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Desmet T, De Paepe P, Eeckloo K. Enhancing hospital emergency response based on the experience of COVID-19. Acta Clin Belg 2024:1-11. [PMID: 39129384 DOI: 10.1080/17843286.2024.2387384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 07/09/2024] [Indexed: 08/13/2024]
Abstract
INTRODUCTION The COVID-19 pandemic required a significant response from global healthcare systems. In Belgium, the crisis began in March 2020, prompting quick action in hospitals. This study assesses the effectiveness of Belgium's hospital emergency plans and compares them with global standards for potential enhancements. METHODOLOGY An online survey targeting CEOs of 60 Flemish general hospitals evaluated the deployment of hospital emergency coordination cells during the pandemic's first and fourth waves, utilizing various statistical analyses. RESULTS Findings indicate a high establishment rate of COVID-19 coordination cells before the government's deadline. Despite this readiness, differences in leadership, involvement, and communication strategies were noted among hospitals. There was a notable shift towards hybrid meetings and an evolving role for coordination cells, highlighting the need for a more structured crisis management approach. CONCLUSION The study concludes that while Flemish hospitals were quick to respond, the lack of a standardized framework suggests the potential for adopting models like the Hospital Incident Command System (HICS) for improved crisis management. Future research should examine the long-term effects of these strategies and the integration of comprehensive emergency management systems in Belgium's healthcare.
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Affiliation(s)
- Tania Desmet
- Department of Basic and Applied Medical Science, Emergency Department, Ghent University Hospital, Gent, Belgium
| | - Peter De Paepe
- Department of Basic and Applied Medical Science, Emergency Department, Ghent University Hospital, Gent, Belgium
| | - Kristof Eeckloo
- Department of Public Health and Primary Care, Strategic Policy Unit, Ghent University Hospital, Gent, Belgium
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2
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Grosman-Rimon L, Li DHY, Collins BE, Wegier P. Can we improve healthcare with centralized management systems, supported by information technology, predictive analytics, and real-time data?: A review. Medicine (Baltimore) 2023; 102:e35769. [PMID: 37960822 PMCID: PMC10637563 DOI: 10.1097/md.0000000000035769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/03/2023] [Indexed: 11/15/2023] Open
Abstract
This narrative review discusses the effects of implementing command centers, centralized management systems, supported by information technology, predictive analytics, and real-time data, as well as small-scale centralized operating systems, on patient outcomes, operation, care delivery, and resource utilization. Implementations of command centers and small-scale centralized operating systems have led to improvement in 3 areas: integration of both multiple services into the day-to-day operation, communication and coordination, and employment of prediction and early warning system. Additional studies are required to understand the full impact of command centers on the healthcare system.
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Affiliation(s)
| | - Donny H Y Li
- Research Institute, Humber River Health, Toronto, Ontario, Canada
- McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
| | | | - Pete Wegier
- Research Institute, Humber River Health, Toronto, Ontario, Canada
- University of Toronto, Institute of Health Policy, Management and Evaluation, Ontario, Canada
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3
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Review of Possible Therapies in Treatment of Novichoks Poisoning and HAZMAT/CBRNE Approaches: State of the Art. J Clin Med 2023; 12:jcm12062221. [PMID: 36983219 PMCID: PMC10054273 DOI: 10.3390/jcm12062221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/02/2023] [Accepted: 03/11/2023] [Indexed: 03/16/2023] Open
Abstract
Novichoks-organophosphorus compounds belong to the nerve agents group, constituting the fourth generation of chemical warfare agents. The tremendous toxicity of Novichoks is assumed to be several times greater than that of VX, whereas no published experimental research supports this. They were surreptitiously created during the Cold War by the Soviet Union. Novichok’s toxic action mechanism consists of the inhibition of acetylcholinesterase activity. The review includes data on treating poisoning caused by OPs which could be used as guidelines for the therapy in case of Novichok exposure and HAZMAT/CBRNE approaches. Novichoks pose a severe threat due to their toxicity; however, there is insufficient information about the identity of A-series nerve agents. Filling in the missing data gaps will accelerate progress in improving protection against Novichoks and developing optimal therapy for treating poisoning casualties. Furthermore, introducing solutions to protect medical personnel in contact with a hazardous substance increases the chances of saving casualties of HAZMAT/CBRNE incidents.
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4
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Tabatabaei AR, Moazam E, Niaraees Zavare AS. Implementation of the Hospital Incident Command System during COVID-19 Pandemic; Experience from an Iranian Reference Hospital. Hosp Top 2022:1-7. [PMID: 36006632 DOI: 10.1080/00185868.2022.2114966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Introduction: There is growing popularity of the Hospital Incident Command System (HICS) as an organizational tool for hospital management in the COVID-19 pandemic. We specifically describe implementation of HICS at the Isfahan province reference hospital (Isabn-e-Maryam) during the COVID-19 pandemic and try to explore performance of it. Methods: To document the actions taken during the COVID-19 pandemic, standard, open-ended interviews were conducted with individuals occupying activated HICS leadership positions during the event. A checklist based on the job action sheets of the HICS was used for performance assessment. Results: With the onset of the pandemic, hospital director revised ICS structure that adheres to span of better control of COVID-19. Methods of expanding hospital inpatient capacity to enable surge capacity were considered. The highest performance score was in the field of planning. Performance was intermediate in Financial/Administration section and good in other fields. Discussion: In the current COVID-19 pandemic, establishing HICS with some consideration about long-standing events can help improve communication, resource use, staff and patient protection, and maintenance of roles.
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Affiliation(s)
| | - Elham Moazam
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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5
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Chuang HN, Shih CH, Tsai HW, Jiang RS, Hsiao TH, Liu PY, Jan YJ, Wang JM. Laboratory Surge Response to the COVID-19 Pandemic: An Incident Command System Approach. J Multidiscip Healthc 2022; 15:1083-1088. [PMID: 35586076 PMCID: PMC9109728 DOI: 10.2147/jmdh.s358096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Han-Ni Chuang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407204, Taiwan
| | - Chien-Hung Shih
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407204, Taiwan
| | - Hung-Wen Tsai
- Medical Administration Department, Taichung Veterans General Hospital, Taichung, 47204, Taiwan
| | - Rong-San Jiang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407204, Taiwan
| | - Tzu-Hung Hsiao
- Medical Administration Department, Taichung Veterans General Hospital, Taichung, 47204, Taiwan
- Department of Public Health, Fu Jen Catholic University, New Taipei City, 24205, Taiwan
- Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, 40227, Taiwan
| | - Po-Yu Liu
- Division of Infection, Taichung Veterans General Hospital, Taichung, 47204, Taiwan
| | - Yee-Jee Jan
- Department of Pathology & Laboratory Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan
- Correspondence: Yee-Jee Jan; Jiunn-Min Wang, Department of Pathology & Laboratory Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan, Tel +886-4-23592525, Fax +886-4-2359-5046, Email ;
| | - Jiunn-Min Wang
- Department of Pathology & Laboratory Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan
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6
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Kaye AD, Cornett EM, Kallurkar A, Colontonio MM, Chandler D, Mosieri C, Brondeel KC, Kikkeri S, Edinoff A, Fitz-Gerald MJ, Ghali GE, Liu H, Urman RD, Fox CJ. Framework for creating an incident command center during crises. Best Pract Res Clin Anaesthesiol 2021; 35:377-388. [PMID: 34511226 PMCID: PMC8428470 DOI: 10.1016/j.bpa.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 11/16/2022]
Abstract
The Hospital Incident Command System (HICS) is an incident management system specific to hospitals based on the principles of Incident Command System (ICS), and it includes prevention, protection, mitigation, response, and recovery. It plays a crucial role in effective and timely response during the periods of disasters, mass casualties, and public health emergencies. In recent times, hospitals have used a customized HICS structure to coordinate effective responses to public health problems such as the Ebola outbreak in the US and SARS epidemic in Taiwan. The current COVID-19 pandemic has placed unprecedented challenges on the healthcare system, necessitating the creation of HICS that can help in the proper allocation of resources and ineffective utilization of healthcare personnel. The key elements in managing a response to this pandemic include screening and early diagnosis, quarantining affected individuals, monitoring disease progression, delivering appropriate treatment, and ensuring an adequate supply of personal protective equipment (PPE) to healthcare staff.
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Affiliation(s)
- Alan D Kaye
- LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Elyse M Cornett
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Anusha Kallurkar
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Matthew M Colontonio
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | | | - Chizoba Mosieri
- Department of Anesthesiology, LSU Health, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Kimberley C Brondeel
- University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA.
| | - Sathyadev Kikkeri
- OMS-IV, Alabama College of Osteopathic Medicine, Dothan, AL 36303, USA.
| | - Amber Edinoff
- LSU Shreveport Department of Psychiatry and Behavioral Medicine, USA.
| | - Mary Jo Fitz-Gerald
- LSU Shreveport Department of Psychiatry and Behavioral Medicine, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - G E Ghali
- Department of Oral & Maxillofacial Surgery, Craniofacial Surgery/Head & Neck Surgery, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Henry Liu
- Department of Anesthesiology, Milton S. Hershey Medical Center, Penn State University School of Medicine, 500 University Drive, H187, Hershey, PA 17033, USA
| | - Richard D Urman
- Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
| | - Charles J Fox
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
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7
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Hertelendy AJ, Tochkin J, Richmond J, Ciottone GR. Preparing for the next COVID-19 wave in Canada: managing the crisis facing emergency management leaders in healthcare organisations. BMJ LEADER 2021; 6:121-124. [DOI: 10.1136/leader-2020-000437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/23/2021] [Indexed: 11/03/2022]
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8
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Bowman C, Branjerdporn G, Turner K, Kamara M, Tyagi N, Reyes NJD, Stapelberg NJC. The impact of viral epidemics and pandemics on acute mental health service use: an integrative review. Health Psychol Rev 2021; 15:1-33. [PMID: 33550940 DOI: 10.1080/17437199.2021.1886864] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The aim of this integrative review was to examine the impact of past viral epidemics on mental health, with a specific focus on changes in numbers of acute mental health presentations and mental health service recommendations in response to this, in the context of the COVID-19 pandemic. Following PRISMA methodology, databases were searched for relevant publications. A total of 83 articles with a range of methodologies were included to ensure broad coverage of this rapidly emerging research area. The literature supports an initial increase in mental health concerns which generally do not reach the threshold for diagnosis with a mental illness, but present to frontline telephone services. There is a potential delay before community and hospital-based mental health services see an increase in new or relapsing mental illness presentations. However vulnerable populations, such as people with pre-existing mental illness, are at increased risk of mental health issues during such public health crises. Many of the general recommendations distilled from the literature are closely aligned with existing strategic frameworks for mental health service provision. However, in review of these frameworks, gaps in the literature become more apparent, such as a failure to include people with lived experience, peer workers, and First Nations People in the COVID-19 mental health response.
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Affiliation(s)
- Candice Bowman
- Mental Health and Specialist Services, Gold Coast Health, Southport, Australia
| | - Grace Branjerdporn
- Mental Health and Specialist Services, Gold Coast Health, Southport, Australia
| | - Kathryn Turner
- Mental Health and Specialist Services, Gold Coast Health, Southport, Australia
| | - Memunatu Kamara
- Mental Health and Specialist Services, Gold Coast Health, Southport, Australia
| | - Nischal Tyagi
- Mental Health and Specialist Services, Gold Coast Health, Southport, Australia
| | | | - Nicolas J C Stapelberg
- Mental Health and Specialist Services, Gold Coast Health, Southport, Australia.,Faculty of Health Science and Medicine, Bond University, Gold Coast, Australia
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9
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Morrissey CK, Bledsoe AD, Zimmerman J, Bott SI, Stuart AR, Johnson KB, DeCou JA, Thackeray EM, Kuck K, Chacin AB, Dorsey DP, Chortkoff B, Drennan EL, Smith DW, Jackman CM, Paulsen LF, Egan TD. Reinvention of an academic anaesthesiology department during pandemic times: lessons learnt and adapting to a “new normal”. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2021. [DOI: 10.36303/sajaa.2021.27.3.2576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- CK Morrissey
- Department of Anesthesiology, University of Utah,
United States of America
| | - AD Bledsoe
- Department of Anesthesiology, University of Utah,
United States of America
| | - J Zimmerman
- Department of Anesthesiology, University of Utah,
United States of America
| | - SI Bott
- Department of Anesthesiology, University of Utah,
United States of America
| | - AR Stuart
- Department of Anesthesiology, University of Utah,
United States of America
| | - KB Johnson
- Department of Anesthesiology, University of Utah,
United States of America
| | - JA DeCou
- Department of Anesthesiology, University of Utah,
United States of America
| | - EM Thackeray
- Department of Anesthesiology, University of Utah,
United States of America
| | - K Kuck
- Department of Anesthesiology, University of Utah,
United States of America
| | - AB Chacin
- Department of Anesthesiology, University of Utah,
United States of America
| | - DP Dorsey
- Department of Anesthesiology, University of Utah,
United States of America
| | - B Chortkoff
- Department of Anesthesiology, University of Utah,
United States of America
| | - EL Drennan
- Department of Anesthesiology, University of Utah,
United States of America
| | - DW Smith
- Department of Anesthesiology, University of Utah,
United States of America
| | - CM Jackman
- Department of Anesthesiology, University of Utah,
United States of America
| | - LF Paulsen
- Department of Anesthesiology, University of Utah,
United States of America
| | - TD Egan
- Department of Anesthesiology, University of Utah,
United States of America
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10
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Lin CH. Disaster Medicine in Taiwan. J Acute Med 2019; 9:83-109. [PMID: 32995238 PMCID: PMC7440387 DOI: 10.6705/j.jacme.201909_9(3).0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study aimed to examine scientific publications that were related to disaster medicine and were authored by emergency medicine physicians in Taiwan. This descriptive study utilized the electronic databases of PubMed, Scopus, and Web of Science. Academic works that were published between January 1, 1999, and December 31, 2018, were collected for review and analysis. Of the 53 articles included in the final analysis,40 (75.5%) were original research, 3 (5.7%) were reviews, 1 (1.9%) was a brief report, and 9 (17.0%) were perspectives. The top 5 themes were disaster response systems (17, 32.1%), endemic diseases (11, 20.8%), emergency department (ED) overcrowding (10, 18.9%), earthquakes (10, 18.9%), and ED administration (9, 17.0%). Sixteen (30.2%) articles involved international collaborations. The median, interquartile range and range of the numbers of citations of the articles were 3, 1-11, and 0-65, respectively. Twenty-four (45.3%) articles were related to specific incidents: the Chi-Chi earthquake in 1999 (n = 5), the Singapore airline crash in 2000 (n = 1), Typhoon Nari in 2001 (n = 1), the outbreak of severe acute respiratory syndrome in 2003 (n = 7), Typhoon Morakot in 2009 (n = 1), the color party explosion in Formosa Fun Coast Park in 2015 (n = 4), and the Tainan earthquake in 2016 (n = 5). Regarding the study methods, 19 (35.8%) articles were quantitative studies; 10 (18.9%) were qualitative or semiqualitative studies; 8 (15.1%) used questionnaire surveys; 3 (5.7%) were literature reviews; 3 (5.7%) used computer simulations; and 10 (18.9%) were descriptive/narrative or other types of studies. Though the number of academic publications related to disaster medicine from the EDs in Taiwan is relatively limited, the quality and diversity of research seem promising. The research environment and education programs on disaster medicine in Taiwan deserve thoughtful consideration.
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Affiliation(s)
- Chih-Hao Lin
- National Cheng Kung University Department of Emergency Medicine National Cheng Kung University Hospital College of Medicine Tainan Taiwan
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11
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Sauer LM, Romig M, Andonian J, Flinn JB, Hynes N, Maloney R, Maragakis LL, Garibaldi B. Application of the Incident Command System to the Hospital Biocontainment Unit Setting. Health Secur 2019; 17:27-34. [PMID: 30779610 DOI: 10.1089/hs.2019.0006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
High-consequence pathogens create a unique problem. To provide effective treatment for infected patients while providing safety for the community, a series of 10 high-level isolation units have been created across the country; they are known as Regional Ebola and Special Pathogen Treatment Centers (RESPTCs). The activation of a high-level isolation unit is a highly resource-intensive activity, with effects that ripple across the healthcare system. The incident command system (ICS), a standard tool for command, control, and coordination in domestic emergencies, is a command structure that may be useful in a biocontainment event. A version of this system, the hospital emergency incident command system, provides an adaptable all-hazards approach in healthcare delivery systems. Here we describe its utility in an operational response to safely care for a patient(s) infected with a high-consequence pathogen on a high-level isolation unit. The Johns Hopkins Hospital created a high-level isolation unit to manage the comprehensive and complex needs of patients with high-consequence infectious diseases, including Ebola virus disease. The unique challenges of and opportunities for providing care in this high-level isolation unit led the authors to modify the hospital incident command system model for use during activation. This system has been tested and refined during full-scale functional and tabletop exercises. Lessons learned from the after-action reviews of these exercises led to optimization of the structure and implementation of ICS on the biocontainment unit, including improved job action sheets, designation of physical location of roles, and communication approaches. Overall, the adaptation of ICS for use in the high-level isolation unit setting may be an effective approach to emergency management during an activation.
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Affiliation(s)
- Lauren M Sauer
- Lauren M. Sauer, MSc, is Director of Operations, Johns Hopkins Office of Critical Event Preparedness and Response, Department of Emergency Medicine, School of Medicine, Johns Hopkins University.,Ms. Sauer and Dr. Romig are co-first authors
| | - Mark Romig
- Mark Romig, MD, is Assistant Professor, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Medicine Armstrong Institute for Quality and Patient Safety, Johns Hopkins University, Baltimore, Maryland.,Ms. Sauer and Dr. Romig are co-first authors
| | - Jennifer Andonian
- Jennifer Andonian, MPH, is Senior Infection Control Epidemiologist, Johns Hopkins Hospital Department of Hospital Epidemiology and Infection Control, Johns Hopkins University, Baltimore, Maryland
| | - Jade Borromeo Flinn
- Jade Borromeo Flinn, RN, is a Nurse Educator, Biocontainment Unit, Johns Hopkins Hospital Department of Medicine & Department of Neurosciences, Johns Hopkins University, Baltimore, Maryland
| | - Noreen Hynes
- Noreen A. Hynes, MD, MPH, is Associate Professor of Medicine, and Director, Geographic Medicine Center, Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Robert Maloney
- Robert Maloney, MS, NREMT-P, is Senior Director, Johns Hopkins Medicine Office of Emergency Management, Johns Hopkins University, Baltimore, Maryland
| | - Lisa L Maragakis
- Lisa L. Maragakis, MD, MPH, is Associate Professor of Medicine, Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Brian Garibaldi
- Brian T. Garibaldi, MD, MEHP, is Director, Johns Hopkins Biocontainment Unit, and Associate Professor, Medicine and Physiology, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland
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Shooshtari S, Tofighi S, Abbasi S. Benefits, barriers, and limitations on the use of Hospital Incident Command System. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:36. [PMID: 28465695 PMCID: PMC5393096 DOI: 10.4103/1735-1995.202146] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 11/12/2016] [Accepted: 12/01/2016] [Indexed: 12/05/2022]
Abstract
Hospital Incident Command System (HICS) has been established with the mission of prevention, response, and recovery in hazards. Regarding the key role of hospitals in medical management of events, the present study is aimed at investigating benefits, barriers, and limitations of applying HICS in hospital. Employing a review study, articles related to the aforementioned subject published from 1995 to 2016 were extracted from accredited websites and databases such as PubMed, Google Scholar, Elsevier, and SID by searching keywords such as HICS, benefits, barriers, and limitations. Then, those articles were summarized and reported. Using of HICS can cause creating preparedness in facing disasters, constructive management in strategies of controlling events, and disasters. Therefore, experiences indicate that there are some limitations in the system such as failure to assess the strength and severity of vulnerabilities of hospital, no observation of standards for disaster management in the design, constructing and equipping hospitals, and the absence of a model for evaluating the system. Accordingly, the conducted studies were investigated for probing the performance HICS. With regard to the role of health in disaster management, it requires advanced international methods in facing disasters. Using accurate models for assessing, the investigation of preparedness of hospitals in precrisis conditions based on components such as command, communications, security, safety, development of action plans, changes in staff's attitudes through effective operational training and exercises and creation of required maneuvers seems necessary.
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Affiliation(s)
- Shahin Shooshtari
- Department of Community Health Sciences, Faculty of Health Sciences, Max Rady College of Medicine Rady, University of Manitoba, Winnipeg, Canada
| | - Shahram Tofighi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Shirin Abbasi
- Health Management in Disaster, Shakhes Pajouh Research Institute, University of Isfahan, Isfahan, Iran
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13
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Grein JD, Murthy AR. Preparing a Hospital for Ebola Virus Disease: a Review of Lessons Learned. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2016. [DOI: 10.1007/s40506-016-0087-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Assessment of a Military Hospital’s Disaster Preparedness Using a Health Incident Command System. Trauma Mon 2016. [DOI: 10.5812/traumamon.31448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Abstract
Given the foundational and the fundamental role that the Incident Command System (ICS) is intended to play in on-scene response efforts across the United States, it is important to determine what is known about the system and how this is known. Accordingly, this study addresses the following research question: 'How has research explored the ICS?'. To probe this question, a methodological review of the scant, but widening, pool of research literature directly related to the ICS was conducted. This paper reports on the findings of the analysis related to the focus, theoretical frameworks, population and sampling, methods, results, and conclusions of the existing research literature. While undertaken using different methodological approaches, the ICS research suggests that the system may be limited in its usefulness. In addition, the paper discusses the implications of the research for the state of knowledge of the system and for the direction of future research.
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Affiliation(s)
- Jessica Jensen
- Assistant Professor, Center for Disaster Studies and Emergency Management, Department of Emergency Management, North Dakota State University, United States
| | - Steven Thompson
- Doctoral Fellow, Center for Disaster Studies and Emergency Management, Department of Emergency Management, North Dakota State University, United States
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16
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Djalali A, Hosseinijenab V, Peyravi M, Nekoei-Moghadam M, Hosseini B, Schoenthal L, Koenig KL. The hospital incident command system: modified model for hospitals in iran. PLOS CURRENTS 2015; 7. [PMID: 25905024 PMCID: PMC4395253 DOI: 10.1371/currents.dis.45d66b5258f79c1678c6728dd920451a] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Effectiveness of hospital management of disasters requires a well-defined and rehearsed system. The Hospital Incident Command System (HICS), as a standardized method for command and control, was established in Iranian hospitals, but it has performed fairly during disaster exercises. This paper describes the process for, and modifications to HICS undertaken to optimize disaster management in hospitals in Iran. METHODS In 2013, a group of 11 subject matter experts participated in an expert consensus modified Delphi to develop modifications to the 2006 version of HICS. RESULTS The following changes were recommended by the expert panel and subsequently implemented: 1) A Quality Control Officer was added to the Command group; 2) Security was defined as a new section; 3) Infrastructure and Business Continuity Branches were moved from the Operations Section to the Logistics and the Administration Sections, respectively; and 4) the Planning Section was merged within the Finance/Administration Section. CONCLUSION An expert consensus group developed a modified HICS that is more feasible to implement given the managerial organization of hospitals in Iran. This new model may enhance hospital performance in managing disasters. Additional studies are needed to test the feasibility and efficacy of the modified HICS in Iran, both during simulations and actual disasters. This process may be a useful model for other countries desiring to improve disaster incident management systems for their hospitals.
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Affiliation(s)
- Ahmadreza Djalali
- Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
| | - Vahid Hosseinijenab
- Department of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmoudreza Peyravi
- Prehospital and Disaster Medicine Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Department of Medical Informatic Management, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Nekoei-Moghadam
- Research Center of Health Services Management and Institute for Futurology in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Bashir Hosseini
- Disaster Management, Natural Disaster Research Institute, Tehran, Iran
| | - Lisa Schoenthal
- Disaster Medical Services Division, California Emergency Medical Services Authority, Rancho Cordova, California, USA
| | - Kristi L Koenig
- Center for Disaster Medical Sciences, University of California, Irvine, California, USA; World Association for Disaster and Emergency Medicine (WADEM)
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Nonclinical core competencies and effects of interprofessional teamwork in disaster and emergency response training and practice: a pilot study. Disaster Med Public Health Prep 2014; 7:395-402. [PMID: 24229523 DOI: 10.1017/dmp.2013.39] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To define and delineate the nontechnical core competencies required for disaster response, Disaster Medical Assistance Team (DMAT) members were interviewed regarding their perspectives and experiences in disaster management. Also explored was the relationship between nontechnical competencies and interprofessional collaboration. METHODS In-depth interviews were conducted with 10 Canadian DMAT members to explore how they viewed nontechnical core competencies and how their experiences influenced their perceptions toward interprofessonalism in disaster response. Data were examined using thematic analysis. RESULTS Nontechnical core competencies were categorized under austere skills, interpersonal skills, and cognitive skills. Research participants defined interprofessionalism and discussed the importance of specific nontechnical core competencies to interprofessional collaboration. CONCLUSIONS The findings of this study established a connection between nontechnical core competencies and interprofessional collaboration in DMAT activities. It also provided preliminary insights into the importance of context in developing an evidence base for competency training in disaster response and management. (Disaster Med Public Health Preparedness. 2013;0:1-8).
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Jensen J, Waugh WL. The United States' Experience with the Incident Command System: What We Think We Know and What We Need to Know More About. JOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT 2014. [DOI: 10.1111/1468-5973.12034] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jessica Jensen
- Department of Emergency Management; North Dakota State University; Dept. 2351, PO Box 6050 Fargo ND 58108 USA
| | - William L. Waugh
- Department of Public Management & Policy; Andrew Young School of Policy Studies; Georgia State University; 14 Marietta Street, NW, Suite 337 Atlanta GA 30302-3992 USA
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19
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Definition and Functions of Health Unified Command and Emergency Operations Centers for Large-scale Bioevent Disasters Within the Existing ICS. Disaster Med Public Health Prep 2013; 1:135-41. [DOI: 10.1097/dmp.0b013e3181583d66] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
ABSTRACTThe incident command system provides an organizational structure at the agency, discipline, or jurisdiction level for effectively coordinating response and recovery efforts during most conventional disasters. This structure does not have the capacity or capability to manage the complexities of a large-scale health-related disaster, especially a pandemic, in which unprecedented decisions at every level (eg, surveillance, triage protocols, surge capacity, isolation, quarantine, health care staffing, deployment) are necessary to investigate, control, and prevent transmission of disease. Emerging concepts supporting a unified decision-making, coordination, and resource management system through a health-specific emergency operations center are addressed and the potential structure, function, roles, and responsibilities are described, including comparisons across countries with similar incident command systems. (Disaster Med Public Health Preparedness. 2007;1:135–141)
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20
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Arnold JL. Disaster Myths and Hurricane Katrina 2005: Can Public Officals and the Media Learn to Provide Reponsible Crisis Communication during Disasters? Prehosp Disaster Med 2012; 21:1-3. [PMID: 16602259 DOI: 10.1017/s1049023x00003241] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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21
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Djalali A, Castren M, Hosseinijenab V, Khatib M, Ohlen G, Kurland L. Hospital Incident Command System (HICS) performance in Iran; decision making during disasters. Scand J Trauma Resusc Emerg Med 2012; 20:14. [PMID: 22309772 PMCID: PMC3296571 DOI: 10.1186/1757-7241-20-14] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 02/06/2012] [Indexed: 11/10/2022] Open
Abstract
Background Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as < 40%; intermediate as 41-70%; high as 71-100% of the maximum score of 192. Descriptive statistics, T-test, and Univariate Analysis of Variance were used. Results None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04). Conclusions The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied.
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Affiliation(s)
- Ahmadreza Djalali
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.
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22
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The Pediatric Hospital Incident Command System: An Innovative Approach to Hospital Emergency Management. ACTA ACUST UNITED AC 2011; 71:S549-54. [DOI: 10.1097/ta.0b013e31823a4d28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Do pandemic preparedness planning systems ignore critical community- and local-level operational challenges? Disaster Med Public Health Prep 2010; 4:24-9. [PMID: 20389192 DOI: 10.1097/dmp.0b013e3181cb4193] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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24
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Bethesda hospitals' emergency preparedness partnership: a model for transinstitutional collaboration of emergency responses. Disaster Med Public Health Prep 2010; 3:168-73. [PMID: 19834325 DOI: 10.1097/dmp.0b013e3181aa2719] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The events of September 11, 2001 identified a need for health care institutions to develop flexible, creative, and adaptive response mechanisms in the event of a local, regional, or national disaster. The 3 major health care institutions in Bethesda, MD-the National Naval Medical Center (NNMC), the Suburban Hospital Healthcare System (SHHS), and the National Institutes of Health Clinical Center (NIHCC)-have created a preparedness partnership that outstrips what any of the institutions could provide independently by pooling complementary resources. The creation of the partnership initially was driven by geographic proximity and by remarkably complementary resources. This article describes the creation of the partnership, the drivers and obstacles to creation, and the functioning and initial accomplishments of the partnership. The article argues that similar proximity and resource relationships exist among institutions at academic centers throughout the United States and suggests that this partnership may serve as a template for other similarly situated institutions.
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25
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Lee JJ, Johnson SJ, Sohmer MJ. Guide for mass prophylaxis of hospital employees in preparation for a bioterrorist attack. Am J Health Syst Pharm 2009; 66:570-5. [DOI: 10.2146/ajhp080018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jeremy John Lee
- Department of Pharmacy, Palomar Medical Center, Escondido, CA
| | | | - Michael J. Sohmer
- San Diego Hospice and The Institute of Palliative Medicine, San Diego; at the time of writing he was System SNF Consultant Pharmacist and DMAT San Diego CA-4 Chief Pharmacist, Sharp HealthCare, Chula Vista, CA
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26
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Kuntz JL, Holley S, Helms CM, Cavanaugh JE, Vande Berg J, Herwaldt LA, Polgreen PM. Use of a pandemic preparedness drill to increase rates of influenza vaccination among healthcare workers. Infect Control Hosp Epidemiol 2008; 29:111-5. [PMID: 18179365 DOI: 10.1086/526434] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the effect of a pandemic influenza preparedness drill on the rate of influenza vaccination among healthcare workers (HCWs). DESIGN Before-after intervention trial. SETTING The University of Iowa Hospitals and Clinics (UIHC), a large, academic medical center, during 2005. SUBJECTS Staff members at UIHC. METHODS UIHC conducted a pandemic influenza preparedness drill that included a goal of vaccinating a large number of HCWs in 6 days without disrupting patient care. Peer vaccination and mobile vaccination teams were used to vaccinate HCWs, educational tools were distributed to encourage HCWs to be vaccinated, and resources were allocated on the basis of daily vaccination reports. Logit models were used to compare vaccination rates achieved during the 2005 vaccination drill with the vaccination rates achieved during the 2003 vaccination campaign. RESULTS UIHC vaccinated 54% of HCWs (2,934 of 5,467) who provided direct patient care in 6 days. In 2 additional weeks, this rate increased to 66% (3,625 of 5,467). Overall, 66% of resident physicians (311 of 470) and 63% of nursing staff (1,429 of 2,255) were vaccinated. Vaccination rates in 2005 were significantly higher than the hospitalwide rate of 41% (5,741 of 14,086) in 2003. CONCLUSIONS UIHC dramatically increased the influenza vaccination rate among HCWs by conducting a pandemic influenza preparedness drill. Additionally, the drill allowed us to conduct a bioemergency drill in a realistic scenario, use innovative methods for vaccine delivery, and secure administrative support for future influenza vaccination campaigns. Our study demonstrates how a drill can be used to improve vaccination rates significantly.
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Affiliation(s)
- Jennifer L Kuntz
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
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Cone DC. Adrenaline storm in the emergency physician. Acad Emerg Med 2006; 13:1342-4. [PMID: 16946284 DOI: 10.1197/j.aem.2006.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- David C Cone
- Academic Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA.
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28
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Burkle FM. Population-based triage management in response to surge-capacity requirements during a large-scale bioevent disaster. Acad Emerg Med 2006; 13:1118-29. [PMID: 17015415 DOI: 10.1197/j.aem.2006.06.040] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Both the naturally occurring and deliberate release of a biological agent in a population can bring catastrophic consequences. Although these bioevents have similarities with other disasters, there also are major differences, especially in the approach to triage management of surge capacity resources. Conventional mass-casualty events use uniform methods for triage on the basis of severity of presentation and do not consider exposure, duration, or infectiousness, thereby impeding control of transmission and delaying recognition of victims requiring immediate care. Bioevent triage management must be population based, with the goal of preventing secondary transmission, beginning at the point of contact, to control the epidemic outbreak. Whatever triage system is used, it must first recognize the requirements of those Susceptible but not exposed, those Exposed but not yet infectious, those Infectious, those Removed by death or recovery, and those protected by Vaccination or prophylactic medication (SEIRV methodology). Everyone in the population falls into one of these five categories. This article addresses a population approach to SEIRV-based triage in which decision making falls under a two-phase system with specific measures of effectiveness to increase likelihood of medical success, epidemic control, and conservation of scarce resources.
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Affiliation(s)
- Frederick M Burkle
- Center for Disaster and Refugee Studies, Department of Emergency Medicine, School of Medicine, Johns Hopkins University Medical Institutions, Baltimore, MD, USA.
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