Prehospital and disaster medicine
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Prehosp Disaster Med · Apr 2004
Practice Guideline GuidelineInternational standards and guidelines on education and training for the multi-disciplinary health response to major events that threaten the health status of a community.
The 13th World Congress on Disaster and Emergency Medicine, convened in Melbourne, Australia in May 2003, requested the World Association for Disaster and Emergency Medicine (WADEM) to lead the development of "International Standards and Guidelines on Education and Training for "Disaster Medicine". This Paper has been developed by a Working Group of the WADEM Education Committee ("the Working Group") in response to that request from the international "Disaster Medicine" and emergency health community. The main focus of the Working Group is to develop standards and guidelines for education and training in the multi-disciplinary health response to major events that threaten the health status of a community. The contemporary view is that of a multi-disciplinary health response to major events which threaten the health status of a community, including the prevention and mitigation of future events, and taking account of the broader context in which these events occur. It is the vision of the Working Group that evidence-based standards and guidelines for education and training must be developed in a broad sense, for all members of the healthcare community. Rather than purely describing isolated performance indicators, the Working Group agreed that priority be given to explaining the general approach, presenting the conceptual framework, clarifying important principles, and describing the educational needs and training requirements for situations for which there exist a major threat to the health status of a community. It is not the intent to produce an updated educational curriculum for special courses in "Disaster Medicine" by listing levels of theoretical knowledge and clinical skills required for medical doctors, nurses, and paramedics. Nor, does the Working Group think it is useful to repeat requirements and learning outcomes that are part of the normal basic education and training for the various health professionals. The purpose of this Issues Paper is to present an initial summary of current issues relating to an international perspective of "Disaster Medicine" education and training. This summary has been prepared following discussions within the Working Group of the WADEM Education Committee. The paper aims to stimulate debate and form the basis of further of discussion at an international meeting scheduled to be held in Brussels (Belgium) on 29-31 October 2004. The Working Group has structured this Issues Paper into five parts and has identified several key issues for discussion. Part 1: Understanding the contemporary interpretation of the multi-disciplinary health response to major events that threaten the health status of a community. Issue 1: Definitions and terminology in "Disaster Medicine"; Issue 2: Getting to grips with the contemporary concepts and international trends in 'Disaster Medicine"; and, Issue 3: Valuing personal attributes in "Disaster Medicine" practitioners. Part 2: Developing an underlying scientific framework for linking theory to practice in "Disaster Medicine". Issue 4: Creating a scientific framework(s) for "Disaster Medicine". Part 3: Defining a conceptual framework and general principals to develop "International Standards and Guidelines on Education and Training for the Multi-disciplinary Health Response to Major Events that Threaten the Health Status of a Community". Issue 5.: Where are we now? Getting to grips with the contemporary concepts and international trends in "Disaster Medicine" education and training. Issue 6: Where do we want to get to? Identifying contemporary, evidence-based education and training standards and guidelines for 'Disaster Medicine" education and training programs. Issue 7: How do we get there? Overcoming barriers to introducing the International Standards and Guidelines. Part 4: Maintaining the momentum--improving international collaboration. Issue 8: Exploring the feasibility of an ongoing, international, collaborative network of "Centres of Excellence" in "Disaster Medicine" research and/or education. Part 5: Additional input. Issue 9: What other issues would you like to bring to the attention of the Working Group? ⋯ The results of the consultation will lead to the development of international standards and guidelines that will be presented and consensus sought during the 14th World Congress on Disaster and Emergency Medicine (WCDEM-14) to be convened in Edinburgh in May, 2005.
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Search and rescue helicopters from the Royal Norwegian Air Force conduct ambulance and search and rescue missions in the Barents Sea. The team on-board includes an anesthesiologist and a paramedic. Operations in this area are challenging due to long distances, severe weather conditions, and arctic winter darkness. ⋯ Using a heavy search and rescue helicopter in the Barents Sea was the right decision in terms of medical gain and operative risk.
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Prehosp Disaster Med · Apr 2004
Challenges of major incident management when excess resources are allocated: experiences from a mass casualty incident after roof collapse of a military command center.
During a military exercise in northern Norway in March 2000, the snow-laden roof of a command center collapsed with 76 persons inside. Twenty-five persons were entrapped and/or buried under snow masses. There were three deaths. ⋯ The stretcher and treatment teams initially could have been more effectively organized. As resources were ample, this was a mass casualty, not a disaster. Firm incident command prevented the influx of excess resources.
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Prehosp Disaster Med · Apr 2004
Mass-casualty terrorist bombings in Istanbul, Turkey, November 2003: report of the events and the prehospital emergency response.
This paper describes the two mass-casualty, terrorist attacks that occurred in Istanbul, Turkey in November 2003, and the resulting pre-hospital emergency response. ⋯ The twin suicide truck bombings on 15 and 20 November 2003 were the two largest terrorist attacks in modern Turkish history, collectively killing 63 persons and injuring an estimated 750 others. The vast majority of victims had secondary blast injuries, which did not require hospitalization. Factors associated with the maldistribution of casualties to medical facilities appeared to include the distance from each bombing site, the type of medical facility, and the personal preference of injured survivors.
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Prehosp Disaster Med · Apr 2004
Efficacy of critical incident monitoring for evaluating disaster medical readiness and response during the Sydney 2000 Olympic Games.
Multiple casualty incidents (MCI) are infrequent events for medical systems. This renders audit and quality improvement of the medical responses difficult. Quality tools and use of such tools for improvement is necessary to ensure that the design of medical systems facilitates the best possible response to MCI. ⋯ Incident monitoring was efficacious as a quality tool in identifying incident contributing factors. Incident monitoring allowed for greater systems evaluation. Further evaluation of this quality tool within different disaster settings is required.