Prehospital and disaster medicine
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The Suwa Onbashira Festival is held every six years and draws approximately one million spectators from across Japan. Men ride the Onbashira pillars (logs) down steep slopes. At each festival, several people are crushed under the heavy log. During the 2004 festival, for the first time, a medical care system that coordinated a medical team, an emergency medical service, related agencies, and local hospitals was constructed. ⋯ Comprehensive medical care is essential for similar mass gatherings. The appropriate triage of patients can lead to efficient medical coverage.
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Prehosp Disaster Med · Sep 2007
Preparing for burn disasters: predictors of improved perceptions of competency after mass burn care training.
Prehospital and community hospital healthcare providers in the United States must be prepared to respond to burn disasters. Continuing education is the most frequently utilized method of updating knowledge, skills, and competence among healthcare professionals. Since preparedness training must meet multiple educational demands, it is vital to understand how participants' work and educational experience and the program's content and delivery methods impact knowledge acquisition, and how learning influences confidence and competence to perform new skills. ⋯ Interventions used to train healthcare providers for burn disasters must cover a broad range of topics. However, learning needs may vary by practice setting, work experience, and previous exposure to disaster events. This evaluation research provides three-fold information for continuing education research: (1) to identify content areas that should be emphasized in future burn care training; (2) to be used as a model for CE evaluation in other domains; and (3) to provide support that many factors must be considered when designing a CE program. Results may be useful to others who are planning CE training programs.
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Prehosp Disaster Med · Sep 2007
Professionalization of disaster medicine--an appraisal of criterion-referenced qualifications.
The landmark Humanitarian Response Review, commissioned by the United Nations Emergency Relief Coordinator in 2005, has catalyzed recent reforms in disaster response through the Inter-Agency Standing Committee. These reforms include a "cluster lead" approach to sectoral responsibilities and the strengthening of humanitarian coordination. Clinical medicine, public health, and disaster incident management are core disciplines underlying expertise in disaster medicine. ⋯ Disaster experience is best characterized in terms of months of full-time, hands-on field service. Future practitioners in disaster medicine will see intensified efforts to define competency benchmarks across underlying core disciplines as well as key field performance indicators. Quantitative decision-support tools are emerging to assist disaster planners and medical coordinators in their personnel selection.
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Disaster preparedness and response have gained increased attention in the United States as a result of terrorism and disaster threats. However, funding of hospital preparedness, especially surge capacity, has lagged behind other preparedness priorities. Only a small portion of the money allocated for national preparedness is directed toward health care, and hospitals receive very little of that. ⋯ Alternatively, the status quo of marginal preparedness can be maintained. In any event, achieving higher levels of preparedness likely will take the combined commitment of the hospital industry, public and private payers, and federal, state, and local governments. Ultimately, the costs of preparedness will be borne by the public in the form of taxes, higher healthcare costs, or through the acceptance of greater risk.