Emergency preparedness for mass gatherings: Lessons of "12.31" stampede in Shanghai Bund.
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ABSTRACT:
SUBMITTER: Dong YH
PROVIDER: S-EPMC5555238 | biostudies-other | 2017 Aug
REPOSITORIES: biostudies-other
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Project description:Outbreaks of infectious diseases during peacetime or in disaster/war-related conditions, may most often need an effective crisis management in the hospital. The emergency preparedness in hospitals may vary within, and between countries, dependent on endemic and epidemic conditions, capacity, knowledge and economy. Lack of preparedness may result in a high risk of disease burden and death and cause a high economic impact on the health care.
| S-EPMC7114984 | biostudies-literature
Project description:BackgroundMass gathering (MG) events may cause delayed emergency responses via various mechanisms and strain the resources of local emergency services. Therefore, preparedness, including adequate pre-planning and sufficient resourcing during MG events, is vital. The aim of this retrospective register study was to investigate the impact of MG events on the workload of rescue and emergency medical service (EMS) personnel during events to enable more precise and sufficient deployment of these authorities' operative resources.MethodsThe data from Finland covered of 25,124 EMS and rescue service missions during a three-year period (2015-2017), including data from nine MG events and reference material for the same weekdays two weeks before and after the event. The data were analysed through statistical and geospatial analyses.ResultsOur findings showed that missions increased in most events included in this study. Analysis of the missions' reasons showed that the categories of violence, traffic accidents and other accidents and injuries increased during events, with violence-related missions showing the highest relative risk (RR 1.87, 95% CI 1.43-2.44). In the four-grade (A-D) urgency grading, the analysis showed an increase in category C missions and a decrease in non-urgent category D missions. The analysis indicated an increase in missions during the evening and night-time. The geospatial analysis revealed dense hotspots of missions in the vicinity of the event area.ConclusionThe workload for EMS and rescue service personnel increases during MG events. Most of the increase is allocated to EMS staff, peaking in evening and night hours. The geospatial analysis showed hotspots of missions on the outskirts of the actual event area during events; thus, the workload can also increase for those authority resources that are not directly allocated to the event. Detailed information regarding workloads is valuable for the authorities that are responsible for resource planning and preparedness for MG events. Replicating the study internationally would improve the methodology for the future.
| S-EPMC8898448 | biostudies-literature
Project description:Background and aimsThe effective response of emergency medical services in mass casualty incidents (MCIs) calls for sufficient preparation. The components of preparation must be determined first to achieve this goal. This study aimed to describe the elements of preparedness of emergency medical services for MCIs.MethodsA qualitative study was carried out on emergency medical service systems in Iran (from April 2022 to mid-March 2023), using in-depth semistructured interviews with participants who were managers and members of the incident command team, experts, technicians, paramedics, and telecommunicators of emergency medical services. Interviews were carried out face-to-face and via telephone. The data were collected using voice recorder and transcript and analyzed by content analysis method. This study was conducted using the consolidated criteria for reporting qualitative research.ResultsThirty-six participants were included in the study. A total of 834 codes were analyzed. Thirteen components were extracted from the study and classified as five categories including "Strengthening management and organization," "individual and group empowerment," "capacity expansion," "technology and infrastructure development," and "operational response measures."ConclusionEmergency medical service preparedness in response to MCIs is a critical issue. For improving preparedness, the main components must be identified. The study results described the elements of emergency medical service preparedness, which could be used as a framework for developing the national model of emergency medical service preparedness in MCIs.
| S-EPMC10587387 | biostudies-literature
Project description:BackgroundLarge-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.MethodsThe 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.ResultsA 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.ConclusionsThe 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.
| S-EPMC8628445 | biostudies-literature
Project description:OBJECTIVES:To assess hospital emergency nurses' self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca. DESIGN:Cross-sectional online survey with primary data collection and non-probabilistic purposive sample conducted in late 2014. SETTING:All 4 public hospitals in Mecca, Saudi Arabia. PARTICIPANTS:106 registered nurses in hospital emergency departments. MAIN OUTCOME MEASURE:Awareness, knowledge, skills and perceptions of emergency nurses in Mecca with regard to mass gathering disaster preparedness. RESULTS:Although emergency nurses' clinical role awareness in disaster response was reported to be high, nurses reported limited knowledge and awareness of the wider emergency and disaster preparedness plans, including key elements of their hospital strategies for managing a mass gathering disaster. Over half of the emergency nurses in Mecca's public hospitals had not thoroughly read the plan, and almost 1 in 10 were not even aware of its existence. Emergency nurses reported seeing their main role as providing timely general clinical assessment and care; however, fewer emergency nurses saw their role as providing surveillance, prevention, leadership or psychological care in a mass gathering disaster, despite all these broader roles being described in the hospitals' emergency disaster response plans. Emergency nurses' responses to topics where there are often misconceptions on appropriate disaster management indicated a significant knowledge deficit with only 1 in 3 nurses at best or 1 in 6 at worst giving correct answers. Respondents identified 3 key training initiatives as opportunities to further develop their professional skills in this area: (1) hospital education sessions, (2) the Emergency Management Saudi Course, (3) bespoke short courses in disaster management. CONCLUSIONS:Recommendations are suggested to help enhance clinical and educational efforts in disaster preparedness.
| S-EPMC5477837 | biostudies-other
Project description:The coronavirus pandemic (COVID-19) has triggered a public health and economic crisis in high and low resource settings since the beginning of 2020. With the first case being discovered on 12th March 2020, Kenya has responded by using health and non-health strategies to mitigate the direct and indirect impact of the disease on its population. However, this has had positive and negative implications for the country's overall health system. This paper aimed to understand the pandemic's impact and develop lessons for future response by identifying the key challenges and opportunities Kenya faced during the pandemic. We conducted a qualitative study with 15 key informants, purposefully sampled for in-depth interviews from September 2020 to February 2021. We conducted direct content analysis of the transcripts to understand the stakeholder's views and perceptions of how COVID-19 has affected the Kenyan healthcare system. Most of the respondents noted that Kenya's initial response was relatively good, especially in controlling the pandemic with the resources it had at the time. This included relaying information to citizens, creating technical working groups and fostering multisectoral collaboration. However, concerns were raised regarding service disruption and impact on reproductive health, HIV, TB, and non-communicable diseases services; poor coordination between the national and county governments; shortage of personal protective equipment and testing kits; and strain of human resources for health. Effective pandemic preparedness for future response calls for improved investments across the health system building blocks, including; human resources for health, financing, infrastructure, information, leadership, service delivery and medical products and technologies. These strategies will help build resilient health systems and improve self-reliance, especially for countries transitioning from donor aid such as Kenya in the event of a pandemic.
| S-EPMC10021887 | biostudies-literature
Project description:The COVID-19 pandemic highlights the importance of Emergency Preparedness & Response (EP&R) education, training, capacity building and infrastructure development in India. During the pandemic, pharmacy professionals (PPs) in India have continued to provide medications, supplies and services. India's public-private healthcare system is complex and of variable quality. Lacunae in pharmacy education, training, and lack of resolution around pharmacist roles present challenges in providing health services to patients. Such lack of differentiation creates challenges around role specifications and appropriate placement of PPs in patient care and on EP&R task forces or representation at the policy level. This study aimed to gain rapid insights from PPs in India regarding their roles and preparedness for the COVID-19 pandemic. An online survey comprising 20 questions regarding EP&R and Operations management was developed using the Qualtrics® survey software and administered to a sample of PPs. Survey results indicate that PPs were actively involved in essential pharmacy services despite minimal EP&R training. Based on lessons learned during COVID-19, lacunae in knowledge, training and regulations were identified and recommendations are provided to broaden PP roles and enable them to be better prepared and actively engaged in EP&R for future emergencies.
| S-EPMC7194881 | biostudies-literature
Project description:BackgroundBest practice recommendations for sports-related emergency preparation include implementation of venue-specific emergency action plans (EAPs), access to early defibrillation, and first responders-specifically coaches-trained in cardiopulmonary resuscitation and automated external defibrillator (AED) use. The objective was to determine whether high schools had implemented these 3 recommendations and whether schools with a certified athletic trainer (AT) were more likely to have done so.HypothesisSchools with an AT were more likely to have implemented the recommendations.Study designCross-sectional study.Level of evidenceLevel 4.MethodsAll Oregon School Activities Association member school athletic directors were invited to complete a survey on sports-related emergency preparedness and AT availability at their school. Chi-square and Fisher exact tests were used to analyze the associations between emergency preparedness and AT availability.ResultsIn total, 108 respondents (37% response rate) completed the survey. Exactly half reported having an AT available. Only 11% (95% CI, 6%-19%) of the schools had implemented all 3 recommendations, 29% (95% CI, 21%-39%) had implemented 2, 32% (95% CI, 24%-42%) had implemented 1, and 27% (95% CI, 19%-36%) had not implemented any of the recommendations. AT availability was associated with implementation of the recommendations (χ2 = 10.3, P = 0.02), and the proportion of schools with ATs increased with the number of recommendations implemented (χ2 = 9.3, P < 0.01). Schools with an AT were more likely to implement venue-specific EAPs (52% vs 24%, P < 0.01) and have an AED available for early defibrillation (69% vs 44%, P = 0.02) but not more likely to require coach training (33% vs 28%, P = 0.68).ConclusionsDespite best practice recommendations, most schools were inadequately prepared for sports-related emergencies. Schools with an AT were more likely to implement some, but not all, of the recommendations. Policy changes may be needed to improve implementation.Clinical relevanceMost Oregon high schools need to do more to prepare for sports-related emergencies. The results provide evidence for sports medicine professionals and administrators to inform policy changes that ensure the safety of athletes.
| S-EPMC5349394 | biostudies-literature
Project description:Simulation exercises are an important part of emergency preparedness activities for the healthcare community but evidence of their impact on the response to real major incidents is limited. This project studied the impact of health emergency preparedness exercises (HEPEs) on the response to a mass casualty terrorist incident. The mixed methods study design was adopted comprising an on-line survey and follow up individual interviews. Participants were healthcare staff who took part in responses to three major terrorist incidents in the UK in 2017. Descriptive statistics and analysis of variance were undertaken with quantitative data. Content and thematic analysis methods were used for qualitative data analysis. The online survey generated 86 responses; 79 (92%) were from the responders to the Manchester Arena bombing. Twenty-one survey respondents shared their experiences in in-depth interviews. Healthcare staff who took part in HEPEs felt better prepared to respond than those who did not attend an exercise. The most commonly reported benefits from HEPEs were awareness of major incident plans and having the opportunity to practice responding to a similar scenario in the recent exercise. Specific benefits included: improved coordination of the response through adherence to recently practiced incident plans; confidence with response roles; real-time modifications of the response and support provided to staff who did not take part in exercises. Exercise recency was highlighted as an important facilitating factor. The study provides strong objective evidence that the response to a mass casualty terrorist incident was enhanced by training and service development achieved through HEPEs.
| S-EPMC7709486 | biostudies-literature
Project description:ContextOn February 3, 2019, Atlanta, Georgia, hosted Super Bowl LIII, which is classified as a National Special Security Event. The festivities comprising this major sporting event brought approximately half a million people to Atlanta, which posed significant challenges to the local public health community. As the lead local agency for public health planning, preparedness, and response efforts, Fulton County Board of Health (FCBOH) needed to address multiple specific tasks based on core functional areas outlined in the Emergency Support Function (ESF) 8 (eg, bioterrorism preparedness and epidemiological surveillance).ProgramTo prepare for the Super Bowl, FCBOH developed a systematic approach to ensure community-wide public health preparedness for mass gatherings. This approach came to be known as the 6 E framework, which consists of (1) engaging stakeholders, (2) examining current capabilities and identifying gaps, (3) establishing roles and responsibilities, (4) executing plans to fill gaps, (5) exercising plans, and (6) evaluating impact.ImplementationWe define each step of the 6 E framework and present practical examples of how FCBOH implemented each step when preparing for the Super Bowl. Challenges that FCBOH faced and the lessons learned in the process are illustrated. The 6 E framework provides a systematic approach to community preparedness and allows local health departments to tailor the approach to serve local public health needs.EvaluationThe successful implementation of the 6 E framework allowed for stakeholders at the federal, state, and local levels (including law enforcement) to effectively coordinate an epidemiological investigation and response when 4 staff members reported gastrointestinal symptoms after eating at a feeding station.DiscussionPreparation for the Super Bowl required months of diligent cross-sectoral and cross-jurisdictional partnership building, and the 6 E framework can help other local public health jurisdictions prepare to host major mass gatherings.
| S-EPMC8291143 | biostudies-literature