
The Social ◽  
National University ◽  
High Level ◽  
The Impact

<div><p><em>The article analyzes the peculiarities of the format of native advertising in the media space, its pragmatic potential (in particular, on the example of native content in the social network Facebook by the brand of the journalism department of ZNU), highlights the types and trends of native advertising. The following research methods were used to achieve the purpose of intelligence: descriptive (content content, including various examples), comparative (content presentation options) and typological (types, trends of native advertising, in particular, cross-media as an opportunity to submit content in different formats (video, audio, photos, text, infographics, etc.)), content analysis method using Internet services (using Popsters service). And the native code for analytics was the page of the journalism department of Zaporizhzhya National University on the social network Facebook. After all, the brand of the journalism department of Zaporozhye National University in 2019 celebrates its 15th anniversary. The brand vector is its value component and professional training with balanced distribution of theoretical and practical blocks (seven practices), student-centered (democratic interaction and high-level teacher-student dialogue) and integration into Ukrainian and world educational process (participation in grant programs).</em></p></div><p><em>And advertising on social networks is also a kind of native content, which does not appear in special blocks, and is organically inscribed on one page or another and unobtrusively offers, just remembering the product as if «to the word». Popsters service functionality, which evaluates an account (or linked accounts of one person) for 35 parameters, but the main three areas: reach or influence, or how many users evaluate, comment on the recording; true reach – the number of people affected; network score – an assessment of the audience’s response to the impact, or how far the network information diverges (how many share information on this page).</em></p><p><strong><em>Key words:</em></strong><em> nativeness, native advertising, branded content, special project, communication strategy.</em></p>

THE IMPACT OF UKRAINE'S EXCISE DUTY POLICY ON THE TRANSFORMATION PROCESSES OF THE TOBACCO MARKET

2020 ◽  
Vol 2020 (10) ◽  
pp. 19-33
Author(s):  
Nadiia NOVYTSKA ◽  
◽  
Inna KHLIEBNIKOVA ◽  
Keyword(s):  
Structural Changes ◽  
Tax Avoidance ◽  
Transformation Process ◽  
State Regulation ◽  
Tobacco Products ◽  
Excise Duty ◽  
Increasing Demand ◽  
High Level ◽  
The Impact ◽  
Transformation Processes

The market of tobacco products in Ukraine is one of the most dynamic and competitive. It develops under the influence of certain factors that cause structural changes, therefore, the aim of the article is to conduct a comprehensive analysis of transformation processes in the market of tobacco and their alternatives in Ukraine and identify the factors that cause them. The high level of tax burden and the proliferation of alternative products with a potentially lower risk to human health, including heating tobacco products and e-cigarettes, are key factors in the market’s transformation process. Their presence leads to an increase in illicit turnover of tobacco products, which accounts for 6.37% of the market, and the gradual replacement of cigarettes with alternative products, which account for 12.95%. The presence on the market of products that are not taxed or taxed at lower rates is one of the reasons for the reduction of excise duty revenues. According to the results of 2019, the planned indicators of revenues were not met by 23.5%. Other reasons for non-fulfillment of excise duty revenues include: declining dynamics of the tobacco products market; reduction in the number of smokers; reorientation of «cheap whites» cigarette flows from Ukraine to neighboring countries; tax avoidance. Prospects for further research are identified, namely the need to develop measures for state regulation and optimization of excise duty taxation of tobacco products and their alternatives, taking into account the risks to public health and increasing demand of illegal products.

Role of Credit Rating in determining Capital structure: Evidence from Non-Financial sector of Pakistan

2020 ◽  
Vol 38 (3) ◽  
Author(s):  
Shoaib Ali ◽  
Imran Yousaf ◽  
Muhammad Naveed
Keyword(s):  
Capital Structure ◽  
Credit Rating ◽  
Least Square ◽  
Annual Data ◽  
Leverage Ratio ◽  
Financial Decisions ◽  
Financial Firms ◽  
High Level ◽  
The Impact ◽  
The Capital Structure

This paper aims to examine the impact of external credit ratings on the financial decisions of the firms in Pakistan.  This study uses the annual data of 70 non-financial firms for the period 2012-2018. It uses ordinary least square (OLS) to estimate the impact of credit rating on capital structure. The results show that rated firm has a high level of leverage. Moreover, Profitability and tanagability are also found to be a significantly negative determinant of the capital structure, whereas, size of the firm has a significant positive relationship with the capital structure of the firm.  Besides, there exists a non-linear relationship between the credit rating and the capital structure. The rated firms have higher leverage as compared to the non-rated firms. The high and low rated firms have a low level of leverage, while mid rated firms have a higher leverage ratio. The finding of the study have practical implications for the manager; they can have easier access to the financial market by just having a credit rating no matter high or low. Policymakers must stress upon the rating agencies to keep improving themselves as their rating severs as the measure to judge the creditworthiness of the firm by both the investors and management as well.

IDENTIFICATION AND ASSESSMENT OF RISK FACTORS ROLE IN MYOCARDIAL INFARCTION DEVELOPMENT

2019 ◽  
Vol 72 (5) ◽  
pp. 779-783
Author(s):  
Victor A. Ognev ◽  
Anna A. Podpriadova ◽  
Anna V. Lisova
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Cardiovascular System ◽  
Control Group ◽  
Biological Factors ◽  
Prevention And Treatment ◽  
High Level ◽  
Social Importance ◽  
The Impact

Introduction:The high level of morbidity and mortality from cardiovascular disease is largely due toinsufficient influence on the main risk factors that contribute to the development of myocardial infarction.Therefore, a detailed study and assessment of risk factors is among the most important problems of medical and social importance. The aim: To study and evaluate the impact of biological, social and hygienic, social and economic, psychological, natural and climatic risk factors on the development of myocardial infarction. Materials and methods: A sociological survey was conducted in 500 people aged 34 to 85. They were divided into two groups. The main group consisted of 310 patients with myocardial infarction. The control group consisted of 190 practically healthy people, identical by age, gender and other parameters, without diseases of the cardiovascular system. Results: It was defined that 30 factors have a significant impact on the development of myocardial infarction.Data analysis revealed that the leading risk factors for myocardial infarction were biological and socio-hygienic. The main biological factors were: hypertension and hypercholesterolemia. The man socio-hygienic factor was smoking. Conclusions: Identification of risk factors provides new opportunities for the development of more effective approaches for the prevention and treatment of myocardial infarction.

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