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1.
J Nurs Educ ; 61(1): 50-52, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35025673

RESUMO

BACKGROUND: Traditional Nursing Programs are required to provide student instruction regarding disaster care. The Brigham Young University College of Nursing, in conjunction with campus emergency medical services (EMS), holds two large-scale mass casualty simulations each year. Nursing students work alongside EMS to provide initial care to the victims. METHOD: After the mass casualty simulation, nursing students completed an anonymous survey evaluating their preparation and experience during the simulation. Students were also prompted to reflect on future implications of the exercise and give suggestions for simulation improvement. RESULTS: Nursing students felt the triage and communication skills they learned during this simulation will help them as future registered nurses. Interdisciplinary communication between nursing and EMS students presented a barrier to effective disaster response. CONCLUSION: Data gathered from this postsimulation survey will be used to improve future nursing student preparation and simulation participation. [J Nurs Educ. 2022;61(1):50-52.].


Assuntos
Serviços Médicos de Emergência , Incidentes com Feridos em Massa , Estudantes de Enfermagem , Simulação por Computador , Humanos , Triagem
2.
Surg Clin North Am ; 102(1): 169-180, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34800385

RESUMO

Mass casualty incidents are increasingly common. They are defined by large numbers of patients arriving nearly simultaneously, overwhelming available resources needed for optimal care. They require rapid mobilization of resources to provide optimal outcomes and limit disability and death. Because the mechanism of injury in a mass casualty incident is often traumatic in nature, surgeons should be aware of the critical role they play in planning and response. The coronavirus disease 2019 pandemic is a notable, resulting in a sustained surge of critically ill patients. Initial response requires local mobilization of resources; large-scale events potentially require a national response.


Assuntos
Defesa Civil , Serviços Médicos de Emergência , Recursos em Saúde , Incidentes com Feridos em Massa , COVID-19/epidemiologia , COVID-19/prevenção & controle , Árvores de Decisões , Humanos , Triagem
3.
BMJ Open ; 11(10): e051802, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34625415

RESUMO

OBJECTIVE: The use of an injury triage method among earthquake injury patients can facilitate the reasonable allocation of resources, but the various existing injury triage methods need further confirmation. This study aims to assess the accuracy of several injury triage methods, namely, the Simple Triage and Rapid Treatment (START) technique; CareFlight Injury Triage (CareFlight); Rapid Emergency Medicine Score (REMS); Triage Revised Trauma Score (T-RTS) and Triage Early Warning Score (TEWS), based on their effects on earthquake injury patients. DESIGN: Data in the Huaxi Earthquake Casualty Database were analysed retrospectively. SETTING: This study was conducted in China. PARTICIPANTS: Data on 29 523 earthquake casualties were separately evaluated using the START technique, CareFlight, REMS, T-RTS and TEWS, with these being the five types of injury triage studied. PRIMARY OUTCOME MEASURE: The receiver operating characteristic (ROC) curves for the five injury triages were calculated based on hospital deaths, injury severity scores greater than 15 points, and whether casualties stayed in the intensive care unit. RESULTS: The ROC curve areas of the START technique, CareFlight, REMS, T-RTS and TEWS were 0.750, 0.737, 0.835, 0.736 and 0.797, respectively. Among the five injury triages, the most accurate in predicting hospital deaths was REMS, with an average area under the curve (AUC) of 0.835, with this due to the inclusion of more evaluation indicators. CONCLUSION: All methods had an effect on the triage of earthquake mass casualties. Among them, the REMS injury triage method had the largest AUC of the five triage methods. Except for REMS, no obvious difference was found in the effect of the other four injury triage methods.


Assuntos
Terremotos , Incidentes com Feridos em Massa , Ferimentos e Lesões , Serviço Hospitalar de Emergência , Humanos , Escala de Gravidade do Ferimento , Curva ROC , Estudos Retrospectivos , Triagem
4.
Mymensingh Med J ; 30(4): 943-949, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605460

RESUMO

A casualty is a loss resulting from an accident or someone who is hurt, wounded, diseased, detained or dead in an accident. The term casualty means a seriously injured patient. It is predominantly a military word, generally used for service for accidents. After a battle or accident the dead, the wounded, the sick are called together as "casualties". Casualty, in respect to personnel, any individual who is lost to his organization by reason of being declared dead, wounded, diseased, detained, captured, or missing. Hospital casualty service is not fully organized all over the Bangladesh. In view of the increasing workload and emerging need, functional casualty services have recently been introduced in our hospital to manage properly the accident patients. This retrospective observational study was carried out in the Casualty department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Patients were enrolled total number of 69740 to investigate the quantity of patients and pattern of casualties. Patients were categorized according to their mode of injury. Total data was collected from hospital records of all patients attended in the Casualty Department of the hospital from November 19, 2017 to November 18, 2019. The modes of Casualties with demographic characteristics of patients were analyzed. Male and female ratio was 3:1. Patient attended in the Casualty department was average 96 per day, maximum was 176 and minimum was 33. According to age sub-division, 11-20 years age group attended in casualty was maximum and it was 48 in number. One day attended Road traffic accident (RTA) maximum was 65 and minimum was 3, maximum Non-RTA was 83 and minimum was 25, maximum physical assaults was 48 and minimum was 1. RTA and Injury due to fall were the common mode of casualty especially in the young population within the study area. We have seen that injury caused by fall from height was 43% among the all patients. Patients due to fall from tree was highest (35%) yearly in between April to June. Second to incidents of all fall was RTA which was 25%. Physical assaults (18%), machinery injury (9%) and others were 5%.


Assuntos
Incidentes com Feridos em Massa , Acidentes por Quedas , Adolescente , Adulto , Bangladesh/epidemiologia , Criança , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Centros de Atenção Terciária , Adulto Jovem
5.
Prehosp Disaster Med ; 36(6): 719-723, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34610852

RESUMO

INTRODUCTION: Mass-casualty incident (MCI) algorithms are used to sort large numbers of patients rapidly into four basic categories based on severity. To date, there is no consensus on the best method to test the accuracy of an MCI algorithm in the pediatric population, nor on the agreement between different tools designed for this purpose. STUDY OBJECTIVE: This study is to compare agreement between the Criteria Outcomes Tool (COT) to previously published outcomes tools in assessing the triage category applied to a simulated set of pediatric MCI patients. METHODS: An MCI triage category (black, red, yellow, and green) was applied to patients from a pre-collected retrospective cohort of pediatric patients under 14 years of age brought in as a trauma activation to a Level I trauma center from July 2010 through November 2013 using each of the following outcome measures: COT, modified Baxt score, modified Baxt combined with mortality and/or length-of-stay (LOS), ambulatory status, mortality alone, and Injury Severity Score (ISS). Descriptive statistics were applied to determine agreement between tools. RESULTS: A total of 247 patients were included, ranging from 25 days to 13 years of age. The outcome of mortality had 100% agreement with the COT black. The "modified Baxt positive and alive" outcome had the highest agreement with COT red (65%). All yellow outcomes had 47%-53% agreement with COT yellow. "Modified Baxt negative and <24 hours LOS" had the highest agreement with the COT green at 89%. CONCLUSIONS: Assessment of algorithms for triaging pediatric MCI patients is complicated by the lack of a gold standard outcome tool and variability between existing measures.


Assuntos
Incidentes com Feridos em Massa , Algoritmos , Criança , Humanos , Estudos Retrospectivos , Centros de Traumatologia , Triagem
6.
JMIR Mhealth Uhealth ; 9(10): e17472, 2021 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-34661548

RESUMO

BACKGROUND: Guidelines provide instructions for diagnostics and therapy in modern medicine. Various mobile devices are used to represent the potential complex decision trees. An example of time-critical decisions is triage in case of a mass casualty incident. OBJECTIVE: In this randomized controlled crossover study, the potential of augmented reality for guideline presentation was evaluated and compared with the guideline presentation provided in a tablet PC as a conventional device. METHODS: A specific Android app was designed for use with smart glasses and a tablet PC for the presentation of a triage algorithm as an example for a complex guideline. Forty volunteers simulated a triage based on 30 fictional patient descriptions, each with technical support from smart glasses and a tablet PC in a crossover trial design. The time to come to a decision and the accuracy were recorded and compared between both devices. RESULTS: A total of 2400 assessments were performed by the 40 volunteers. A significantly faster time to triage was achieved in total with the tablet PC (median 12.8 seconds, IQR 9.4-17.7; 95% CI 14.1-14.9) compared to that to triage with smart glasses (median 17.5 seconds, IQR 13.2-22.8, 95% CI 18.4-19.2; P=.001). Considering the difference in the triage time between both devices, the additional time needed with the smart glasses could be reduced significantly in the course of assessments (21.5 seconds, IQR 16.5-27.3, 95% CI 21.6-23.2) in the first run, 17.4 seconds (IQR 13-22.4, 95% CI 17.6-18.9) in the second run, and 14.9 seconds (IQR 11.7-18.6, 95% CI 15.2-16.3) in the third run (P=.001). With regard to the accuracy of the guideline decisions, there was no significant difference between both the devices. CONCLUSIONS: The presentation of a guideline on a tablet PC as well as through augmented reality achieved good results. The implementation with smart glasses took more time owing to their more complex operating concept but could be accelerated in the course of the study after adaptation. Especially in a non-time-critical working area where hands-free interfaces are useful, a guideline presentation with augmented reality can be of great use during clinical management.


Assuntos
Realidade Aumentada , Incidentes com Feridos em Massa , Simulação por Computador , Estudos Cross-Over , Humanos , Triagem
7.
Prehosp Disaster Med ; 36(6): 739-746, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34658318

RESUMO

OBJECTIVES: Considering the pediatric peculiarities and the difficulty of assisting this population in mass-casualty situations, this study aims to identify the main topics regarding children's health care in mass-casualty incidents (MCIs) that are discussed in the Emergency Medicine area. METHODS: This systematic review was performed according to the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered with the PROSPERO database of systematic reviews with the number CRD42021229552. The last update of the search in the databases was on May 27, 2021 and resulted in 45 documents to be analyzed. The inclusion criteria included the peer-reviewed academic papers in English, Portuguese, Spanish, and Italian languages; the databases used were PubMed, Scopus, MEDLINE/Bireme (Virtual Library of Health - VLH), and Web of Science, which execute the query on the topic, keywords, or abstracts. Also, to be included, documents that were available with full-text access through CAPES, Google, or Google Scholar. Books, non-academic research, and content in languages other than the presented ones were represented as exclusion criteria. RESULTS: From the resulting papers, 21 articles served as the basis for this analysis. Revealed were the year of publication, the first author's institution nationality, topic, and disaster management phase for each study, which allow other researchers to understand the main topics regarding children's health care in MCIs. CONCLUSIONS: The topics regarding child's health care in MCIs found in the primary studies of this review, in order of frequency, were: Disaster Response (including the following sub-topics: simulation, education, quality of care, use of technological tools, and damage analysis); Triage; and Disaster Planning. The Emergency Medicine operation was focused on harm reduction after the occurrence of an MCI. Further studies focusing on the pre-disaster and post-disaster phases are needed.


Assuntos
Planejamento em Desastres , Incidentes com Feridos em Massa , Criança , Saúde da Criança , Atenção à Saúde , Humanos , Triagem
8.
Scand J Trauma Resusc Emerg Med ; 29(1): 156, 2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-34717723

RESUMO

BACKGROUND: In a terror attack mass casualty incident (TerrorMASCAL), compared to a "normal" MASCAL, there is a dynamic course that can extend over several hours. The injury patterns are penetrating and perforating injuries. This article addresses the provision of material and personnel for the care of special injuries of severely injured persons that may occur in the context of a TerrorMASCAL. METHODS: To answer the research question about the preparation of hospitals for the care of severely injured persons in a TerrorMASCAL, a survey of trauma surgery departments in Bavaria (Germany) was conducted using a questionnaire, which was prepared in three defined steps based on an expert consensus. The survey is divided into a general, neurosurgical, thoracic, vascular and trauma surgery section. In the specialized sections, the questions relate to the implementation of and material and personnel requirements for special interventions that are required, particularly for injury patterns following gunshot and explosion injuries, such as trepanation, thoracotomy and balloon occlusion of the aorta. RESULTS: In the general section, it was noted that only a few clinics have an automated system to notify off-duty staff. When evaluating the data from the neurosurgical section, the following could be established with regard to the performance of trepanation: the regional trauma centers do not perform trepanation but nevertheless have the required material and personnel available. A similar result was recorded for local trauma centers. In the thoracic surgery section, it could be determined that almost all trauma centers that do not perform thoracotomy have the required material available. This group of trauma centers also stated that they have staff who can perform thoracotomy independently. The retrograde endovascular aortic occlusion procedure is possible in 88% of supraregional, 64% of regional and 10% of local trauma centers. Pelvic clamps and external fixators are available at all trauma centers. CONCLUSION: The results of the survey show potential for optimization both in the area of framework conditions and in the care of patients. Consistent and specific training measures, for example, could improve the nationwide performance of these special interventions. Likewise, it must be discussed whether the abovementioned special procedures should be reserved for higher-level trauma centers.


Assuntos
Incidentes com Feridos em Massa , Terrorismo , Explosões , Alemanha/epidemiologia , Hospitais , Humanos , Centros de Traumatologia
9.
Prehosp Disaster Med ; 36(6): 756-761, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34702422

RESUMO

INTRODUCTION: The proliferation of unmanned aerial vehicle (UAV) technology has the potential to change the situational awareness of medical incident commanders' (ICs') scene assessment of mass gatherings. Mass gatherings occur frequently and the potential for injury at these events is considered higher than the general population. These events have generated mass-casualty incidents (MCIs) in the past. The aim of this study was to compare UAV technology to standard practice (SP) in scene assessment using paramedic students during a mass-gathering event (MGE). METHODS: This study was conducted in two phases. Phase One consisted of validation of the videos and accompanying data collection tool. Phase One was completed by 11 experienced paramedics from a provincial Emergency Medical Services (EMS) service. Phase Two was a randomized comparison with 47 paramedic students from the Holland College Paramedicine Program (Charlottetown, Prince Edward Island, Canada) of the two scene assessment systems. For Phase Two, the paramedic students were randomized into a UAV or a SP group. The data collection tool consisted of two board categories: primary importance with 20 variables and secondary importance with 25 variables. After a brief narrative, participants were either shown UAV footage or the ground footage depending on their study group. After completion of the videos, study participants completed the data collection tool. RESULTS: The Phase One validation showed good consensus in answers to most questions (average 79%; range 55%-100%). For Phase Two, a Fisher's exact test was used to compare each variable from the UAV and SP groups using a P value of .05. Phase Two demonstrated a significant difference between the SP and UAV groups in four of 20 primary variables. Additionally, significant differences were found for seven out of 25 secondary variables. CONCLUSION: This study demonstrated the accurate, safe, and feasible use of a UAV as a tool for scene assessment by paramedic students at an MGE. No observed statistical difference was noted in a majority of both primary and secondary variables using a UAV for scene assessment versus SP.


Assuntos
Auxiliares de Emergência , Incidentes com Feridos em Massa , Pessoal Técnico de Saúde , Humanos , Estudantes , Tecnologia
11.
J Emerg Manag ; 19(4): 367-377, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34580852

RESUMO

INTRODUCTION: The number of mass casualty incidents (MCIs) is increasing. While many healthcare systems have not experienced an MCI, the need for preparedness is ever present. The unique challenges of MCI preparedness require the use of simulation, which has been found to be an effective model for training in medical environments. OBJECTIVE: To determine common discussion points when a multidisciplinary team designed and implemented in situ MCI simulation drills to enhance our emergency preparedness plan. DESIGN: This was a retrospective qualitative evaluation of the multidisciplinary mass casualty drill design team's weekly meeting minutes documents. These documents provided insight into the evolution of a mass casualty drill design team and the advancement of our emergency response plan. RESULTS: Continuous discussions surrounding resource restraints helped to inform the emergence of the three themes, which were "Staff," "Space," and "Stuff." These three themes were further broken down into different subthemes, but there was a continued focus on resource scarcity. CONCLUSIONS: Our results indicate the use of an MCI drill design team and in situ simulations assisted in better understanding of how hospital departments struggled with resource scarcity and provided opportunities to strengthen the emergency preparedness response plan. Incorporating a multidisciplinary mass casualty drill design team helped to ensure different perspectives and department needs were acknowledged and addressed through the in situ simulation trainings.


Assuntos
Planejamento em Desastres , Incidentes com Feridos em Massa , Serviço Hospitalar de Emergência , Humanos , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos
12.
Scand J Trauma Resusc Emerg Med ; 29(1): 140, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34556163

RESUMO

BACKGROUND: Major incidents (MI) are rare occurrences in Scandinavia. Literature depicting Scandinavian MI management is scarce and case reports and research is called for. In 2019, a trailer falling off a freight train struck a passing high-speed train on the Great Belt Bridge in Denmark, killing eight people instantly and injuring fifteen people. We aim to describe the emergency medical services (EMS) response to this MI and evaluate adherence to guidelines to identify areas of improvement for future MI management. CASE PRESENTATION: Nineteen EMS units were dispatched to the incident site. Ambulances transported fifteen patients to a trauma centre after evacuation. Deceased patients were pronounced life-extinct on-scene. Radio communication was partly compromised, since 38.9% of the radio shifts were not according to the planned radio grid and presented a potential threat to patient outcome and personnel safety. Access to the incident site was challenging and delayed due to traffic congestion and safety issues. CONCLUSION: Despite harsh weather conditions and complex logistics, the availability of EMS units was sufficient and patient treatment and evacuation was uncomplicated. Triage was relevant, but at the physicians' discretion. Important findings were communication challenges and the consequences of difficult access to the incident site. There is a need for an expansion of capacity in formal education in MI management in Denmark.


Assuntos
Serviços Médicos de Emergência , Incidentes com Feridos em Massa , Acidentes , Ambulâncias , Humanos , Triagem
14.
J Spec Oper Med ; 21(3): 123-125, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34529819

RESUMO

In January 2020, an American base was attacked by the largest theater ballistic missile strike in history. This case report covers the resulting mass casualty (MASCAL) incident. In this case, we defined this incident as a MASCAL due to a lack of medical personnel available to properly and timely evaluate the patients. There was no loss of life during the attack but there were > 80 traumatic brain injuries (TBIs). This article focuses on lessons learned from diagnosing and treating Soldiers during a TBI MASCAL event.


Assuntos
Lesões Encefálicas Traumáticas , Incidentes com Feridos em Massa , Militares , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/terapia , Humanos , Estados Unidos
15.
J Bus Contin Emer Plan ; 15(1): 17-29, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34465407

RESUMO

Exercise GTA Unified was a functional, multi-agency, cross-jurisdictional, health-sector focused mass casualty preparedness exercise conducted in the Greater Toronto Area (GTA) on 28th November, 2019. With over 1,000 unique paper-based and electronic injects and 34 participating agencies, including 22 separate hospital sites, Exercise GTA Unified is likely the largest health-sector focused mass casualty preparedness exercise ever conducted in Canada. The exercise design approach supported a successful, objective-based functional exercise, with elements of marked realism for participants. The exercise offered a unique opportunity to collect data for future analysis and the insights gained will have a transformative impact on interagency engagement and cooperation for emergency response planning. Furthermore, the approach adopted for the exercise is affordable, reproducible, scalable and transferrable to sectors beyond the health system. This paper provides a detailed review of the key planning and design components adopted in the development and implementation of the exercise, as well as practical insights for the design and conduct of multi-agency, cross-jurisdictional functional exercises.


Assuntos
Planejamento em Desastres , Incidentes com Feridos em Massa , Canadá , Emergências , Serviço Hospitalar de Emergência , Humanos
16.
Prehosp Disaster Med ; 36(5): 536-542, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34486507

RESUMO

INTRODUCTION AND OBJECTIVE: Scientific reporting on major incidents, mass-casualty incidents (MCIs), and disasters is challenging and made difficult by the nature of the medical response. Many obstacles might explain why there are few and primarily non-heterogenous published articles available. This study examines the process of scientific reporting through first-hand experiences from authors of published reports. It aims to identify learning points and challenges that are important to address to mitigate and improve scientific reporting after major incidents. METHODS: This was a qualitative study design using semi-structured interviews. Participants were selected based on a comprehensive literature search. Ten researchers, who had published reports on major incidents, MCIs, or disasters from 2013-2018 were included, of both genders, from eight countries on three continents. The researchers reported on large fires, terrorist attacks, shootings, complex road accidents, transportation accidents, and earthquakes. RESULTS: The interview was themed around initiation, workload, data collection, guidelines/templates, and motivation factors for reporting. The most challenging aspects of the reporting process proved to be a lack of dedicated time, difficulties concerning data collection, and structuring the report. Most researchers had no prior experience in reporting on major incidents. Guidelines and templates were often chosen based on how easily accessible and user-friendly they were. CONCLUSION AND RELEVANCE: There are few articles presenting first-hand experience from the process of scientific reporting on major incidents, MCIs, and disasters. This study presents motivation factors, challenges during reporting, and factors that affected the researchers' choice of reporting tools such as guidelines and templates. This study shows that the structural tools available for gathering data and writing scientific reports need to be more widely promoted to improve systematic reporting in Emergency and Disaster Medicine. Through gathering, comparing, and analyzing data, knowledge can be acquired to strengthen and improve responses to future major incidents. This study indicates that transparency and willingness to share information are requisite for forming a successful scientific report.


Assuntos
Medicina de Desastres , Planejamento em Desastres , Incidentes com Feridos em Massa , Terrorismo , Feminino , Humanos , Masculino , Editoração , Pesquisa Qualitativa
17.
Am J Disaster Med ; 16(2): 147-162, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34392526

RESUMO

Since the events of 9/11, a concerted interagency effort has been undertaken to create comprehensive emergency planning and preparedness strategies for management of a radiological or nuclear event in the US. These planning guides include protective action guidelines, medical countermeasure recommendations, and systems for diagnosing and triaging radiation injury. Yet, key areas such as perception of risk from radiation exposure by first responders have not been addressed. In this article, we identify the need to model and develop new strategies for the medical manage-ment of large-scale population exposures to radiation, examine the phenomena of radiation dread and its role in emergency response, and review recent findings on the willingness to work of first responders and other personnel involved in mass casualty medical management during a radiological or nuclear event.


Assuntos
Planejamento em Desastres , Socorristas , Incidentes com Feridos em Massa , Lesões por Radiação , Liberação Nociva de Radioativos , Emergências , Humanos
18.
Prehosp Disaster Med ; 36(5): 519-525, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34399863

RESUMO

INTRODUCTION: Mass-casualty incidents (MCIs), specifically incidents with chemical, biological, radiological, and nuclear agents (CBRN) or terrorist attacks, challenge medical coordination, rescue, availability, and adequate provision of prehospital and hospital-based emergency care. In the Netherlands, a new model for Mass Casualty and Disaster Management (MCDM) along with a Terror Attack Mitigation Approach (TAMA) was introduced in 2016. STUDY OBJECTIVE: The objective of this study was to provide insight in the first experiences of health policy advisors and managers with a medical rescue coordinator and ambulance nursing background regarding the new MCDM and TAMA in order to identify strengths and pitfalls in emergency preparedness and to provide recommendations for improvement. METHODS: The study had a qualitative design and was performed from January 2017 through June 2018. Purposeful sampling was used and the inclusion comprehended health policy advisors and managers with a medical rescue coordinator and ambulance nursing background involved in emergency preparedness. The respondents were interviewed semi-structured and the researchers used a topic list that was based on the literature and content of the newly introduced model and approach. All interviews were typed out verbatim and qualitative content analyzing was used in order to identify relevant themes. RESULTS: Respondents based their perceptions on large-scale training exercises, as MCDM and TAMA were not yet used during MCIs. Perceived issues of MCDM were the two-tiered triage system, the change in focus from "stay and play" towards "scoop and run," difficulties with new tasks and roles of professionals, and improvement in material provision. Regarding TAMA, all respondents supported the principles (do the most for the most; scoop and run; acceptable personal risk; never walk alone; and standard operational procedure); however, the definitions were lacking clarity while the awareness of optimal personal safety of professionals was absent.As there are currently regional differences in the level of implementation of MCDM and TAMA, this may pose a risk for an optimal inter-regional collaboration. CONCLUSION: The conclusions refer to experiences of professionals in the Netherlands. Elements of the MCDM and TAMA were highly appreciated and seemed to improve emergency preparedness, while other aspects needed further attention, training, and integration in daily routine. The Netherlands' MCDM model and TAMA will need continuous systematic evaluation based on (inter)national performance criteria in order to underpin the useful and effective elements and to improve the observed pitfalls in emergency preparedness.


Assuntos
Planejamento em Desastres , Serviços Médicos de Emergência , Incidentes com Feridos em Massa , Enfermeiras e Enfermeiros , Ambulâncias , Humanos , Países Baixos
19.
Prehosp Disaster Med ; 36(5): 636-638, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34334152

RESUMO

The mass proliferation and increasing affordability of unmanned aerial vehicles (UAVs) in recent years has given rise to weaponized UAV use by terrorists, leading to mounting and credible concerns this attack methodology will be the next terrorism modus operandi. Counter-Terrorism Medicine (CTM) specialists need to consider how UAVs alter or create new mass-casualty scenarios that can further exploit existing medical preparedness vulnerabilities. With an opportunity to be proactive in disaster prevention, mitigation, and preparedness, it is imperative this gathering storm be acknowledged and stakeholders explore how best to prepare for, respond to, and mitigate the consequences of UAV incidents.


Assuntos
Planejamento em Desastres , Serviços Médicos de Emergência , Incidentes com Feridos em Massa , Terrorismo , Humanos , Saúde Pública
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