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Kippnich M, Schorscher N, Sattler H, Kippnich U, Meybohm P, Wurmb T. Managing CBRN mass casualty incidents at hospitals-Find a simple solution for a complex problem: A pilot study. Am J Disaster Med 2024; 19:25-31. [PMID: 38597644 DOI: 10.5055/ajdm.0471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Chemical, biological, radiological, and nuclear (CBRN) incidents are a major challenge for emergency medical services and the involved hospitals, especially if decontamination needs to be performed nearby or even within the hospital campus. The University Hospital Wuerzburg has developed a comprehensive and alternative CBRN response plan. The focus of this study was to proof the practicability of the concept, the duration of the decontamination process, and the temperature management. METHODS The entire decontamination area can be deployed 24/7 by the hospitals technical staff. Fire and rescue services are responsible for the decontamination process itself. This study was designed as full-scale exercise with 30 participants. RESULTS The decontamination area was ready for operation within 30 minutes. The decontamination of the four simulated patients took 5.5 ± 0.6 minutes (mean ± SD). At the end of the decontamination process, the temperature of the undressed upper body of the training patients was 27.25 ± 1°C (81.05 ± 2°F) (mean ± SD) and the water in the shower was about 35°C (95°F). CONCLUSION The presented concept is comprehensive and simple for a best possible care during CBRN incidents at hospitals. It ensures wet decontamination by Special Forces, while the technical requirements are created by the hospital.
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Affiliation(s)
- Maximilian Kippnich
- Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Subsection Emergency and Disaster Relief Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Nora Schorscher
- Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Subsection Emergency and Disaster Relief Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Helmut Sattler
- Fire Department Wuerzburg, Office for Civil Defence and Fire Protection, Wuerzburg, Germany
| | - Uwe Kippnich
- Bavarian Red Cross, Headquarters, Munich, Germany
| | - Patrick Meybohm
- Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Thomas Wurmb
- Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Subsection Emergency and Disaster Relief Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
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Zoran DL, Bassinger SC, Budke CM, Fridley JL. Mass Decontamination of Companion Dogs in Disaster: Planning for Personnel, Water, and Time Requirements. Disaster Med Public Health Prep 2024; 18:e40. [PMID: 38415396 DOI: 10.1017/dmp.2023.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE The importance of companion animals in the daily lives of people, and the increasing incidence and severity of natural disasters impacting people and their animals, is very well documented. However, despite the advancement of companion animal response capabilities, decontamination remains an inconsistently implemented component of disaster response. The challenge for local authorities is their need for planning factors and protocols specific to companion animal decontamination which are generally lacking. Data is provided on the average time requirements, water use and containment resources necessary, and the personnel required to decontaminate (decon) a large number of companion dogs. METHODS Sixty-three lightly contaminated, medium weight, short to medium coat, highly tractable dogs (Labradors and Hounds) from a State facility colony were used to determine the water requirements, soap effectiveness, and time required to complete decon (washing/bathing). Data were collected over a 6-mo period using 2 personnel that were randomly assigned to wash the dogs. Difference in weight, bathing time, and water use between groups was evaluated using a 2-tailed 2-sample t-test for independent data. RESULTS The time and water requirements were significantly different between medium coated dogs and short coated dogs. On average, for a short coated dog, the amount of time to complete decon was 7 min, and the amount of water was 8-10 gal. For medium coated dogs, the time increased to 10-12 min to complete the process and 12-15 gal water. DISCUSSION The results of this study provide important insights emergency management planners, animal response team members, and community personnel tasked with implementation of mass decontamination of companion dogs following a natural or man-made disaster.
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Affiliation(s)
- Debra L Zoran
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences (VMBS) Texas A&M University, College Station, TX, USA
| | - Shawn C Bassinger
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences (VMBS) Texas A&M University, College Station, TX, USA
| | - Christine M Budke
- Department of Integrative Biosciences, School of Veterinary Medicine and Biomedical Sciences (VMBS) Texas A&M University, College Station, TX, USA
| | - Jennifer L Fridley
- Department of Large Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences (VMBS) Texas A&M University, College Station, TX, USA
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Razak S, Hignett S, Barnes J, Hancox G. The Standardization of the Emergency Department Response to Chemical, Biological, Radiological, and Nuclear (CBRN) Events: Human Factors/Ergonomics Approach. Disaster Med Public Health Prep 2023; 17:e487. [PMID: 37694303 DOI: 10.1017/dmp.2023.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
OBJECTIVE To provide standardized recommendations for the emergency department (ED) response to chemical, biological, radiological, and nuclear (CBRN) events by combining the human factors/ergonomics method of hierarchical task analysis with the theoretical framework for Work as Imagined versus Work as Done. METHODS Document analyses were used to represent CBRN response operational procedures. Semi-structured interviews using scenario cards were carried out with 57 first receivers (ED staff) to represent CBRN practice at 2 acute hospitals in England. RESULTS Variability existed in general organizational responsibilities associated with the CBRN response. Variability was further evident in top level CBRN tasks and CBRN phases at both EDs. Operational procedures focused on tasks such as documentation, checking, and timing. CBRN practice focused on patient needs through assessment, treatment, and diagnosis. CONCLUSION The findings provide top-down and bottom-up insights to enhance the ED CBRN response through standardization. The standardized CBRN action card template embeds the choice approach to standardization. The standardized CBRN framework implements the streamlined categorization of CBRN phases. Work as Imagined versus Work as Done is a useful theoretical framework to unpack a complex sociotechnical system, and hierarchical task analysis is an effective system mapping tool in health care.
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Affiliation(s)
- Saydia Razak
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Sue Hignett
- School of Design & Creative Arts, Loughborough University, Loughborough, United Kingdom
| | - Jo Barnes
- School of Design & Creative Arts, Loughborough University, Loughborough, United Kingdom
| | - Graham Hancox
- Digital Technology Services, University of Nottingham, Nottingham, United Kingdom
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Ebeling M, Bloom A, Boggiano MM, Peterson DT, Peterson T. Employing High-Fidelity Simulation for the High-Risk, Low-Frequency Diagnosis and Management of Acute Radiation Syndrome (ARS). MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2023; 19:11331. [PMID: 37538304 PMCID: PMC10394119 DOI: 10.15766/mep_2374-8265.11331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 04/21/2023] [Indexed: 08/05/2023]
Abstract
Introduction Acute radiation syndrome (ARS) is a high-risk, low-frequency diagnosis that can be fatal and is difficult to diagnose without an obvious history of ionizing radiation exposure. Methods Twenty-two emergency medicine residents and one pharmacy resident participated in an hour-long simulation session. To accommodate all learners, the simulation was conducted eight times over a block of scheduled time (two to four learners/session). Sessions included a prebriefing, pre/post questionnaires, the ARS case, and a debriefing. Learners evaluated and managed a 47-year-old male (manikin) with the hematopoietic and cutaneous subsyndromes of ARS who presented with hand pain/erythema/edema and underlying signs of infection 2 weeks after an unrecognized radiation exposure. Learners had to perform a history and physical, recognize/manage abnormal vitals, order/interpret labs, consult appropriate disciplines, and initiate supportive care. Results There was a mean reported increase in ability to recognize signs and symptoms of ARS (p < .001) and appropriately manage a patient with this condition (p = .03) even after controlling for baseline confidence in ability to make and manage uncommon diagnoses, respectively. Learners rated this simulation as a valuable learning experience, effective in teaching them how to diagnose and treat ARS, and one they would recommend to other health care professionals. Discussion This simulation aimed to teach the diagnosis and initial management of the hematopoietic and cutaneous subsyndromes of ARS. It should be used to increase awareness of the potential for ionizing radiation exposure under less obvious conditions and raise the index of suspicion for ARS in the undifferentiated patient.
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Affiliation(s)
- Mel Ebeling
- Third-Year Medical Student, University of Alabama at Birmingham Heersink School of Medicine
| | - Andrew Bloom
- Assistant Professor, Department of Emergency Medicine, University of Alabama at Birmingham Heersink School of Medicine
| | - Mary M. Boggiano
- Associate Professor, Department of Psychology, University of Alabama at Birmingham
| | - Dawn Taylor Peterson
- Associate Professor, Department of Medical Education, University of Alabama at Birmingham Heersink School of Medicine
| | - Todd Peterson
- Associate Professor, Department of Emergency Medicine, University of Alabama at Birmingham Heersink School of Medicine
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Erickson TB, Harvin D, Schmid A, Loevinsohn G, Poriechna A, Martyshyn O, Kliukach K, Sydlowski M, Strong J, Kivlehan SM. Evaluation of Chemical, Biological, Radiological, Nuclear, Explosives (CBRNE) Knowledge Change and Skills Confidence Among Frontline-Line Providers During the Russia-Ukraine War. Disaster Med Public Health Prep 2023; 17:e387. [PMID: 37157855 PMCID: PMC10171778 DOI: 10.1017/dmp.2023.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the change in knowledge and skill confidence after implementation of a chemical, biological, radiological, nuclear, and explosive (CBRNE) training course during the Russia-Ukraine War. METHODS Pre/post-test study in the Ukrainian cities of Kyiv, Dnipro, Zaporizhzhia, and Odesa. Fifteen CBRNE courses were conducted over a 3-mo period, August to October 2022. Change in knowledge and skills confidence were evaluated with pre/post-course written exams and practical skill assessments that were observed during the training exercises. Changes were analyzed based on nonparametric Wilcoxon matched-pairs signed-rank testing. Pre/post self-efficacy surveys were analyzed with McNemar's test for paired data. Course evaluations were conducted with standardized questions which assessed instruction quality, teaching relevance, knowledge gained, and post-course skills confidence. RESULTS A total of 523 participants registered and completed 1 of the 15 courses. Overall mean pre-course test score: 57.8% (SD 20.7%); mean post-course test score: 81.4% (SD 11.3%); participants with increasing test scores: 90.7%; mean difference in score (95% confidence interval) 23.6% (21.2%-25.9%), P < 0.0001. Pre/post self-efficacy surveys (4-point Likert scale) noted participants recognized signs and symptoms of a CBRNE incident, and necessary skills to manage CBRNE exposures, P < 0.0001. CONCLUSIONS The implementation of this CBRNE course for front-line providers in Ukraine was successful. To our knowledge, it was the first implementation of a field course during the current Russian-Ukraine war. Future research should evaluate knowledge retention and impact of our innovative Train-the-Trainer model. Further iterations should emphasize expanding the quantity of training equipment and practical skill sessions.
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Affiliation(s)
- Timothy B. Erickson
- Division of Medical Toxicology, Department of Emergency Medicine, Mass General Brigham, Harvard Medical School, Boston, Massachusetts
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts, USA
| | - Donell Harvin
- Rand Corporation, Homeland Security Operational Analysis Center and Georgetown University, Applied Intelligence and Emergency and Disaster Management Program, Washington, D.C
| | - Alexis Schmid
- Boston Children’s Hospital, Department of Pediatrics, Division of Emergency Medicine, Global Health Program, Boston, MA
| | - Gideon Loevinsohn
- Division of Global Emergency Care and Humanitarian Studies, Department of Emergency Medicine, Mass General Brigham, Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | - Jonathan Strong
- Division of Global Emergency Care and Humanitarian Studies, Department of Emergency Medicine, Mass General Brigham, Harvard Medical School, Boston, Massachusetts
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts, USA
| | - Sean M. Kivlehan
- Division of Global Emergency Care and Humanitarian Studies, Department of Emergency Medicine, Mass General Brigham, Harvard Medical School, Boston, Massachusetts
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts, USA
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Pohanka M. Immunosensors for Assay of Toxic Biological Warfare Agents. BIOSENSORS 2023; 13:402. [PMID: 36979614 PMCID: PMC10046508 DOI: 10.3390/bios13030402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 06/18/2023]
Abstract
An immunosensor for the assay of toxic biological warfare agents is a biosensor suitable for detecting hazardous substances such as aflatoxin, botulinum toxin, ricin, Shiga toxin, and others. The application of immunosensors is used in outdoor assays, point-of-care tests, as a spare method for more expensive devices, and even in the laboratory as a standard analytical method. Some immunosensors, such as automated flow-through analyzers or lateral flow tests, have been successfully commercialized as tools for toxins assay, but the research is ongoing. New devices are being developed, and the use of advanced materials and assay techniques make immunosensors highly competitive analytical devices in the field of toxic biological warfare agents assay. This review summarizes facts about current applications and new trends of immunosensors regarding recent papers in this area.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, CZ-50001 Hradec Kralove, Czech Republic
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Structural Elements and Requirements in Forming Prehospital Health Response Teams in Response to Chemical, Biological, Radiation, and Nuclear Incidents (CBRN), a Comparative Review Study. Disaster Med Public Health Prep 2023; 17:e300. [PMID: 36785533 DOI: 10.1017/dmp.2022.259] [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: 02/15/2023]
Abstract
One of the important indicators of increasing the capacity of the health system and the chances of survival of patients and injured immediately after chemical, biological, radiation and nuclear (CBRN) accidents is rapid access to medical services. Establishing prehospital health response teams is one of the main strategies to improve the capacity and ability to respond to unusual events. The aim of this study was to investigate the factors influencing the formation of rapid response teams in the field of health in response to chemical, biological, radiation and nuclear accidents (CBRN EDMRT). In this study, the comparative review method was used. The study period was from November 1, 2021 to March 2022. Forming and deploying rapid health response teams based on an extensive multi-step search and keywords in multiple databases such as PubMed, CINHAL, Blackwell, Iranmedex, SID, Cochrane Database of Systematic Reviews, Google Scholar, Scopus Also, the websites of the Ministry of Health and the responsible organizations in different countries and the proposed structure were done by international institutions and sites. After accessing the resources and documents, the process of analysis and comparison of different team structures was performed. After the initial search, the structure and required elements of their teams were extracted. According to published articles and texts, 10 teams from the International Atomic Energy Agency (IAEA), the US Centers for Disease Control and Prevention (CDC), the US Department of Homeland Security, and the North Atlantic Treaty Organization (NATO), Australia, the British Public Health Organization, and the Japanese Red Cross were compared. Team requirements, population distribution, type of accident, level of team activity and training, equipment required by the team after the accident, according to which, each country/organization should consider the above factors to design and establish the structure of CBRN EDMRT to take. A study should be conducted to design a comprehensive and evidence-based structure.
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Mackie BR, Weber S, Mitchell ML, Crilly J, Wilson B, Handy M, Wullschleger M, Sharpe J, McCaffery K, Lister P, Boyd M, Watkins N, Ranse J. Chemical, Biological, Radiological, or Nuclear Response in Queensland Emergency Services: A Multisite Study. Health Secur 2022; 20:222-229. [PMID: 35612425 DOI: 10.1089/hs.2021.0214] [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: 11/12/2022] Open
Abstract
A disaster overwhelms the normal operating capacity of a health service. Minimal research exists regarding Australian hospitals' capacity to respond to chemical, biological, radiological, or nuclear (CBRN) disasters. This article, and the research supporting it, begins to fill that research gap. We conducted a descriptive quantitative study with 5 tertiary hospitals and 1 rural hospital in Queensland, Australia. The study population was the hospitals' clinical leaders for disaster preparedness. The 25-item survey consisted of questions relating to each hospital's current response capacity, physical surge capacity, and human surge capacity in response to a CBRN disaster. Data were analyzed using descriptive statistics. The survey data indicated that over the previous 12 months, each site reached operational capacity on average 66 times and that capacity to respond and create additional emergency, intensive care, or surgical beds varied greatly across the sites. In the previous 12 months, only 2 sites reported undertaking specific hospital-wide training to manage a CBRN disaster, and 3 sites reported having suitable personal protective equipment required for hazardous materials. There was a noted shortfall in all the hospitals' capacity to respond to a radiological disaster in particular. Queensland hospitals are crucial to CBRN disaster response, and they have areas for improvement in their response and capacity to surge when compared with international preparedness benchmarks. CBRN-focused education and training must be prioritized using evidence-based training approaches to better prepare hospitals to respond following a disaster event.
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Affiliation(s)
- Benjamin R Mackie
- Benjamin R. Mackie, PhD, MAdvPrac, MN, is a Senior Instructor, Army School of Health, Bonegilla, Victoria. Benjamin R. Mackie is also an Adjunct Associate Professor; at Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Sarah Weber
- Sarah Weber, RN, MPH, is a Clinical Nurse, Emergency Department, at Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Marion L Mitchell
- Marion L. Mitchell, PhD, BN, is an Emeritus Professor; at Menzies Health Institute Queensland, Griffith University, Queensland, Australia. Marion L. Mitchell is an Emeritus Professor, Intensive Care Department; at Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Julia Crilly
- Julia Crilly, OAM, RN, MEmergN, PhD, is a Professor; the Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Bridget Wilson
- Bridget Wilson, BN, is a Research Nurse; the Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Michael Handy
- Michael Handy, BNur, MNurSciNP, is Assistant Nursing Director, the Trauma Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Martin Wullschleger
- Martin Wullschleger, MD, PhD, FRACS, FACS, is Director of Trauma; the Trauma Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Joseph Sharpe
- Joseph Sharpe, RN, BN, CNC, is a Clinical Nurse Consultant, Trauma Service, Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Kevin McCaffery
- Kevin McCaffery, MD, is a Paediatric Intensivist, Queensland Children's Hospital, Queensland, Australia
| | - Paula Lister
- Paula Lister, MBBCh, PhD, is an Associate Professor, Griffith University, and Director, Paediatric Critical Care, Sunshine Coast University Hospital and Health Service, Queensland, Australia
| | - Matt Boyd
- Matt Boyd, RN, RM, is a Nurse Unit Manager, Emergency, Darling Downs Health Service, Queensland, Australia
| | - Nathan Watkins
- Nathan Watkins, MBChB, BPhty, FACEM, Emergency Senior Staff Specialist; the Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Jamie Ranse
- Jamie Ranse, RN, PhD, is an Associate Professor; at Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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Bajow N, Alkhalil S, Maghraby N, Alesa S, Najjar AA, Aloraifi S. Assessment of the effectiveness of a course in major chemical incidents for front line health care providers: a pilot study from Saudi Arabia. BMC MEDICAL EDUCATION 2022; 22:350. [PMID: 35534890 PMCID: PMC9082960 DOI: 10.1186/s12909-022-03427-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 05/03/2022] [Indexed: 05/30/2023]
Abstract
BACKGROUND Mass chemical exposure emergencies are infrequent but can cause injury, illness, or loss of life for large numbers of victims. These emergencies can stretch and challenge the available resources of healthcare systems within the community. Political unrest in the Middle East, including chemical terrorist attacks against civilians in Syria and increasing chemical industry accidents, have highlighted the lack of hospital preparedness for chemical incidents in the region. This study aimed to evaluate the effectiveness of a course designed to empower frontline healthcare providers involved in mass casualty incidents with the basic knowledge and essential operational skills for mass chemical exposure incidents in Saudi Arabia. METHODS A mixed-methods approach was used to develop a blended learning, simulation enhanced, competency-based course for major chemical incidents for front line healthcare providers. The course was designed by experts from different disciplines (disaster medicine, poisoning / toxicology, and Hazard Material Threat - HAZMAT team) in four stages. The course was piloted over five days at the Officers Club of the Ministry of Interior (Riyadh, Saudi Arabia). The 41 participants were from different government health discipline sectors in the country. Pre- and post-tests were used to assess learner knowledge while debriefing sessions after the decontamination triage session and simulation-enhanced exercises were used for team performance assessment. RESULTS The overall knowledge scores were significantly higher in the post-test (69.47%) than the pre-test (46.3%). All four knowledge domains also had significant differences between pre- and post-test results. There were no differences in the pre and post-test scores for healthcare providers from the different health disciplines. A one-year post-event survey demonstrated that participants were satisfied with their knowledge retention. Interestingly, 38.3% had the opportunity to put this knowledge into practice in relation to mass chemical exposure incidents. CONCLUSION Delivering a foundation level competency-based blended learning course with enhanced simulation training in major chemical incidents for front line healthcare providers may improve their knowledge and skills in response to such incidents. This in turn can improve the level of national preparedness and staff availability and make a crucial difference in reducing the health impacts among victims.
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Affiliation(s)
- Nidaa Bajow
- Security Forces Hospital Program, P O Box 89489, Riyadh, 11682, Kingdom of Saudi Arabia.
| | - Shahnaz Alkhalil
- Faculty of Engineering and Technology, Alzaytoonah University, Amman, Jordan
| | - Nisreen Maghraby
- King Fahad University Hospital Collage of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Saleh Alesa
- General Directorate of Medical Services Special Security Forces, Riyadh, Kingdom of Saudi Arabia
| | - Amal Al Najjar
- Security Forces Hospital Program, P O Box 89489, Riyadh, 11682, Kingdom of Saudi Arabia
| | - Samer Aloraifi
- Hail Health Cluster Ministry of Health, Hail, Kingdom of Saudi Arabia
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Iyama K, Kakamu T, Yamashita K, Sato Y, Shimada J, Tasaki O, Hasegawa A. Increasing Disaster Medical Assistance Teams' Intent to Engage with Specific Hazards. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111630. [PMID: 34770143 PMCID: PMC8583079 DOI: 10.3390/ijerph182111630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/30/2021] [Accepted: 10/31/2021] [Indexed: 11/16/2022]
Abstract
To ensure human resource availability for a smooth response during various types of disasters, there is a need to improve the intent of those involved in responding to each hazard type. However, Disaster Medical Assistance Team personnel’s intent to engage with specific hazards has yet to be clarified. This study therefore aimed to clarify the factors affecting Disaster Medical Assistance Team members’ (n = 178) intent to engage with each type of hazard through an anonymous web questionnaire survey containing 20 questions. Our results show that the intent to engage in disaster response activities was significantly lower for chemical (50), biological (47), radiological/nuclear (58), and explosive (52) incidents compared with natural (82) and man-made hazards (82) (p < 0.01). Multiple regression analysis showed that incentives were the most common factor affecting responders’ intent to engage with all hazard types, followed by self-confidence. Thus, creating a system that provides generous incentives could effectively improve disaster responders’ intent to engage with specific hazards. Another approach could be education and training to increase disaster responders’ confidence. We believe that the successful implementation of these measures would improve the intent of responders to engage with hazards and promote the recruitment of sufficient human resources.
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Affiliation(s)
- Keita Iyama
- Department of Radiation Disaster Medicine, Fukushima Medical University, Fukushima 960-1295, Japan;
- Department of Disaster Medicine, Fukushima Medical University Hospital, Fukushima 960-1295, Japan;
| | - Takeyasu Kakamu
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima 960-1295, Japan;
| | - Kazunori Yamashita
- Acute and Critical Care Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (K.Y.); (O.T.)
| | - Yoshinobu Sato
- Department of Disaster Medicine, Fukushima Medical University Hospital, Fukushima 960-1295, Japan;
| | - Jiro Shimada
- Futaba Emergency Medical Support Center, Fukushima Medical University, Fukushima 960-1295, Japan;
| | - Osamu Tasaki
- Acute and Critical Care Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan; (K.Y.); (O.T.)
| | - Arifumi Hasegawa
- Department of Radiation Disaster Medicine, Fukushima Medical University, Fukushima 960-1295, Japan;
- Department of Disaster Medicine, Fukushima Medical University Hospital, Fukushima 960-1295, Japan;
- Correspondence: ; Tel.: +81-24-547-1507; Fax: +81-24-547-1509
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Disaster preparedness: A concept analysis and its application to the intensive care unit. Aust Crit Care 2021; 35:204-209. [PMID: 34024715 DOI: 10.1016/j.aucc.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/11/2021] [Accepted: 04/15/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of the study is to understand the concept of disaster preparedness in relation to the intensive care unit through the review and critique of the peer-reviewed literature. REVIEW METHOD USED Rodgers' method of evolutionary concept analysis was used in the study. DATA SOURCES Healthcare databases included in the review were Cumulative Index to Nursing and Allied Health Literature, Public MEDLINE, Scopus, and ProQuest. REVIEW METHODS Electronic data bases were searched using terms such as "intensive care unit" OR "critical care" AND prep∗ OR readiness OR plan∗ AND disaster∗ OR "mass casualty incidents" OR "natural disaster" OR "disaster planning" NOT paed∗ OR ped∗ OR neonat∗. Peer-reviewed articles published in English between January 2000 and April 2020 that focused on intensive care unit disaster preparedness or included intensive care unit disaster preparedness as part of a facility-wide strategy were included in the analysis. RESULTS Eighteen articles were included in the concept analysis. Fourteen different terms were used to describe disaster preparedness in intensive care. Space, physical resources, and human resources were attributes that relied on each other and were required in sufficient quantities to generate an adequate response to patient surges from disasters. When one attribute is extended beyond normal operational capacities, the effectiveness and capacity of the other attributes will likely be limited. CONCLUSION This concept analysis has shown the varied language used when referring to disaster preparedness relating to the intensive care unit within the research literature. Attributes including space, physical resources, and human resources were all found to be integral to a disaster response. Future research into what is required of these attributes to generate an all-hazards approach in disaster preparedness in intensive care units will contribute to optimising standards of care.
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Nuclear Power Risk Perception in Serbia: Fear of Exposure to Radiation vs. Social Benefits. ENERGIES 2021. [DOI: 10.3390/en14092464] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nuclear power remains one of the most accessible choices in addressing environmental and social concerns due to the continuously increasing energy needs around the world. While it remains an excellent source of energy due to its low price and low level of emissions, potential accidents remain a serious problem. An example of such is the most recent accident in the Fukushima Daiichi Nuclear Power Plant (2011), which reminded the world of the potential risks of nuclear energy and the consequences of which continue to have a lasting effect. There is no nuclear power plant in Serbia, but there are about 15 nuclear power stations scattered within its neighboring countries. Therefore, the Serbian Government decided to study how the Serbian public perceives the risks related to the potential construction of nuclear power stations in the country, nuclear energy in general, and its possible benefits and risks. The objective of this paper is to present the results of this assessment along with a literature overview on the (environmental) risk of nuclear power. A pilot study consisted of a series of 270 randomized face-to-face interviews that took place in the public square of Belgrade in March 2019. Logistic regression was used to examine the cumulative effects of the different risk factors. The results showed that the majority of the respondents are skeptical and do not support the construction of nuclear power stations in Serbia. Furthermore, this research identified several additional important correlations that have a significant impact on the public perception of risk.
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Sharififar S, Jahangiri K, Zareiyan A, Khoshvaghti A. Factors affecting hospital response in biological disasters: A qualitative study. Med J Islam Repub Iran 2020; 34:21. [PMID: 32551310 PMCID: PMC7293813 DOI: 10.34171/mjiri.34.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Indexed: 11/05/2022] Open
Abstract
Background: The fatal pandemics of infectious diseases and the possibility of using microorganisms as biological weapons are both rising worldwide. Hospitals are vital organizations in response to biological disasters and have a crucial role in the treatment of patients. Despite the advances in studies about hospital planning and performance during crises, there are no internationally accepted standards for hospital preparedness and disaster response. Thus, this study was designed to explain the effective factors in hospital performance during biological disasters. Methods: Qualitative content analysis with conventional approach was used in the present study. The setting was Ministry of Health and related hospitals, and other relevant ministries responsible at the time of biologic events in Islamic Republic of Iran (IR of Iran) in 2018. Participants were experts, experienced individuals providing service in the field of biological disaster planning and response, policymakers in the Ministry of Health, and other related organizations and authorities responsible for the accreditation of hospitals in IR of Iran. Data were collected using 12 semi-structured interviews in Persian language. Analysis was performed according to Graneheim method. Results: After analyzing 12 interviews, extraction resulted in 76 common codes, 28 subcategories, and 8 categories, which are as follow: detection; treatment and infection control; coordination, Resources; training and exercises; communication and information system; construction; and planning and assessment. Conclusion: Hospital management in outbreaks of infectious diseases (intentional or unintentional) is complex and requires different actions than during natural disasters. In such disasters, readiness to respond and appropriate action is a multifaceted operation. In IR of Iran, there have been few researches in the field of hospital preparation in biologic events, and the possibility of standardized assessment has be reduced due to lack of key skills in confronting biological events. It is hoped that the aggregated factors in the 8 groups of this study can evaluate hospital performance more coherently.
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Affiliation(s)
- Simintaj Sharififar
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Katayoun Jahangiri
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Armin Zareiyan
- Department of Health in Disasters and Emergencies, School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Amir Khoshvaghti
- Infectious Diseases Research Center, Aerospace and Subaquatic Medicine Faculty, Aja University of Medical Sciences, Tehran, Iran
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Evaluation of cancer risk after a release from a hypothetical nuclear reactor steam generator tube rupture accident (SGTR). ANN NUCL ENERGY 2020. [DOI: 10.1016/j.anucene.2019.107023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Emergency Department Response to Chemical, Biological, Radiological, Nuclear, and Explosive Events: A Systematic Review. Prehosp Disaster Med 2018; 33:543-549. [DOI: 10.1017/s1049023x18000900] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIntroductionA Chemical, Biological, Radiological, Nuclear, and explosive (CBRNe) event is an emergency which can result in injury, illness, or loss of life. The emergency department (ED) as a health system is at the forefront of the CBRNe response with staff acting as first receivers. Emergency departments are under-prepared to respond to CBRNe events - recognizing key factors which underlie the ED CBRNe response is crucial to provide evidence-based knowledge to inform policies and, most importantly, clinical practice.ProblemChallenges in detection, decontamination, and diagnosis are associated with the ED CBRNe response when faced with self-presenting patients.MethodsA systematic review was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). An in-depth search strategy was devised to identify studies which focused on the ED and CBRNe events. The inclusion criteria were stringent in terms of the environment (ED), participants (first receivers), situation (CBRNe response), and actions (detection, decontamination, and diagnosis). Fifteen databases and topic-specific journals were searched. Studies were critically appraised using the Mixed Methods Appraisal Tool (MMAT). Papers were thematically coded and synthesized using NVivo 10 (QSR International Ltd, Melbourne, Australia).ResultsSixty-seven full-text papers were critically appraised using the MMAT; 70% were included (n = 60) as medium- or high-quality studies. Data were grouped into four themes: preparedness, response, decontamination, and personal protective equipment (PPE) problems.DiscussionThis study has recognized the ED as a system which depends on four key factors - preparedness, response, decontamination, and PPE problems - which highlight challenges, uncertainties, inconsistencies, and obstacles associated with the ED CBRNe response. This review suggests that response planning and preparation should be considered at three levels: organizational (policies and procedures); technological (decontamination, communication, security, clinical care, and treatment); and individual (willingness to respond, PPE, knowledge, and competence). Finally, this study highlighted that there was a void specific to detection and diagnosis of CBRNe exposure on self-presenting patients in the ED.Conclusion:The review identified concerns for both knowledge and behaviors which suggests that a systems approach would help understand the ED response to CBRNe events more effectively. The four themes provide an evidence-based summary for the state of science in ED CBRNe response, which can be used to inform future policies and clinical procedures.RazakS,HignettS,BarnesJ.Emergency department response to chemical, biological, radiological, nuclear, and explosive events: a systematic review.Prehosp Disaster Med.2018;33(5):543–549.
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