Pediatric disaster triage education and skills assessment: A coalition approach

2014 ◽  
Vol 12 (2) ◽  
pp. 141 ◽  
Author(s):  
Katherine Kenningham, MD ◽  
Kathryn Koelemay, MD, MPH ◽  
Mary A. King, MD, MPH
Keyword(s):  
Disaster Preparedness ◽  
Life Support ◽  
De Novo ◽  
Advanced Life Support ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Washington State ◽  
King County ◽  
Cross Sectional ◽  
Life Threatening

Objective: This study aims to 1) demonstrate one method of pediatric disaster preparedness education using a regional disaster coalition organized workshop and 2) evaluate factors reflecting the greatest shortfall in pediatric mass casualty incident (MCI) triage skills in a varied population of medical providers in King County,WA.Design: Educational intervention and cross-sectional survey.Setting: Pediatric disaster preparedness conference created de novo and offered by the King County Healthcare Coalition, with didactic sessions and workshops including a scored mock pediatric MCI triage. Participants: Ninety-eight providers from throughout the King County, WA, region selected by their own institutions following invitation to participate, with 88 completing exit surveys.Interventions: Didactic lectures regarding pediatric MCI triage followed by scored exercises.Main outcome measures: Mock triage scores were analyzed and compared according to participant characteristics and workplace environment.Results: A half-day regional pediatric disaster preparedness educational conference convened in September 2011 by the King County Healthcare Coalition in partnership with regional pediatric experts was so effective and well-received that it has been rescheduled yearly (2012 and 2013) and has expanded to three Washington State venues sponsored by the Washington State Department of Health. Emergency department (ED) or intensive care unit (ICU) employment and regular exposure to pediatric patients best predicted higher mock pediatric MCI triage scores (ED/ICU 80 percent vs non-ED/ICU 73 percent, p = 0.026; regular pediatric exposure 80 percent vs less exposure 77 percent, p = 0.038, respectively). Pediatric Advanced Life Support training was not found to be associated with improved triage performance, and mock patients whose injuries were not immediately life threatening tended to be over-triaged (observed trend).Conclusions: A regional coalition can effectively organize member hospitals and provide education for focused populations using specialty experts such as pediatricians. Providers working in higher acuity environments and those with regular pediatric patient exposure perform better mock pediatric MCI triage than their counterparts after just-in-time training. Pediatric MCI patients with less than life-threatening injuries tended to be over-triaged.

scholarly journals (P2-20) Explosion At A Steelwork Plant

2011 ◽  
Vol 26 (S1) ◽  
pp. s142-s142
Author(s):  
M. Bortolin ◽  
M. Raviolo ◽  
R. Vacca ◽  
D. Bono
Keyword(s):  
Life Support ◽  
Advanced Life Support ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Use Of Resources ◽  
Management Of Resources ◽  
Response Plan ◽  
Disaster Severity ◽  
The City

IntroductionOn the night of 06 December 2007, an explosion occurred at a steelworks plant in the city of Turin. The incident involved 10 people. The emergency medical services (EMS 118 Turin) declared a mass-casualty incident (MCI).ObjectivesThe aim of this case report is to analyze the response of the EMS 118 Turin to the MCI in order to identify problems or short-comings and improve the service for future responses.MethodsInformation from the dispatch center, medical report of the EMS, and hospitals that received the patients were analyzed.ResultsThe emergency call was placed at 01:04 hours, and the MCI was declared closed at 04:40 hours. The disaster, in according to Disaster Severity Scale (DSS), was classified 3. The METHANE message was sent to the dispatch center by the first ambulance 4 minutes after the call. There were 10 patients: seven T1; one T2; and two T3. The dispatch center deployed nine teams, which consisted of five advanced life support (ALS) teams and four basic life support (BLS) teams. All of the casualties were able to walk when they arrived to the medical care. The T1 casualties had burns to > 80% of their body surface area (BSA), the T2 and T1 casualties suffered inhalation of smoke gas. The first casualties were evacuated to the hospital 28 minutes after the call. Four casualties (three T1 and one T3) were transported to the nearest hospital. the other four T1 casualties were transported to four different hospitals of the city. All the T1 casualties died in the next 24 days.ConclusionsThe management of resources during this MCI was suboptimal. The number of ALS teams that responded to the MCI was high considering the number of casualties and the time taken to resolve the incident. The lessons learned from this incident and other cases have permitted the EMS Turin to improve their response plan concerning the use of resources and surge capacity.

scholarly journals Prehospital Triage by Lay Person First Responders: A Scoping Review and Proposal for a new Prehospital Triage Tool

2021 ◽  
pp. 1-11
Author(s):  
Wesley D Jetten ◽  
Jeroen Seesink ◽  
Markus Klimek
Keyword(s):  
Scoping Review ◽  
Life Support ◽  
First Responders ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Lay People ◽  
Online Databases ◽  
Healthcare Experience ◽  
Prehospital Triage

Abstract Objective: The primary aim of this study is to review the available tools for prehospital triage in case of mass casualty incidents and secondly, to develop a tool which enables lay person first responders (LPFRs) to perform triage and start basic life support in mass casualty incidents. Methods: In July 2019, online databases were consulted. Studies addressing prehospital triage methods for lay people were analyzed. Secondly, a new prehospital triage tool for LPFRs was developed. Therefore, a search for prehospital triage models available in literature was conducted and triage actions were extracted. Results: The search resulted in 6188 articles, and after screening, a scoping review of 4 articles was conducted. All articles stated that there is great potential to provide accurate prehospital triage by people with no healthcare experience. Based on these findings, and combined with the pre-existing prehospital triage tools, we developed a, not-yet validated, prehospital triage tool for lay people, which may improve disaster awareness and preparedness and might positively contribute to community resilience. Conclusion: The prehospital triage tool for lay person first responders may be useful and may help professional medical first responders to determine faster, which casualties most urgently need help in a mass casualty incident.

scholarly journals Parada cardiorrespiratória pré-hospitalar: avaliação dos atendimentos segundo o utstein style*

2019 ◽  
Vol 13 ◽  
Author(s):  
Robson Cristiano Zandomenighi ◽  
Eleine Aparecida Penha Martins
Keyword(s):  
Life Support ◽  
Cardiopulmonary Arrest ◽  
Advanced Life Support ◽  
Venous Access ◽  
Orotracheal Intubation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Epinephrine Administration ◽  
Peripheral Venous Access ◽  
Utstein Style

Objetivo: analisar as ocorrências, respostas e desfechos da parada cardiorrespiratória pré-hospitalar segundo o Utstein Style e identificar os fatores associados à sobrevida. Método: trata-se de um estudo quantitativo, documental e transversal, com vítimas de parada cardiorrespiratória atendidas nas unidades de suporte avançado de vida, no ano de 2015. Coletaram-se os dados a partir dos relatórios de atendimento do socorrista, organizando-os e analisando-os de acordo com o Utstein Style. Apresentaram-se os resultados em forma de tabelas. Resultados: verificaram-se 163 atendimentos, predominando o sexo masculino, não havendo associação entre idade e os desfechos. Identificou-se a maioria das PCRs como sendo de causa clínica, na residência e em assistolia, sendo entubação orotraqueal, acesso venoso periférico e administração de adrenalina os procedimentos mais frequentes. Constatou-se que as ocorrências presenciadas por espectadores leigos e o tempo-resposta da ambulância demonstraram uma associação com o desfecho sobrevida. Calculou-se a taxa de sobrevida em 25,1%. Conclusão: avaliou-se o serviço por meio da análise das ocorrências segundo o Utstein Style e verificaram-se associações entre o desfecho e as lacunas no atendimento, havendo a necessidade de intervenções em cada elo da corrente de sobrevivência. Descritores: Parada Cardíaca Extra-Hospitalar; Ressuscitação Cardiopulmonar; Serviços Médicos de Emergência; Ambulâncias; Emergências; Avaliação de Resultados. ABSTRACTObjective: to analyze the occurrences, responses and outcomes of prehospital cardiopulmonary arrest according to Utstein Style and to identify factors associated with survival. Method: this is a quantitative, documentary and cross-sectional study with victims of cardiopulmonary arrest treated at the advanced life support units in 2015. Data were collected from the rescuer's care reports and organized. and analyzing them according to Utstein Style. Results were presented in tables. Results: 163 cases were observed, predominantly male, with no association between age and outcomes. Most CRPs were identified as being of clinical cause, at home and in asystole, with orotracheal intubation, peripheral venous access and epinephrine administration being the most frequent procedures. It was found that the occurrences witnessed by lay spectators and the ambulance response time demonstrated an association with the survival outcome. The survival rate was calculated at 25.1%. Conclusion: the service was evaluated by analyzing the occurrences according to the Utstein Style and there were associations between the outcome and the gaps in care, requiring interventions in each link of the survival chain. Descriptors:  Out-of-Hospital Cardiac Arrest; Cardiopulmonary Resuscitation; Emergency Medical Services; Ambulances; Emergencies; Outcome Assessment. RESUMENObjetivo: analizar las ocurrencias, las respuestas y los resultados del paro cardiopulmonar prehospitalario según el Utstein Style e identificar los factores asociados con la supervivencia. Método: este es un estudio cuantitativo, documental y transversal con víctimas de paro cardiopulmonar tratadas en las unidades de soporte vital avanzado en 2015. Los datos se recopilaron de los informes de atención del rescatista, organizándolos y analizándolos según el Utstein Style. Los resultados se presentaron en tablas. Resultados: se observaron 163 casos, predominantemente masculinos, sin asociación entre la edad y los resultados. La mayoría de las PCRs se identificaron como de causa clínica, en el hogar y en la asistolia, siendo los procedimientos más frecuentes la intubación orotraqueal, el acceso venoso periférico y la administración de adrenalina los procedimientos más frecuentes. Se descubrió que las ocurrencias presenciadas por espectadores legos y el tiempo de respuesta de la ambulancia demostraron una asociación con el resultado de supervivencia. La tasa de supervivencia se calculó en 25.1%. Conclusión: el servicio se evaluó analizando las ocurrencias según el Utstein Style y hubo asociaciones entre el resultado y las brechas en la atención, lo que requiere intervenciones en cada eslabón de la cadena de supervivencia. Descriptores: Paro Cardíaco Extra-Hospitalario; Reanimación Cardiopulmonar; Servicios Médicos de Urgencia; Ambulancias, Urgencias Médicas, Evaluación de Resultado. 

Is the Willingness and Ability of Nurses to Respond to Various Disasters the Same? A Cross-Sectional Study in Iran

2020 ◽  
Author(s):  
Maryam Moradi ◽  
Simintaj Sharififar ◽  
Seyyed- Javad Hosseini Shokouh
Keyword(s):  
Natural Disasters ◽  
Disaster Response ◽  
Family Health ◽  
The Elderly ◽  
Mass Casualty Incident ◽  
Cross Sectional Study ◽  
Mass Casualty ◽  
Critical Conditions ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background: Healthcare centers, as the primary organizations involved in the occurrence of unexpected events, require to identify significant and influential motivational factors in the creation of willingness and, consequently, the ability of health personnel and staff (nurses) to respond to critical situations as the main organizational assets. This study was designed with the aim to determine the factors affecting the willingness and ability of nurses to deal with various disasters in Tehran hospitals.Methods: This research is a cross-sectional study. The instrument used is a researcher-made questionnaire, which consists of three parts of demographic information, evaluation of the level of nurses' willingness and ability to respond to various disasters, and obstacles to continuing to work in disasters.Results: A total of 308 questionnaires were completed. 39.3% of participants were female, and 60.7% of them were male. The level of willingness and ability of participants to continue working in crisis indicates that the highest willingness and ability are associated with natural disasters (floods, earthquakes), and the lowest willingness and ability are related to participating in response to the disease epidemic. The prioritization of the participants in this study in connection with the most critical barriers to responding to the crisis demonstrated that caring for children in natural disasters and Mass Casualty Incident, concern for family health in chemical disasters, fear of contamination in nuclear disasters, and fear of Infection in epidemic of diseases are among the most important obstacles. In examining the factors influencing the willingness and ability of research units to participate in disaster response raised, the factors of gender, age, marital status, and health level of individuals affected the level of willingness and ability of individuals. Besides, the components of income level, care for the elderly, and care for the disabled have only been influential on the willingness of people to participate in disaster response.Conclusion: The professional preparation of health care personnel to perform their duties in critical conditions is essential. Hence, preventive measures to minimize the risk and strengthen the ethical obligations of employees in this profession in crises will be beneficial.

Life-threatening emergencies

2012 ◽  
pp. 40-61
Author(s):  
Jonathan P. Wyatt ◽  
Robin N. Illingworth ◽  
Colin A. Graham ◽  
Kerstin Hogg ◽  
Michael J. Clancy ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Basic Life Support ◽  
Life Support ◽  
Central Venous Access ◽  
Treatment Algorithm ◽  
Advanced Life Support ◽  
Venous Access ◽  
Central Venous ◽  
Life Threatening

Anaphylaxis 42 Treatment algorithm for adults with anaphylaxis 44 Choking 45 Cardiac arrest 46 In-hospital resuscitation algorithm 47 Adult basic life support 48 Cardiac arrest management 50 Advanced life support algorithm 52 Notes on using the advanced life support algorithm 53 Post-resuscitation care 54 Central venous access ...

scholarly journals MP20: Evaluation of the disruptors during advanced life support in emergency departments

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S49-S49
Author(s):  
J. Truchot ◽  
D. Michelet ◽  
D. Drummond ◽  
P. Plaisance
Keyword(s):  
Emergency Departments ◽  
Exploratory Study ◽  
Online Survey ◽  
Life Support ◽  
Medical Curriculum ◽  
Real Life ◽  
Advanced Life Support ◽  
Cross Sectional ◽  
Phone Calls ◽  
Ed Overcrowding

Introduction: Simulation is used as a teaching technique in the medical curriculum, and especially for advanced life support (ALS). However, simulated ALS can differ greatly from real life ALS. The aim of this exploratory study was to identify the different disruptors associated with real life ALS. Methods: We conducted a cross-sectional, anonymous, online survey that included 32 items. It was distributed by email to emergency physicians from five emergency departments in Paris. The aim of this online survey was to identify the elements perceived as disruptors during ALS. Other aspects of the survey explored the perceived differences between simulated ALS and real life ALS. Descriptive statistics of percentage, mean and standard deviation were used to analyse the data. Results: Among 100 surveyed physicians, 43 (43%) answers were analysed. 53% were women with a mean age of 32 ± 3 years old. The identified disruptors from real life ALS were task interruptions mainly from non-medical staff (n = 16; 37%), patient's siblings (n = 5; 12%), other specialists (n = 5; 12%) and the phone calls (n = 2; 5%). The situation of ED overcrowding (n = 12; 28%) was also mentioned as a potential disruptor. Overall, physicians reported that some technical and non-technical tasks were harder to perform in real life compared to simulated sessions. Conclusion: This exploratory study allowed the identification of disruptors encountered in real life cases of ALS, and may be used for future simulation-based teaching to enhance realism during sessions

The effect of training and experience on mass casualty incident triage performance: Evidence from emergency personnel in a high complexity university hospital

2019 ◽  
Vol 14 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Juan P. Vargas, MD, MSc ◽  
Ives Hubloue, MD, PhD ◽  
Jazmín J. Pinzón, MD ◽  
Alejandra Caycedo Duque, MD
Keyword(s):  
Emergency Department ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
University Hospital ◽  
Trauma Patients ◽  
Post Intervention ◽  
Cross Sectional ◽  
Emergency Department Staff ◽  
Department Staff ◽  
Before And After

Mass casualty incident (MCI) can occur at any time and place and health care institutions must be prepared to deal with these incidents. Emergency department staff rarely learn how to triage MCI patients during their medical or nurse degrees, or through on-the-job training. This study aims to evaluate the effect of training and experience on the MCI triage performance of emergency personnel.Methodology: This was a cross-sectional prospective study that analyzed the performance of 94 emergency department staff on the triage classifications of 50 trauma patients, before and after a short training in MCI triage, while taking into account their academic background and work experience.Results: The participants were assigned initially to one of two groups: low experience if they had less than 5 years of practice, and high experience if they had more than 5 years of practice. In the low experience group, the initial accuracy was 45.76 percent, over triage 45.84 percent, and subtriage 8.38 percent. In the high experience group, the initial accuracy was 53.80 percent, over triage 37.66 percent, and sub triage 8.57 percent.Postintervention Results: In the low experience group, the post intervention accuracy was 63.57 percent, over triage 21.15 percent, and subtriage 15.30 percentage. In the high experience group, the post-intervention accuracy was 67.66 percentage, over triage 15.19 percentage, and subtriage 17.14 percentage.  Conclusion: Upon completion of this study, it can be concluded that MCI triage training significantly improved the performance of all those involved in the workshop and that experience plays an important role in MCI triage performance.

Development of an “All-Hazards” Hospital Disaster Preparedness Training Course Utilizing Multi-Modality Teaching

2008 ◽  
Vol 23 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Brett Collander ◽  
Brad Green ◽  
Yuri Millo ◽  
Christine Shamloo ◽  
Joyce Donnellan ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Life Support ◽  
Core Competencies ◽  
Effective Means ◽  
Course Evaluation ◽  
Mass Casualty ◽  
Average Score ◽  
Training Course ◽  
Post Test ◽  
Hospital Disaster Preparedness

AbstractObjectives:The objectives of the study were to develop and evaluate an “all-hazards” hospital disaster preparedness training course that utilizes a combi-nation of classroom lectures, skills sessions, tabletop sessions, and disaster exercises to teach the principles of hospital disaster preparedness to hospital-based employees.Methods:Participants attended a two-day, 16-hour course, entitled Hospital Disaster Life Support (HDLS). The course was designed to address seven core competencies of disaster training for healthcare workers. Specific disaster situations addressed during HDLS included: (1) biological; (2) conventional; (3) radiological; and (4) chemical mass-casualty incidents. The primary goal of HDLS was not only to teach patient care for a disaster, but more important-ly, to teach hospital personnel how to manage the disaster itself. Knowledge gained from the HDLS course was assessed by pre- and post-test evaluations. Additionally, participants completed a course evaluation survey at the conclu-sion of HDLS to assess their attitudes about the course.Results:Participants included 11 physicians, 40 nurses, 23 administrators/direc-tors, and 10 other personnel (n = 84). The average score on the pre-test was 69.1 ±12.8 for all positions, and the post-test score was 89.5 ±6.7, an improve-ment of 20.4 points (p <0.0001, 17.2–23.5).Participants felt HDLS was edu-cational (4.2/5), relevant (4.3/5) and organized (4.3/5).Conclusions:Identifying an effective means of teaching hospital disaster pre-paredness to hospital-based employees is an important task. However, the opti-mal strategy for implementing such education still is under debate.The HDLS course was designed to utilize multiple teaching modalities to train hospital-based employees on the principles of disaster preparedness. Participants of HDLS showed an increase in knowledge gained and reported high satisfaction from their experiences at HDLS. These results suggest that HDLS is an effec-tive way to train hospital-based employees in the area of disaster preparedness.

scholarly journals (P1-52) Educational Program of Disaster Preparedness in the Earthquake Prone Area, Mie, Japan

2011 ◽  
Vol 26 (S1) ◽  
pp. s115-s115
Author(s):  
T. Takeda
Keyword(s):  
Earthquake Engineering ◽  
Disaster Preparedness ◽  
Life Support ◽  
Advanced Life Support ◽  
Medical Personnel ◽  
Educational Programs ◽  
Disaster Medicine ◽  
General Idea ◽  
Local Residents ◽  
New Community

BackgroundMajor earthquakes with a magnitude of 7-8 are anticipated to occur in the next 30 years at a 60 percent chance on the southern coast of Mie, Japan. Since the most part of the Mie Prefecture, Japan, is likely to be damaged by tsunami and landslides, residents are expected to take self-reliant approach on the initial several days after the earthquake.AimDeveloping disaster support system in including community based medical disaster preparedness in the region.MethodsWe have been providing knowledge and techniques to cope with the earthquake cooperated with experts of earthquake engineering. Basic and advanced life support educational programs for acute illness and trauma that may occur in earthquake and/or tsunami as well as during the evacuation and sheltering have been developed for public, local medical associations and the main hospital in the region. Moreover, we have started a new community continuous educational course to promote the public disaster preparedness. We teach introduction of emergency and disaster medicine to enhance knowledge of natural and social science on disaster preparedness.ResultsLocal residents including public and medical personnel started to acquire a general idea of disaster and emergency medicine. The educational programs seemed to motivate local residents and healthcare professions.

scholarly journals (A207) Resuscitation of Casualties Following Exposure to Toxic Chemicals: What is New?

2011 ◽  
Vol 26 (S1) ◽  
pp. s57-s57 ◽  
Author(s):  
D.J. Baker
Keyword(s):  
Animal Studies ◽  
Emergency Services ◽  
Life Support ◽  
Advanced Life Support ◽  
Lung Ventilation ◽  
Protective Equipment ◽  
Early Application ◽  
Life Threatening ◽  
Ventilation Strategies ◽  
The Ideal

Injury following exposure to toxic chemical agents has potential life–threatening effects, particularly on the respiratory system. Antidotes alone often are not sufficient to reverse this situation, and the need to provide early and effective advanced life support for chemical casualties increasingly has been accepted by emergency services around the world. Although the principles of life support are the same for toxic as for conventional casualties, the requirement for responders to wear personal protective equipment makes airway and ventilation management more difficult. Special training and familiarity with devices and equipment used are essential to ensure effectiveness. Recent studies have indicated both the limitations and the possibilities for resuscitation of casualties in a contaminated environment before decontamination. Ventilation of patients with respiratory failure or arrest requires the use of devices which are able to operate and be used by responders wearing protective equipment. The laryngeal mask airway has been shown to be an easier and viable alternative to intubation in this situation. Portable automatic ventilators have been developed which can be used to provide controlled ventilation in a contaminated zone. The ideal mode of ventilation for potentially damaged lungs, following exposure to agents such as chlorine and phosgene has yet to be established. There may be a case for early application of the protective lung ventilation strategies that are now common in intensive care units. This presentation will review recent human and animal studies related to resuscitation in a contaminated zone and provide illustrations of the practical approaches currently used by emergency medical services.

Sign in / Sign up

Export Citation Format

Share Document