Nota informativa nº 05 /2020-GST/DVAST/SVS/SES: recomendações aos gestores e profissionais da segurança pública para enfrentamento da pandemia de Coronavírus ­ COVID-19 (infecção pelo SARS-CoV-2) / Informative note nº 05/2020-GST / DVAST / SVS / SES: recommendations to managers and public security professionals to cope with the Coronavirus pandemic - COVID-19 (SARS-CoV-2 infection)

Recomendações aos gestores e trabalhadores da Segurança pública (policiais federais, rodoviários, militares, civis, municipais, bombeiros, agentes penitenciários e socioeducativos) para discussão coletiva sobre medidas que amenizem os riscos à saúde dos trabalhadores e pessoas privadas de liberdade, como também, reduzam a disseminação do COVID-19 para seus familiares e a população em geral.

Recommendations to the managers and workers of public security (police federais, rodoviários, military, civis, municipais, bombeiros, penitentiary and socio-educational agents) for collective discussion on measures that mitigate the risks to the health of two workers and people deprived of freedom, as also, also, a dissemination of COVID-19 for family members and general population.

Recomendaciones a los gerentes y trabajadores de seguridad pública (federal, vial, militar, civil, municipal, bomberos, agentes penitenciarios y socioeducativos) para la discusión colectiva sobre medidas para mitigar los riesgos para la salud de los trabajadores y personas privadas de libertad, así como reducir la difusión del COVID-19 a sus familias y población en general.

Usual Care for Emergency Department Patients Who Present with Suicide Risk: A Survey of Hospital Procedures in Washington State.

Hospital emergency departments (EDs) are important settings for the implementation of effective suicide-specific care. Usual care for suicidal patients who present to EDs remains understudied. This study surveyed EDs in Washington State to assess the adoption of written procedures for recommended standards of care for treating suicidality. Most (N = 79, 84.9%) of the 93 EDs in Washington State participated. Most (n = 58, 73.4%) hospitals had a written protocol for suicide risk assessment, but half (n = 42, 53.2%) did not include documentation of access to lethal means. There was evidence of an association between patient volume and the adoption of suicide-specific protocols and procedures. Our findings suggest the need to enhance the adoption and implementation of recommended standard care in this setting.

Emergency response teams in and outside of medicine-structurally crafted to be worlds apart.

Medical emergency response teams (MERTs) are widespread throughout inpatient hospital care facilities. Besides the rise of the ubiquitous rapid response team, current MERTs span trauma, stroke, myocardial infarction, and sepsis in many hospitals. Given the multiplicity of teams with widely varying membership, leadership, and functionality, the structure of MERTs is appropriate to review to determine opportunities for improvement. Since nonmedical ERTs predate MERT genesis and are similar across multiple disciplines, nonmedical ERTs provide a standard against which to compare and review MERT design and function.Nonmedical ERTs are crafted to leverage team members who are fully trained and dedicated to that domain, whose skills are regularly updated, with leadership tied to unique skill sets rather than based on hierarchical rank; activity is immediately reviewed at the conclusion of each deployment and teams continue to work together between team deployments. Medical emergency response teams, in sharp contradistinction, often incorporate trainees into teams that do not train together, are not focused on the discipline required to be leveraged, are led based on arrival time or hierarchy, and are usually reviewed at a time remote from team action; teams rapidly disperse after each activity and generally do not continue to work together in between team activations. These differences between ERTs and MERTs may impede MERT success with regard to morbidity and mortality mitigation. Readily deployable approaches to bridge identified gaps include dedicated Advanced Practice Provider (APP) team leadership, reductions in trainee MERT leadership while preserving participation, discipline-dedicated rescue teams, and interteam integration training.Emergency response teams in medical and nonmedical domains share parallels yet lack congruency in structure, function, membership, roles, and performance evaluation. Medical emergency response team structural redesign may be warranted to embrace the beneficial elements of nonmedical ERTs to improve patient outcome and reduce variation in rescue practices and team functionality.

Identifying and Prioritizing Information Needs and Research Priorities of Public Health Emergency Preparedness and Response Practitioners.

OBJECTIVE: This study describes findings from an assessment conducted to identify perceived knowledge gaps, information needs, and research priorities among state, territorial, and local public health preparedness directors and coordinators related to public health emergency preparedness and response (PHPR). The goal of the study was to gather information that would be useful for ensuring that future funding for research and evaluation targets areas most critical for advancing public health practice. METHODS: We implemented a mixed-methods approach to identify and prioritize PHPR research questions. A web survey was sent to all state, city, and territorial health agencies funded through the Public Health Emergency Preparedness (PHEP) Cooperative Agreement program and a sample of local health departments (LHDs). Three focus groups of state and local practitioners and subject matter experts from the Centers for Disease Control and Prevention (CDC) were subsequently conducted, followed by 3 meetings of an expert panel of PHPR practitioners and CDC experts to prioritize and refine the research questions. RESULTS: We identified a final list of 44 research questions that were deemed by study participants as priority topics where future research can inform PHPR programs and practice. We identified differences in perceived research priorities between PHEP awardees and LHD survey respondents; the number of research questions rated as important was greater among LHDs than among PHEP awardees (75%, n=33, compared to 24%, n=15). CONCLUSIONS: The research questions identified provide insight into public health practitioners' perceived knowledge gaps and the types of information that would be most useful for informing and advancing PHPR practice. The study also points to a higher level of information need among LHDs than among PHEP awardees. These findings are important for CDC and the PHPR research community to ensure that future research studies are responsive to practitioners' needs and provide the information required to enhance their capacity to meet the needs of the communities and jurisdictions they serve. (Disaster Med Public Health Preparedness. 2017;11:552-561).

Residentes, guardias en el servicio de Urgencias y síndrome de Burnout / Residents, shifts in the Emergency department and Burnout syndrome

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