Dataset Information

Rethinking preparedness planning in disaster emergency care: lessons from a beyond-surge-capacity event.

ABSTRACT:

Background

Large-scale burn disasters can produce casualties that threaten medical care systems. This study proposes a new approach for developing hospital readiness and preparedness plan for these challenging beyond-surge-capacity events.

Methods

The Formosa Fun Coast Dust Explosion (FFCDE) was studied. Data collection consisted of in-depth interviews with clinicians from four initial receiving hospitals and their relevant hospital records. A detailed timeline of patient flow and emergency department (ED) workload changes of individual hospitals were examined to build the EDs' overload patterns. Data analysis of the multiple hospitals' responses involved chronological process-tracing analysis, synthesis, and comparison analysis in developing an integrated adaptations framework.

Results

A four-level ED overload pattern was constructed. It provided a synthesis of specifics on patient load changes and the process by which hospitals' surge capacity was overwhelmed over time. Correspondingly, an integrated 19 adaptations framework presenting holistic interrelations between adaptations was developed. Hospitals can utilize the overload patterns and overload metrics to design new scenarios with diverse demands for surge capacity. The framework can serve as an auxiliary tool for directive planning and cross-check to address the insufficiencies of preparedness plans.

Conclusions

The study examined a wide-range spectrum of emergency care responses to the FFCDE. It indicated that solely depending on policies or guidelines for preparedness plans did not contribute real readiness to MCIs. Hospitals can use the study's findings and proposal to rethink preparedness planning for the future beyond surge capacity events.

SUBMITTER: Chuang S

PROVIDER: S-EPMC8628445 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Background. The emergency medical service (EMS) provides first-line medical care to people who require urgent medical care in emergency and disaster situations. Preparedness is the most effective approach for the management of disaster risks, and it is essential for the emergency medical service (EMS) providers, such as paramedics, emergency medical technicians (EMT), and other EMS personnel. This systematic review will explore evidence on the preparedness of emergency medical service providers in emergency and disaster situations by reviewing peer-reviewed journal articles. Methods/Design. This study will be conducted on peer-reviewed articles published between 2005 and 2019 to explore the preparedness of emergency medical service providers in emergencies and disasters. Scopus, Web of Science, PubMed, and Google Scholar will be thoroughly searched to identify published studies on emergency and disaster preparedness. The following keywords will be used for searching the databases: "Medical Technician," "Paramedic," "Emergency Paramedic," "Emergency Medicine Technician," "Emergency Medical Technician," "Emergency Prehospital Provider," "Emergency Preparedness," "Disaster Preparedness," "Hospital Preparedness," "Disaster management," "Disaster Competencies," "Disaster Readiness," "Disaster," "Disaster Role," "Readiness, Preparedness, Terrorist," "Mass Casualty Incident," "Major incidents," "Mass Casualty," "Mass Gathering," "CBRNE," "Weapons of Mass Destruction," and "Chemical, Biological, Radiological, Nuclear, and Explosive Event." Discussion. To the best of our knowledge, no comprehensive review study has been conducted on the preparedness of emergency medical service providers in disaster situations. This study is the first attempt to address this gap. It will also explore the key dimensions in disaster preparedness of EMS providers and the strategies to enhance their preparedness. Identifying the key dimensions of disaster preparedness is the first step in designing and developing valid instruments to evaluate EMS provider's disaster preparedness and as well as adopting appropriate strategies to improve the level of their preparedness (This systematic review is registred in PROSPERO with CRD42020149689).