Challenges Faced by Medical Rescue Teams During Disaster Response: A Systematic Review Study.

This study was conducted to identify the challenges faced by medical rescue teams during the response phase of sudden-onset disasters and provide a comprehensive understanding of these challenges. Peer-reviewed, English-language articles published until January 2023 that described the challenges faced by medical rescue teams during disaster response were searched in the Web of Science, Scopus, Cochrane, PubMed, and Science Direct databases. The articles were assessed using the Mixed Methods Appraisal Tool (MMAT) version 2018, a quality evaluation tool, and a qualitative thematic synthesis approach was adopted. A total of 353 publications were identified, and 18 of these met the inclusion criteria. Of the 18 included studies, 8 were review articles, 4 were special reports, 3 were cross-sectional studies, 1 was a mixed methods study, 1 was a qualitative study, and 1 was a short communication. Through qualitative analysis, the challenges faced by medical rescue teams during disaster response were categorized into 6 factors: organizational, individual, environmental and health, logistical, communication and information, and other factors. These factors are significant in terms of issues such as delayed access to disaster victims, disruptions in response processes, and an increase in morbidity and mortality rates. Therefore, the findings in our study shed light on future research in the field of disasters and offer opportunities to develop a roadmap for improving the conditions of medical rescue teams.

Temporary impact on medical system and effectiveness of mitigation strategies after COVID-19 policy adjustment in China: a modeling study.

Background: As China amends its "zero COVID" strategy, a sudden increase in the number of infections may overwhelm medical resources and its impact has not been quantified. Specific mitigation strategies are needed to minimize disruption to the healthcare system and to prepare for the next possible epidemic in advance. Method: We develop a stochastic compartmental model to project the burden on the medical system (that is, the number of fever clinic visits and admission beds) of China after adjustment to COVID-19 policy, which considers the epidemiological characteristics of the Omicron variant, age composition of the population, and vaccine effectiveness against infection and severe COVD-19. We also estimate the effect of four-dose vaccinations (heterologous and homologous), antipyretic drug supply, non-pharmacological interventions (NPIs), and triage treatment on mitigating the domestic infection peak. Result: As to the impact on the medical system, this epidemic is projected to result in 398.02 million fever clinic visits and 16.58 million hospitalizations, and the disruption period on the healthcare system is 18 and 30 days, respectively. Antipyretic drug supply and booster vaccination could reduce the burden on emergency visits and hospitalization, respectively, while neither of them could not reduce to the current capacity. The synergy of several different strategies suggests that increasing the heterologous booster vaccination rate for older adult to over 90% is a key measure to alleviate the bed burden for respiratory diseases on the basis of expanded healthcare resource allocation. Conclusion: The Omicron epidemic followed the adjustment to COVID-19 policy overloading many local health systems across the country at the end of 2022. The combined effect of vaccination, antipyretic drug supply, triage treatment, and PHSMs could prevent overwhelming medical resources.

[Research and Practice of Vehicle-mounted Mobile CT Based on Emergency Medical Rescue].

OBJECTIVE: In order to solve the problem of inadequate CT screening ability in emergency medical rescue in remote mountainous areas, high-altitude areas, other public health events and sudden natural disasters, a vehicle-mounted mobile CT suitable for emergency medical rescue is studied. METHODS: A vehicle chassis system suitable for long-distance transportation and a cabin system suitable for epidemic prevention and control was designed. A domestic 32-slice CT with small volume, light weight and high stability was selected to design a vehicle-mounted mobile CT suitable for emergency medical rescue. RESULTS: The high-performance vehicle-mounted mobile CT can provide rapid support, and provide large-scale screening, emergency medical rescue, a supplement to daily CT scanning in peacetime and wartime. CONCLUSIONS: The vehicle CT has high stability, fast scanning speed and high social and economic value.

Characteristics of Emergencies in the Workplace from the Perspective of the Emergency Medical Services: A 4-Year Case-Control Study.

INTRODUCTION: Accidents and emergencies in the workplace account for a significant proportion of emergency calls worldwide. The specificity of these events is often associated with hazards at a given workplace. Patients do not always require hospitalization; therefore, the characteristics of events can only be determined from the perspective of emergency medical services teams. The aim of the study was to analyze calls and the course of emergency ambulance interventions to patients at their workplace. MATERIAL AND METHODS: The study was conducted based on a retrospective analysis of data contained in the medical records of the ambulance service from central Poland from 2015-2018. From all interventions (n = 155,993), 1601 calls to work were selected, and the urgency code, time of day and year, patients' sex, general condition, as well as diagnoses according to the International Classification of Diseases-ICD-10 and the method of ending the call were considered. RESULTS: The mean age of patients in the study group was 42.4 years (SD ± 13.5). The majority were men (n = 918; 57.3%). The number of calls increased in the autumn (n = 457; 28.5%) and in the morning (n = 609; 38.0%). The main reasons for the intervention were illnesses (ICD-10 group: R-'symptoms') and injuries (ICD-10 group: S, T-'injuries'). Calls at workplaces most often ended with the patient being transported to the hospital (78.8%), and least often with his death (0.8%). CONCLUSIONS: The patient profile in the workplace indicates middle-aged men who fall ill in the fall, requiring transport to the hospital and further diagnostics.

Research on the intelligent management system for equipment and supplies of provincial medical rescue teams for nuclear and radiation accidents / 中国职业医学

{L-End}Objective To establish the construction of intelligent management system for equipment and supplies of medical rescue teams for provincial nuclear and radiation accidents, based on modern Internet+ Internet of Things. {L-End}Methods The current status and requirements of emergency equipment and supplies allocation and management of medical emergency teams for provincial nuclear and radiation accidents were analyzed. Utilizing technologies such as Internet of Things, low-power Bluetooth, and radio frequency identification, an intelligent management system for medical rescue teams, its equipment and supplies for provincial nuclear and radiation accidents was designed. {L-End}Results The intelligent management system for medical rescue teams, its equipment and supplies for nuclear and radiation accidents was able to perform the inventory warning, expiration date warning, maintenance alert, and warning for emergency personnel health status, based on dynamic management of rescue personnel, equipment and supplies. It provided an effective support for on-site commanders in making emergency decisions. {L-End}Conclusion The use of Internet+Internet of Things technology can achieve intelligent management for medical rescue teams and its equipment and supplies can effectively improve the level of personnel and equipment support for the rescue of nuclear and radiation accidents at the provincial level.

Research and Practice of Vehicle-mounted Mobile CT Based on Emergency Medical Rescue / 中国医疗器械杂志

OBJECTIVE@#In order to solve the problem of inadequate CT screening ability in emergency medical rescue in remote mountainous areas, high-altitude areas, other public health events and sudden natural disasters, a vehicle-mounted mobile CT suitable for emergency medical rescue is studied.@*METHODS@#A vehicle chassis system suitable for long-distance transportation and a cabin system suitable for epidemic prevention and control was designed. A domestic 32-slice CT with small volume, light weight and high stability was selected to design a vehicle-mounted mobile CT suitable for emergency medical rescue.@*RESULTS@#The high-performance vehicle-mounted mobile CT can provide rapid support, and provide large-scale screening, emergency medical rescue, a supplement to daily CT scanning in peacetime and wartime.@*CONCLUSIONS@#The vehicle CT has high stability, fast scanning speed and high social and economic value.

Research progress in emergency drug stockpile for nuclear and radiological accidents / 中华放射医学与防护杂志

In the current international situation, there is the possibility of nuclear war and nuclear terrorism. The nuclear and radiological emergency in the event of an accident should be enhanced. The World Health Organization (WHO) issued a publication on January 27, 2023, updating the list of drugs recommended for stockpiling in response to radiation and nuclear emergencies, which was the first update since 2007. The list of recommended drug stocks in the publication includes drugs to prevent or reduce the effects of radiation, as well as drugs used to treat injuries after exposure. Based on the list of drugs, this article reviews the emergency response to nuclear and radiological accidents, the general situation of emergency drug stockpiles, drug reserves in some countries, and current considerations, with a view to providing references for emergency medical rescue in nuclear and radiological accidents in China.

Management of helicopter medical transport in 36 patients with critical cardiac disease / 中华危重病急救医学

Objective:To summarize the management experience of helicopter medical transport in patients with critical heart disease, so as to provide reference for transport of patients with critical heart disease under the background of major natural disasters.Methods:The clinical and transport data of 36 critically ill cardiac patients in Fuwai Central China Cardiovascular Hospital from 16:30 on July 21 to 19:30 on July 22, 2021 due to historically rare heavy rainstorms were collected. All 36 critically ill cardiac patients were transported by helicopter. The safe transportation was implemented under the measures of quickly forming a transport leadership and coordination group, clarifying responsibilities and division of labor, doing a good job in the pretreatment of the patient's condition, pipeline assessment and mechanical circulation support (MCS) equipment, simulating and practicing the transfer process, improving the safety of the transfer implementation process, and effectively handing over with the target hospital. The gender, age, disease type, MCS, transport and outcome of patients were collected.Results:Thirty-six patients with cardiac critical illness were from adult extracardiac intensive care unit (ICU), adult cardiac care unit (CCU), children's CCU, comprehensive ICU and department of neurology. There were 24 males and 12 females; age (50.93±20.86) years old. There were 12 patients using respirator, 7 patients needing MCS, 2 of whom needed both extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP), and 7 patients with post-cardiac surgery. The total distance of transportation of 36 patients was 1 638.4 km, the transit time was 10.5 hours, one way flight time of helicopter was about 8 minutes, and the average transport time per patient was about 17.5 minutes. The vital signs of 36 patients during transport were basically stable, without complications, and all of them reached the target hospital safely.Conclusion:Under the seamless connection of the rapid establishment of the transfer leadership coordination group, assessment of the patient's condition and pretreatment, the simulation of the transfer process, and the effective handover with the receiving hospital, the use of helicopter for medical transport for critically ill heart patients is feasible and safe, which can buy valuable time for saving patients' lives and further treatment.

Comparative Analysis of the Wounded in Patients and Deaths in a Hospital Following the Three Major Earthquakes in Western China.

The purpose of this study was to analyze the injury characteristics of patients and therapeutic strategies for patients injured in the last three big earthquakes in China, so as to provide a reference for the improvement of emergency plans for earthquakes. The analysis was based on the data provided by the Mianyang Central Hospital (MCH) from May 12th, 2008 to September 26th, 2017. Microsoft EXCEL software was used for data input, and SPSS was used for statistical analysis. A total of 1,390 earthquake-related patients were hospitalized in MCH. Most patients were admitted to the hospital within the first 2 weeks after the earthquake. The main causes for seismic injuries involved hit/strike by objects or building collapse /burying. Extremity fractures accounted for most injuries, especially 3 days after an earthquake. But soft tissue injuries cannot be neglected. Most earthquake patients were mainly treated by means of surgery and the majority were related to orthopedics. We found that different areas, population, and religions needed a tailored approach to the rescue effort. Therefore, the earthquake magnitude scale has a significant influence on mechanisms, types and severity of the injury of patients injured in earthquakes, as well as their timely transfer, management, and prognosis. Traumatic injuries are very common and thereby various surgical procedures especially orthopedic and neurosurgery are the domain of treatment modalities. Disaster preparedness and combined surgical team effort need to be focused on to reduce both mortality and morbidity.

Comparison of Standard Training to Virtual Reality Training in Nuclear Radiation Emergency Medical Rescue Education.

OBJECTIVE: Due to the particularity of nuclear radiation emergencies, professional technical training is necessary. However, nuclear radiation emergency medical rescue nurses are not well prepared to respond in time. This study aims to explore the effect of virtual reality (VR) in training nurses for nuclear radiation emergency medical rescue. METHODS: Thirty nurses who received traditional nuclear radiation rescue training from May 2020 to October 2020 were selected as the control group, and another 30 nurses who received VR nuclear radiation emergency medical rescue training from November 2020 to April 2021 were selected as the experimental group. The examination results, learning enthusiasm, training effect evaluation, and training satisfaction were compared between the 2 groups. RESULTS: The experimental group had significantly higher examination score, learning enthusiasm, training effect evaluation, and training satisfaction than the control group (P < 0.05). CONCLUSIONS: The application of VR in the training of nuclear radiation emergency medical rescue can improve the training performance, learning enthusiasm, training effect, and training satisfaction of trainees. Considering the advantages of VR, it could be widely used in the training of nuclear radiation emergency medical rescue in the future.

Nursing characteristics and measures in the medical rescue support of Shenzhou-12 space station / 中华急诊医学杂志

Objective:To summarize the nursing experience of medical rescue mission of Chinese manned spaceflight and space station astronauts returning to Dongfeng landing site, to analyze the characteristics of different mission stages of Shenzhou-12 manned spacecraft and Dongfeng landing site, and to take steps to implement effective medical rescue support of the space station missions.Methods:The relevant literature and reports at home and abroad were consulted, the nursing experience of previous medical rescue support tasks was summarized, and the corresponding clinical measures were put forward according to the orbit time of Shenzhou-12 and the complex terrain and climate of the main landing site.Results:Based on the existing experience, the rescue process had been further detailed, the emergency plan had been formulated, the clinical process in each plan had been refined, the clinical process in front of the cabin, in the carrier and in the evacuation process of nurses under different injury conditions had been formulated and improved, and the special training of nurses' own quality and nursing skills was carried out to improve the overall quality and combat ability of the nursing echelon.Conclusions:The improvement and refinement of clinical process in the medical rescue support task of the main landing site of Shenzhou-12 has provided a solid assurance for the successful completion of manned aerospace medical rescue support task.

Experience of medical rescue support and nursing in space station mission / 中华急诊医学杂志

Objective:To explore the characteristics and nursing measures of medical rescue support in space station.Methods:According to the characteristics of medical rescue support task of manned space mission, practical nursing schemes and corresponding nursing measures were formulated from the aspects of personnel selection, personnel training, material preparation, process formulation, training exercise and epidemic prevention.Results:The "Shenzhou-12" mission includes the whole launch phase, operation phase and return phase. There are many tasks that cover a long time. The contents of medical rescue support include personnel's physical and mental quality, technical ability, environmental equipment, the possible injuries of astronauts, and the normalization of COVID-19's task guarantee. In view of this content, a practical nursing scheme was formulated to enable nurses to quickly master and skillfully cooperate with the treatment, win more time for the treatment and improve the overall rescue level.Conclusions:Various process plans have been integrated and optimized for medical rescue support of space mission. The equipment carried is advanced, and can be used in various complex environments and complex working conditions. The rescue support personnel have also done their best, kept improving and solidified the state. We should constantly sum up experience, explore and study new problems, and make new achievements in medical rescue support for space missions.

Stochastic Petri Net Based Modeling of Emergency Medical Rescue Processes during Earthquakes.

The post-disaster emergency medical rescue (EMR) is critical for people's lives. This paper presents a stochastic Petri net (SPN) model based on the process of the rescue structure and a Markov chain model (MC), which is applied to the optimization of the EMR process, with the aim of identifying the key activities of EMR. An isomorphic MC model is developed for measuring and evaluating the time performance of the EMR process during earthquakes with the data of the 2008 Wenchuan earthquake. This paper provides a mathematical approach to simulate the process and to evaluate the efficiency of EMR. Simultaneously, the expressions of the steady state probabilities of this system under various states are obtained based on the MC, and the variations of the probabilities are analyzed by changing the firing rates for every transition. Based on the concrete data of the event, the authors find the most time consuming and critical activities for EMR decisions. The model results show that the key activities can improve the efficiency of medical rescue, providing decision-makers with rescue strategies during the large scale earthquake.

Analysis of Emergency Medical Rescue in the "8-12" Tianjin Port Heavy Fire Explosion Accident.

With the progress in science and technology, hazardous chemicals are becoming more essential in chemical products, industrial and agricultural production, and daily life. Hazardous chemicals have poisoning, corrosive, explosive, and combusting natures; once on fire, they can trigger a chain of catastrophic incidences, resulting in casualties, property loss, and environmental pollution and posing hazards to life and property. Using the "8-12" explosion of the Ruihai Logistics warehouse in Tianjin Port (Binhai New District, China), the present study analyzes the characteristics of trauma of the casualties in this accident and the emergency medical rescue strategies. The goals were to improve the ability of emergency rescue in such accidents and to save people's lives and property to the maximum extent.

Cooperation Between The Rescue And Fire Brigade Corps And The Medical Rescue Service Representing A Basis For An Effective Integrated Rescue System In The Slovak Republic.

The aim of this paper is to identify the legislative basis referring to the position and activities of the Rescue and Fire Brigade Corps, the Medical Rescue Service and the Voluntary Municipal Fire Brigade in Slovakia. The paper deals with the results of an analysis based on a questionnaire research focusing on cooperation between professional and voluntary fire brigades and the Medical Rescue Service during common interventions. The research includes answers from 97 respondents. The analysis shows that cooperation between the afore-mentioned rescue units is in general good, however it has some shortcomings and problems, such as poor communication and insufficient common training. In favour of improving cooperation, members of the rescue units recommend not only frequent tactical training focusing on particular situations, but also professional training and other similar common meetings.

Le but de cet article est d 'évaluer l'état de la législation concernant le positionnement et les activités du corps des sapeurs- pompiers professionnels, du service médical d'urgence et des sapeurs- pompiers volontaires municipaux en Slovaquie. Il se base sur l'analyse d'un questionnaire évaluant la coopération entre ces trois entités lors des interventions courantes, auquel ont répondu 97 personnes. Cette coopération est globalement bonne mais il existe quelques difficultés dans la communication et concernant une formation commune insuffisante. Dans ce but, les intervenants proposent non seulement des exercices communs ciblés mais aussi des sessions d'entraînement et des congrès mixtes.

Research on the evaluation system of nuclear emergency medical rescue drills / 中华医学教育探索杂志

Objective:To explore the formulation of the evaluation system of nuclear emergency medical rescue drills.Methods:By using the analytic hierarchy process, theoretical analysis and expert consultation, the evaluation system was established, and online questionnaires were used to investigate student satisfaction. Excel software was used for data entry, Matlab 6.5 software was used for weight calculation, and questionnaire data were authorized to SPSSAU online platform to analyze the correlation coefficient between trainees' attitude towards drills and satisfaction of the evaluation system.Results:An evaluation system of nuclear emergency medical rescue drills composed of multiple indicators was constructed, and the weights of each indicator of the system were obtained. The corresponding weights for group comprehensive proficiency, topic theoretical oral examination, personal practice and virtual system were 0.108, 0.557, 0.280 and 0.054, respectively. Simultaneously, the evaluation of the system by the trainees was investigated, and it was found that there was a significant correlation between the trainee's attitude towards the drills and satisfaction with the system.Conclusion:The nuclear emergency medical rescue evaluation system formed in this research is expected to provide theoretical methods for comprehensive evaluation of students' knowledge and capabilities, and at the same time it's helpful to improve the nuclear emergency rescue capabilities of students.

CHARACTERISTICS OF THE INTERVENTION OF EMERGENCY MEDICAL TEAMS IN THE SOUTHERN PART OF POLAND IN 12-MONTH OBSERVATION.

OBJECTIVE: The aim: The aim of this study was to characterize the general characteristics of the completed interventions by the Voivodeship Rescue Service of Katowice in the time period from 1st January 2018 to 31 December 2018. PATIENTS AND METHODS: Material and methods: Analysis of the characteristics of the trips was done based on the information contained in the dispatch order cards and medical emergency services cards. In the statistical analysis the Chi-Square (p<0.05) test was utilized. RESULTS: Results: The total number of interventions was 211,548 cases. It is also worth observing, that the general number of interventions out of town amounted to 20,344 interventions, whereas, in town, there were 191,204 interventions. It can be observed that the most common decision made by the Emergency Medical Team was the decision to directly transported and received by the emergency department (126,553 cases; p<0.05). The definite most common reason for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (ICD-10 code : R; p<0.05). CONCLUSION: Conclusion: The largest number of interventions completed by the Voivodeship Rescue Service in Katowice in 2018 was due to injuries and poisonings, symptoms, diseases features and incorrect results of diagnostic tests, and in third place were cardiovascular diseases.

Role of Anesthesia Nurses in the Treatment and Management of Patients With COVID-19.

As the backbone for the treatment of patients with coronavirus disease 2019 (COVID-19), nurses have been playing key roles in cabin hospitals, isolation wards, and intensive care units for critical cases. Anesthesia nurses have their own professional specialties, such as airway management, the use and maintenance of life support equipment, including ventilators, and the use of high-flow oxygen equipment. With rich experience in emergency responses and nursing, anesthesia nurses, along with emergency nurses and critical care nurses, play important roles during the treatment of patients with COVID-19. In our hospital, 27 of 34 anesthesia nurses participated in the front-line fight against COVID-19 and did an excellent job. Anesthesia care by nurses is relatively new in China, and the role of anesthesia nurses during a disaster response has not been fully appreciated. Given their specialty, anesthesia nurses have played important roles in the treatment of patients with COVID-19. We hope that authorities will consider including anesthesia nurses in national disaster response medical rescue teams.

[Supporting the battle against COVID-19 in E'zhou, Hubei Province: the experience of Guizhou medical team].

To suppress the rapid spread of coronavirus disease 2019 (COVID-19) in Hubei province, a medical rescue team consisting of 860 members was sent to E'zhou, one of the hard-hit cities in east Hubei. A total of 414 of the team members, whose core members were from Guizhou Medical University and its Affiliated Hospital, took over the full operation of Leishan hospital of E'zhou, a makeshift hospital built for treating COVID-19 patients. Under the instructions by the E'zhou Medical Team Front Command, the staff made quick responses to the surging number of patients with COVID-19 and rapidly formulated treatment plans based on the local conditions. The medical team efficiently carried out the operations and successfully completed the rescue mission. Herein the authors, as members of Guizhou Medical Team supporting COVID-19 containment in E'zhou, analyze and summarize the experiences of Guizhou Medical Team with the organization, implementation and logistic support of medical rescue operations, which may provide reference for future rescue missions in a similar scenario.