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  • 1.
    Celik, Daniel H.
    et al.
    Academic and Community Emergency Specialists, Uniontown Ohio, USA; Summa Health System, Akron Ohio, USA.
    Mencl, Francis R.
    Academic and Community Emergency Specialists, Uniontown Ohio, USA; Summa Health System, Akron Ohio, USA.
    Debacker, Michel
    Research Group on Emergency and Disaster Medicine (ReGEDiM), Vrije Universiteit Brussel, Brussels, Belgium.
    Kurland, Lisa
    Örebro University, School of Medical Sciences. Department of Emergency Medicine.
    Wilber, Scott T.
    Summa Health System, Akron Ohio, USA.
    Frey, Jennifer A.
    Summa Health System, Akron Ohio, USA; The Ohio State University, Columbus Ohio, USA.
    Triage Performance of School Personnel Using the SALT System2019In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 34, no 4, p. 401-406Article in journal (Refereed)
    Abstract [en]

    Introduction: The aim of this study was to determine if school personnel can understand and apply the Sort, Assess, Life-saving interventions, Treat/Transport (SALT) triage methods after a brief training. The investigators predicted that subjects can learn to triage with accuracy similar to that of medically trained personnel, and that subjects can pass an objective-structured clinical exam (OSCE) evaluating hemorrhage control.

    Methods: School personnel were eligible to participate in this prospective observational study. Investigators recorded subject demographic information and prior medical experience. Participants received a 30-minute lecture on SALT triage and a brief lecture and demonstration of hemorrhage control and tourniquet application. A test with brief descriptions of mass-casualty victims was administered immediately after training. Participants independently categorized the victims as dead, expectant, immediate, delayed, or minimal. They also completed an OSCE to evaluate hemorrhage control and tourniquet application using a mannequin arm.

    Results: Subjects from two schools completed the study. Fifty-nine were from a private school that enrolls early childhood through grade eight, and 45 from a public school that enrolls grades seven and eight (n = 104). The average subject age was 45 years and 68% were female. Approximately 81% were teachers and 87% had prior cardiopulmonary resuscitation (CPR) training. Overall triage accuracy was 79.2% (SD = 10.7%). Ninety-six (92.3%) of the subjects passed the hemorrhage control OSCE.

    Conclusions: After two brief lectures and a short demonstration, school personnel were able to triage descriptions of mass-casualty victims with an overall accuracy similar to medically trained personnel, and most were able to apply a tourniquet correctly. Opportunities for future study include integrating high-fidelity simulation and mock disasters, evaluating for knowledge retention, and exploring the study population's baseline knowledge of medical care, among others.

  • 2.
    Djalali, Ahmadreza
    et al.
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; RIMEDIM - Center for Research and Education in Emergency and Disaster Medicine, Università del Piemonte Orientale, Novara, Italy.
    Castren, Maaret
    Department of Clinical Sciences and Education and Section of Emergency Medicine, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Khankeh, Hamidreza
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Nursing Department, University of Social Welfare and Rehabilitation, Tehran, Iran.
    Gryth, Dan
    Department of Physiology and Pharmacology and Section of Anaesthesiology and Intensive care, Karolinska Institutet, Stockholm, Sweden.
    Radestad, Monica
    Department of Clinical Sciences and Education and Section of Emergency Medicine, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Öhlen, Gunnar
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Kurland, Lisa
    Department of Clinical Sciences and Education and Section of Emergency Medicine, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Hospital disaster preparedness as measured by functional capacity: a comparison between Iran and Sweden2013In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 28, no 5, p. 454-461Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Hospitals are expected to continue to provide medical care during disasters. However, they often fail to function under these circumstances. Vulnerability to disasters has been shown to be related to the socioeconomic level of a country. This study compares hospital preparedness, as measured by functional capacity, between Iran and Sweden.

    METHODS: Hospital affiliation and size, and type of hazards, were compared between Iran and Sweden. The functional capacity was evaluated and calculated using the Hospital Safety Index (HSI) from the World Health Organization. The level and value of each element was determined, in consensus, by a group of evaluators. The sum of the elements for each sub-module led to a total sum, in turn, categorizing the functional capacity into one of three categories: A) functional; B) at risk; or C) inadequate.

    RESULTS: The Swedish hospitals (n = 4) were all level A, while the Iranian hospitals (n = 5) were all categorized as level B, with respect to functional capacity. A lack of contingency plans and the availability of resources were weaknesses of hospital preparedness. There was no association between the level of hospital preparedness and hospital affiliation or size for either country.

    CONCLUSION: The results suggest that the level of hospital preparedness, as measured by functional capacity, is related to the socioeconomic level of the country. The challenge is therefore to enhance hospital preparedness in countries with a weaker economy, since all hospitals need to be prepared for a disaster. There is also room for improvement in more affluent countries.

  • 3.
    Hugelius, Karin
    et al.
    Örebro University, School of Health Sciences. Karlskoga Hospital, Örebro Region County Council, Karlskoga, Sweden.
    Adolfsson, Annsofie
    Örebro University, School of Health Sciences.
    Örtenwall, Per
    Sahlgrenska Akademin, Gothenburg University, Gothenburg, Sweden.
    Gifford, Mervyn
    Örebro University, School of Health Sciences.
    Being Both Helpers and Victims: Health Professionals' Experiences of Working During a Natural Disaster2017In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 32, no 2, p. 117-123Article in journal (Refereed)
    Abstract [en]

    Background: In November 2013, the Haiyan typhoon hit parts of the Philippines. The typhoon caused severe damage to the medical facilities and many injuries and deaths. Health professionals have a crucial role in the immediate disaster response system, but knowledge of their experiences of working during and in the immediate aftermath of a natural disaster is limited. Aim The aim of this study was to explore health professionals' experiences of working during and in the immediate aftermath of a natural disaster.

    Method: Eight health professionals were interviewed five months after the disaster. The interviews were analyzed using phenomenological hermeneutic methods.

    Results: The main theme, being professional and survivor, described both positive and negative emotions and experiences from being both a helper, as part of the responding organization, and a victim, as part of the surviving but severely affected community. Sub-themes described feelings of strength and confidence, feelings of adjustment and acceptance, feelings of satisfaction, feelings of powerless and fear, feelings of guilt and shame, and feelings of loneliness.

    Conclusion: Being a health professional during a natural disaster was a multi-faceted, powerful, and ambiguous experience of being part of the response system at the same time as being a survivor of the disaster. Personal values and altruistic motives as well as social aspects and stress-coping strategies to reach a balance between acceptance and control were important elements of the experience. Based on these findings, implications for disaster training and response strategies are suggested. Hugelius K , Adolfsson A , Örtenwall P , Gifford M . Being both helpers and victims: health professionals' experiences of working during a natural disaster.

  • 4.
    Hugelius, Karin
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Anaesthesia, Karlskoga Hospital, Karlskoga, Sweden.
    Berg, Sara
    School of Health and Medical Science, Örebro University, Örebro, Sweden; Ambulance Department, Värmland County Council, Karlstad, Sweden.
    Westerberg, Elin
    School of Health and Medical Science, Örebro University, Örebro, Sweden; Ambulance Department, Värmland County Council, Karlstad, Sweden.
    Gifford, Mervyn
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Adolfsson, Annsofie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Swedish ambulance managers descriptions of crisis support for ambulance staff after potentially traumatic events2014In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 29, no 6, p. 589-592Article in journal (Refereed)
    Abstract [en]

    Introduction:Ambulance staff face complex and sometimes stressful or potentially traumaticsituations, not only in disasters but also in theirroutine daily work. The aim of this study wasto survey ambulance managers’ descriptions of crisis support interventions for ambulance staffafter potential traumatic events (PTEs).

    Methods:Semistructured interviews with a qualitative descriptive design were conductedwith six ambulance managers in a health care region in central Sweden. The data wasanalyzed using content analysis.

    Result:Five categories were found in the result: (1) description of a PTE; (2) descriptionand performance of crisis support interventions; (3) impact of working in potentiallytraumatic situations; (4) the ambulance managers’ role in crisis support interventions;and (5) the ambulance managers’ suggestions for improvement.Ambulance managersdescribed crisis support interventions after a PTE as a single, mandatory group meetingwith a structure reminiscent of debriefing. The ambulance managers also expressed doubtsabout the present structures for crisis support and mentioned an alternative approachwhich is more in line with present evidence-based recommendations.

    Conclusion:The results indicated a need for increased understanding of the importanceof the managers’ attitudes for ambulance staff; a need for further implementation ofevidence-based recommendations for crisis support interventions was also highlighted.

  • 5.
    Khankeh, Hamidreza
    et al.
    University of Social Welfare & Rehabilitation Sciences, Tehran, Iran; Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
    Nakhaei, Maryam
    University of Social Welfare & Rehabilitation Sciences, Tehran, Iran.
    Masoumi, Gholamreza
    Iran University of Medical Sciences, Teheran, Iran.
    Hosseini, Mohammadali
    University of Social Welfare & Rehabilitation Sciences, Tehran, Iran.
    Parsa-Yekta, Zohreh
    Tehran University of Medical Sciences, Teheran, Iran.
    Kurland, Lisa
    Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
    Castren, Maaret
    Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
    Life recovery after disasters: a qualitative study in the Iranian context2013In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 28, no 6, p. 573-9Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Planned and organized long-term rehabilitation services should be provided to victims of a disaster for social integration, economic self-sufficiency, and psychological health. There are few studies on recovery and rehabilitation issues in disaster situations. This study explores the disaster-related rehabilitation process.

    METHOD: This study was based on qualitative analysis. Participants included 18 individuals (eight male and ten female) with experience providing or receiving disaster health care or services. Participants were selected using purposeful sampling. Data were collected through in-depth and semi-structured interviews. All interviews were transcribed and content analysis was performed based on qualitative content analysis.

    RESULTS: The study explored three main concepts of recovery and rehabilitation after a disaster: 1) needs for health recovery; 2) intent to delegate responsibility; and 3) desire for a wide scope of social support. The participants of this study indicated that to provide comprehensive recovery services, important basic needs should be considered, including the need for physical rehabilitation, social rehabilitation, and livelihood health; the need for continuity of mental health care; and the need for family re-unification services. Providing social activation can help reintegrate affected people into the community.

    CONCLUSION: Effective rehabilitation care for disaster victims requires a clear definition of the rehabilitation process at different levels of the community. Involving a wide set of those most likely to be affected by the process provides a comprehensive, continuous, culturally sensitive, and family-centered plan.

1 - 5 of 5
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