Boundaries as Mechanisms for Learning in Emergency Exercises with Students from Emergency Service Organisations

ERIC Educational Resources Information Center

Andersson, Annika

2016-01-01

To prepare emergency response organisations for collaborative work in unpredictable and dynamic situations, various types of exercises are widely used. Still, our knowledge of collaboration exercises with emergency response students is limited. This study aimed to contribute to this field by exploring boundaries that emerged between collaborating…

Faster response time : effective use of resources : integrating transportation systems and emergency management systems

DOT National Transportation Integrated Search

1999-01-01

This brochure discusses how coordinating the efforts of emergency dispatchers with transportation management agencies can improve efficiency and response times. It is noted that when emergency services agencies share facilities and traffic monitoring...

Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel.

PubMed

Wolkow, Alexander; Ferguson, Sally; Aisbett, Brad; Main, Luana

2015-01-01

Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel) that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextualize the significance of such responses to assist emergency service agencies monitor the health of their personnel. The available literature suggests that sleep restriction across multiple work days can disrupt cytokine and cortisol levels, deteriorate mood and elicit simultaneous physiological and psychological responses. However, research concerning the interaction between such responses is limited and inconclusive. Therefore, it is unknown if a psycho-physiological relationship exists and as a result, it is currently not feasible for agencies to monitor sleep restriction related stress based on psycho- physiological interactions. Sleep restriction does however, appear to be a major stressor contributing to physiological and psychological responses and thus, warrants further investigation. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

48 CFR 452.236-77 - Emergency Response.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Response. As prescribed in 436.577, the following clause may be used in Forest Service construction contracts: Emergency Response (NOV 1996) (a) Contractor's Responsibility for Fire Fighting. (1) The..., Equipment, Utilities, and Improvements, shall immediately extinguish all fires on the work site other than...

48 CFR 452.236-77 - Emergency Response.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Response. As prescribed in 436.577, the following clause may be used in Forest Service construction contracts: Emergency Response (NOV 1996) (a) Contractor's Responsibility for Fire Fighting. (1) The..., Equipment, Utilities, and Improvements, shall immediately extinguish all fires on the work site other than...

48 CFR 452.236-77 - Emergency Response.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Response. As prescribed in 436.577, the following clause may be used in Forest Service construction contracts: Emergency Response (NOV 1996) (a) Contractor's Responsibility for Fire Fighting. (1) The..., Equipment, Utilities, and Improvements, shall immediately extinguish all fires on the work site other than...

48 CFR 452.236-77 - Emergency Response.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Response. As prescribed in 436.577, the following clause may be used in Forest Service construction contracts: Emergency Response (NOV 1996) (a) Contractor's Responsibility for Fire Fighting. (1) The..., Equipment, Utilities, and Improvements, shall immediately extinguish all fires on the work site other than...

48 CFR 452.236-77 - Emergency Response.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Response. As prescribed in 436.577, the following clause may be used in Forest Service construction contracts: Emergency Response (NOV 1996) (a) Contractor's Responsibility for Fire Fighting. (1) The..., Equipment, Utilities, and Improvements, shall immediately extinguish all fires on the work site other than...

The Use of Autonomous Systems in Emergency Medical Services: Bridging Human Intelligence and Technology

DTIC Science & Technology

2015-12-01

significant impact on emergency medical services ( EMS ). EMS provider organizations must be prepared to not only interact with AS by having response... EMS will be high, that the number of opportunities to improve required emergency response and deliver expedient medical care will be diminished, and...that strengths may be nonexistent. The thesis focuses on the analysis of what AS are, how they are used in the provision of EMS today, how they may be

Faster response time, effective use of resources : integrating transportation systems and emergency management systems.

DOT National Transportation Integrated Search

1999-01-01

When emergency services agencies share : facilities and traffic monitoring resources : with transportation management agencies, : the efficiency and speed of incident : response are measurably improved.

Designated Medical Directors for Emergency Medical Services: Recruitment and Roles

ERIC Educational Resources Information Center

Slifkin, Rebecca T.; Freeman, Victoria A.; Patterson, P. Daniel

2009-01-01

Context: Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight. Purpose: To assess rural-urban…

Medical rehabilitation after natural disasters: why, when, and how?

PubMed

Rathore, Farooq A; Gosney, James E; Reinhardt, Jan D; Haig, Andrew J; Li, Jianan; DeLisa, Joel A

2012-10-01

Natural disasters can cause significant numbers of severe, disabling injuries, resulting in a public health emergency and requiring foreign assistance. However, since medical rehabilitation services are often poorly developed in disaster-affected regions and not highly prioritized by responding teams, physical and rehabilitation medicine (PRM) has historically been underemphasized in global disaster planning and response. Recent development of the specialties of "disaster medicine" and "disaster rehabilitation" has raised awareness of the critical importance of rehabilitation intervention during the immediate postdisaster emergency response. The World Health Organization Liaison Sub-Committee on Rehabilitation Disaster Relief of the International Society of Physical and Rehabilitation Medicine has authored this report to assess the role of emergency rehabilitation intervention after natural disasters based on current scientific evidence and subject matter expert accounts. Major disabling injury types are identified, and spinal cord injury, limb amputation, and traumatic brain injury are used as case studies to exemplify the challenges to effective management of disabling injuries after disasters. Evidence on the effectiveness of disaster rehabilitation interventions is presented. The authors then summarize the current state of disaster-related research, as well as lessons learned from PRM emergency rehabilitation response in recent disasters. Resulting recommendations for greater integration of PRM services into the immediate emergency disaster response are provided. This report aims to stimulate development of research and practice in the emerging discipline of disaster rehabilitation within organizations that provide medical rehabilitation services during the postdisaster emergency response. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

75 FR 42448 - Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency Response; Notice of..., 1972, that the Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency Response, Department of Health and Human Services, has amended their charter to reflect the change...

National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

PubMed

Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

2018-01-01

Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

Suggested Guide for Fire Service Standard Operating Procedures.

ERIC Educational Resources Information Center

Gillett, Merl; Hertzler, Simon L.

Suggested guidelines for the development of fire service standard operating procedures are presented in this document. Section topics are as follow: chain of command; communications; emergency response; apparatus; fire service training; disaster response; aircraft fire safety; mutual aid; national reporting system (example reporting forms);…

National Response Framework

DTIC Science & Technology

2008-01-01

special needs should enhance their awareness of risk and threats, develop household emergency plans that include care for pets and service animals , and...including persons, property, and structures. – Individuals with special needs, including those with service animals . – Individuals with household pets...supplies for household pets and service animals . See the recommended disaster supplies list at http://www.ready.gov. • Monitoring emergency

USGS Emergency Response Resources

USGS Publications Warehouse

Bewley, Robert D.

2011-01-01

Every day, emergency responders are confronted with worldwide natural and manmade disasters, including earthquakes, floods, hurricanes, landslides, tsunami, volcanoes, wildfires, terrorist attacks, and accidental oil spills.The U.S. Geological Survey (USGS) is ready to coordinate the provisioning and deployment of USGS staff, equipment, geospatial data, products, and services in support of national emergency response requirements.

Responsibilities of the USDA-Food and Nutrition Service in Nutrition Assistance Response to Natural Disasters.

PubMed

Abernathy, Toni

2015-01-01

USDA makes sure that nutritious USDA Foods are made available to States, Indian Tribal Organizations and Emergency Feeding Organizations to help feed survivors of natural disasters and other emergencies when needed.

[Organisation of emergency medicine in France].

PubMed

Braun, Françis

2015-01-01

The French emergency medicine infrastructure (structures de médecine d'urgence) ensures patients care from the very location of the distress to the appropriate hospital department: medical care in the field, by hospital clinical teams (the services mobiles d'urgence et de réanimation [SMUR]), is a key characteristic of our medical emergency response system. Response to medical distress revolves around information about not only the location and characteristics of the medical need, but also the availability of adapted hospital services. Gathering and transmitting this information is the prerogative of the service d'aide médicale d'urgence (SAMU) and its telephone dispatch center (Centre 15). For patients coming directly to the hospital, the emergency room (ER), a former underfunded and neglected hospital service, has become a key point of access. The ER is now responsible, after providing immediate first line care, to guide the patient through the care system. As such they are equipped with short term hospitalization units designed to enable up to 24h patient observation before orientation. This ensemble, networked at the level of a health territory, ensures the quality, safety, and efficacy that the population is entitled to demand.

Hazardous materials responses in a mid-sized metropolitan area.

PubMed

Walter, Frank G; Bates, Gerry; Criss, Elizabeth A; Bey, Tareg; Spaite, Daniel W; Valenzuela, Terence

2003-01-01

To determine the chemicals involved in fire department hazardous materials (hazmat) responses and analyze the concomitant emergency medical services' patient care needs. The setting was a mid-sized metropolitan area in the southwestern United States with a population base of 400,000 and an incorporated area of 165 square miles. The authors conducted a retrospective evaluation of all fire department hazmat reports, with associated emergency medical services patient encounter forms, and in-patient hospital records from January 1, 1992, through December 31, 1994. The fire department hazardous materials control team responded to 468 hazmat incidents, involving 62 chemicals. The majority of incidents occurred on city streets, with a mean incident duration of 46 minutes. More than 70% of the responses involved flammable gases or liquids. A total of 32 incidents generated 85 patients, 53% of whom required transport for further evaluation and care. Most patients were exposed to airborne toxicants. Only two patients required hospital admission for carbon monoxide poisoning. Most hazmat incidents result in few exposed patients who require emergency medical services care. Most patients were exposed to airborne toxicants and very few required hospitalization. Routine data analysis such as this provides emergency response personnel with the opportunity to evaluate current emergency plans and identify areas where additional training may be necessary.

[Terrorism, public health and health services].

PubMed

Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

2009-01-01

Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

Speeding response -- saving lives : automatic vehicle location capabilities for emergency vehicles

DOT National Transportation Integrated Search

1999-01-01

This brochure focuses on the application of automatic vehicle location systems to emergency services. It discusses how AVL works with emergency vehicles. how it accommodates a wide range of emergency situations, and the benefits of its use.

Call selection for the Helicopter Emergency Medical Service: implications for ambulance control.

PubMed Central

Coats, T J; Newton, A

1994-01-01

The increasing sophistication of pre-hospital care, with paramedics and many types of 'rapid response' units, requires the use of advanced systems of ambulance control. The introduction of call selection by a paramedic in the ambulance control room significantly improved the tasking of the Helicopter Emergency Medical Service. This paper illustrates the need for a system to grade 999 calls, so that the appropriate pre-hospital response can be directed to each patient. PMID:8182675

First contact: acute stress reactions and experiences of emergency department consultations following an incident of intimate partner violence.

PubMed

Olive, Philippa

2017-08-01

The aim of this research was to explore women's emotional and affective responses following an incident of intimate partner violence experienced during emergency department attendances. A growing body of research has explored women's experiences of emergency departments following intimate partner violence still little remains known about the experience and impact of emotional and affective responses during these attendances. A descriptive qualitative design was used, underpinned theoretically by critical realism and postmodern complexity theory to attend to multiple, intersecting mechanisms that lie behind events and experiences. Semistructured interviews with six women who had attended an emergency department directly following an incident of intimate partner violence. Interview data were transcribed and thematically analysed in nvivo9 using a coding framework. There were three interconnected key findings. First, was the commonality of acute stress experiences among women attending an emergency department following partner violence, second was that these acute stress reactions negatively impacted women's consultations, and third was the need for specialist domestic violence services at the point of first contact to assist service users navigate an effective consultation. Acute stress reactions were an important feature of women's experiences of emergency department consultations following intimate partner violence. Attending to psychological first aid; providing a safe and quiet space; and affording access to specialist violence advocacy services at the point of first contact will limit harm and improve health consultation outcomes for this population. This research provides an account of emotional and affective responses experienced by women attending emergency departments following intimate partner violence and explicates how these acute stress reactions impacted their consultation. This research has relevance for practitioners in many first contact health services, such as urgent and emergency care, general practice, community public health and mental health. © 2016 John Wiley & Sons Ltd.

Is Service-Learning the Kind Face of the Neo-Liberal University?

ERIC Educational Resources Information Center

Raddon, Mary-Beth; Harrison, Barbara

2015-01-01

The emergence of service-learning pedagogies in Canada has received a variety of critical responses. Some regard service-learning as a public relations effort of universities and colleges; others see it as a countermovement to academic corporatization; still others consider it part of a wider cultural project to produce self-responsible and…

Lessons learned from Chicago's emergency response to mass evacuations caused by Hurricane Katrina.

PubMed

Broz, Dita; Levin, Elise C; Mucha, Amy P; Pelzel, Darlene; Wong, William; Persky, Victoria W; Hershow, Ronald C

2009-08-01

We analyzed the response of the Chicago Department of Public Health with respect to its effectiveness in providing health care to Hurricane Katrina evacuees arriving in the city. Between September 12 and October 21, 2005, we conducted a real-time qualitative assessment of a medical unit in Chicago's Hurricane Victim Welcome and Relief Center. A semistructured guide was used to interview 33 emergency responders in an effort to identify key operational successes and failures. The medical unit functioned at a relatively high level, primarily as a result of the flexibility, creativity, and dedication of its staff and the presence of strong leadership. Chronic health care services and prescription refills were the most commonly mentioned services provided, and collaboration with a national pharmacy proved instrumental in reconstructing medication histories. The lack of a comprehensive and well-communicated emergency response plan resulted in several preventable inefficiencies. Our findings highlight the need for improved planning for care of evacuee populations after a major emergency event and the importance of ensuring continuity of care for the most vulnerable. We provide an emergency response preparedness checklist for local public health departments.

The changing nature and scope of public health emergencies in response to annual flu.

PubMed

Hodge, James G

2013-06-01

The rapid spread of influenza during the 2012-13 season brought a series of public health challenges and corresponding response efforts. For decades, responses to annual flu have been undertaken routinely without extensive legal intervention. With the recent declaration of states of public health emergencies in Boston (January 9, 2013) and New York State (January 12, 2013), however, the legal baseline is changing. Propelled by a slate of state and local emergency declarations during the 2009-10 H1N1 pandemic, public officials are beginning to show cause for the issuance of formal emergency declarations in support of flu response efforts. The legal effects of these types of declarations are profound. Public and private actors are given significant, expedited public health powers. Scarce resources like vaccines can be more efficiently allocated. Laws relating to licensure, scope of practice, and liability can be effectively waived. Though originally conceptualized and once reserved for catastrophic, long-term health-related or bioterrorism events, public health emergency declarations are evolving to address temporary impacts on health care and public health services arising annually from flu outbreaks. This commentary explores the changing nature of public health emergencies and their current and potential impact on the provision of healthcare services in response to national or regional threats to the public's health.

United States Geological Survey (USGS) Natural Hazards Response

USGS Publications Warehouse

Lamb, Rynn M.; Jones, Brenda K.

2012-01-01

The primary goal of U.S. Geological Survey (USGS) Natural Hazards Response is to ensure that the disaster response community has access to timely, accurate, and relevant geospatial products, imagery, and services during and after an emergency event. To accomplish this goal, products and services provided by the National Geospatial Program (NGP) and Land Remote Sensing (LRS) Program serve as a geospatial framework for mapping activities of the emergency response community. Post-event imagery and analysis can provide important and timely information about the extent and severity of an event. USGS Natural Hazards Response will also support the coordination of remotely sensed data acquisitions, image distribution, and authoritative geospatial information production as required for use in disaster preparedness, response, and recovery operations.

What is a health emergency? The difference in definition and understanding between patients and health professionals.

PubMed

Morgans, Amee; Burgess, Stephen J

2011-08-01

Investigations into 'inappropriate' use of emergency health services are limited by the lack of definition of what constitutes a health emergency. Position papers from Australian and international sources emphasise the patient's right to access emergency healthcare, and the responsibility of emergency health care workers to provide treatment to all patients. However, discordance between the two perspectives remain, with literature labelling patient use of emergency health services as 'inappropriate'. To define a 'health emergency' and compare patient and health professionals perspectives. A sample of 600 emergency department (ED) patients were surveyed about a recent health experience and asked to rate their perceived urgency. This rating was compared to their triage score allocated at the hospital ED. No significant relationship was found between the two ratings of urgency (P=0.51). CONCLUSIONS; Differing definitions of a 'health emergency' may explain patient help-seeking behaviour when accessing emergency health resources including hospital ED and ambulance services. A new definition of health emergency that encapsulates the health professional and patient perspectives is proposed. An agreed definition of when emergency health resources should be used has the potential to improve emergency health services demand and patient flow issues, and optimise emergency health resource allocation.

Emergency Medical Services Instructor Training Program. A National Standard Curriculum. Course Guide. First Edition.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

This course guide is designed to aid the course administrator and coordinator in understanding, developing, and implementing all phases of an Emergency Medical Services (EMS) instructor training course. An introduction provides an overview of the training program and the administrator's and coordinator's responsibilities in the organization and…

Hurricane Hugo: Emergency Preparedness Planning and Response for Mental Health Services.

ERIC Educational Resources Information Center

Carter, Nancy C.; And Others

This report describes how, in the aftermath of Hurricane Hugo, the South Carolina Department of Mental Health activated its Emergency Preparedness Plan to assist mental health centers and their staff in providing crisis counseling services to the general public. The first section explains the history and structure of the involvement by the…

Getting Down to Business: An Action Plan for Public-Private Disaster Response Coordination. The Report of the Business Response Task Force

DTIC Science & Technology

2007-01-01

gency Management Association ( NEMA ) to explore application of the Emergency Management Assistance Compact (EMAC) model to the task of identifying...organizations combined—are the norm . The challenge for government and the private sector is to ensure that donated goods and services from the latter...Association ( NEMA ). EOC – Emergency Operations Center – the central command and control facility responsible for carrying out emergency preparedness and

Are human service agencies ready for disasters? Findings from a mixed-methods needs assessment and planning project.

PubMed

Hipper, Thomas J; Orr, Ashley; Chernak, Esther

2015-01-01

A mixed-methods design was used to assess the current capacity of human service agencies to provide services in a major disaster, identify challenges and successful strategies for providing those services, and formulate specific recommendations for government planners and the nonprofit sector to promote the integration of human service agencies into emergency preparedness and response. A web-based survey was completed by 188 unique human service agencies, 31 semistructured interviews were conducted with human service agency and government leaders from southeastern Pennsylvania and the mid-Atlantic region, and a collaborative planning meeting was held to review the findings and develop systems-based recommendations. Survey results indicated that human service agencies serve the most vulnerable communities during disasters and would welcome integration into preparedness and response plans, but they currently face challenges that include a lack of real-time communication and opportunities for collaborative planning with government partners. Interview findings were grouped according to 5 themes that emerged: capacity, coordination, communication, training, and leadership. This study identified recommendations to assist human service agencies, local health departments, and emergency management agencies as they work to ensure that needed human services are available during disasters, despite the resource challenges that most agencies face.

The crisis in United States hospital emergency services.

PubMed

Harrison, Jeffrey P; Ferguson, Emily D

2011-01-01

Emergency services are critical for high-quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (U.S.) acute care hospital staffs ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers. Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities. U.S. acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, U.S. emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staffs ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state-of-the-art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement. This research uses the AHA annual surveys,which represent self-reported data by individual hospital staff. However, the AHA expendssignificant resources to validate reported information and the annual survey data are widely used for hospital research. The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure. This article has important information on US emergency service availability in the hospital industry.

Meeting national response time targets for priority 1 incidents in an urban emergency medical services system in South Africa: More ambulances won't help.

PubMed

Stein, Christopher; Wallis, Lee; Adetunji, Olufemi

2015-09-19

Response time is viewed as a key performance indicator in most emergency medical services (EMS) systems. To determine the effect of increased emergency vehicle numbers on response time performance for priority 1 incidents in an urban EMS system in Cape Town, South Africa, using discrete-event computer simulation. A simulation model was created, based on input data from part of the EMS operations. Two different versions of the model were used, one with primary response vehicles and ambulances and one with only ambulances. In both cases the models were run in seven different scenarios. The first scenario used the actual number of emergency vehicles in the real system, and in each subsequent scenario vehicle numbers were increased by adding the baseline number to the cumulative total. The model using only ambulances had shorter response times and a greater number of responses meeting national response time targets than models using primary response vehicles and ambulances. In both cases an improvement in response times and the number of responses meeting national response time targets was observed with the first incremental addition of vehicles. After this the improvements rapidly diminished and eventually became negligible with each successive increase in vehicle numbers. The national response time target for urban areas was never met, even with a seven-fold increase in vehicle numbers. The addition of emergency vehicles to an urban EMS system improves response times in priority 1 incidents, but alone is not capable of the magnitude of response time improvement needed to meet the national response time targets.

The Usefulness of Information and Communication Technologies in Crisis Response

PubMed Central

Paul, Sharoda A.; Reddy, Madhu; Abraham, Joanna; DeFlitch, Christopher

2008-01-01

Information and communication technologies (ICTs) play a vital role in coordinating crisis response between pre-hospital services and emergency departments of hospitals. In spite of the advances in these technologies, there remain a variety of challenges to their usage during a crisis. To identify these challenges, we conducted focus group interviews with emergency department (ED) and emergency medical services (EMS) personnel. We found that ED and EMS personnel have widely varying perceptions about the usefulness and ease-of-use of information tools and communication tools used in crisis management. We discuss the importance of bringing together communication and information tools into integrated networks of ICTs for effective crisis response. We also highlight design features of ICTs which can support seamless and effective communication and coordination between ED and EMS teams. PMID:18998898

The usefulness of information and communication technologies in crisis response.

PubMed

Paul, Sharoda A; Reddy, Madhu; Abraham, Joanna; DeFlitch, Christopher; Deflitch, Christopher J

2008-11-06

Information and communication technologies (ICTs) play a vital role in coordinating crisis response between pre-hospital services and emergency departments of hospitals. In spite of the advances in these technologies, there remain a variety of challenges to their usage during a crisis. To identify these challenges, we conducted focus group interviews with emergency department (ED) and emergency medical services (EMS) personnel. We found that ED and EMS personnel have widely varying perceptions about the usefulness and ease-of-use of information tools and communication tools used in crisis management. We discuss the importance of bringing together communication and information tools into integrated networks of ICTs for effective crisis response. We also highlight design features of ICTs which can support seamless and effective communication and coordination between ED and EMS teams.

A Profile of Indian Health Service Emergency Departments.

PubMed

Bernard, Kenneth; Hasegawa, Kohei; Sullivan, Ashley; Camargo, Carlos

2017-06-01

The Indian Health Service provides health care to eligible American Indians and Alaskan Natives. No published data exist on emergency services offered by this unique health care system. We seek to determine the characteristics and capabilities of Indian Health Service emergency departments (EDs). All Indian Health Service EDs were surveyed about demographics and operational characteristics for 2014 with the National Emergency Department Inventory survey (available at http://www.emnet-nedi.org/). Of the forty eligible sites, there were 34 respondents (85% response rate). Respondents reported a total of 637,523 ED encounters, ranging from 521 to 63,200 visits per site. Overall, 85% (95% confidence interval 70% to 94%) had continuous physician coverage. Of all physicians staffing the ED, a median of 13% (interquartile range 0% to 50%) were board certified or board prepared in emergency medicine. Overall, 50% (95% confidence interval 34% to 66%) of respondents reported that their ED was operating over capacity. Indian Health Service EDs varied widely in visit volume, with many operating over capacity. Most were not staffed by board-certified or -prepared emergency physicians. Most lacked access to specialty consultation and telemedicine capabilities. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Hazards Data Distribution System (HDDS)

USGS Publications Warehouse

Jones, Brenda; Lamb, Rynn M.

2015-07-09

When emergencies occur, first responders and disaster response teams often need rapid access to aerial photography and satellite imagery that is acquired before and after the event. The U.S. Geological Survey (USGS) Hazards Data Distribution System (HDDS) provides quick and easy access to pre- and post-event imagery and geospatial datasets that support emergency response and recovery operations. The HDDS provides a single, consolidated point-of-entry and distribution system for USGS-hosted remotely sensed imagery and other geospatial datasets related to an event response. The data delivery services are provided through an interactive map-based interface that allows emergency response personnel to rapidly select and download pre-event ("baseline") and post-event emergency response imagery.

Exploratory analysis of real personal emergency response call conversations: considerations for personal emergency response spoken dialogue systems.

PubMed

Young, Victoria; Rochon, Elizabeth; Mihailidis, Alex

2016-11-14

The purpose of this study was to derive data from real, recorded, personal emergency response call conversations to help improve the artificial intelligence and decision making capability of a spoken dialogue system in a smart personal emergency response system. The main study objectives were to: develop a model of personal emergency response; determine categories for the model's features; identify and calculate measures from call conversations (verbal ability, conversational structure, timing); and examine conversational patterns and relationships between measures and model features applicable for improving the system's ability to automatically identify call model categories and predict a target response. This study was exploratory and used mixed methods. Personal emergency response calls were pre-classified according to call model categories identified qualitatively from response call transcripts. The relationships between six verbal ability measures, three conversational structure measures, two timing measures and three independent factors: caller type, risk level, and speaker type, were examined statistically. Emergency medical response services were the preferred response for the majority of medium and high risk calls for both caller types. Older adult callers mainly requested non-emergency medical service responders during medium risk situations. By measuring the number of spoken words-per-minute and turn-length-in-words for the first spoken utterance of a call, older adult and care provider callers could be identified with moderate accuracy. Average call taker response time was calculated using the number-of-speaker-turns and time-in-seconds measures. Care providers and older adults used different conversational strategies when responding to call takers. The words 'ambulance' and 'paramedic' may hold different latent connotations for different callers. The data derived from the real personal emergency response recordings may help a spoken dialogue system classify incoming calls by caller type with moderate probability shortly after the initial caller utterance. Knowing the caller type, the target response for the call may be predicted with some degree of probability and the output dialogue could be tailored to this caller type. The average call taker response time measured from real calls may be used to limit the conversation length in a spoken dialogue system before defaulting to a live call taker.

The effect of occupational cultures on coordination of emergency medical service aircrew.

PubMed

Fonne, V M; Myhre, G

1996-06-01

The purpose of the study was to see whether one can determine different occupational cultures in the Emergency Medical Air Ambulance Service and whether these differences in orientation among the crewmembers may have an impace on effective crew coordination. Due to different requirements of the Emergency Medical Service (EMS), each crewmember joins the duty with different backgrounds, interests and expectations. The operational stresses of this kind of service, however, demand teamwork and may easily expose the crew's ability to coordinate their actions to work as a team. The initial study consisted of 60 operational crewmembers from the Norwegian Air Ambulance Service. Hofstede's questionnaire Values Survey Module was administered for an evaluation of occupational culture. The analysis reveals group differences at the occupational level in the perception of power distribution, team orientation and achievement preferences. We conclude that differences in certain work goals might be attributed partly by specific attitudes and values from the occupational categories' professional background, which influence the interpretation of established rules and procedures in the service. The results are further discussed in relation to the crewmembers' different task demands and areas of responsibility, and emphasis is put on organizational responsibility for enhancing safety and efficiency in the service.

WebGIS based community services architecture by griddization managements and crowdsourcing services

NASA Astrophysics Data System (ADS)

Wang, Haiyin; Wan, Jianhua; Zeng, Zhe; Zhou, Shengchuan

2016-11-01

Along with the fast economic development of cities, rapid urbanization, population surge, in China, the social community service mechanisms need to be rationalized and the policy standards need to be unified, which results in various types of conflicts and challenges for community services of government. Based on the WebGIS technology, the article provides a community service architecture by gridding management and crowdsourcing service. The WEBGIS service architecture includes two parts: the cloud part and the mobile part. The cloud part refers to community service centres, which can instantaneously response the emergency, visualize the scene of the emergency, and analyse the data from the emergency. The mobile part refers to the mobile terminal, which can call the centre, report the event, collect data and verify the feedback. This WebGIS based community service systems for Huangdao District of Qingdao, were awarded the “2015’ national innovation of social governance case of typical cases”.

Physiotherapists in emergency departments: responsibilities, accountability and education.

PubMed

Crane, Jacqueline; Delany, Clare

2013-06-01

Emergency physiotherapy roles have evolved within the UK and are increasingly being adopted in Australia in response to a need for greater workforce flexibility and improved service provision to meet growing patient demand. This paper discusses the need for the physiotherapy profession to develop evidence-based regulatory, ethical and educative frameworks to keep pace with the changing clinical environment and service delivery in emergency departments. Definitions of Emergency Physiotherapy as either advanced practice or extended scope of practice are identified, and the implications for both regulation of practice and education are highlighted. Suggestions for education in areas of clinical skills, ethical understanding and legal and professional knowledge are highlighted as important areas to support physiotherapists moving into this area of practice. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

[Resources and capacity of emergency trauma care services in Peru].

PubMed

Rosales-Mayor, Edmundo; Miranda, J Jaime; Lema, Claudia; López, Luis; Paca-Palao, Ada; Luna, Diego; Huicho, Luis

2011-09-01

The objectives of this study were to evaluate the resources and capacity of emergency trauma care services in three Peruvian cities using the WHO report Guidelines for Essential Trauma Care. This was a cross-sectional study in eight public and private healthcare facilities in Lima, Ayacucho, and Pucallpa. Semi-structured questionnaires were applied to the heads of emergency departments with managerial responsibility for resources and capabilities. Considering the profiles and volume of care in each emergency service, most respondents in all three cities classified their currently available resources as inadequate. Comparison of the health facilities showed a shortage in public services and in the provinces (Ayacucho and Pucallpa). There was a widespread perception that both human and physical resources were insufficient, especially in public healthcare facilities and in the provinces.

Lessons Learned From Chicago's Emergency Response to Mass Evacuations Caused by Hurricane Katrina

PubMed Central

Levin, Elise C.; Mucha, Amy P.; Pelzel, Darlene; Wong, William; Persky, Victoria W.; Hershow, Ronald C.

2009-01-01

Objectives. We analyzed the response of the Chicago Department of Public Health with respect to its effectiveness in providing health care to Hurricane Katrina evacuees arriving in the city. Methods. Between September 12 and October 21, 2005, we conducted a real-time qualitative assessment of a medical unit in Chicago's Hurricane Victim Welcome and Relief Center. A semistructured guide was used to interview 33 emergency responders in an effort to identify key operational successes and failures. Results. The medical unit functioned at a relatively high level, primarily as a result of the flexibility, creativity, and dedication of its staff and the presence of strong leadership. Chronic health care services and prescription refills were the most commonly mentioned services provided, and collaboration with a national pharmacy proved instrumental in reconstructing medication histories. The lack of a comprehensive and well-communicated emergency response plan resulted in several preventable inefficiencies. Conclusions. Our findings highlight the need for improved planning for care of evacuee populations after a major emergency event and the importance of ensuring continuity of care for the most vulnerable. We provide an emergency response preparedness checklist for local public health departments. PMID:19197088

The German approach to emergency/disaster management.

PubMed

Domres, B; Schauwecker, H H; Rohrmann, K; Roller, G; Maier, G W; Manger, A

2000-01-01

Disaster control and disaster relief in Germany are public tasks. But the government has shifted the responsibility of the administration of these tasks to the 16 states, the so called "Lander", because the EFG is a federal republic. The same is valid for the civil defense and the civil protection in the case of military or international risks. The 16 states are also responsible for the legislation of rescue service, fire fighting service and disaster control (natural and technical disasters). Counties and district-free cities are responsible for the organisation of these services. The German system is based on the principle of subsidiary between official and private institutions. A lot of official and private relief organisations are responsible for the execution of disaster relief tasks. In Germany the following organisations exist: Official (GO): Technisches Hilfswerk (THW/Federal Technical Support Service), Feuerwehren (Fire Brigades/professionals and volunteers) Academie of Emergency Planning and Civil Defense Private (NGO): Arbeiter-Samariter-Bund Deutschland (ASB/Workers' Samaritan Association Germany), Deutsche Gesellschaft zur Rettung Schiffbruchiger (DGzRS, German Lifesaving Association), Deutsches Rotes Kreuz (DRK/German Red Cross), Johanniter-Unfall-Hilfe (JUH/St. John's Ambulance), Malteser Hilfsdienst (MEID/Maltese-Relief-Organisation). ASB, DRK, JUH and MHD are specialised in the field of rescue, medical and welfare services and medical disaster relief. 80% of the German rescue service and 95% of the German disaster medical relief are realised by these NGO's. NGO's and GO's employ more than 1.2 million volunteers and appr. 100,000 professionals. Rescue service is carried out by professionals, disaster relief by volunteers. The German constitution allows to call the federal army in case of disaster, to support the disaster relief organisations (for example: flood Oder River 1997, train-crash "ICE" 1998). In all counties and district free cities disaster control staffs are set up by the administration. During disaster relief operations a operational command is on site. Most of the counties and district free cities, medical executives, rescue staff executives along with fire executive officers are responsible for the medical rescue organisation. All emergency physicians and medical executives have attended special training or a 520 hours-training-course (Paramedics). All volunteers of the medical service in the disaster relief organisations are trained in separate special courses (90 hours). Over the last years, civil protection, disaster relief and rescue services in the FRG have been reorganised. In 1997, the civil protection was reformed by a new federal act. Disaster relief of the "Lander" is supported by Federal Government with about 9000 vehicles and a budget for training. Emergency physicians have to take part in a (80) eighty hours lasting course on emergency medicine from an interdisciplinary point of view; they are only allowed to do rescue missions after having proved basic experience in emergency medicine as well as having completed a (18) eighteen-months-postgraduate training period at least. Senior emergency physicians receive and additional (40) forty-hours-lasting theoretical and practical training-after three years practice in rescue services as a minimum. There are special training courses offered for Medical and Non-Medical Personal to cope with disaster situation by different institutions and organisations.

Beyond 'flood hotspots': Modelling emergency service accessibility during flooding in York, UK

NASA Astrophysics Data System (ADS)

Coles, Daniel; Yu, Dapeng; Wilby, Robert L.; Green, Daniel; Herring, Zara

2017-03-01

This paper describes the development of a method that couples flood modelling with network analysis to evaluate the accessibility of city districts by emergency responders during flood events. We integrate numerical modelling of flood inundation with geographical analysis of service areas for the Ambulance Service and the Fire & Rescue Service. The method was demonstrated for two flood events in the City of York, UK to assess the vulnerability of care homes and sheltered accommodation. We determine the feasibility of emergency services gaining access within the statutory 8- and 10-min targets for high-priority, life-threatening incidents 75% of the time, during flood episodes. A hydrodynamic flood inundation model (FloodMap) simulates the 2014 pluvial and 2015 fluvial flood events. Predicted floods (with depth >25 cm and areas >100 m2) were overlain on the road network to identify sites with potentially restricted access. Accessibility of the city to emergency responders during flooding was quantified and mapped using; (i) spatial coverage from individual emergency nodes within the legislated timeframes, and; (ii) response times from individual emergency service nodes to vulnerable care homes and sheltered accommodation under flood and non-flood conditions. Results show that, during the 2015 fluvial flood, the area covered by two of the three Fire & Rescue Service stations reduced by 14% and 39% respectively, while the remaining station needed to increase its coverage by 39%. This amounts to an overall reduction of 6% and 20% for modelled and observed floods respectively. During the 2014 surface water flood, 7 out of 22 care homes (32%) and 15 out of 43 sheltered accommodation nodes (35%) had modelled response times above the 8-min threshold from any Ambulance station. Overall, modelled surface water flooding has a larger spatial footprint than fluvial flood events. Hence, accessibility of emergency services may be impacted differently depending on flood mechanism. Moreover, we expect emergency services to face greater challenges under a changing climate with a growing, more vulnerable population. The methodology developed in this study could be applied to other cities, as well as for scenario-based evaluation of emergency preparedness to support strategic decision making, and in real-time forecasting to guide operational decisions where heavy rainfall lead-time and spatial resolution are sufficient.

Emergency Planning Guidelines for Campus Health Services: An All-Hazards Approach

ERIC Educational Resources Information Center

Journal of American College Health, 2011

2011-01-01

This document, written collaboratively by members of ACHA's Emerging Public Health Threats and Emergency Response Coalition and Campus Safety and Violence Coalition, is designed to assist members of the college health community in planning for emergencies using an all-hazards approach. Its perspective is both macro and micro, beginning with a…

Speeding response, saving lives : automatic vehicle location capabilities for emergency services.

DOT National Transportation Integrated Search

1999-01-01

Information from automatic vehicle location systems, when combined with computeraided dispatch software, can provide a rich source of data for analyzing emergency vehicle operations and evaluating agency performance.

An Examination of Charitable Meal Programs in Five Canadian cities.

PubMed

Pettes, Tyler; Dachner, Naomi; Gaetz, Stephen; Tarasuk, Valerie

2016-01-01

While there has recently been considerable research and public investment in strategies to address homelessness in Canada, food charity remains the primary response to hunger, with little evaluation of current efforts and no initiatives to develop more effective approaches. Using data from a 2010-2011 survey of charitable food assistance in five Canadian cities, this study was undertaken to describe charitable meal provisioning in each city and to compare the relative roles of emergency programs and multi-service agencies and their capacity to meet food needs. Most meals were provided by multi-service agencies, but like emergency programs, these agencies were heavily dependent on donations and they were more likely than emergency programs to report constraints and service interruptions because demands exceeded available supplies. Our findings underscore the resource-limited and often fragile nature of charitable meal programs in Canada and highlight the need for more effective models of response to problems of hunger.

IMPRESS: medical location-aware decision making during emergencies

NASA Astrophysics Data System (ADS)

Gkotsis, I.; Eftychidis, G.; Leventakis, G.; Mountzouris, M.; Diagourtas, D.; Kostaridis, A.; Hedel, R.; Olunczek, A.; Hahmann, S.

2017-09-01

Emergency situations and mass casualties involve several agencies and public authorities, which need to gather data from the incident scene and exchange geo-referenced information to provide fast and accurate first aid to the people in need. Tracking patients on their way to the hospitals can prove critical in taking lifesaving decisions. Increased and continuous flow of information combined by vital signs and geographic location of emergency victims can greatly reduce the response time of the medical emergency chain and improve the efficiency of disaster medicine activity. Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware medical applications. IMPRESS is an advanced ICT platform based on adequate technologies for developing location-aware medical response during emergencies. The system incorporates mobile and fixed components that collect field data from diverse sources, support medical location and situation-based services and share information on the patient's transport from the field to the hospitals. In IMPRESS platform tracking of victims, ambulances and emergency services vehicles is integrated with medical, traffic and crisis management information into a common operational picture. The Incident Management component of the system manages operational resources together with patient tracking data that contain vital sign values and patient's status evolution. Thus, it can prioritize emergency transport decisions, based on medical and location-aware information. The solution combines positioning and information gathered and owned by various public services involved in MCIs or large-scale disasters. IMPRESS solution, were validated in field and table top exercises in cooperation with emergency services and hospitals.

Pilot statewide study of pediatric emergency department alignment with national guidelines.

PubMed

Costich, Julia F; Fallat, Mary E; Scaggs, C Morgan; Bartlett, Richard

2013-07-01

The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nursing Association have developed consensus guidelines for pediatric emergency department policies, procedures, supplies, and equipment. Kentucky received funding from the Health Resources and Services Administration through the Emergency Medical Services for Children program to pilot test the guidelines with the state's hospitals. In addition to providing baseline data regarding institutional alignment with the guidelines, the survey supported development of grant funding to procure missing items. Survey administration was undertaken by staff and members of the Kentucky Board of Emergency Medical Services Emergency Medical Services for Children work group and faculty and staff of the University of Kentucky College of Public Health and the University of Louisville School of Medicine. Responses were solicited primarily online with repeated reminders and offers of assistance. Seventy respondents completed the survey section on supplies and equipment either online or by fax. Results identified items unavailable at 20% or more of responding facilities, primarily the smallest sizes of equipment. The survey section addressing policy and procedure received only 16 responses. Kentucky facilities were reasonably well equipped by national standards, but rural facilities and small hospitals did not stock the smallest equipment sizes because of low reported volume of pediatric emergency department cases. Thus, a centralized procurement process that gives them access to an adequate range of pediatric supplies and equipment would support capacity building for the care of children across the entire state. Grant proposals were received from 28 facilities in the first 3 months of funding availability.

Prehospital care in Hong Kong.

PubMed

Lo, C B; Lai, K K; Mak, K P

2000-09-01

A quick and efficient prehospital emergency response depends on immediate ambulance dispatch, patient assessment, triage, and transport to hospital. During 1999, the Ambulance Command of the Hong Kong Fire Services Department responded to 484,923 calls, which corresponds to 1329 calls each day. Cooperation between the Fire Services Department and the Hospital Authority exists at the levels of professional training of emergency medical personnel, quality assurance, and a coordinated disaster response. In response to the incident at the Hong Kong International Airport in the summer of 1999, when an aircraft overturned during landing, the pre-set quota system was implemented to send patients to designated accident and emergency departments. Furthermore, the 'first crew at the scene' model has been adopted, whereby the command is established and triage process started by the first ambulance crew members to reach the scene. The development of emergency protocols should be accompanied by good field-to-hospital and interhospital communication, the upgrading of decision-making skills, a good monitoring and auditing structure, and commitment to training and skills maintenance.

Utilization of emergency services for non-traumatic dental disease.

PubMed

Da Silva, Keith; Kunzel, Carol; Yoon, Richard K

2013-01-01

To identify and characterize children who utilize emergency dental services for non-traumatic dental disease. Caregivers of children under 12 years old who seek out emergency services for the treatment of non-traumatic dental disease will be surveyed regarding their child's current oral health status. Patient's clinical data will be obtained and they will be further followed for a period of 2 months to determine if they follow-up with recommendations for comprehensive dental care. One hundred and ninety-eight people participated in the study (97% response rate). Eighty-three percent of the children were diagnosed with dental caries. Seventy-four percent of patients of record presented with an emergency at least once before and 73% had a history of one or more broken appointments. Patients with a history of previous emergency visits (OR = 3.45, CI = 2.05, 5.81) or a history of missed appointments (OR = 2.21, CI = 1.42, 3.58) were significantly more likely to fail to return for comprehensive care (P < .01). This study shows that those who utilize emergency services more than once, or have a history of missed appointments are more likely to continue to utilize emergency dental services as their primary means for dental care.

A Decade of Experience: Which Network Structures Maximize Fire Service Capacity for Homeland Security Incidents in Metropolitan Regions?

DTIC Science & Technology

2011-12-01

Pennsylvania Emergency Management Agency QHSR Quadrennial Homeland Security Review Report RCP Regional Catastrophic Preparedness SAA State...service has evolved from a single-purpose service focused on controlling fires to a multidimensional response element responsible for pre- hospital ... hospital preparedness program Preparedness Training for all personnel; training and network activities during prior year assist in preparedness

Are there any differences in medical emergency team interventions between rural and urban areas? A single-centre cohort study.

PubMed

Aftyka, Anna; Rybojad, Beata; Rudnicka-Drozak, Ewa

2014-10-01

To compare interventions of medical emergency teams in urban and rural areas with particular emphasis on response time and on-site medical rescue activities. A retrospective analysis of ambulance call reports from two emergency medical service substations: one in the city and the other in a rural area. Two emergency medical service substations: one in the city and the other in a rural area. Medical emergency teams. Interventions in the city were associated with a substantially shorter response time in comparison to rural areas. In the city, the distances were generally less than 10 km. In the rural area, however, such short distances accounted for only 7.2% of events, while 33.8% were over 30 km. Medical emergency teams more often acted exclusively on-site or ceased any interventions in rural areas. Compared with the city, actions in the rural setting were associated with significantly increased use of cervical collars and decreased use of intravenous access. The presence of a physician in the team raised the probability of pharmacotherapy. The relationship between medical emergency teams activities and the location of intervention shows the real diversity of the functioning of emergency medical service within a city and rural areas. Further research should aim to improve the generalisability of these findings. © 2014 National Rural Health Alliance Inc.

The Hazards Data Distribution System update

USGS Publications Warehouse

Jones, Brenda K.; Lamb, Rynn M.

2010-01-01

After a major disaster, a satellite image or a collection of aerial photographs of the event is frequently the fastest, most effective way to determine its scope and severity. The U.S. Geological Survey (USGS) Emergency Operations Portal provides emergency first responders and support personnel with easy access to imagery and geospatial data, geospatial Web services, and a digital library focused on emergency operations. Imagery and geospatial data are accessed through the Hazards Data Distribution System (HDDS). HDDS historically provided data access and delivery services through nongraphical interfaces that allow emergency response personnel to select and obtain pre-event baseline data and (or) event/disaster response data. First responders are able to access full-resolution GeoTIFF images or JPEG images at medium- and low-quality compressions through ftp downloads. USGS HDDS home page: http://hdds.usgs.gov/hdds2/

Awareness of Emerging Wireless Technologies: Ad-hoc and Personal Area Networks Standards and Emerging Technologies (Sensibilisation a l’emergence des technologies sans fil: technologies emergeantes et normes de reseaux personnels et ad-hoc)

DTIC Science & Technology

2007-04-01

for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data...Control Organization NRL Navy Research Laboratory nrtPS Non-real- time Polling Services OFDM Orthogonal frequency division multiplex OFDMA...Routeur IDentifier RTG RTO Task Group RTO Research & Technology Organization rtPS Real- time Polling Services SC Single-carrier modulation

The perspective of USDA APHIS Veterinary Services Emergency Management and Diagnostics in preparing and responding to Foreign Animal Diseases - plans, strategies, and countermeasures.

PubMed

Díez, J R; Styles, D K

2013-01-01

The United States Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) Veterinary Services (VS) is charged with monitoring, controlling, and responding to select reportable diseases and all foreign animal diseases. Emergency Management and Diagnostics (EM&D) oversees Foreign Animal Disease (FAD) preparedness and response. In order to effectively prepare for and respond to FADs, such as highly pathogenic avian influenza and foot-and-mouth disease, VS develops plans, strategies, and policies to effectively combat an intrusion. USDA APHIS VS has made significant gains in preparedness and response planning. However, much remains to be done especially in surveillance, diagnostic tools, and vaccines. There are significant needs for novel medical technologies to improve diagnostic capabilities and offer additional approaches for FAD response.

Review of Considerations, Management, and Treatment of Medical Emergencies During Commercial Flight

DTIC Science & Technology

2017-04-01

OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for...assistance during an in-flight medical emergency. 15. SUBJECT TERMS In-flight medical emergency, commercial air travel , in-flight medical care...England [7-10]. These ground-based medical consultation services establish a 24- hour, 7-day, 365-days-per-year response capability for real- time

Public-private implementation of integrated emergency response services: Case study of GVK Emergency Management and Research Institute in Karnataka, India.

PubMed

Sriram, Veena M; Gururaj, Gopalkrishna; Hyder, Adnan A

2017-12-01

Emergency medical services are important to the functioning of health systems, but these services tend to be neglected in low- and middle-income countries, such as India. In recent years, several models of pre-hospital emergency medical services have emerged in India. Research on these models holds important lessons for existing and future emergency medical service programs in low- and middle-income countries. Our objective was to provide a comprehensive description of the organizational structure and service delivery model of a public-private partnership in the southern Indian state of Karnataka, GVK Emergency Management and Research Institute, with a particular focus on its operations in Bengaluru. A case study methodology was used to explore systematically the organizational model of GVK Emergency Management and Research Institute in Karnataka. Qualitative data were collected through an in-person site visit to GVK Emergency Management and Research Institute headquarters in Bengaluru in July 2013. Three sources were used: in-depth, semistructured interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. The organization follows a standardized model across the states and union territories where they have contractual arrangements, including Karnataka. Processes for fleet maintenance, information systems/information technology and training, and deployment were well structured at the organizational level. The public-private partnership appears pro-poor in orientation; however, further demand-side research is required on the perspective of patients. Our study reveals a functional structure at the organizational level, which provides a key service at no cost to users. Detailed analyses of this nature can help inform global efforts for the development and strengthening of emergency medical services systems. Copyright © 2017 Elsevier Inc. All rights reserved.

The 2011 Tuscaloosa tornado: integration of pediatric disaster services into regional systems of care.

PubMed

Kanter, Robert K

2012-09-01

To empirically describe the integration of pediatric disaster services into regional systems of care after the April 27, 2011, tornado in Tuscaloosa, Alabama, a community with no pediatric emergency department or pediatric intensive care unit and few pediatric subspecialists. Data were obtained in interviews with key informants including professional staff and managers from public health and emergency management agencies, prehospital emergency medical services, fire departments, hospital nurses, physicians, and the trauma program coordinator. A single hospital in Tuscaloosa served 800 patients on the night of the tornado. More than 100 of these patients were children, including more than 20 with critical injuries. Many children were unaccompanied and unidentified on arrival. Resuscitation and stabilization were performed by nonpediatric prehospital and emergency department staff. More than 20 children were secondarily transported to the nearest children's hospital an hour's drive away under the care of nonpediatric local emergency medical services providers. No preventable adverse events were identified in the resuscitation and secondary transport phases of care. Stockpiled supplies and equipment were adequate to serve the needs of the disaster victims, including the children. Essential aspects of preparation include pediatric-specific clinical skills, supplies and equipment, operational disaster plans, and interagency practice embedded in everyday work. Opportunities for improvement identified include more timely response to warnings, improved practices for identifying unaccompanied children, and enhanced child safety in shelters. Successful responses depended on integration of pediatric services into regional systems of care. Copyright © 2012 Mosby, Inc. All rights reserved.

Emergency Response of Iranian Hospitals Against Disasters: A Practical Framework for Improvement.

PubMed

Janati, Ali; Sadeghi-Bazargani, Homayoun; Hasanpoor, Edris; Sokhanvar, Mobin; HaghGoshyie, Elaheh; Salehi, Abdollah

2018-04-01

Hospital emergency management is a continuous process that requires monolithic integration of planning and response attempts with local and national schemes. The aim of the current study is to evaluate emergency response by hospitals against potential disasters in Tabriz, north-west Iran. A cross-sectional study was conducted in the city of Tabriz, in Iran, in 2016. The study population included all hospitals in Tabriz. A total of 18 hospitals were assessed. The hospital emergency response checklist was used to collect data. Tool components included command and control, communication, safety and security, triage, surge capacity, continuity of essential services, human resources, logistics and supply management, and post-disaster recovery. Data entry and analysis were carried out using SPSS software (version 20). The results showed that the emergency response rate of hospitals was 54.26% in Tabriz. The lowest response rates were for Shafaa hospital (18.89%) and the highest response rates were for Razi Hospital (91.67%). The components of hospital emergency response were assessed to be between 48.07% (surge capacity) and 58.95% (communication). On the basis of the World Health Organization checklist, the emergency response rate for hospitals in Tabriz was only 54.26%. Therefore, hospital emergency responses against disasters have to be improved and must be made to reach 100%. It is essential to design a comprehensive framework for hospital emergency response. (Disaster Med Public Health Preparedness. 2018;12:166-171).

Oslo government district bombing and Utøya island shooting July 22, 2011: The immediate prehospital emergency medical service response

PubMed Central

2012-01-01

Background On July 22, 2011, a single perpetrator killed 77 people in a car bomb attack and a shooting spree incident in Norway. This article describes the emergency medical service (EMS) response elicited by the two incidents. Methods A retrospective and observational study was conducted based on data from the EMS systems involved and the public domain. The study was approved by the Data Protection Official and was defined as a quality improvement project. Results We describe the timeline and logistics of the EMS response, focusing on alarm, dispatch, initial response, triage and evacuation. The scenes in the Oslo government district and at Utøya island are described separately. Conclusions Many EMS units were activated and effectively used despite the occurrence of two geographically separate incidents within a short time frame. Important lessons were learned regarding triage and evacuation, patient flow and communication, the use of and need for emergency equipment and the coordination of helicopter EMS. PMID:22280935

"Why Are You Here? Can't You Cope at Home?" The Psychiatric Crisis of People with Intellectual Disabilities and the Community's Response

ERIC Educational Resources Information Center

Spassiani, Natasha; Abou Chacra, Megan Sarah; Lunsky, Yona

2017-01-01

Introduction: Individuals with intellectual disability (ID) are high users of emergency mental health services and can experience stigmatization in these circumstances. The purpose of the study was to examine the experiences of people with ID living in the community who interact with emergency services as a result of a psychiatric crisis, from the…

Physicians in Hospital Emergency Departments. [Proceedings, New Jersey Training Program].

ERIC Educational Resources Information Center

Health Services and Mental Health Administration (DHEW), Rockville, MD. Div. of Emergency Health Services.

This program was organized in response to the rapidly increasing demands placed upon the emergency departments of general hospitals, and in recognition of the fact that the crucial ingredient in emergency department services is physician capability. The training program was implemented for hospital department physicians and other interested…

A multi-method approach to curriculum development for in-service training in China's newly established health emergency response offices.

PubMed

Wang, Yadong; Li, Xiangrui; Yuan, Yiwen; Patel, Mahomed S

2014-01-01

To describe an innovative approach for developing and implementing an in-service curriculum in China for staff of the newly established health emergency response offices (HEROs), and that is generalisable to other settings. The multi-method training needs assessment included reviews of the competency domains needed to implement the International Health Regulations (2005) as well as China's policies and emergency regulations. The review, iterative interviews and workshops with experts in government, academia, the military, and with HERO staff were reviewed critically by an expert technical advisory panel. Over 1600 participants contributed to curriculum development. Of the 18 competency domains identified as essential for HERO staff, nine were developed into priority in-service training modules to be conducted over 2.5 weeks. Experts from academia and experienced practitioners prepared and delivered each module through lectures followed by interactive problem-solving exercises and desktop simulations to help trainees apply, experiment with, and consolidate newly acquired knowledge and skills. This study adds to the emerging literature on China's enduring efforts to strengthen its emergency response capabilities since the outbreak of SARS in 2003. The multi-method approach to curriculum development in partnership with senior policy-makers, researchers, and experienced practitioners can be applied in other settings to ensure training is responsive and customized to local needs, resources and priorities. Ongoing curriculum development should reflect international standards and be coupled with the development of appropriate performance support systems at the workplace for motivating staff to apply their newly acquired knowledge and skills effectively and creatively.

USDA APHIS | National Animal Health Monitoring System (NAHMS)

Science.gov Websites

USDA - APHIS United States Department of Agriculture Animal and Plant Health Inspection Service Facebook Email Blog Home Our Focus Animal Health Animal Welfare Biotechnology Business Services Civil Rights Emergency Response Imports & Exports International Services Plant Health Science Tribal

A Novel Space Partitioning Algorithm to Improve Current Practices in Facility Placement

PubMed Central

Jimenez, Tamara; Mikler, Armin R; Tiwari, Chetan

2012-01-01

In the presence of naturally occurring and man-made public health threats, the feasibility of regional bio-emergency contingency plans plays a crucial role in the mitigation of such emergencies. While the analysis of in-place response scenarios provides a measure of quality for a given plan, it involves human judgment to identify improvements in plans that are otherwise likely to fail. Since resource constraints and government mandates limit the availability of service provided in case of an emergency, computational techniques can determine optimal locations for providing emergency response assuming that the uniform distribution of demand across homogeneous resources will yield and optimal service outcome. This paper presents an algorithm that recursively partitions the geographic space into sub-regions while equally distributing the population across the partitions. For this method, we have proven the existence of an upper bound on the deviation from the optimal population size for sub-regions. PMID:23853502

42 CFR 417.558 - Emergency, urgently needed, and out-of-area services for which the HMO or CMP accepts...

Code of Federal Regulations, 2010 CFR

2010-10-01

... services for which the HMO or CMP accepts responsibility. 417.558 Section 417.558 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost...

Disaster planning for vulnerable populations: leveraging Community Human Service Organizations direct service delivery personnel.

PubMed

Levin, Karen L; Berliner, Maegan; Merdjanoff, Alexis

2014-01-01

Given the variability, complexities, and available resources for local vulnerable populations, it is clear that preparing effectively for catastrophic events cannot be accomplished with a single, simple template. Inclusion of Community Human Service Organizations' (CHSO's) direct service delivery personnel ensures that emergency disaster planning efforts for vulnerable populations are effective and responsive to unique needs and constraints. By leveraging existing local resources, it extends the preparedness system's reach to the whole community. CHSO personnel already perform community-based services and directly engage with vulnerable and special needs populations; typically they are on the front lines during an emergency event. Generally, however, the CHSOs, staff, and clients are neither adequately prepared for disasters nor well integrated into emergency systems. To address preparedness gaps identified during Hurricane Sandy, regional CHSO and local health department partners requested that the Columbia Regional Learning Center provide preparedness trainings for their agencies and staff responsible for vulnerable clients. Evaluation of this initiative was begun with a mixed-methods approach consisting of collaborative learning activities, a function-based assessment tool, and a 5 Steps to Preparedness module. Results from a survey were inclusive because of a low response rate but suggested satisfaction with the training format and content; increases in awareness of a client preparedness role; and steps toward improved personal, agency, and client preparedness. Direct service delivery personnel can leverage routine client interactions for preparedness planning and thus can contribute significantly to vulnerable population and community disaster readiness. Trainings that provide preparedness tools can help support this role. CHSO personnel are knowledgeable and have the expertise to assist clients in personal preparedness planning; yet, there are challenges around their ability and willingness to take on additional responsibilities.

GNSS-based emergency management system

NASA Astrophysics Data System (ADS)

Wu, Yuhang; Chen, Xiuwan; Ma, Lei

2009-06-01

Public safety and public service is a particularly challenging task. The questions of how to use the limited resources efficiently, how to improve the Government's emergency rapid response and ability of risk resistance, and how to provide a more efficient emergency service for the public, have increasingly become the focus to strengthen urban management. Emergency Response Management System is a highly efficient and powerful command system dealing with natural and social disasters, by using all aspects of the force being gathered in a short period of time, sudden events can be handled efficiently, and further development of the incident can be controlled. In this paper, based on the analysis of development status of the emergency management system at home and abroad, and the key technologies of the emergency management system based on GNSS, research and development on emergency command system based on GNSS has been done. Meanwhile, test in Sichuan earthquake has also been carried out. Practice in Sichuan province earthquake relief work has proved that the emergency management command system based on GNSS can play the advantage function and exert the maximum potential, and can play the role of "lifeline" in the critical moment.

Youth with Mental Health Disorders: Issues and Emerging Responses. Also: Wraparound Milwaukee Program: Suicide Prevention in Juvenile Facilities.

ERIC Educational Resources Information Center

Juvenile Justice, 2000

2000-01-01

This issue of Juvenile Justice presents three main articles. "Youth with Mental Health Disorders: Issues and Emerging Responses" (J. J. Cocozza and K. Skowyra) discusses tragic mass homicides by juveniles, documented cases of neglect and inadequate services, and federal policy focusing on providing systems of care for at-risk juveniles that have…

[Emergency medical aid in a paediatrics context].

PubMed

Branchard, Delphine; Tentillier, Éric; Gillet, Stéphane; Naud, Julien

2016-01-01

In France, the organisation of aid involves the intervention of the emergency medical services (Samu), which coordinate the medical regulation platforms for site 15 and the mobile emergency and intensive care services (Smur). Since they were created, the Samu have been tirelessly adapting their response to the various characteristics of pre-hospital assignments. Pre- and inter-hospital paediatrics has seen the development of specialised teams with the aim of providing effective aid which is adapted to the youngest and most vulnerable patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Determinants of Demand in the Public Dental Emergency Service.

PubMed

Matsumoto, Maria Sa; Gatti, Marcia An; de Conti, Marta Hs; de Ap Simeão, Sandra F; de Oliveira Braga Franzolin, Solange; Marta, Sara N

2017-02-01

Although dental emergencies are primarily aimed at pain relief, in practice, dental emergency services have been overwhelmed by the massive inflow of patients with less complex cases, which could be resolved at basic levels of health care. They frequently become the main gateway to the system. We investigated the determinant factors of demand at the Central Dental Emergency Unit in Bauru, São Paulo, Brazil. The questionnaire was applied to 521 users to evaluate sociodemographic profile; factors that led users to seek the service at the central dental emergency; perception of service offered. About 80.4% of users went directly to the central dental emergency, even before seeking basic health units. The reasons were difficulty to be attended (34.6%) and incompatible time (9.8%). To the perception of the necessity of the service, responses were problem as urgent (78.3%) and pain was the main complaint (69.1%). The profile we found was unmarried (41.5%), male (52.2%), white (62.8%), aged 30 to 59 (52.2%), incomplete basic education (41.6%), family income up to 2 minimum wages (47.4%), and no medical/dental plan (88.9%). It was concluded that the users of central dental emergency come from all sectors of the city, due to difficult access to basic health units; they consider their complaint urgent; and they are satisfied with the service offered. To meet the profile of the user urgency's service so that it is not overloaded with demand that can be fulfilled in basic health units.

The first 7 years of the metropolitan fire brigade emergency responder program – an overview of incidents attended

PubMed Central

Boyle, Malcolm J; Williams, Brett; Bibby, Colin; Morton, Allan; Huggins, Chris

2010-01-01

Purpose The Melbourne Metropolitan Fire and Emergency Services Board (MFESB) was the first fire service in Australia to implement a service-wide emergency medical response (EMR) program in 2001. No additional scientific analysis of the first responder program has been reported since the pilot program. The objective of this study was to report the first 7 years of responses by firefighters as first responders. Patients and methods The MFESB have three separate datasets with cardiac arrest information: (i) callout record; (ii) patient care record; and (iii) cardiac arrest record, including data from the automatic external defibrillator. Descriptive statistics were used to summarize the demographic and specific outcome data. Ethics approval was granted. Results A total of 8227 incidents were attended over the first 7 years. The most incidents attended were cardiac arrest 54% (n = 4450) followed by other medical 19% (n = 1579), and drug overdose 11% (n = 908); the remainder were <10% each. Sixty-three percent of incidents involved males. Average age was 57.2 years, median age 63 years, range from <1 month to 101 years; average response time was 6.1 minutes, median response time 5.6 minutes, range from 9 seconds to 31.5 minutes. Firefighters provided “initial care” in 57% and assisted in 26% of the incidents. Firefighters spent on average 4.8 minutes with the patient before handing over to paramedics; median 3.9 minutes, range of a few seconds to 39.2 minutes. Conclusion This study suggests that the MFESB EMR program is providing firefighter first responders to emergency situations in a short timeframe to assist the ambulance service. PMID:27147841

Development and clinical study of mobile 12-lead electrocardiography based on cloud computing for cardiac emergency.

PubMed

Fujita, Hideo; Uchimura, Yuji; Waki, Kayo; Omae, Koji; Takeuchi, Ichiro; Ohe, Kazuhiko

2013-01-01

To improve emergency services for accurate diagnosis of cardiac emergency, we developed a low-cost new mobile electrocardiography system "Cloud Cardiology®" based upon cloud computing for prehospital diagnosis. This comprises a compact 12-lead ECG unit equipped with Bluetooth and Android Smartphone with an application for transmission. Cloud server enables us to share ECG simultaneously inside and outside the hospital. We evaluated the clinical effectiveness by conducting a clinical trial with historical comparison to evaluate this system in a rapid response car in the real emergency service settings. We found that this system has an ability to shorten the onset to balloon time of patients with acute myocardial infarction, resulting in better clinical outcome. Here we propose that cloud-computing based simultaneous data sharing could be powerful solution for emergency service for cardiology, along with its significant clinical outcome.

21 CFR 50.24 - Exception from informed consent requirements for emergency research.

Code of Federal Regulations, 2010 CFR

2010-04-01

... emergency research. 50.24 Section 50.24 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROTECTION OF HUMAN SUBJECTS Informed Consent of Human Subjects § 50.24 Exception from informed consent requirements for emergency research. (a) The IRB responsible for the review...

75 FR 31447 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management and Budget Title: State Personal Responsibility Education Program. OMB No.: New Collection. Description: An emergency request is being made to solicit comments from the...

E-DECIDER Disaster Response and Decision Support Cyberinfrastructure: Technology and Challenges

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Parker, J. W.; Pierce, M. E.; Wang, J.; Eguchi, R. T.; Huyck, C. K.; Hu, Z.; Chen, Z.; Yoder, M. R.; Rundle, J. B.; Rosinski, A.

2014-12-01

Timely delivery of critical information to decision makers during a disaster is essential to response and damage assessment. Key issues to an efficient emergency response after a natural disaster include rapidly processing and delivering this critical information to emergency responders and reducing human intervention as much as possible. Essential elements of information necessary to achieve situational awareness are often generated by a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. A key challenge is the current state of practice does not easily support information sharing and technology interoperability. NASA E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) has worked with the California Earthquake Clearinghouse and its partners to address these issues and challenges by adopting the XChangeCore Web Service Data Orchestration technology and participating in several earthquake response exercises. The E-DECIDER decision support system provides rapid delivery of advanced situational awareness data products to operations centers and emergency responders in the field. Remote sensing and hazard data, model-based map products, information from simulations, damage detection, and crowdsourcing is integrated into a single geospatial view and delivered through a service oriented architecture for improved decision-making and then directly to mobile devices of responders. By adopting a Service Oriented Architecture based on Open Geospatial Consortium standards, the system provides an extensible, comprehensive framework for geospatial data processing and distribution on Cloud platforms and other distributed environments. While the Clearinghouse and its partners are not first responders, they do support the emergency response community by providing information about the damaging effects earthquakes. It is critical for decision makers to maintain a situational awareness that is knowledgeable of potential and current conditions, possible impacts on populations and infrastructure, and other key information. E-DECIDER and the Clearinghouse have worked together to address many of these issues and challenges to deliver interoperable, authoritative decision support products.

Educating First Responders to Provide Emergency Services to Individuals with Disabilities

PubMed Central

Wolf-Fordham, Susan B.; Twyman, Janet S.; Hamad, Charles D.

2015-01-01

Objective Individuals with disabilities experience more negative outcomes due to natural and manmade disasters and emergencies than do people without disabilities. This vulnerability appears due in part to knowledge gaps among public health and safety emergency planning and response personnel (responders). The research assessed the effectiveness of an online program to increase emergency responder knowledge about emergency planning and response for individuals with disabilities. Method Researchers developed an online course designed to teach public health, emergency planning/management and other first response personnel about appropriate, efficient and equitable emergency planning, response, interaction and communication with children and adults with disabilities before, during and after disasters or emergencies. Course features include an ongoing storyline, exercises embedded in the form of “real life” scenarios, and game-like features such as points and timed segments. Results Evaluation measures indicated significant pre- to post-test gains in learner knowledge and simulated applied skills. Conclusion An online program using scenarios and simulations is an effective means to make disability-related training available to a wide variety of emergency responders across geographically disparate areas. PMID:25859692

Combinations of Personal Responsibility: Differences on Pre-service and Practicing Teachers’ Efficacy, Engagement, Classroom Goal Structures and Wellbeing

PubMed Central

Daniels, Lia M.; Radil, Amanda I.; Goegan, Lauren D.

2017-01-01

Pre-service and practicing teachers feel responsible for a range of educational activities. Four domains of personal responsibility emerging in the literature are: student achievement, student motivation, relationships with students, and responsibility for ones own teaching. To date, most research has used variable-centered approaches to examining responsibilities even though the domains appear related. In two separate samples we used cluster analysis to explore how pre-service (n = 130) and practicing (n = 105) teachers combined personal responsibilities and their impact on three professional cognitions and their wellbeing. Both groups had low and high responsibility clusters but the third cluster differed: Pre-service teachers combined responsibilities for relationships and their own teaching in a cluster we refer to as teacher-based responsibility; whereas, practicing teachers combined achievement and motivation in a cluster we refer to as student-outcome focused responsibility. These combinations affected outcomes for pre-service but not practicing teachers. Pre-service teachers in the low responsibility cluster reported less engagement, less mastery approaches to instruction, and more performance goal structures than the other two clusters. PMID:28620332

Combinations of Personal Responsibility: Differences on Pre-service and Practicing Teachers' Efficacy, Engagement, Classroom Goal Structures and Wellbeing.

PubMed

Daniels, Lia M; Radil, Amanda I; Goegan, Lauren D

2017-01-01

Pre-service and practicing teachers feel responsible for a range of educational activities. Four domains of personal responsibility emerging in the literature are: student achievement, student motivation, relationships with students, and responsibility for ones own teaching. To date, most research has used variable-centered approaches to examining responsibilities even though the domains appear related. In two separate samples we used cluster analysis to explore how pre-service ( n = 130) and practicing ( n = 105) teachers combined personal responsibilities and their impact on three professional cognitions and their wellbeing. Both groups had low and high responsibility clusters but the third cluster differed: Pre-service teachers combined responsibilities for relationships and their own teaching in a cluster we refer to as teacher-based responsibility; whereas, practicing teachers combined achievement and motivation in a cluster we refer to as student-outcome focused responsibility. These combinations affected outcomes for pre-service but not practicing teachers. Pre-service teachers in the low responsibility cluster reported less engagement, less mastery approaches to instruction, and more performance goal structures than the other two clusters.

Terrorism in Argentina.

PubMed

Muro, Marcelo; Cohen, Roberto; Maffei, Daniel; Ballesteros, Marcelo; Espinosa, Luis

2003-01-01

Major terrorist attacks in Argentina since 1990 have been limited to two bombings in Buenos Aires, which together caused 115 deaths and left at least 555 injured. Following these attacks, national, regional, and local institutions responsible for emergency response in Argentina sought to improve their planning and preparedness for terrorism-related events. In 1996, the national government enacted legislation, which launched the Sistema Federal de Emergencias (SIFEM) or Federal Emergency System under the direction of the president. Since 1997, several of Argentina's major cities have developed emergency plans for terrorism-related events, including intentional biological and chemical releases. Institutional participants in emergency preparedness for terrorism-related events include Emergency Medical Services, hospitals, and the public health system. Remaining challenges include: (1) Improving intra-agency coordination; (2) Improving intra-agency communication; and (3) Improving and expanding emergency response training programs for responders and the general population.

Assessing STD Partner Services in State and Local Health Departments.

PubMed

Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L

2018-02-07

State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.

47 CFR 212.3 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Responsibilities. 212.3 Section 212.3 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL PROCEDURES FOR OBTAINING INTERNATIONAL TELECOMMUNICATION SERVICE FOR USE DURING A WARTIME EMERGENCY § 212.3 Responsibilities. (a...

47 CFR 212.3 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Responsibilities. 212.3 Section 212.3 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL PROCEDURES FOR OBTAINING INTERNATIONAL TELECOMMUNICATION SERVICE FOR USE DURING A WARTIME EMERGENCY § 212.3 Responsibilities. (a...

47 CFR 212.3 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Responsibilities. 212.3 Section 212.3 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL PROCEDURES FOR OBTAINING INTERNATIONAL TELECOMMUNICATION SERVICE FOR USE DURING A WARTIME EMERGENCY § 212.3 Responsibilities. (a...

47 CFR 212.3 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Responsibilities. 212.3 Section 212.3 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL PROCEDURES FOR OBTAINING INTERNATIONAL TELECOMMUNICATION SERVICE FOR USE DURING A WARTIME EMERGENCY § 212.3 Responsibilities. (a...

47 CFR 212.3 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Responsibilities. 212.3 Section 212.3 Telecommunication OFFICE OF SCIENCE AND TECHNOLOGY POLICY AND NATIONAL SECURITY COUNCIL PROCEDURES FOR OBTAINING INTERNATIONAL TELECOMMUNICATION SERVICE FOR USE DURING A WARTIME EMERGENCY § 212.3 Responsibilities. (a...

A priority dispatch system for emergency medical services.

PubMed

Slovis, C M; Carruth, T B; Seitz, W J; Thomas, C M; Elsea, W R

1985-11-01

A decision tree priority dispatch system for emergency medical services (EMS) was developed and implemented in Atlanta and Fulton County, Georgia. The dispatch system shortened the average response time from 14.2 minutes to 10.4 minutes for the 30% of patients deemed most urgent (P less than or equal to .05); resulted in a significant increase in the use of advanced life support units for this group (P less than or equal to .02); decreased the number of calls that required a backup ambulance service; and significantly increased conformity to national EMS response time standards for critically ill and injured patients (P less than or equal to .0009). Due to dispatch error, 0.3% of calls were dispatched as least severe but subsequently were found to be most urgent.

78 FR 77478 - Agency Information Collection Activities: Proposed Collection; Comment Request, Federal Emergency...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

..., Federal Emergency Management Agency Individual Assistance Customer Satisfaction Surveys AGENCY: Federal... concerning the collection of Individual Assistance customer satisfaction survey responses and information for..., Customer Satisfaction Analysis Section of the National Processing Service Center Division, Recovery...

When The Shooting Stops: Recovery From Active Shooter Events For K-12 Schools

DTIC Science & Technology

2017-12-01

ems -insider/articles/2014/02/a-new-response.html. 2 Ashby, Cornelia, and William O. Jenkins Jr. Emergency Management: Most School Districts Have...of Emergency Medical Services, March 18, 2014, http://www.jems.com/ ems -insider/ articles/2014/02/a-new-response.html. xviii THIS PAGE...Gang violence  Bomb threats  Domestic violence and abuse  Cyber attacks  Suicide 72

Deployment of Small Unmanned Aerial Systems (sUAS) in Emergency and Disaster Response Scenarios to Support Local Emergency Management Agencies

NASA Astrophysics Data System (ADS)

Calamaio, C. L.; Walker, J.; Beck, J. M.; Graves, S. J.; Johnson, C.

2017-12-01

Researchers at the Information Technology and Systems Center at the University of Alabama in Huntsville are working closely with the Madison County Emergency Management Agency (EMA), GeoHuntsville's UAS Working Group, and the NOAA UAS Program Office, to conduct a series of practical demonstrations testing the use of small unmanned aerial systems (sUAS) for emergency response activities in Madison County, Alabama. These exercises demonstrate the use of UAS to detect and visualize hazards in affected areas via the delivery of aerial imagery and associated data products to law enforcement first responders in a variety of different scenarios, for example, search and rescue, tornado track mapping, damage assessment, and situational awareness/containment during active shooter incidents. In addition to showcasing the use of UAS as a tool for emergency services, these pilot exercises provide the opportunity to engage the appropriate stakeholders from several communities including first responders, geospatial intelligence, active members of the unmanned systems industry, and academia. This presentation will showcase the challenges associated with delivering quality data products for emergency services in a timely manner as well as the related challenges in integrating the technology into local emergency management.

Opportunity for change in the future roles for the health library and information professional: meeting the challenges in NHS Scotland.

PubMed

Maclean, Gerry

2006-12-01

NHS Education for Scotland (NES) is the Special Health Board responsible for supporting best practice in education, training and development for all staff groups within NHS Scotland. As part of its remit, the Knowledge Services Group within NES is responsible for the e-Library, a national electronic resource providing and supporting access to the evidence base. The Knowledge Services Group also supports the national development of library services to NHS Scotland. This article aims to provide a reflective overview of some recent challenges within the health library and information field in Scotland, and the positive role opportunities these have afforded. The information was gathered through extensive professional interaction with staff across the sector over the first year of establishing the new role of Librarian Staff Development Manager. New roles have emerged for health library and information professionals generally; for example, in response to new technology or new user groups. The development of the NHS Scotland e-Library provides examples of role development that emerges symbiotically from core skills applied to a new situation or applied in an innovative way. Role development among health library and information professionals operating at the local service level can be both reactive and proactive. Working together, the partnership between the national Knowledge Services Group and local library and knowledge services for NHS Scotland has resulted in the emergence of additional new roles, extending the role portfolio of the local professional (for example, the Librarian-Tutor role) and supported by other national infrastructures (for example, the competency framework initiative).

The evolution of Earth Observation satellites in Europe and its impact on the performance of emergency response services

NASA Astrophysics Data System (ADS)

Denis, Gil; de Boissezon, Hélène; Hosford, Steven; Pasco, Xavier; Montfort, Bruno; Ranera, Franck

2016-10-01

The paper reviews the evolution of Earth Observation systems in Europe and Worldwide and analyses the potential impact of their performance in support of emergency response services. Earth Observation satellites play already a significant role in supporting the action of first responders in case of major disasters. The main principle is the coordinated use of satellites in order to ensure a rapid response and the timely delivery of images and geospatial information of the area affected by the event. The first part of the paper reviews the main instruments and evaluates their current performance. The International Charter ;Space and Major Disasters;, signed in October 2000, was the first international initiative aimed at establishing a unified system for the acquisition of space data. The charter is a cooperation agreement between space agencies and operators of space systems. At regional level, a similar instrument exists in Asia: Sentinel-Asia. In the frame of the European programme Copernicus, the emergency management service was launched in 2009. Geo-information products derived from space imagery are delivered during all phases of the emergency management cycle, in either rush or non-rush mode, free of charge for the users. In both cases, the capacities were historically drawn from national missions, funded with public money and directly operated by the space agencies or by national operators.

32 CFR 105.4 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... capable and engaged. (2) Require that medical care and SAPR services are gender-responsive, culturally... actions shall be supported by all commanders. (e) Standardized SAPR requirements, terminology, guidelines... comprehensive medical and psychological treatment, including emergency care treatment and services, as described...

32 CFR 105.4 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... capable and engaged. (2) Require that medical care and SAPR services are gender-responsive, culturally... actions shall be supported by all commanders. (e) Standardized SAPR requirements, terminology, guidelines... comprehensive medical and psychological treatment, including emergency care treatment and services, as described...

Out from under the rock: improving FDNY information sharing

DTIC Science & Technology

2017-03-01

56 Figure 7. Map of Firehouses and EMS Stations in Brooklyn, New York .................57... EMS emergency medical services EOC emergency operations center ERP emergency response plan FBI Federal Bureau of Investigation FDNY Fire...highlights thin readership and a need for improvement. An FDNY survey of 500 firefighters and EMS personnel was conducted from 2014 to 2015, the

Emergency Simulation Drill

NASA Image and Video Library

2013-12-04

ISS038-E-011708 (4 Dec. 2013) --- In the International Space Station?s Zvezda Service Module, Russian cosmonaut Sergey Ryazanskiy, Expedition 38 flight engineer, reads a procedures checklist during an emergency simulation drill with participation from flight controllers on the ground. During the exercise, the crew practiced emergency communication and procedures in response to a predetermined scenario such as pressure leak.

Assessment of Emergency Medical Services in the Ashanti Region of Ghana.

PubMed

Mould-Millman, N K; Oteng, R; Zakariah, A; Osei-Ampofo, M; Oduro, G; Barsan, W; Donkor, P; Kowalenko, T

2015-09-01

We aimed to assess the structure, function and performance of Ashanti Region's emergency medical services system in the context of the regional need for prehospital emergency care. A mixed-methods approach was employed, using retrospective collection of quantitative data and prospectively gathered qualitative data. Setting - pertinent data were collected from Ghanaian and international sources; interviews and technical assessments were performed primarily in the Ashanti Region of Ghana. All stakeholders relevant to emergency medical services in the Ashanti Region of Ghana were assessed; there was a special focus on National Ambulance Service (NAS) and Ashanti Region healthcare personnel. This was an observational study using qualitative and quantitative assessment techniques. The structure, function and performance of the Ashanti emergency medical services system, guided by a relevant technical assessment framework. NAS is the premier and only true prehospital agency in the Ashanti Region. NAS has developed almost every essential aspect of an EMS system necessary to achieve its mission within a low-resource setting. NAS continues to increase its number of response units to address the overwhelming Ashanti region demand, especially primary calls. Deficient areas in need of development are governance, reliable revenue, public access, community integration, clinical care guidelines, research and quality assurance processes. The Ashanti Region has a growing and thriving emergency medical services system. Although many essential areas for development were identified, NAS is well poised to meet the regional demand for prehospital emergency care and transport.

78 FR 34031 - Burned Area Emergency Response, Forest Service

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-06

...) Evaluate potential threats to critical values; (2) determine the risk level for each threat; (3) identify... actions that meet the objectives; (6) evaluate potential response actions on likelihood for timely... stabilization actions. Improved the descriptive guidelines for employing response actions involving...

Piloting a real-time surface water flood nowcasting system for enhancing operational resilience of emergency responders

NASA Astrophysics Data System (ADS)

Yu, Dapeng; Guan, Mingfu; Wilby, Robert; Bruce, Wright; Szegner, Mark

2017-04-01

Emergency services (such as Fire & Rescue, and Ambulance) can face the challenging tasks of having to respond to or operate under extreme and fast changing weather conditions, including surface water flooding. UK-wide, return period based surface water flood risk mapping undertaken by the Environment Agency provides useful information about areas at risks. Although these maps are useful for planning purposes for emergency responders, their utility to operational response during flood emergencies can be limited. A street-level, high resolution, real-time, surface water flood nowcasting system, has been piloted in the City of Leicester, UK to assess emergency response resilience to surface water flooding. Precipitation nowcasting over 7- and 48-hour horizons are obtained from the UK Met Office and used as inputs to the system. A hydro-inundation model is used to simulate urban surface water flood depths/areas at both the city and basin scale, with a 20 m and 3 m spatial resolution respectively, and a 15-minute temporal resolution, 7-hour and 48-hour in advance. Based on this, we evaluate both the direct and indirect impacts of potential surface water flood events on emergency responses, including: (i) identifying vulnerable populations (e.g. care homes and schools) at risk; and (ii) generating novel metrics of accessibility (e.g. travel time from service stations to vulnerable sites; spatial coverage with certain legislative timeframes) in real-time. In doing so, real-time information on potential risks and impacts of emerging flood incidents arising from intense rainfall can be communicated via a dedicated web-based platform to emergency responders thereby improving response times and operational resilience.

A Systematic Review on Recent Advances in mHealth Systems: Deployment Architecture for Emergency Response

PubMed Central

2017-01-01

The continuous technological advances in favor of mHealth represent a key factor in the improvement of medical emergency services. This systematic review presents the identification, study, and classification of the most up-to-date approaches surrounding the deployment of architectures for mHealth. Our review includes 25 articles obtained from databases such as IEEE Xplore, Scopus, SpringerLink, ScienceDirect, and SAGE. This review focused on studies addressing mHealth systems for outdoor emergency situations. In 60% of the articles, the deployment architecture relied in the connective infrastructure associated with emergent technologies such as cloud services, distributed services, Internet-of-things, machine-to-machine, vehicular ad hoc network, and service-oriented architecture. In 40% of the literature review, the deployment architecture for mHealth considered traditional connective infrastructure. Only 20% of the studies implemented an energy consumption protocol to extend system lifetime. We concluded that there is a need for more integrated solutions specifically for outdoor scenarios. Energy consumption protocols are needed to be implemented and evaluated. Emergent connective technologies are redefining the information management and overcome traditional technologies. PMID:29075430

A Systematic Review on Recent Advances in mHealth Systems: Deployment Architecture for Emergency Response.

PubMed

Gonzalez, Enrique; Peña, Raul; Avila, Alfonso; Vargas-Rosales, Cesar; Munoz-Rodriguez, David

2017-01-01

The continuous technological advances in favor of mHealth represent a key factor in the improvement of medical emergency services. This systematic review presents the identification, study, and classification of the most up-to-date approaches surrounding the deployment of architectures for mHealth. Our review includes 25 articles obtained from databases such as IEEE Xplore, Scopus, SpringerLink, ScienceDirect, and SAGE. This review focused on studies addressing mHealth systems for outdoor emergency situations. In 60% of the articles, the deployment architecture relied in the connective infrastructure associated with emergent technologies such as cloud services, distributed services, Internet-of-things, machine-to-machine, vehicular ad hoc network, and service-oriented architecture. In 40% of the literature review, the deployment architecture for mHealth considered traditional connective infrastructure. Only 20% of the studies implemented an energy consumption protocol to extend system lifetime. We concluded that there is a need for more integrated solutions specifically for outdoor scenarios. Energy consumption protocols are needed to be implemented and evaluated. Emergent connective technologies are redefining the information management and overcome traditional technologies.

Le Bon Samaritain: A Community-Based Care Model Supported by Technology.

PubMed

Gay, Valerie; Leijdekkers, Peter; Gill, Asif; Felix Navarro, Karla

2015-01-01

The effective care and well-being of a community is a challenging task especially in an emergency situation. Traditional technology-based silos between health and emergency services are challenged by the changing needs of the community that could benefit from integrated health and safety services. Low-cost smart-home automation solutions, wearable devices and Cloud technology make it feasible for communities to interact with each other, and with health and emergency services in a timely manner. This paper proposes a new community-based care model, supported by technology, that aims at reducing healthcare and emergency services costs while allowing community to become resilient in response to health and emergency situations. We looked at models of care in different industries and identified the type of technology that can support the suggested new model of care. Two prototypes were developed to validate the adequacy of the technology. The result is a new community-based model of care called 'Le Bon Samaritain'. It relies on a network of people called 'Bons Samaritains' willing to help and deal with the basic care and safety aspects of their community. Their role is to make sure that people in their community receive and understand the messages from emergency and health services. The new care model is integrated with existing emergency warning, community and health services. Le Bon Samaritain model is scalable, community-based and can help people feel safer, less isolated and more integrated in their community. It could be the key to reduce healthcare cost, increase resilience and drive the change for a more integrated emergency and care system.

Medical Emergency Workload of a Regional UK HEMS Service.

PubMed

McQueen, Carl; Crombie, Nick; Cormack, Stef; Wheaton, Steve

2015-01-01

Regionalized trauma networks have been established in England to centralize specialist care at dedicated centers of excellence throughout the country. Helicopter emergency medical services (HEMS) in the West Midlands region have been redesigned to form an integrated component of such systems. The continued use of such valuable and scarce resources for medical emergencies requires evaluation. A retrospective review of mission data for a regional Air Ambulance Service in England over a two year period. Medical emergencies continue to contribute a large proportion of the overall workload of the service. Requirement for advanced interventions at the scene was rare, with less than 10% of patients attended by HEMS teams having care needs that fall beyond the scope of standard paramedic practice. Dynamic solutions are needed to ensure that HEMS support for cases of medical emergency are appropriately targeted to incidents in which clinical benefit is conferred to the patient. Intelligent tasking of appropriate resources has the potential to improve the HEMS response to medical emergencies while optimizing the availability of resources to respond to other incidents, most notably cases of major trauma. Copyright © 2015 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Soil ecosystem services in loblolly pine plantations 15 years after harvest, compaction, and vegetation control

Treesearch

D. Andrew Scott; Robert J. Eaton; Julie A. Foote; Benjamin Vierra; Thomas W. Boutton; Gary B. Blank; Kurt Johnsen

2014-01-01

Site productivity has long been identified as the primary ecosystem service to be sustained in timberlands. However, soil C sequestration and ecosystem biodiversity have emerged as critical services provided by managed forest soils that must also be sustained. These ecosystem services were assessed in response to gradients of organic matter removal, soil compaction,...

Overcoming Medicaid Reimbursement Barriers to Funding School Nursing Services for Low-Income Children with Asthma

ERIC Educational Resources Information Center

Malcarney, Mary-Beth; Horton, Katherine; Seiler, Naomi

2016-01-01

Background: School nurses can provide direct services for children with asthma, educate, and reinforce treatment recommendations to children and their families, and coordinate the school-wide response to students' asthma emergencies. Unfortunately, school-based health services today depend on an unreliable patchwork of funding. Limited state and…

Ecosystem services: foundations, opportunities, and challenges for the forest products sector

Treesearch

Trista M. Patterson; Dana L. Coelho

2009-01-01

The ecosystem service concept has been proposed as a meaningful framework for natural resource management. In theory, it holds concomitant benefit and consequence for the forest product sector. However, numerous barriers impede practitioners from developing concrete and enduring responses to emerging ecosystem service markets, policies, and initiatives. Principal among...

Web-based data delivery services in support of disaster-relief applications

USGS Publications Warehouse

Jones, Brenda K.; Risty, Ron R.; Buswell, M.

2003-01-01

The U.S. Geological Survey Earth Resources Observation Systems Data Center responds to emergencies in support of various government agencies for human-induced and natural disasters. This response consists of satellite tasking and acquisitions, satellite image registrations, disaster-extent maps analysis and creation, base image provision and support, Web-based mapping services for product delivery, and predisaster and postdisaster data archiving. The emergency response staff are on call 24 hours a day, 7 days a week, and have access to many commercial and government satellite and aerial photography tasking authorities. They have access to value-added data processing and photographic laboratory services for off-hour emergency requests. They work with various Federal agencies for preparedness planning, which includes providing base imagery. These data may include digital elevation models, hydrographic models, base satellite images, vector data layers such as roads, aerial photographs, and other predisaster data. These layers are incorporated into a Web-based browser and data delivery service that is accessible either to the general public or to select customers. As usage declines, the data are moved to a postdisaster nearline archive that is still accessible, but not in real time.

Ground and Helicopter Emergency Medical Services Time Tradeoffs Assessed with Geographic Information.

PubMed

Widener, Michael J; Ginsberg, Zac; Schleith, Daniel; Floccare, Douglas J; Hirshon, Jon Mark; Galvagno, Samuel

2015-07-01

We describe how geographic information systems (GIS) can be used to assess and compare estimated transport time for helicopter and ground emergency medical services. Recent research shows that while the odds of a trauma patient's survival increase with helicopter emergency medical services (HEMS), they may not increase to the extent necessary to make HEMS cost effective. This study offers an analytic tool to objectively quantify the patient travel time advantage that HEMS offers compared to ground emergency medical services (GEMS). Using helicopter dispatch data from the Maryland State Police from 2000-2011, we computed transport time estimates for HEMS and GEMS, compare these results to a reference transport time of 60 min, and use geospatial interpolation to extrapolate the total response times for each mode across the study region. Mapping the region's trauma incidents and modeling response times, our findings indicate the GIS framework for calculating transportation time tradeoffs is useful in identifying which areas can be better served by HEMS or GEMS. The use of GIS and the analytical methodology described in this study present a method to compare transportation by air and ground in the prehospital setting that accounts for how mode, distance, and road infrastructure impact total transport time. Whether used to generate regional maps in advance or applied real-time, the presented framework provides a tool to identify earlier incident locations that favor HEMS over GEMS transport modes.

Financial management services in consumer-directed programs.

PubMed

Scherzer, Teresa; Wong, Alice; Newcomer, Robert

2007-01-01

Shifting from an agency-based model of personal assistance services to consumer direction has important consequences for both recipients and workers. In consumer direction, recipients assume the responsibilities of employing their attendants--for both self-directing their supportive services and being responsible for numerous fiscal responsibilities. Many states have eased these fiscal responsibilities among recipients in publicly financed personal care programs by using Financial Management Services (also known as fiscal intermediaries). This article introduces the major types of Financial Management Services organizations used by Medicaid consumer-directed personal care programs, and examines the extent to which the varied approaches can and do serve the needs of both recipients and workers. Despite the expansion of consumer-directed programs and the accompanying emergence of Financial Management Services, these organizations have not been extensively studied or evaluated. The paper concludes with a discussion of the challenges, opportunities, and policy implications of the current practice; and suggests directions for future research.

Is there a doctor in the house? Standards of physician availability for laboring women.

PubMed

Minkoff, Howard; Ecker, Jeffrey

2010-09-01

Unexpected emergencies requiring urgent intervention can arise in the course of labor even among uncomplicated pregnancies in low-risk women. The possibility of such emergencies requires that responsible practitioners be available for management. The recent National Institutes of Health-sponsored consensus conference on vaginal birth after cesarean delivery highlighted this issue in discussing alternate standards of "ready" and "immediate" availability. The merits, feasibility, and ethics of alternate systems for coverage of all laboring women have not been widely or previously discussed and are considered in this opinion. Although there are potential advantages to having a responsible practitioner immediately available, logistic and economic considerations will make immediate availability unfeasible in all centers and systems, particularly on smaller services where distance or other factors may limit the option of consolidation (ie, the merging of different hospitals' obstetric services). We discuss training, systems, and planning to optimize response to emergencies in all systems, whether practitioners are readily or immediately available. Finally, we suggest that the ethical principle of respect for autonomy argues that particularly where alternate systems exist, practitioners and patients discuss the details, merits, and limitations of individual centers' clinical systems and plans for responding to emergencies.

MVERT: common solutions for technological disasters--a study on cooperation

NASA Astrophysics Data System (ADS)

Roberts, Walter O.; Allred, William D.

1999-01-01

Most Idaho communities are not prepared to handle a hazardous materials incident and must rely on resources outside of their jurisdiction for assistance. Idaho has established four Regional Response Teams (RRT) to help the communities. The teams are located in the northern, north-central, south-western and south-eastern parts of the state. The south-central area is served by a team from Boise or Pocatello. Response from either team requires nearly four hours of travel time. After analyzing the problems of time and distance, six counties from south-central Idaho have agreed to provide a team to function as an RRT during the initial phases of an incident. This organization is unprecedented because it consists of members from law enforcement, local fire protection organizations, emergency medical personnel, and local government agencies who will share personnel, equipment, resources, and training. The Magic Valley Emergency Response Team (MVERT) is locally funded and self- governed. MVERT has received support from the Idaho Bureau of Hazardous Materials, State Bureau of Disaster Services, Idaho Division of Environmental Quality, Idaho Emergency Services Training and Idaho State Police. MVERT is not limited to hazardous materials incidents and can respond to any emergency requiring specialized training and equipment.

Recommended emergency preparedness guidelines for elderly and disabled rail-transit passengers. Final report, November 1987-March 1989

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hathaway, W.T.; Markos, S.H.; Balog, J.N.

1989-08-01

Rail transit has become an important source of transportation for many elderly and disabled persons. The principal reasons for the increased use are improved accessibility, low cost, and expanded areas of service. For the purposes of the report, 'elderly' is defined as any member of the population who is 60 years of age or older, and 'disabled' is defined as any person who has some type of disability. The Urban Mass Transportation Administration (UMTA) has recognized the need to consider the unique characteristics of elderly and disabled passengers in rail-transit emergency response planning. The needs of these passengers can bemore » addressed through carefully planned emergency response procedures, proper training of transit and emergency-response personnel, and effective use of equipment. The recommendations contained herein are therefore intended to assist rail-transit and emergency response organization personnel in evaluating their emergency response plans in terms of the needs of elderly and disabled passengers and, if necessary, to modify or supplement those plans accordingly. The report is intended to supplement the UMTA publication Recommended Emergency Preparedness Guidelines for Rail Transit Systems. That report contains general guidelines designed to assist rail-transit systems in assessing, developing, documenting, and improving their capabilities for responding to emergencies and in coordinating those efforts with emergency response organizations.« less

Did Harvey Learn from Katrina? Initial Observations of the Response to Companion Animals during Hurricane Harvey.

PubMed

Glassey, Steve

2018-03-30

The aftermath of Hurricane Katrina in 2005 became the genesis of animal emergency management and created significant reforms in the US particularly the passage of the Pets Emergency and Transportation Standards Act in 2006 that required state and local emergency management arrangements to be pet- and service animal-inclusive. More than a decade later Hurricane Harvey struck the Gulf states with all 68 directly related deaths occurring in the state of Texas. In this study, six key officials involved in the response underwent a semi-structured interview to investigate the impact of the PETS Act on preparedness and response. Though the results have limitations due to the low sample size, it was found that the PETS Act and the lessons of Hurricane Katrina had contributed to a positive cultural shift to including pets (companion animals) in emergency response. However, there was a general theme that plans required under the PETS Act were under-developed and many of the animal response lessons from previous emergencies remain unresolved. The study also observed the first empirical case of disaster hoarding which highlights the need for animal law enforcement agencies to be active in emergency response.

School Emergency Planning Guide. [Revised.

ERIC Educational Resources Information Center

Pennsylvania State Emergency Management Agency, Harrisburg.

Guidelines to help school districts in Pennsylvania recognize potential hazards and develop a plan of community action are presented in this guidebook. The 1988 Emergency Management Services Code requires that every publicly funded state school have a disaster response plan that is exercised annually. Further, all publicly funded educational…

75 FR 28810 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Addressing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-24

... evaluation of applications received in response to ``Addressing Emerging Infectious Diseases and Related... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Addressing Emerging Infectious...

No longer 'flying blind': how access has changed emergency mental health care in rural and remote emergency departments, a qualitative study.

PubMed

Saurman, Emily; Kirby, Sue E; Lyle, David

2015-04-14

Mental health presentations are considered to be a difficult aspect of emergency care. Although emergency department (ED) staff is qualified to provide emergency mental health care, for some, such presentations pose a challenge to their training, confidence, and time. Providing access to relevant and responsive specialist mental health care can influence care and management for these patients. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telepsychiatry program that was established to improve access to specialist emergency mental health care across rural and remote western NSW, Australia. This study uses interviews with ED providers to understand their experience of managing emergency mental health patients and their use of MHEC-RAP. The lens of access was applied to assess program impact and inform continuing program development. With MHEC-RAP, these ED providers are no longer 'flying blind'. They are also more confident to manage and care for emergency mental health patients locally. For these providers, access to specialists who are able to conduct assessments and provide relevant and responsive advice for emergency mental health presentations was valued. Assessing the fit between the consumer and service as a requirement for the development, evaluation, and ongoing management of the service should result in decisions about design and delivery that achieve improved access to care and meet the needs of their consumers. The experience of these providers prior to MHEC-RAP is consistent with that reported in other rural and remote populations suggesting that MHEC-RAP could address limitations in access to specialist care and change the provision of emergency mental health care elsewhere. MHEC-RAP has not only provided access to specialist mental health care for local ED providers, but it has changed their practice and perspective. MHEC-RAP could be adapted for implementation elsewhere. Provider experience confirms that the program is accessible and offers insights to those considering how to establish an emergency telepyschiatry service in other settings.

Implementation of Technology in an Elementary Mathematics Lesson: The Experiences of Pre-Service Teachers at One University

ERIC Educational Resources Information Center

Herron, Julie

2010-01-01

This study examined pre-service teachers' responses to implementing technology into elementary mathematics lessons. Instructional Architect (IA) was the web-base technology used by the pre-service teachers. Four themes emerged from the data: (a) insights into technology, (b) struggles with technology, (c) access to the mathematics and (d) learning…

Assessing Sexually Transmitted Disease Partner Services in State and Local Health Departments.

PubMed

Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L

2018-06-01

State and local health department sexually transmitted disease (STD) programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.

Implementing the Hospital Emergency Incident Command System: an integrated delivery system's experience.

PubMed

Zane, Richard D; Prestipino, Ann L

2004-01-01

Hospital disaster manuals and response plans often lack formal command structure; instead, they rely on the presence of key individuals who are familiar with hospital operations, or who are in leadership positions during routine, day-to-day operations. Although this structure occasionally may prove to be successful, it is unreliable, as this leadership may be unavailable at the time of the crisis, and may not be sustainable during a prolonged event. The Hospital Emergency Incident Command System (HEICS) provides a command structure that does not rely on specific individuals, is flexible and expandable, and is ubiquitous in the fire service, emergency medical services, military, and police agencies, thus allowing for ease of communication during event management. A descriptive report of the implementation of the HEICS throughout a large healthcare network is reviewed. Implementation of the HEICS provides a consistent command structure for hospitals that enables consistency and commonality with other hospitals and disaster response entities.

Assistive Technologies and Issues Relating to Privacy, Ethics and Security

NASA Astrophysics Data System (ADS)

Martin, Suzanne; Bengtsson, Johan E.; Dröes, Rose-Marie

Emerging technologies provide the opportunity to develop innovative sustainable service models, capable of supporting adults with dementia at home. Devices range from simple stand-alone components that can generate a responsive alarm call to complex interoperable systems that even can be remotely controlled. From these complex systems the paradigm of the ubiquitous or ambient smart home has emerged, integrating technology, environmental design and traditional care provision. The service context is often complex, involving a variety of stakeholders and a range of interested agencies. Against this backdrop, as anecdotal evidence and government policies spawn further innovation it is critical that due consideration is given to the potential ethical ramifications at an individual, organisational and societal level. Well-grounded ethical thinking and proactive ethical responses to this innovation are required. Explicit policy and practice should therefore emerge which engenders confidence in existing supported living option schemes for adults with dementia and informs further innovation.

Initial experience in setting up a medical student first responder scheme in South Central England.

PubMed

Seligman, William H; Ganatra, Sameer; England, David; Black, John J M

2016-02-01

Prehospital emergency medicine (PHEM) is a recently recognised subspecialty of emergency medicine, and anaesthetics, intensive care and acute medicine, in the UK, and yet it receives little to no mention in many undergraduate medical curricula. However, there is growing interest in PHEM among medical students and junior doctors. Several programmes are in existence across the UK that serve to provide teaching and exposure of prehospital care to medical students and junior doctors. However, relatively few students are able to gain significant first-hand experience of treating patients in the prehospital phase. In this short report, we discuss our experience of launching the student first responder (SFR) scheme across three counties in the Thames Valley. Medical students are trained by the regional ambulance service and respond to life-threatening medical emergencies in an ambulance response vehicle. The scheme is likely to benefit the ambulance service by providing a wider pool of trained volunteer first responders able to attend to emergency calls, to benefit patients by providing a quick response at their time of need, and to benefit medical students by providing first-hand experience of medical emergencies in the community. In its first 15 months of operation, SFRs were dispatched to 343 incidents. This scheme can serve as a training model for other ambulance services and medical schools across the UK. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Palliative care and end-of-life patients in emergency situations. Recommendations on optimization of out-patient care].

PubMed

Wiese, C H R; Vagts, D A; Kampa, U; Pfeiffer, G; Grom, I-U; Gerth, M A; Graf, B M; Zausig, Y A

2011-02-01

At the end of life acute exacerbations of medical symptoms (e.g. dyspnea) in palliative care patients often result in emergency medical services being alerted. The goals of this study were to discuss cooperation between emergency medical and palliative care structures to optimize the quality of care in emergencies involving palliative care patients. For data collection an open discussion of the main topics by experts in palliative and emergency medical care was employed. Main outcome measures and recommendations included responses regarding current practices related to expert opinions and international literature sources. As the essential points of consensus the following recommendations for optimization of care were named: (1) integration of palliative care in the emergency medicine curricula for pre-hospital emergency physicians and paramedics, (2) development of outpatient palliative care, (3) integration of palliative care teams into emergency medical structures, (4) cooperation between palliative and emergency medical care, (5) integration of crisis intervention into outpatient palliative emergency medical care, (6) provision of emergency plans and emergency medical boxes, (7) provision of palliative crisis cards and do not attempt resuscitation (DNAR) orders, (8) psychosocial aspects concerning palliative emergencies and (9) definition of palliative patients and their special situation by the physician responsible for prior treatment. Prehospital emergency physicians are confronted with emergencies in palliative care patients every day. In the treatment of these emergencies there are potentially serious conflicts due to the different therapeutic concepts of palliative medical care and emergency medical services. This study demonstrates that there is a need for regulated criteria for the therapy of palliative patients and patients at the end of life in emergency situations. Overall, more clinical investigations concerning end-of-life care and unresponsive palliative care patients in emergency medical situations are necessary.

Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre.

PubMed

Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

2016-01-01

This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eltoweissy, Mohamed Y.; Du, David H.C.; Gerla, Mario

Mission-Critical Networking (MCN) refers to networking for application domains where life or livelihood may be at risk. Typical application domains for MCN include critical infrastructure protection and operation, emergency and crisis intervention, healthcare services, and military operations. Such networking is essential for safety, security and economic vitality in our complex world characterized by uncertainty, heterogeneity, emergent behaviors, and the need for reliable and timely response. MCN comprise networking technology, infrastructures and services that may alleviate the risk and directly enable and enhance connectivity for mission-critical information exchange among diverse, widely dispersed, mobile users.

Non-Communicable Diseases in Emergencies: A Call to Action

PubMed Central

Demaio, Alessandro; Jamieson, Jennifer; Horn, Rebecca; de Courten, Maximilian; Tellier, Siri

2013-01-01

Recent years have demonstrated the devastating health consequences of complex emergencies and natural disasters and thereby highlighted the importance of comprehensive and collaborative approaches to humanitarian responses and risk reduction. Simultaneously, noncommunicable diseases are now recognised as a real and growing threat to population health and development; a threat that is magnified by and during emergencies. Noncommunicable diseases, however, continue to receive little attention from humanitarian organisations in the acute phase of disaster and emergency response. This paper calls on all sectors to recognise and address the specific health challenges posed by noncommunicable diseases in emergencies and disaster situations. This publication aims to highlight the need for: • Increased research on morbidity and mortality patterns due to noncommunicable diseases during and following emergencies; • Raised awareness through greater advocacy for the issue and challenges of noncommunicable diseases during and following emergencies; • Incorporation of noncommunicable diseases into existing emergency-related policies, standards, and resources; • Development of technical guidelines on the clinical management of noncommunicable diseases in emergencies; • Greater integration and coordination in health service provision during and following emergencies; • Integrating noncommunicable diseases into practical and academic training of emergency workers and emergency-response coordinators. PMID:24056956

Experimental Simulation-Based Performance Evaluation of an SMS-Based Emergency Geolocation Notification System

PubMed Central

Osebor, Isibor

2017-01-01

In an emergency, a prompt response can save the lives of victims. This statement generates an imperative issue in emergency medical services (EMS). Designing a system that brings simplicity in locating emergency scenes is a step towards improving response time. This paper therefore implemented and evaluated the performance of an SMS-based emergency geolocation notification system with emphasis on its SMS delivery time and the system's geolocation and dispatch time. Using the RAS metrics recommended by IEEE for evaluation, the designed system was found to be efficient and effective as its reliability stood within 62.7% to 70.0% while its availability stood at 99% with a downtime of 3.65 days/year. PMID:29065643

The development and implementation of a Hospital Emergency Response Team (HERT) for out-of-hospital surgical care.

PubMed

Scott, Christopher; Putnam, Brant; Bricker, Scott; Schneider, Laura; Raby, Stephanie; Koenig, William; Gausche-Hill, Marianne

2012-06-01

Over the past two decades, Los Angeles County has implemented a Hospital Emergency Response Team (HERT) to provide on-scene, advanced surgical care of injured patients as an element of the local Emergency Medical Services (EMS) system. Since 2008, the primary responsibility of the team has been to perform surgical procedures in the austere field setting when prolonged extrication is anticipated. Following the maxim of "life over limb," the team is equipped to provide rapid amputation of an entrapped extremity as well as other procedures and medical care, such as anxiolytics and advanced pain control. This report describes the development and implementation of a local EMS system HERT.

Prevalence of burnout among public health nurses in charge of mental health services and emergency care systems in Japan.

PubMed

Imai, Hirohisa; Nakao, Hiroyuki; Nakagi, Yoshihiko; Niwata, Satoko; Sugioka, Yoshihiko; Itoh, Toshihiro; Yoshida, Takahiko

2006-11-01

The Community Health Act came into effect in 1997 in Japan. This act altered the work system for public health nurses (PHNs) in public health centers (PHCs) nationwide from region-specific to service-specific work. Such major changes to working environment in the new system seem to be exposing PHNs to various types of stress. The present study examined whether prevalence of burnout is higher among PHNs in charge of mental health services (psychiatric PHNs) than among PHNs in charge of other services (non-psychiatric PHNs), and whether attributes of emergency mental health care systems in communities are associated with increased prevalence of burnout. A questionnaire including the Pines burnout scale for measuring burnout was mailed to 525 psychiatric PHNs and 525 non-psychiatric PHNs. The 785 respondents included in the final analysis comprised 396 psychiatric PHNs and 389 non-psychiatric PHNs. Prevalence of burnout was significantly higher for psychiatric PHNs (59.2%) than for non-psychiatric PHNs (51.5%). When prevalence of burnout in each group was analyzed in relation to question responses regarding emergency service and patient referral systems, prevalence of burnout for psychiatric PHNs displayed significant correlations to frequency of cases requiring overtime emergency services, difficulties referring patients, and a feeling of "restriction". Prevalence of burnout is high among psychiatric PHNs, and inadequate emergency mental health service systems contribute to burnout among these nurses. Countermeasures for preventing such burnout should be taken as soon as possible.

Geolocation of WiMAX Subscriber Stations Based on the Timing Adjust Ranging Parameter

DTIC Science & Technology

2009-12-01

to cellular networks hoping to offer location based services and to emergency response and tactical personnel who may need to locate mobile persons...applications. Location - based services have grown increasingly popular in the current generation of cellular phones, providing weather, traffic, and

Emerging Patient-Driven Health Care Models: An Examination of Health Social Networks, Consumer Personalized Medicine and Quantified Self-Tracking

PubMed Central

Swan, Melanie

2009-01-01

A new class of patient-driven health care services is emerging to supplement and extend traditional health care delivery models and empower patient self-care. Patient-driven health care can be characterized as having an increased level of information flow, transparency, customization, collaboration and patient choice and responsibility-taking, as well as quantitative, predictive and preventive aspects. The potential exists to both improve traditional health care systems and expand the concept of health care though new services. This paper examines three categories of novel health services: health social networks, consumer personalized medicine and quantified self-tracking. PMID:19440396

After-action review of the 2009-10 H1N1 Influenza Outbreak Response: Ohio's Public Health System's performance.

PubMed

Mase, William A; Bickford, Beth; Thomas, Casey L; Jones, Shamika D; Bisesi, Michael

In early 2009, H1N1 influenza was identified within the human population. Centers for Disease Control and Prevention (CDC) officials responded with focused assessment, policy development, and assurances. The response was mobilized through efforts including procurement of adequate vaccine supply, local area span of control, materials acquisition, and facilities and resource identification. Qualitative evaluation of the assurance functions specific to the system's ability to assure safe and healthy conditions are reported. The methodology mirrors the Homeland Security Exercise and Evaluation Program used to assess system capability. Findings demonstrate the effectiveness of community responsive disease prevention efforts in partnership with the public health systems mission to unify traditional public sector systems, for-profit systems, and local area systems was accomplished. As a result of this response pharmaceutical industries, healthcare providers, healthcare agencies, police/safety, colleges, and health and human service agencies were united. Findings demonstrate the effectiveness of community response strategies utilizing feedback from system stakeholders. After-action review processes are critical in all-hazards preparedness. This analysis of local health district response to the H1N1 influenza outbreak informs future public health service delivery. Results provide a synthesis of local health department's emergency response strategies, challenges encountered, and future-focused emergency response strategy implementation. A synthesis is provided as to policy and practice developments which have emerged over the past seven years with regard to lessons learned from the 2009-10 H1N1 influenza outbreak and response.

Research on sudden environmental pollution public service platform construction based on WebGIS

NASA Astrophysics Data System (ADS)

Bi, T. P.; Gao, D. Y.; Zhong, X. Y.

2016-08-01

In order to actualize the social sharing and service of the emergency-response information for sudden pollution accidents, the public can share the risk source information service, dangerous goods control technology service and so on, The SQL Server and ArcSDE software are used to establish a spatial database to restore all kinds of information including risk sources, hazardous chemicals and handling methods in case of accidents. Combined with Chinese atmospheric environmental assessment standards, the SCREEN3 atmospheric dispersion model and one-dimensional liquid diffusion model are established to realize the query of related information and the display of the diffusion effect under B/S structure. Based on the WebGIS technology, C#.Net language is used to develop the sudden environmental pollution public service platform. As a result, the public service platform can make risk assessments and provide the best emergency processing services.

Secure, Autonomous, Intelligent Controller for Integrating Distributed Emergency Response Satellite Operations

NASA Astrophysics Data System (ADS)

Ivancic, W. D.; Paulsen, P. E.; Miller, E. M.; Sage, S. P.

This report describes a Secure, Autonomous, and Intelligent Controller for Integrating Distributed Emergency Response Satellite Operations. It includes a description of current improvements to existing Virtual Mission Operations Center technology being used by US Department of Defense and originally developed under NASA funding. The report also highlights a technology demonstration performed in partnership with the United States Geological Service for Earth Resources Observation and Science using DigitalGlobe® satellites to obtain space-based sensor data.

The evolution of internet-based map server applications in the United States Department of Agriculture, Veterinary Services.

PubMed

Maroney, Susan A; McCool, Mary Jane; Geter, Kenneth D; James, Angela M

2007-01-01

The internet is used increasingly as an effective means of disseminating information. For the past five years, the United States Department of Agriculture (USDA) Veterinary Services (VS) has published animal health information in internet-based map server applications, each oriented to a specific surveillance or outbreak response need. Using internet-based technology allows users to create dynamic, customised maps and perform basic spatial analysis without the need to buy or learn desktop geographic information systems (GIS) software. At the same time, access can be restricted to authorised users. The VS internet mapping applications to date are as follows: Equine Infectious Anemia Testing 1972-2005, National Tick Survey tick distribution maps, the Emergency Management Response System-Mapping Module for disease investigations and emergency outbreaks, and the Scrapie mapping module to assist with the control and eradication of this disease. These services were created using Environmental Systems Research Institute (ESRI)'s internet map server technology (ArcIMS). Other leading technologies for spatial data dissemination are ArcGIS Server, ArcEngine, and ArcWeb Services. VS is prototyping applications using these technologies, including the VS Atlas of Animal Health Information using ArcGIS Server technology and the Map Kiosk using ArcEngine for automating standard map production in the case of an emergency.

Remote sensing and geospatial support to burned area emergency response teams

USGS Publications Warehouse

McKinley, Randy; Clark, Jess

2011-01-01

A major concern of land managers in the United States is the response of watersheds to weather after a wildfire. With an ever-expanding wildland-urban interface (WUI), land managers must be cognizant of potential damage to private property and other values at risk. In the United States, land-management agencies from the U.S. Department of Agriculture (USDA) and the U.S. Department of the Interior (DOI) deploy Burned Area Emergency Response (BAER) teams to address these concerns and to “prescribe and implement emergency treatments to minimize threats to life or property or to stabilize and prevent unacceptable degradation to natural and cultural resources resulting from the effects of a fire” (USDA Forest Service 2004, p. 17). BAER teams’ objective is emergency stabilization of burned areas, rather than long-term restoration of the landscape after a fire.

The 2010 Haiti earthquake response.

PubMed

Raviola, Giuseppe; Severe, Jennifer; Therosme, Tatiana; Oswald, Cate; Belkin, Gary; Eustache, Eddy

2013-09-01

This article presents an overview of the mental health response to the 2010 Haiti earthquake. Discussion includes consideration of complexities that relate to emergency response, mental health and psychosocial response in disasters, long-term planning of systems of care, and the development of safe, effective, and culturally sound mental health services in the Haitian context. This information will be of value to mental health professionals and policy specialists interested in mental health in Haiti, and in the delivery of mental health services in particularly resource-limited contexts in the setting of disasters. Copyright © 2013 Elsevier Inc. All rights reserved.

76 FR 36139 - Agency Information Collection Activities: Submission for OMB Review; Comment Request; Generic...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-21

... requirements or power calculations that justify the proposed sample size, the expected response rate, methods... for the Collection of Qualitative Feedback on Agency Service Delivery AGENCY: Federal Emergency...): ``Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery'' to the Office of...

USDA forest service southern region – It’s all about GRITS

Treesearch

Barbara S. Crane; Kevin M. Potter

2017-01-01

Genetic resource management programs across the U.S. Department of Agriculture Forest Service (USDA FS) play a key role in supporting successful land management activities. The programs are responsible for developing and providing plant material for revegetation, seed management guidelines, emergency fire recovery assistance, genetic conservation strategies, climate...

Mental health and psychosocial support in humanitarian emergencies.

PubMed

van Ommeren, M; Hanna, F; Weissbecker, I; Ventevogel, P

2015-09-28

Armed conflicts and natural disasters impact negatively on the mental health and well-being of affected populations in the short- and long-term and affect the care of people with pre-existing mental health conditions. This paper outlines specific actions for mental health and psychosocial support by the health sector in the preparedness, response and recovery phases of emergencies. Broad recommendations for ministries of health are to: (1) embed mental health and psychosocial support in national health and emergency preparedness plans; (2) put in place national guidelines, standards and supporting tools for the provision of mental health and psychosocial support during emergencies; (3) strengthen the capacity of health professionals to identify and manage priority mental disorders during emergencies; and (4) utilize opportunities generated by the emergency response to contribute to development of sustainable mental health-care services.

Disaster Response and Decision Support in Partnership with the California Earthquake Clearinghouse

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Rosinski, A.; Vaughan, D.; Morentz, J.

2014-12-01

Getting the right information to the right people at the right time is critical during a natural disaster. E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) is a NASA decision support system designed to produce remote sensing and geophysical modeling data products that are relevant to the emergency preparedness and response communities and serve as a gateway to enable the delivery of NASA decision support products to these communities. The E-DECIDER decision support system has several tools, services, and products that have been used to support end-user exercises in partnership with the California Earthquake Clearinghouse since 2012, including near real-time deformation modeling results and on-demand maps of critical infrastructure that may have been potentially exposed to damage by a disaster. E-DECIDER's underlying service architecture allows the system to facilitate delivery of NASA decision support products to the Clearinghouse through XchangeCore Web Service Data Orchestration that allows trusted information exchange among partner agencies. This in turn allows Clearinghouse partners to visualize data products produced by E-DECIDER and other NASA projects through incident command software such as SpotOnResponse or ArcGIS Online.

Quantitative evaluation of "Can It Happen in Kansas: Response to Terrorism and Emerging Infections".

PubMed

Ablah, Elizabeth; Molgaard, Craig A; Fredrickson, Doren D; Wetta-Hall, Ruth; Cook, David J

2005-11-01

This study describes the evaluation of a 2-year plan to train 10 percent of Kansas' multidisciplinary health professionals for response to terrorism and emerging infections. This project was part of a national effort covering 19 states funded by the Health Resources and Services Administration in 2003. The initial training occurred in six 2-day workshops. A terrorism preparedness questionnaire was developed to assess Health Resources and Services Administration terrorism response competencies/learning objectives. These were measured before, after, and 3 months after training in a hybrid cross-sectional and cohort follow-up design. Health professionals' mean scores significantly improved on all four Health Resources and Services Administration terrorism self-reported competencies from pretest to posttest. Three months posttraining, health professionals' mean scores decreased slightly but remained significantly higher than their pretest scores. This project prepared healthcare professionals to respond to the medical consequences of terrorism. The integration of core competencies into the evaluation plan allowed for trainees to evaluate their confidence and abilities. The evaluation plan and curriculum may serve as useful tools for preparation of healthcare workers nationwide, with the potential to rebuild the public health infrastructure to assume preparedness responsibilities.

47 CFR Appendix B to Part 64 - Priority Access Service (PAS) for National Security and Emergency Preparedness (NSEP)

Code of Federal Regulations, 2010 CFR

2010-10-01

... leadership; (iii) Disaster shelter coordination and management; and (iv) Critical Disaster Field Office... telecommunications management and response functions during emergency/disaster situations. 3. Initiate PAS requests... priorities, priority one being the highest. The five priority levels are: 1. Executive Leadership and Policy...

Emergency Home - PHE

Science.gov Websites

and reload this page. Skip over global navigation links U.S. Department of Health and Human Services Health Emergency - Leading a Nation Prepared Search Search Right Box1 Content 2017 Hurricane Response and Deaf or Hard of Hearing For Public Health Communicators and the Media Tools for the Media and Public

75 FR 1041 - Office of Safe and Drug-Free Schools; Overview Information; Grants for the Integration of Schools...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-08

... received or receives a grant under the Department of Education's Readiness and Emergency Management for Schools (REMS) program (CFDA 84.184E), formerly known as the Emergency Response and Crisis Management... prevention, diagnosis, and treatment services to students. (2) Enhancing the availability of crisis...

Early response to the emergence of influenza A(H7N9) virus in humans in China: the central role of prompt information sharing and public communication.

PubMed

Vong, Sirenda; O'Leary, Michael; Feng, Zijian

2014-04-01

In 2003, China's handling of the early stages of the epidemic of severe acute respiratory syndrome (SARS) was heavily criticized and generally considered to be suboptimal. Following the SARS outbreak, China made huge investments to improve surveillance, emergency preparedness and response capacity and strengthen public health institutions. In 2013, the return on these investments was evaluated by investigating China's early response to the emergence of avian influenza A(H7N9) virus in humans. Clusters of human infection with a novel influenza virus were detected in China - by national surveillance of pneumonia of unknown etiology - on 26 February 2013. On 31 March 2013, China notified the World Health Organization (WHO) of the first recorded human infections with A(H7N9) virus. Poultry markets - which were rapidly identified as a major source of transmission of A(H7N9) to humans - were closed down in the affected areas. Surveillance in humans and poultry was heightened and technical guidelines were quickly updated and disseminated. The health authorities collaborated with WHO in risk assessments and risk communication. New cases were reported promptly and publicly. The relevant infrastructures, surveillance systems and response capacity need to be strengthened in preparation for future emergencies caused by emerging or existing disease threats. Results of risk assessments and other data should be released promptly and publicly and such release should not jeopardize future publication of the data in scientific journals. Coordination between public health and veterinary services would be stronger during an emergency if these services had already undertaken joint preparedness planning.

Emergency Department Telepsychiatry Service Model for a Rural Regional Health System: The First Steps.

PubMed

Meyer, James D; McKean, Alastair J S; Blegen, Rebecca N; Demaerschalk, Bart M

2018-05-09

Emergency departments (EDs) have recognized an increasing number of patients presenting with mental health (MH) concerns. This trend imposes greater demands upon EDs already operating at capacity. Many ED providers do not feel they are optimally prepared to provide the necessary MH care. One consideration in response to this dilemma is to use advanced telemedicine technology for psychiatric consultation. We examined a rural- and community-based health system operating 21 EDs, none of which has direct access to psychiatric consultation. Dedicated beds to MH range from zero (in EDs with only 3 beds) to 6 (in an ED with 38 beds). We conducted a needs assessment of this health system. This included a survey of emergency room providers with a 67% response rate and site visits to directly observe patient flow and communication with ED staff. A visioning workshop provided input from ED staff. Data were also obtained, which reflected ED admissions for the year 2015. The data provide a summary of provider concerns, a summary of MH presentations and diagnosis, and age groupings. The data also provide a time when most MH concerns present to the ED. Based upon these results, a proposed model for delivering comprehensive regional emergency telepsychiatry and behavioral health services is proposed. Emergency telepsychiatry services may be a tenable solution for addressing the shortage of psychiatric consultation to EDs in light of increasing demand for MH treatment in the ED.

Airborne Platforms for Emergency Communications and Reconnaissance in Domestic Disaster Response

DTIC Science & Technology

2010-04-01

primarily focused in the areas of tourism , port operations, and educational services. 3 Telecommunications are foundational in our nation’s...concerted effort to successfully integrate these airborne platforms into domestic disaster response operations must be undertaken, or we are doomed to

The potential benefit of a home fire safety intervention during emergency medical services calls.

PubMed

Pirrallo, R G; Rubin, J M; Murawsky, G A

1998-03-01

To determine how often house fires occur at 1- and 2-family dwellings visited previously by emergency medical services (EMS) personnel and whether these visits were missed opportunities for a point-of-contact home fire safety intervention. A retrospective, consecutive, case series analysis of all Milwaukee Fire Department alarm responses during 1994 was performed. Measurements included date of service, type of response, property type, dollar loss estimate, number of injuries and fatalities, cause of alarm, and presence of an operational smoke detector. Descriptive, chi2, and relative risk statistics were used to describe the relationship between EMS responses and fire responses at 1- and 2-family dwellings. The Milwaukee Fire Department dispatched 94,378 requests for service to 43,556 addresses. 16,150 addresses generated multiple requests; 7.2% (1,162/16,150) were for an "alarm of fire" response [relative risk 1.83 (95% CI: 1.69-1.99) for addresses with multiple requests vs those with a single request for service]. Most [62% (721/1,162)] of the addresses were visited by EMS personnel prior to the alarm; 28% (205/721) were 1- and 2-family dwellings. A mean of 1.8 (376/205) EMS responses occurred prior to the "alarm of fire" response; 121 addresses received 1 response, 46 received 2, 18 received 3, and 20 received > or = 4 responses. Of 169 addresses with complete data, there was a total fire dollar loss of $1,963,020 (1994) along with 32 injuries and 0 fatalities. While 47% (80/169) of the 1- and 2-family dwellings had a smoke detector present, only 17% (29/169) of the dwellings had an operational smoke detector. A point-of-contact home fire safety intervention appears of potential benefit for frequent users of EMS care. Determination of the presence of an operational smoke detector in 1- and 2-family dwellings may be a useful injury prevention act during such EMS calls.

Disaster planning and emergency preparedness: lessons learned.

PubMed

Babb, John; Tosatto, Robert; Hayslett, James

2002-01-01

Following the terrorist attacks of September 11, 2001, the federal response plan was activated immediately, with most efforts focused on helping recovery workers at Ground Zero in New York City. Comprehensive pharmacy services were critical in protecting the health of those potentially exposed to anthrax at U.S. Postal Service facilities and the U.S. Capitol. Responding to anthrax attacks taught many valuable lessons to emergency workers on how to manage a bioterrorist attack. Because of its central place in the life of many American communities, pharmacy is a natural and important ally of public health.

Benchmark requirements for the the Energy Emergency Management Information System (EEMIS). Phase 1: Work plan

NASA Astrophysics Data System (ADS)

1980-09-01

The energy emergency management information system (EEMIS) has responsibility for providing special information and communication services to government officials at Federal and state levels, who must deal with energy emergencies. Because of proprietary information residing in the data base used for federal purposes, a special system (EEMIS-S) must be established for use by the states. It is planned to acquire teleprocessing services for EEMIS-S from a time-sharing commercial vendor, and the process for procurement must meet guidelines for approval. The work plan and schedule for meeting these guidelines are discussed. Tasks to be included contain estimates of time, cost, and resources required, all of which are briefly described.

Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre

PubMed Central

Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

2016-01-01

Objectives This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. Methods We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Results Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Conclusion Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users. PMID:28002491

KSC-2011-6644

NASA Image and Video Library

2011-08-31

CAPE CANAVERAL, Fla. -- An ambulance and several NASA Fire Rescue Services vehicles arrive to assist a Huey II helicopter participating in the aviation safety exercise during Emergency Response Safety Training at the Shuttle Landing Facility, Runway 33, at NASA’s Kennedy Space Center in Florida. The simulated helicopter mishap exercise was conducted to evaluate emergency response and mishap investigations of aircraft at Kennedy. Participants included Air Rescue Fire Fighters, Flight Operations, Disaster Preparedness, Security, and Safety. NASA mandates simulated aviation safety training take place every two years. Photo credit: NASA/Kim Shiflett

KSC-2011-6634

NASA Image and Video Library

2011-08-31

CAPE CANAVERAL, Fla. -- A NASA Fire Rescue Services vehicle and a Huey II helicopter support the aviation safety exercise during Emergency Response Safety Training at the Shuttle Landing Facility, Runway 33, at NASA’s Kennedy Space Center in Florida. The simulated helicopter mishap exercise was conducted to evaluate emergency response and mishap investigations of aircraft at Kennedy. Participants included Air Rescue Fire Fighters, Flight Operations, Disaster Preparedness, Security, and Safety. NASA mandates simulated aviation safety training take place every two years. Photo credit: NASA/Kim Shiflett

KSC-2011-6636

NASA Image and Video Library

2011-08-31

CAPE CANAVERAL, Fla. -- A NASA Fire Rescue Services vehicle, ambulance and Huey II helicopter take part in the aviation safety exercise during Emergency Response Safety Training at the Shuttle Landing Facility, Runway 33, at NASA’s Kennedy Space Center in Florida. The simulated helicopter mishap exercise was conducted to evaluate emergency response and mishap investigations of aircraft at Kennedy. Participants included Air Rescue Fire Fighters, Flight Operations, Disaster Preparedness, Security, and Safety. NASA mandates simulated aviation safety training take place every two years. Photo credit: NASA/Kim Shiflett

Secure, Autonomous, Intelligent Controller for Integrating Distributed Emergency Response Satellite Operations

NASA Technical Reports Server (NTRS)

Ivancic, William D.; Paulsen, Phillip E.; Miller, Eric M.; Sage, Steen P.

2013-01-01

This report describes a Secure, Autonomous, and Intelligent Controller for Integrating Distributed Emergency Response Satellite Operations. It includes a description of current improvements to existing Virtual Mission Operations Center technology being used by US Department of Defense and originally developed under NASA funding. The report also highlights a technology demonstration performed in partnership with the United States Geological Service for Earth Resources Observation and Science using DigitalGlobe(Registered TradeMark) satellites to obtain space-based sensor data.

38 CFR 17.86 - Provision of hospital care and medical services during certain disasters and emergencies under 38...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 1701(6). (e) Unless the cost of care is charged at rates agreed upon in a sharing agreement as described in § 17.102(e), the cost of hospital care and medical services provided under this section to an... individuals who receive hospital care or medical services under this section are responsible for the cost of...

38 CFR 17.86 - Provision of hospital care and medical services during certain disasters and emergencies under 38...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 1701(6). (e) Unless the cost of care is charged at rates agreed upon in a sharing agreement as described in § 17.102(e), the cost of hospital care and medical services provided under this section to an... individuals who receive hospital care or medical services under this section are responsible for the cost of...

38 CFR 17.86 - Provision of hospital care and medical services during certain disasters and emergencies under 38...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 1701(6). (e) Unless the cost of care is charged at rates agreed upon in a sharing agreement as described in § 17.102(e), the cost of hospital care and medical services provided under this section to an... individuals who receive hospital care or medical services under this section are responsible for the cost of...

Right service, right place: optimising utilisation of a community nursing service to reduce planned re-presentations to the emergency department.

PubMed

Lawton, Jessica Kirsten; Kinsman, Leigh; Dalton, Lisa; Walsh, Fay; Bryan, Helen; Williams, Sharon

2017-01-01

Congruent with international rising emergency department (ED) demand, a focus on strategies and services to reduce burden on EDs and improve patient outcomes is necessary. Planned re-presentations of non-urgent patients at a regional Australian hospital exceeded 1200 visits during the 2013-2014 financial year. Planned re-presentations perpetuate demand and signify a lack of alternative services for non-urgent patients. The Community Nursing Enhanced Connections Service (CoNECS) collaboratively evolved between acute care and community services in 2014 to reduce planned ED re-presentations. This study aimed to investigate the evolution and impact of a community nursing service to reduce planned re-presentations to a regional Australian ED and identify enablers and barriers to interventionist effectiveness. A mixed-methods approach evaluated the impact of CoNECS. Data from hospital databases including measured numbers of planned ED re-presentations by month, time of day, age, gender and reason were used to calculate referral rates to CoNECS. These results informed two semistructured focus groups with ED and community nurses. The researchers used a theoretical lens, 'diffusion of innovation', to understand how this service could inform future interventions. Analyses showed that annual ED planned re-presentations decreased by 43% (527 presentations) after implementation. Three themes emerged from the focus groups. These were right service at the right time, nursing uncertainty and system disconnect and medical disengagement. CoNECS reduced overall ED planned re-presentations and was sustained longer than many complex service-level interventions. Factors supporting the service were endorsement from senior administration and strong leadership to drive responsive quality improvement strategies. This study identified a promising alternative service outside the ED, highlighting possibilities for other hospital emergency services aiming to reduce planned re-presentations.

Dreams, teachers, and legislation.

PubMed

Edlich, Richard F

2010-11-01

When I accepted the James D. Mills Award from The American College of Emergency Physicians, I had three goals in mind, which I wanted to share with those attending the commemorative dinner meeting. My first goal was to remind those in attendance that each of us must make our academic dreams come true. My next goal was to acknowledge two of my empowering teachers at the dinner, Dr. Peter Rosen and Dr. William Sacco, who have made revolutionary advances in health care; and finally, I wished to remind the membership of the need to work with Congressional leaders to pass the Access to Emergency Medical Services Act of 2009. I warned the leaders in emergency medicine of the necessity to pass the Access to Emergency Medical Services Act of 2009 to ensure that our emergency medical patients receive prompt and responsible care. This has been our quest. Copyright © 2010 Elsevier Inc. All rights reserved.

Considerations and benefits of implementing an online database tool for business continuity.

PubMed

Mackinnon, Susanne; Pinette, Jennifer

2016-01-01

In today's challenging climate of ongoing fiscal restraints, limited resources and complex organisational structures there is an acute need to investigate opportunities to facilitate enhanced delivery of business continuity programmes while maintaining or increasing acceptable levels of service delivery. In 2013, Health Emergency Management British Columbia (HEMBC), responsible for emergency management and business continuity activities across British Columbia's health sector, transitioned its business continuity programme from a manual to automated process with the development of a customised online database, known as the Health Emergency Management Assessment Tool (HEMAT). Key benefits to date include a more efficient business continuity input process, immediate situational awareness for use in emergency response and/or advanced planning and streamlined analyses for generation of reports.

Fire Service Emergency Management Handbook

DTIC Science & Technology

1985-01-01

students to survey buildings to determine the degree to which they provide protec- t on against nuclear disaster effects. TYPES OF ASSISTANCE: Training... SURVEY A-i APPENDIX B SELECTED EMERGENCY MANAGEMENT RESOURCES B-I ILLUSTRATIONS -e (Key Figures, Tables, and Charts) 1. FOUR PHASES OF CEM ACTIVITIES 2-3 2...1979 IAFC survey ,* about 28% of Fire Chiefs are also their community’s emergency preparedness directors, i.e., "the person who is primarily responsible

Getting past widgets and digits: the fundamental transformation of the foundations of nursing practice.

PubMed

Porter-O'Grady, Tim

2014-01-01

Health reform and transformation now call for the creation of a new landscape for nursing practice based on intentional translation application of value-driven measures of service, quality, and price. Nursing is a central driver in the effective recalibration of health care within the rubric of health transformation under the aegis of the Patient Protection and Affordable Care Act. Increasingly relying on a growing digital infrastructure, the nursing profession must now reframe both its practice foundations and patterns of practice to reflect emerging value-driven, health-grounded service requisites. Specific nursing responses are suggested, which position nursing to best coordinate, integrate, and facilitate health delivery in the emerging value-driven service environment.

Emerging trends in the finance and delivery of long-term care: public and private opportunities and challenges.

PubMed

Cohen, M A

1998-02-01

A number of key trends are emerging in long-term care related to financing, new models of service delivery, and shifts in consumer expectations and preferences. Taken together, changes occurring in these areas point to a rapidly transforming long-term care landscape. Financing responsibility is shifting away from the federal government to states, individuals, and their families; providers are integrating and managing acute and long-term care services and adding new services to the continuum of care; and consumers are thinking more seriously about how to plan and pay for their future care needs, as well as how to independently navigate the long-term care system.

Geospatial Information Response Team

USGS Publications Warehouse

Witt, Emitt C.

2010-01-01

Extreme emergency events of national significance that include manmade and natural disasters seem to have become more frequent during the past two decades. The Nation is becoming more resilient to these emergencies through better preparedness, reduced duplication, and establishing better communications so every response and recovery effort saves lives and mitigates the long-term social and economic impacts on the Nation. The National Response Framework (NRF) (http://www.fema.gov/NRF) was developed to provide the guiding principles that enable all response partners to prepare for and provide a unified national response to disasters and emergencies. The NRF provides five key principles for better preparation, coordination, and response: 1) engaged partnerships, 2) a tiered response, 3) scalable, flexible, and adaptable operations, 4) unity of effort, and 5) readiness to act. The NRF also describes how communities, tribes, States, Federal Government, privatesector, and non-governmental partners apply these principles for a coordinated, effective national response. The U.S. Geological Survey (USGS) has adopted the NRF doctrine by establishing several earth-sciences, discipline-level teams to ensure that USGS science, data, and individual expertise are readily available during emergencies. The Geospatial Information Response Team (GIRT) is one of these teams. The USGS established the GIRT to facilitate the effective collection, storage, and dissemination of geospatial data information and products during an emergency. The GIRT ensures that timely geospatial data are available for use by emergency responders, land and resource managers, and for scientific analysis. In an emergency and response capacity, the GIRT is responsible for establishing procedures for geospatial data acquisition, processing, and archiving; discovery, access, and delivery of data; anticipating geospatial needs; and providing coordinated products and services utilizing the USGS' exceptional pool of geospatial experts and equipment.

Using social network analysis to understand Missouri's system of public health emergency planners.

PubMed

Harris, Jenine K; Clements, Bruce

2007-01-01

Effective response to large-scale public health threats requires well-coordinated efforts among individuals and agencies. While guidance is available to help states put emergency planning programs into place, little has been done to evaluate the human infrastructure that facilitates successful implementation of these programs. This study examined the human infrastructure of the Missouri public health emergency planning system in 2006. The Center for Emergency Response and Terrorism (CERT) at the Missouri Department of Health and Senior Services has responsibility for planning, guiding, and funding statewide emergency response activities. Thirty-two public health emergency planners working primarily in county health departments contract with CERT to support statewide preparedness. We surveyed the planners to determine whom they communicate with, work with, seek expertise from, and exchange guidance with regarding emergency preparedness in Missouri. Most planners communicated regularly with planners in their region but seldom with planners outside their region. Planners also reported working with an average of 12 local entities (e.g., emergency management, hospitals/ clinics). Planners identified the following leaders in Missouri's public health emergency preparedness system: local public health emergency planners, state epidemiologists, the state vaccine and grant coordinator, regional public health emergency planners, State Emergency Management Agency area coordinators, the state Strategic National Stockpile coordinator, and Federal Bureau of Investigation Weapons of Mass Destruction coordinators. Generally, planners listed few federal-level or private-sector individuals in their emergency preparedness networks. While Missouri public health emergency planners maintain large and varied emergency preparedness networks, there are opportunities for strengthening existing ties and seeking additional connections.

Qualities and Practices of Professional Social Work Leadership in an Interdisciplinary Mental Health Service: An Action Learning Approach

ERIC Educational Resources Information Center

McNabb, David; Webster, Michael

2010-01-01

Since the mid-1980s, health service restructuring in New Zealand has strengthened managerialism, arguably detracting from professional considerations. Professional leaders without line-management responsibilities have replaced social work departments headed by a professional social worker. An emerging social work contribution to interdisciplinary…

Enterprise 2.0 in Engineering and Business Education: Engineering and Business Students' View

ERIC Educational Resources Information Center

Ahrens, Andreas; Zascerinska, Jelena; Bassus, Olaf

2010-01-01

Contemporary engineers and entrepreneurs need to become more cognizant and responsive to the emerging needs of the market for engineering, enterprise and technology services. Enterprise 2.0 which penetrates our society more thoroughly with the availability of broadband services has the potential to contribute decisively to the sustainable…

Social Dimension of Web 2.0 in Engineering Education

ERIC Educational Resources Information Center

Ahrens, Andreas; Zascerinska, Jelena

2010-01-01

Contemporary engineers need to become more cognizant and more responsive to the emerging needs of the market for engineering and technology services. Social dimension of Web 2.0 which penetrates our society more thoroughly with the availability of broadband services has the potential to contribute decisively to the sustainable development of…

Social Dimension of Web 2.0 in Engineering Education: Students' View

ERIC Educational Resources Information Center

Zascerinska, Jelena; Bassus, Olaf; Ahrens, Andreas

2010-01-01

Contemporary engineers need to become more cognizant and more responsive to the emerging needs of the market for engineering and technology services. Social dimension of Web 2.0 which penetrates our society more thoroughly with the availability of broadband services has the potential to contribute decisively to the sustainable development of…

Soil functional zone management: a vehicle for enhancing production and soil ecosystem services in row-crop agroecosystems

USDA-ARS?s Scientific Manuscript database

There is increasing demand for food, bioenergy feedstocks and a wide variety of bio-based products. In response, agriculture has made great gains in production, but is increasingly depleting soil regulating and supporting ecosystem services. New production systems have emerged, such as Conservation ...

78 FR 7784 - Office of the Secretary; Office of the Assistant Secretary for Preparedness and Response...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary; Office of the Assistant Secretary... the Department of Health and Human Services (HHS) is being amended at Chapter AN, Office of the... June 21, 2010. This organizational change is to realign the Division of Emergency Care Coordination...

42 CFR 51d.10 - What are the reporting requirements?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false What are the reporting requirements? 51d.10 Section 51d.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.10 What are the reporting requirements? (a...

42 CFR 51d.10 - What are the reporting requirements?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false What are the reporting requirements? 51d.10 Section 51d.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.10 What are the reporting requirements? (a...

42 CFR 51d.10 - What are the reporting requirements?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false What are the reporting requirements? 51d.10 Section 51d.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.10 What are the reporting requirements? (a...

42 CFR 51d.10 - What are the reporting requirements?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false What are the reporting requirements? 51d.10 Section 51d.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.10 What are the reporting requirements? (a...

Workload differences across command levels and emergency response organizations during a major joint training exercise.

PubMed

Prytz, Erik G; Rybing, Jonas; Jonson, Carl-Oscar

2016-01-01

This study reports on an initial test using a validated workload measurement method, the NASA Task Load Index (TLX), as an indicator of joint emergency exercise effectiveness. Prior research on emergency exercises indicates that exercises must be challenging, ie, result in high workload, to be effective. However, this is often problematic with some participants being underloaded and some overloaded. The NASA TLX was used to test for differences in workload between commanders and subordinates and among three different emergency response organizations during a joint emergency exercise. Questionnaire-based evaluation with professional emergency responders. The study was performed in conjunction with a large-scale interorganizational joint emergency exercise in Sweden. A total of 20 participants from the rescue services, 12 from the emergency medical services, and 12 from the police participated in the study (N=44). Ten participants had a command-level role during the exercise and the remaining 34 were subordinates. The main outcome measures were the workload subscales of the NASA TLX: mental demands, physical demands, temporal demands, performance, effort, and frustration. The results showed that the organizations experienced different levels of workload, that the commanders experienced a higher workload than the subordinates, and that two out of three organizations fell below the twenty-fifth percentile of average workload scores compiled from 237 prior studies. The results support the notion that the NASA TLX could be a useful complementary tool to evaluate exercise designs and outcomes. This should be further explored and verified in additional studies.

A 'mixed reality' simulator concept for future Medical Emergency Response Team training.

PubMed

Stone, Robert J; Guest, R; Mahoney, P; Lamb, D; Gibson, C

2017-08-01

The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts. Until now, the provision of airborne pre-deployment MERT training had been dependent on either the availability of an operational aircraft (eg, the CH-47 Chinook helicopter) or access to one of only two ground-based facsimiles of the Chinook 's rear cargo/passenger cabin. Although MERT training has high priority, there will always be competition with other military taskings for access to helicopter assets (and for other platforms in other branches of the Armed Forces). This paper describes the development of an inexpensive, reconfigurable and transportable MERT training concept based on 'mixed reality' technologies-in effect the 'blending' of real-world objects of training relevance with virtual reality reconstructions of operational contexts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A scalable healthcare information system based on a service-oriented architecture.

PubMed

Yang, Tzu-Hsiang; Sun, Yeali S; Lai, Feipei

2011-06-01

Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.

The role of physician staffing of helicopter emergency medical services in prehospital trauma response.

PubMed

Garner, Alan A

2004-08-01

The crewing of Helicopter Emergency Medical Service (HEMS) for scene response to trauma patients is generally considered to be controversial, particularly regarding the role of physicians. This is reflected in HEMS in Australia with some services utilizing physician crewing for all prehospital missions. Others however, use physicians for selected missions only whilst others do not use physicians at all. This review seeks to determine whether the literature supports using physicians in addition to paramedics in HEMS teams for prehospital trauma care. Studies were excluded if they compared physician teams with basic life support teams (BLS) teams rather than paramedics. Ambulance officers were considered to be paramedics where they were able to administer intravenous fluids and use a method of airway management beyond bag-valve-mask ventilation. Studies were excluded if the skill set of the ambulance team was not defined, the level of staffing of the helicopter service was not stated, team composition varied without reporting outcomes for each team type, patient outcome data were not reported, or the majority of the transports were interhospital rather than prehospital transports.

User acceptance of mobile health services from users' perspectives: The role of self-efficacy and response-efficacy in technology acceptance.

PubMed

Zhang, Xiaofei; Han, Xiaocui; Dang, Yuanyuan; Meng, Fanbo; Guo, Xitong; Lin, Jiayue

2017-03-01

With the swift emergence of electronic medical information, the global popularity of mobile health (mHealth) services continues to increase steadily. This study aims to investigate the efficacy factors that directly or indirectly influence individuals' acceptance of mHealth services. Based on the technology acceptance model, this research incorporates efficacy factors into the acceptance decision process. A research model was proposed involving the direct and indirect effects of self-efficacy and response-efficacy on acceptance intention, along with their moderating effects. The model and hypotheses were validated using data collected from a field survey of 650 potential service users. The results reveal that: (1) self-efficacy and response-efficacy are both positively associated with perceived ease of use; and (2) self-efficacy and response-efficacy moderate the impact of perceived usefulness toward adoption intention. Self-efficacy and response-efficacy both play an important role in individuals' acceptance of mHealth services, which not only affect their perceived ease of use of mHealth services, but also positively moderate the effects of perceived usefulness on adoption intention. Our findings serve to provide recommendations that are specifically customized for mHealth service providers and their marketers.

20 CFR 671.160 - What rapid response activities are required before a national emergency grant application is...

Code of Federal Regulations, 2010 CFR

2010-04-01

... EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS... needs of the affected workers and the resources available to them. (b) In accordance with national... section 132(b)(2)(B) of the Act, have been used to initiate appropriate services to the eligible workers...

20 CFR 671.160 - What rapid response activities are required before a national emergency grant application is...

Code of Federal Regulations, 2011 CFR

2011-04-01

... EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL EMERGENCY GRANTS FOR DISLOCATED WORKERS... needs of the affected workers and the resources available to them. (b) In accordance with national... section 132(b)(2)(B) of the Act, have been used to initiate appropriate services to the eligible workers...

The Potential for Development of a Clearinghouse for Emergency Information in the Public Library.

ERIC Educational Resources Information Center

Magrath, Lynn L.; Dowlin, Kenneth E.

1987-01-01

Presents the role of the Pikes Peak Library District's services in the creation and dissemination of an online clearinghouse in all four phases of emergency management: mitigation, preparedness, response, and recovery. Seven agencies and organizations involved in the network of community information that has been created are briefly described.…

The Rescue911 Emergency Response Information System (ERIS): A Systems Development Project Case

ERIC Educational Resources Information Center

Cohen, Jason F.; Thiel, Franz H.

2010-01-01

This teaching case presents a systems development project useful for courses in object-oriented analysis and design. The case has a strong focus on the business, methodology, modeling and implementation aspects of systems development. The case is centered on a fictitious ambulance and emergency services company (Rescue911). The case describes that…

Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community.

PubMed

VanderBurgh, D; Jamieson, R; Beardy, J; Ritchie, S D; Orkin, A

2014-01-01

Community-based first aid training is the collaborative development of locally relevant emergency response training. The Sachigo Lake Wilderness Emergency Response Education Initiative was developed, delivered, and evaluated through two intensive 5-day first aid courses. Sachigo Lake First Nation is a remote Aboriginal community of 450 people in northern Ontario, Canada, with no local paramedical services. These courses were developed in collaboration with the community, with a goal of building community capacity to respond to medical emergencies. Most first aid training programs rely on standardized curriculum developed for urban and rural contexts with established emergency response systems. Delivering effective community-based first aid training in a remote Aboriginal community required specific adaptations to conventional first aid educational content and pedagogy. Three key lessons emerged during this program that used collaborative principles to adapt conventional first aid concepts and curriculum: (1) standardized approaches may not be relevant nor appropriate; (2) relationships between course participants and the people they help are relevant and important; (3) curriculum must be attentive to existing informal and formal emergency response systems. These lessons may be instructive for the development of other programs in similar settings.

The utilization of bicycles in the delivery of emergency medical services: a preliminary report.

PubMed

Gorham, J F; Kramer, T S

1997-01-01

Bicycles may be useful in the delivery of out-of-hospital emergency medical services. The use of bicycles in providing emergency medical services was investigated by surveying currently existing bicycle-medic systems. Two questionnaires were developed to gain information on service areas, injuries, gear used, missions, and specific data from bicycle-medic response. Of 210 surveys mailed to bicycle-medics, 21 (10%) were completed and returned by the pre-established deadline. Of 11 surveys mailed to bicycle-medic supervisors, four (36%) were returned. Preliminary results showed that 76% of respondents are career providers and the remainder serve as volunteers. Mean age for respondents was 33 +/- 7.4 years, with 96% being males. Most teams have been in existence for three to four years. Job satisfaction was greater when participating on the bicycle crews than when not performing on the bicycle crew, t = 4.15, p = 0.0002. The teams varied in size (6-100 persons) with a mean value of 31. On the average, team size represented 10% of total number of personnel for the respective organizations. The majority of bicycle teams operate all year in all conditions. Most bicycle-medic teams were initiated for special events. Nineteen percent reported injuries while on duty or in training. Ninety percent of units that responded use existing agency protocols and have no special protocols related to the bicycle team. Eighty percent of the units are dispatched through the normal agency procedures. Eighty-five percent of respondents coordinate for transport units via dispatch. Reported response times were under two minutes for special event responses. These were within established agency response times. In approximately 25% of the responses, the patients refused transport, and another 65% of the responses were for relatively minor injuries or complaints that did not require transport to a hospital. This survey begins to characterize the utilization of bicycles as a tool to gain patient access in specialized situations. The use of bicycle-medics may be cost-effective, may help to improve employee morale, and possibly reduce employee health-care costs. Further study is needed to determine the impact of bicycle-medics on patient outcomes and response times.

Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

PubMed

Heggestad, Torhild; Børsheim, Knut Yngve

2002-01-01

To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998. The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases. The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS. Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.

The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa.

PubMed

Newton, P R; Naidoo, R; Brysiewicz, P

2015-09-19

 Emergency medical services (EMS) are sometimes required to respond to cases that are later found not to be emergencies, resulting in high levels of inappropriate responses. This study evaluated the extent to which this occurs.  All cases dispatched over 72 hours by the eThekwini EMS in Durban, South Africa, were prospectively enrolled in a quantitative descriptive study. Vehicle control forms containing dispatch data were matched and compared with patient report forms containing epidemiological and clinical data to describe the nature and extent of inappropriate responses based on patient need. Data were subjected to simple descriptive analysis, correlations and χ2 testing.  A total of 1 385 cases met the study inclusion criteria. Marked variations existed between dispatch and on-scene priority settings, most notably in the highest priority 'red-code' category, which constituted >56% of cases dispatched yet accounted for <2% at the scene (p<0.001). Conversely, >80% of 'red-code' dispatches required a lower priority response. When comparing resource allocation according to patient interventional needs, >58% of cases required either no intervention or transport only and almost 36% required basic life support intervention only (p<0.001). Moreover, <12% of advanced life support dispatches were for patients found to be 'red code' at the scene.  There is a significant mismatch between the dispatch of EMS resources and actual patient need in the eThekwini district, with significantly high levels of inappropriate emergency responses.

Opioid Substitution Treatment Planning in a Disaster Context: Perspectives from Emergency Management and Health Professionals in Aotearoa/New Zealand

PubMed Central

Blake, Denise; Lyons, Antonia

2016-01-01

Opioid Substitution Treatment (OST) is a harm reduction strategy enabling opiate consumers to avoid withdrawal symptoms and maintain health and wellbeing. Some research shows that within a disaster context service disruptions and infrastructure damage affect OST services, including problems with accessibility, dosing, and scripts. Currently little is known about planning for OST in the reduction and response phases of a disaster. This study aimed to identify the views of three professional groups working in Aotearoa/New Zealand about OST provision following a disaster. In-depth, semi-structured interviews were conducted with 17 service workers, health professionals, and emergency managers in OST and disaster planning fields. Thematic analysis of transcripts identified three key themes, namely “health and wellbeing”, “developing an emergency management plan”, and “stock, dose verification, and scripts” which led to an overarching concept of “service continuity in OST preparedness planning”. Participants viewed service continuity as essential for reducing physical and psychological distress for OST clients, their families, and wider communities. Alcohol and drug and OST health professionals understood the specific needs of clients, while emergency managers discussed the need for sufficient preparedness planning to minimise harm. It is concluded that OST preparedness planning must be multidisciplinary, flexible, and inclusive. PMID:27834915

Epidemiology of Pediatric Prehospital Basic Life Support Care in the United States.

PubMed

Diggs, Leigh Ann; Sheth-Chandra, Manasi; De Leo, Gianluca

2016-01-01

Children have unique medical needs compared to adults. Emergency medical services personnel need proper equipment and training to care for children. The purpose of this study is to characterize emergency medical services pediatric basic life support to help better understand the needs of children transported by ambulance. Pediatric basic life support patients were identified in this retrospective descriptive study. Descriptive statistics were used to examine incident location, possible injury, cardiac arrest, resuscitation attempted, chief complaint, primary symptom, provider's primary impression, cause of injury, and procedures performed during pediatric basic life support calls using the largest aggregate of emergency medical services data available, the 2013 National Emergency Medical Services Information System (NEMSIS) Public Release Research Data Set. Pediatric calls represented 7.4% of emergency medical services activations. Most pediatric patients were male (49.8%), White (40.0%), and of non-Hispanic origin (56.5%). Most incidents occurred in the home. Injury, cardiac arrest, and resuscitation attempts were highest in the 15 to 19 year old age group. Global complaints (37.1%) predominated by anatomic location and musculoskeletal complaints (26.9%) by organ system. The most common primary symptom was pain (30.3%) followed by mental/psychiatric (13.4%). Provider's top primary impression was traumatic injury (35.7%). The most common cause of injury was motor vehicle accident (32.3%). The most common procedure performed was patient assessment (27.4%). Median EMS system response time was 7 minutes (IQR: 5-12). Median EMS scene time was 12 minutes (IQR: 8-19). Median transport time was 14 minutes (IQR: 8-24). Median EMS total call time was 51 minutes (IQR: 33-77). The epidemiology of pediatric basic life support can help to guide efforts in both emergency medical services operations and training.

78 FR 69090 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [60 Day-14-0636... Prevention (CDC) Secure Public Health Emergency Response Communications Network (Epi-X) (OMB Control No. 0920... uncertainty with potential negative impacts on public health response operations. Secure communications with...

Is it resources, habit or both: interpreting twenty years of hospital strategic response to prospective payment.

PubMed

Balotsky, Edward R

2005-01-01

The 1983 Tax Equity and Fiscal Responsibility Act (TEFRA) transformed acute care from a benevolent to malevolent environment. A dual-paradigm of resource dependency and institutional theories that balances isomorphic with economic variables has emerged to better explain hospital strategic response to the resultant constraint on resources than a traditional single paradigm approach. Using the population of non-rural, non-federal acute-care hospitals, strategic response from 1982 to 2001 is studied; distinct cost and service changes occur. Cost strategy is linked primarily to Medicare utilization, a resource dependence response. Service strategy favors high technology regardless of prospective payment diffusion, an institutional theory perspective. Strategic implications are discussed.

Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low- and Middle-Income Countries: A Comparative Health Systems and Service Analysis.

PubMed

Colombini, Manuela; Dockerty, Colleen; Mayhew, Susannah H

2017-06-01

This systematic review synthesizes 11 studies of health-sector responses to intimate partner violence (IPV) in low- and middle-income countries. The services that were most comprehensive and integrated in their responsiveness to IPV were primarily in primary health and antenatal care settings. Findings suggest that the following facilitators are important: availability of clear guidelines, policies, or protocols; management support; intersectoral coordination with clear, accessible on-site and off-site referral options; adequate and trained staff with accepting and empathetic attitudes toward survivors of IPV; initial and ongoing training for health workers; and a supportive and supervised environment in which to enact new IPV protocols. A key characteristic of the most integrated responses was the connection or "linkages" between different individual factors. Irrespective of their service entry point, what emerged as crucial was a connected systems-level response, with all elements implemented in a coordinated manner. © 2017 The Population Council, Inc.

Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low‐ and Middle‐Income Countries: A Comparative Health Systems and Service Analysis

PubMed Central

Colombini, Manuela; Dockerty, Colleen; Mayhew, Susannah H.

2017-01-01

This systematic review synthesizes 11 studies of health‐sector responses to intimate partner violence (IPV) in low‐ and middle‐income countries. The services that were most comprehensive and integrated in their responsiveness to IPV were primarily in primary health and antenatal care settings. Findings suggest that the following facilitators are important: availability of clear guidelines, policies, or protocols; management support; intersectoral coordination with clear, accessible on‐site and off‐site referral options; adequate and trained staff with accepting and empathetic attitudes toward survivors of IPV; initial and ongoing training for health workers; and a supportive and supervised environment in which to enact new IPV protocols. A key characteristic of the most integrated responses was the connection or “linkages” between different individual factors. Irrespective of their service entry point, what emerged as crucial was a connected systems‐level response, with all elements implemented in a coordinated manner. PMID:28422291

ERLN Regional Support

EPA Pesticide Factsheets

Regional labs play important roles in the Environmental Response Laboratory Network. They can serve as point of contact; coordinate sample flow, special analytical service requests, or training exercises; and partner with regional emergency/disaster staff.

Response interval comparison between urban fire departments and ambulance services.

PubMed

Jermyn, B D

1999-01-01

To measure the response intervals of fire departments compared with ambulance services in three urban centers to determine whether defibrillators should be added to fire vehicles. A prospective sample of 1,882 code 4 (life-threatening) tiered calls were collected over a six-month period from March 1, 1994, to August 31, 1994. A matched pairs experimental design compared the response interval of the fire department with that of the ambulance service for each call. This emergency medical services (EMS) system encompasses three urban centers with populations of 80,000, 95,000, and 170,000. In two of three of the urban centers, the fire department arrived on scene more than a minute sooner than the ambulance service: Cambridge (n = 571, mean = 2.22 min, p < 0.0001); Kitchener (n = 1,011, mean = 1.24 min, p < 0.003); and Waterloo (n = 300, mean = 0.69 min, p < 0.98). The shorter response interval of fire departments suggests placing defibrillators on fire response vehicles in an effort to decrease the time to defibrillation for cardiac arrest victims in this EMS system.

Keep calm and carry on: the 2009 NEHA sabbatical exchange ambassador report.

PubMed

Barnett, Marcy

2011-06-01

Sabbatical goal as an environmental health specialist working with the California Department of Public Health as an emergency planner, I was interested in the NEHA sabbatical exchange program for the opportunity it affords its awardees to see how Canada and the United Kingdom utilize their environmental health workforce. Specifically, I wanted to examine the role environmental health has in the preparations being made for the 2012 Olympic Games to be held in London. I had a special interest in the emergency preparedness efforts related to the games as my work involves promoting the integration of environmental health into the emergency response structure. In California, environmental health services are delivered by several state agencies as well as 62 local jurisdictions. This multifaceted system tends to diminish the important role environmental health plays in disaster response and recovery operations due to the lack of a central focus, and as a result, environmental health is often an overlooked resource. This situation is not unique to California, as the emergency management system in the U.S. has traditionally focused primarily on "blue light" first responders: police, fire, and emergency medical services. After an article caught my eye on involving environmental health in emergency planning, posted on the Chartered Institute of Environmental Health (CIEH) (NEHA's counterpart in the UK) Web site, I became intrigued and used it to form the basis of my sabbatical mission.

Decision support system for the response to infectious disease emergencies based on WebGIS and mobile services in China.

PubMed

Li, Ya-pin; Fang, Li-qun; Gao, Su-qing; Wang, Zhen; Gao, Hong-wei; Liu, Peng; Wang, Ze-Rui; Li, Yan-Li; Zhu, Xu-Guang; Li, Xin-Lou; Xu, Bo; Li, Yin-Jun; Yang, Hong; de Vlas, Sake J; Shi, Tao-Xing; Cao, Wu-Chun

2013-01-01

For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts.

A spatial analysis of urban transit accidents assisted by Emergency Mobile Care Services: an analysis of space and time.

PubMed

Mendonça, Marcela Franklin Salvador de; Silva, Amanda Priscila de Santana Cabral; Castro, Claudia Cristina Lima de

2017-01-01

Urban transit accident are a global public health problem. The objective of this study was to describe the profile of the victims and the occurrences of urban transit accidents attended to by emergency mobile care services (Serviço de Atendimento Móvel de Urgência- SAMU) in Recife, and their distribution based on spatial analysis. An ecological study, developed through secondary data from emergency mobile care services in Recife, referring to the total number of occurrences of urban transit accidents attended to from January 1 to June 30, 2015. The spatial analysis was performed using the Moran index. Basic support units performed most of the emergency services (89.2%). Among the victims, there was a predominance of males (76.8%) and an age group of 20 - 29 years old (31.5%). Collisions were responsible for 59.9% of the transit accidents, and motorcycles for 61.6% of the accidents among all means of transportation. Friday was the day that showed the highest risk for treatment, and there was a concentration of events between 6:00 am - 8:59am and 6:00pm - 8:59pm. The MoranMap identified critical areas where calls came from traffic accidents during the period analyzed. The records of the mobile service from the spatial analysis are an important source of information for health surveillance. The spatial analysis of urban transit accidents identified regions with a positive spatial correlation, providing subsidies to the logistical planning of emergency mobile care services. This study is groundbreaking in that it offers such information about the region.

Homeland security and public health: role of the Department of Veterans Affairs, the US Department of Homeland Security, and implications for the public health community.

PubMed

Koenig, Kristi L

2003-01-01

The terrorist attacks of 11 September 2001 led to the largest US Government transformation since the formation of the Department of Defense following World War II. More than 22 different agencies, in whole or in part, and >170,000 employees were reorganized to form a new Cabinet-level Department of Homeland Security (DHS), with the primary mission to protect the American homeland. Legislation enacted in November 2002 transferred the entire Federal Emergency Management Agency and several Department of Health and Human Services (HHS) assets to DHS, including the Office of Emergency Response, and oversight for the National Disaster Medical System, Strategic National Stockpile, and Metropolitan Medical Response System. This created a potential separation of "health" and "medical" assets between the DHS and HHS. A subsequent presidential directive mandated the development of a National Incident Management System and an all-hazard National Response Plan. While no Department of Veterans Affairs (VA) assets were targeted for transfer, the VA remains the largest integrated healthcare system in the nation with important support roles in homeland security that complement its primary mission to provide care to veterans. The Emergency Management Strategic Healthcare Group (EMSHG) within the VA's medical component, the Veteran Health Administration (VHA), is the executive agent for the VA's Fourth Mission, emergency management. In addition to providing comprehensive emergency management services to the VA, the EMSHG coordinates medical back-up to the Department of Defense, and assists the public via the National Disaster Medical System and the National Response Plan. This article describes the VA's role in homeland security and disasters, and provides an overview of the ongoing organizational and operational changes introduced by the formation of the new DHS. Challenges and opportunities for public health are highlighted.

A systematic approach to very important person preparedness for a trauma center.

PubMed

Bulson, Julie; Mattice, Connie; Bulson, Timothy

2012-01-01

Hospitals across the United States are more involved in disaster/rapid response planning than ever. This collaboration is often driven by continuing federal and state preparedness and all-hazards planning efforts that provide cooperative agreement and/or grant support. These efforts currently include programs administered by the US assistant secretary for preparedness and response, the US Centers for Disease Control and Prevention, the US Department of Defense, and the US Department of Homeland Security. Beyond legislated support or mandates, key emergency management regulations governing hospital-specific disaster planning and response activities are required of hospitals by The Joint Commission, the largest national hospital accrediting body. Despite this ongoing, heightened awareness and inclusion of health care in local and regional emergency response planning, there is 1 partnership to yet strengthen: the relationship between community trauma centers and US Secret Service staff responsible for White House travel and health care contingency plans. One Michigan hospital system designed a program that has made preevent communications and preparedness for rapid very important person response with the Secret Service as important as other local all-hazards planning; the evolution of this partnership is the focus of this article.

42 CFR 51d.8 - Which other HHS regulations apply to these awards?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Which other HHS regulations apply to these awards? 51d.8 Section 51d.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.8 Which other HHS...

42 CFR 51d.9 - What other conditions apply to these awards?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false What other conditions apply to these awards? 51d.9 Section 51d.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.9 What other conditions apply to these...

42 CFR 51d.9 - What other conditions apply to these awards?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false What other conditions apply to these awards? 51d.9 Section 51d.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.9 What other conditions apply to these...

42 CFR 51d.9 - What other conditions apply to these awards?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false What other conditions apply to these awards? 51d.9 Section 51d.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.9 What other conditions apply to these...

42 CFR 51d.8 - Which other HHS regulations apply to these awards?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Which other HHS regulations apply to these awards? 51d.8 Section 51d.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.8 Which other HHS...

42 CFR 51d.8 - Which other HHS regulations apply to these awards?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Which other HHS regulations apply to these awards? 51d.8 Section 51d.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.8 Which other HHS...

42 CFR 51d.9 - What other conditions apply to these awards?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false What other conditions apply to these awards? 51d.9 Section 51d.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.9 What other conditions apply to these...

KSC-2011-6642

NASA Image and Video Library

2011-08-31

CAPE CANAVERAL, Fla. -- Volunteers, portraying their individual roles, stand beside a NASA Fire Rescue Services vehicle and a Huey II helicopter in support of the aviation safety exercise during Emergency Response Safety Training at the Shuttle Landing Facility, Runway 33, at NASA’s Kennedy Space Center in Florida. The simulated helicopter mishap exercise was conducted to evaluate emergency response and mishap investigations of aircraft at Kennedy. Participants included Air Rescue Fire Fighters, Flight Operations, Disaster Preparedness, Security, and Safety. NASA mandates simulated aviation safety training take place every two years. Photo credit: NASA/Kim Shiflett

Law, liability, and public health emergencies.

PubMed

Hoffman, Sharona; Goodman, Richard A; Stier, Daniel D

2009-06-01

According to many experts, a public health emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the public health and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and clinics, vaccine manufacturers, governmental authorities, and many others. Conducting response activities in emergency circumstances may give rise to numerous issues of liability, and medical professionals and other potential responders have expressed concern about liability exposure. Providers may face inadequate resources, an insufficient number of qualified personnel, overwhelming demand for services, and other barriers to providing optimal treatment, which could lead to injury or even death in some cases. This article describes the different theories of liability that may be used by plaintiffs and the sources of immunity that are available to public health emergency responders in the public sector, private sector, and as volunteers. It synthesizes the existing immunity landscape and analyzes its gaps. Finally, the authors suggest consideration of the option of a comprehensive immunity provision that addresses liability protection for all health care providers during public health emergencies and that, consequently, assists in improving community emergency response efforts.

Predictors of posttraumatic stress symptoms among runaway youth utilizing two service sectors.

PubMed

Thompson, Sanna J; Maccio, Elaine M; Desselle, Sherry K; Zittel-Palamara, Kimberly

2007-08-01

Youth who run away often experience situations that produce symptoms of traumatic distress. This exploratory study assessed predictors of trauma symptomatology among runaway youth who had been admitted to youth emergency shelter services or juvenile detention. Findings demonstrated high levels of trauma-related symptoms for both groups. Worry about family, greater runaway episodes, and living with a father who abused alcohol/drugs significantly predicted higher posttraumatic stress symptoms in detained youth, whereas only worry about family relationships predicted higher trauma symptom scores among youth in emergency shelter care. Findings suggest distressful family life may induce complex emotional responses in youth. Although services to runaway youth must continue to focus on safe, short-term residential care, trauma issues must be acknowledged.

Blowout control: Response, intervention and management; Part 2, Logistics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Flak, L.H.; Wright, J.W.; Tuppen, J.A.

1993-12-01

This paper represents part two of a series regarding the development of emergency response and contingency plans for oil and gas well blowouts. The first paper dealt with developing plans to prevent blowouts and developing blowout task forces to respond when one occurred. This paper deals with the logistics of the transport of personnel and equipment to the blowout site. The paper describes a plan to identify the best sources of personnel, equipment, and services prior to a blowout. Services include methods for establishing emergency billing, cash flow and credit assistance, hazardous duty pay, welding and fabrication equipment, etc. Themore » paper also discusses the need to plan and establish base camps at the blowout sites, the logistics of establishing this base camp, and establishing viable communications to these base camps.« less

Cleanups In My Community (CIMC) - Removals/Responses, National Layer

EPA Pesticide Factsheets

This data layer provides access to Removal/Response sites as part of the CIMC web service. Removals are hazardous substance releases that require immediate or short-term response actions. These are generally addressed under the Emergency Response program and are initially tracked centrally by the federal government's National Reporting Center. Cleanups in My Community maps and lists removals that are included in EPA??s epaosc.org site, and provides direct links to information on these sites. CIMC obtains updated removal data through a web service from epaosc.org just before the 18th of each month.The CIMC web service was initially published in 2013, but the data are updated on the 18th of each month. The full schedule for data updates in CIMC is located here: http://iaspub.epa.gov/enviro/data_update_v2.

Assessing program efficiency: a time and motion study of the Mental Health Emergency Care - Rural Access Program in NSW Australia.

PubMed

Saurman, Emily; Lyle, David; Kirby, Sue; Roberts, Russell

2014-07-31

The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas.

Developing an operational capabilities index of the emergency services sector.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Collins, M.J.; Eaton, L.K.; Shoemaker, Z.M.

2012-02-20

In order to enhance the resilience of the Nation and its ability to protect itself in the face of natural and human-caused hazards, the ability of the critical infrastructure (CI) system to withstand specific threats and return to normal operations after degradation must be determined. To fully analyze the resilience of a region and the CI that resides within it, both the actual resilience of the individual CI and the capability of the Emergency Services Sector (ESS) to protect against and respond to potential hazards need to be considered. Thus, a regional resilience approach requires the comprehensive consideration of allmore » parts of the CI system as well as the characterization of emergency services. This characterization must generate reproducible results that can support decision making with regard to risk management, disaster response, business continuity, and community planning and management. To address these issues, Argonne National Laboratory, in collaboration with the U.S. Department of Homeland Security (DHS) Sector Specific Agency - Executive Management Office, developed a comprehensive methodology to create an Emergency Services Sector Capabilities Index (ESSCI). The ESSCI is a performance metric that ranges from 0 (low level of capabilities) to 100 (high). Because an emergency services program has a high ESSCI, however, does not mean that a specific event would not be able to affect a region or cause severe consequences. And because a program has a low ESSCI does not mean that a disruptive event would automatically lead to serious consequences in a region. Moreover, a score of 100 on the ESSCI is not the level of capability expected of emergency services programs; rather, it represents an optimal program that would rarely be observed. The ESSCI characterizes the state of preparedness of a jurisdiction in terms of emergency and risk management. Perhaps the index's primary benefit is that it can systematically capture, at a given point in time, the capabilities of a jurisdiction to protect itself from, mitigate, respond to, and recover from a potential incident. On the basis of this metric, an interactive tool - the ESSCI Dashboard - can identify scenarios for enhancement that can be implemented, and it can identify the repercussions of these scenarios on the jurisdiction. It can assess the capabilities of law enforcement, fire fighting, search and rescue, emergency medical services, hazardous materials response, dispatch/911, and emergency management services in a given jurisdiction and it can help guide those who need to prioritize what limited resources should be used to improve these capabilities. Furthermore, this tool can be used to compare the level of capabilities of various jurisdictions that have similar socioeconomic characteristics. It can thus help DHS define how it can support risk reduction and community preparedness at a national level. This tool aligns directly with Presidential Policy Directive 8 by giving a jurisdiction a metric of its ESS's capabilities and by promoting an interactive approach for defining options to improve preparedness and to effectively respond to a disruptive event. It can be used in combination with other CI performance metrics developed at Argonne National Laboratory, such as the vulnerability index and the resilience index for assessing regional resilience.« less

Inter-association task force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement.

PubMed

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-03-01

To assist high school and college athletic programs prepare for and respond to sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. SCA is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishing an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of onsite responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.

A Quantitative Research Study on the Implementation of the Response-to-Intervention Model

ERIC Educational Resources Information Center

Mahoney, Jamie

2011-01-01

Response to Intervention (RTI) emerged as a new service delivery model designed to meet the learning needs of all students prior to diagnosis and placement in the special education setting. The problem was few research studies had been conducted between general education teachers with intensive professional development and those without…

Emergency responders' critical infrared (ERCI)

NASA Astrophysics Data System (ADS)

Konsin, Larry S.

2004-08-01

Emergency Responders (Fire, Police, Medical, and Emergency Management) face a high risk of injury or death. Even before September 11, 2001, public and private organizations have been driven to better protect Emergency Responders through education, training and improved technology. Recent research on Emergency Responder safety, health risks, and personal protective requirements, shows infrared (IR) imaging as a critical need. Today"s Emergency Responders are increasingly challenged to do more, facing demands requiring technological assistance and/or solutions. Since the introduction of Fire Service IR imaging in the mid 1990s, applications have increased. Emergency response IR is no longer just seeing through smoke to find victims or the seat of a fire. Many more mission critical needs now exist across the broad spectrum of emergency response. At the same time, Emergency Responder injuries and deaths are increasing. The Office of Domestic Preparedness (ODP) has also recognized IR imaging as critical in protecting our communities -- and in preventing many of the injuries and deaths of Emergency Responders. Currently, only 25% of all fire departments (or less than 7% of individual firefighters) have IR imaging. Availability to Police, EMS and Emergency Management is even lower. Without ERCI, Emergency Responders and our communities are at risk.

Survey of Emergency and Essential Surgical, Obstetric and Anaesthetic Services Available in Bangladeshi Government Health Facilities.

PubMed

Loveday, Jonathan; Sachdev, Sonal P; Cherian, Meena N; Katayama, Francisco; Akhtaruzzaman, A K M; Thomas, Joe; Huda, N; Faragher, E Brian; Johnson, Walter D

2017-07-01

Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services. Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies. For this survey, the Bangladeshi Ministry of Health sent the SAT to sub-district, district/general and teaching hospitals throughout the country in April 2013. Responses were received from 240 healthcare facilities (49.5% response rate): 218 sub-district and 22 district/general hospitals. At the sub-district level, caesarean section was offered by 55% of facilities, laparotomy by 7% and open fracture repair by 8%. At the district/general hospital level, 95% offered caesarean section, 86% offered laparotomy and 77% offered open fracture treatment. Availability of anaesthesia services, general equipment and supplies reflected this trend, where district/general hospitals were better equipped than sub-district hospitals, though equipment and infrastructure shortages persist. There has been overall impressive progress by the Bangladeshi Government in providing essential surgical services. Areas for improvement remain across all key areas, including infrastructure, human resources, surgical interventions offered and available equipment. Investment in surgical services offers a cost-effective opportunity to continue to improve the health of the Bangladeshi population and move the country towards universal healthcare coverage.

[Case-Mix of hospital emergencies in the Andalusian Health Service based on the 2012 Minimum Data Set. Spain].

PubMed

Goicoechea Salazar, Juan Antonio; Nieto García, María Adoración; Laguna Téllez, Antonio; Larrocha Mata, Daniel; Canto Casasola, Vicente David; Murillo Cabezas, Francisco

2013-01-01

The implementation of digital health records in emergency departments (ED) in hospitals in the Andalusian Health Service and the development of an automatic encoder for this area have allowed us to establish a Minimum Data Set for Emergencies (MDS-ED). The aim of this article is to describe the case mix of hospital EDs using various dimensions contained in the MDS-ED. 3.235.600 hospital emergency records in 2012 were classified in clinical categories from the ICD-9-CM codes generated by the automatic encoder. Operating rules to obtain response time and length of stay were defined. A descriptive analysis was carried out to obtain demographic and chronological indicators as well as hospitalization, return and death rates and response time and length of stay in the Eds. Women generated 54,26% of all occurrences and their average age (39,98 years) was higher than men's (37,61). Paediatric emergencies accounted for 21,49% of the total. The peak hours were from 10:00 to 13:00 and from 16:00 to 17:00. Patients who did not undergo observation (92,67%) remained in the ED an average of 153 minutes. Injuries and poisoning, respiratory diseases, musculoskeletal diseases and symptoms and signs generated over 50% of all visits. 79.191 cases of chest pain, 28.741 episodes of heart failure and 27.989 episodes of serious infections were identified among the most relevant disorders. The MDS-ED makes it possible to address systematically the analysis of hospital emergencies by identifying the activity developed, the case-mix attended, the response times, the time spent in ED and the quality of the care.

Role of academic institutions in community disaster response since september 11, 2001.

PubMed

Dunlop, Anne L; Logue, Kristi M; Beltran, Gerald; Isakov, Alexander P

2011-10-01

To describe the role of academic institutions in the community response to Federal Emergency Management Agency-declared disasters from September 11, 2001, to February 1, 2009. We conducted a review of the published literature and Internet reports to identify academic institutions that participated in the community response to disaster events between September 11, 2001, to February 1, 2009, inclusive. From retrieved reports, we abstracted the identity of the academic institutions and the resources and services each provided. We characterized the resources and services in terms of their contribution to established constructs of community disaster resilience and disaster preparedness and response. Between September 11, 2001, and February 1, 2009, there were 98 published or Internet-accessible reports describing 106 instances in which academic institutions participated in the community response to 11 Federal Emergency Management Agency-declared disaster events that occurred between September 11, 2001, and February 1, 2009. Academic institutions included academic health centers and community teaching hospitals; schools of medicine, nursing, and public health; schools with graduate programs such as engineering and psychology; and 4-year programs. The services and resources provided by the academic institutions as part of the community disaster response could be categorized as contributing to community disaster resilience by reducing the consequences or likelihood of an event or to specific dimensions of public health preparedness and response, or both. The most common dimensions addressed by academic institutions (in order of occurrence) were resource management, enabling and sustaining a public health response, information capacity management, and performance evaluation. Since September 11, 2001, the participation of academic institutions in community disaster response has contributed to community resilience and the achievement of specific dimensions of disaster preparedness and response.

The changing UK careers landscape: tidal waves, turbulence and transformation.

PubMed

Hughes, Deirdre

2013-06-01

This article explores how the UK careers landscape in each of the four home nations is changing in response to neo-liberal policies. In this context, careers services are increasingly under pressure to demonstrate their added value, impact and returns on investment. As fiscal arrangements tighten and governments state their preferences and priorities for national careers services, differing strategic responses are beginning to emerge. A quasi-market, experimental approach is now the dominant discourse in England, in contrast to differing and complementary arrangements in Northern Ireland, Scotland and Wales. The article suggests that insofar as these developments are transforming national careers services, they are also creating significant challenges which require new forms of policy imagery and imagination for high-impact, all-age careers services.

Digital detectives and virtual volunteers: Integrating emergent online communities into disaster response operations.

PubMed

Griswold, Alisha

2013-01-01

The demonstration of altruistic behaviours by disaster survivors, and even those observing emergencies from afar, is well documented. Over the past few decades, government-sponsored crisis planning has evolved to include affiliated volunteer agencies, with a general acknowledgment of the need to plan for unaffiliated or spontaneous volunteers. Just as the understanding of the need for volunteers has grown, so too have the ways in which volunteers are able to donate their time and skills. The popularity of social media networks and online communities provide new ways for the public to get involved in disaster response. Public service agencies should be proactive in investigating these emerging platforms and understanding their impacts during crises. Established methods of integrating on-scene volunteers into post-disaster response operations can be used as templates for creating virtual volunteer programmes.

Locating helicopter emergency medical service bases to optimise population coverage versus average response time.

PubMed

Garner, Alan A; van den Berg, Pieter L

2017-10-16

New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along the eastern seaboard. The aim of this study was to estimate optimal HEMS base locations within NSW using advanced mathematical modelling techniques. We used high resolution census population data for NSW from 2011 which divides the state into areas containing 200-800 people. Optimal HEMS base locations were estimated using the maximal covering location problem facility location optimization model and the average response time model, exploring the number of bases needed to cover various fractions of the population for a 45 min response time threshold or minimizing the overall average response time to all persons, both in green field scenarios and conditioning on the current base structure. We also developed a hybrid mathematical model where average response time was optimised based on minimum population coverage thresholds. Seven bases could cover 98% of the population within 45mins when optimised for coverage or reach the entire population of the state within an average of 21mins if optimised for response time. Given the existing bases, adding two bases could either increase the 45 min coverage from 91% to 97% or decrease the average response time from 21mins to 19mins. Adding a single specialist prehospital rapid response HEMS to the area of greatest population concentration decreased the average state wide response time by 4mins. The optimum seven base hybrid model that was able to cover 97.75% of the population within 45mins, and all of the population in an average response time of 18 mins included the rapid response HEMS model. HEMS base locations can be optimised based on either percentage of the population covered, or average response time to the entire population. We have also demonstrated a hybrid technique that optimizes response time for a given number of bases and minimum defined threshold of population coverage. Addition of specialized rapid response HEMS services to a system of multirole retrieval HEMS may reduce overall average response times by improving access in large urban areas.

A Descriptive Analysis of US Prehospital Care Response to Law Enforcement Tactical Incidents.

PubMed

Aberle, Sara J; Lohse, Christine M; Sztajnkrycer, Matthew D

2015-01-01

Law enforcement tactical incidents involve high-risk operations that exceed the capabilities of regular, uniformed police. Despite the existence of tactical teams for 50 years, little is known about the frequency or nature of emergency medical services (EMS) response to tactical events in the United States. The purpose of this study was to perform a descriptive analysis of tactical events reported to a national EMS database. Descriptive analysis of the 2012 National Emergency Medical Services Information System (NEMSIS) Public Release research data set, containing EMS emergency response data from 41 states. A total of 17,479,328 EMS events were reported, of which 3,953 events were coded as "Activation-Tactical or SWAT Specialty Service/Response Team." The most common level of prehospital care present on scene was basic life support (55.2%). The majority (72.3%) of tactical incident activations involved a single patient; mass casualty incidents occurred in 0.5% of events. The most common EMS response locations were homes (48.4%), streets or highways (37.0%), and public buildings (6.3%). The mean age of treated patients was 44.1 years ± 22.0 years; 3.5% of tactical incident activation patients were aged 8 years or less. Injuries were coded as firearm assault in 14.8% and as chemical exposure in 8.9% of events. Cardiac arrest occurred in 5.1% of patients, with the majority (92.2%) occurring prior to EMS arrival. The primary symptoms reported by EMS personnel were pain (37.4%), change in responsiveness (13.1%), and bleeding (8.1%). Advanced airway procedures occurred in 30 patients. No patients were documented as receiving tourniquets or needle thoracostomy. Approximately 11 EMS responses in support of law enforcement tactical operations occur daily in the United States. The majority occur in homes and involve a single patient. Advanced airway procedures are required in a minority of patients. Cardiac arrest is rare and occurs prior to EMS response in the majority of cases. Better understanding of the nature and location of EMS responses to tactical incidents is required to develop consistent EMS policies in support of law enforcement tactical operations. 2015.

Federal Emergency Management Information System (FEMIS) system administration guide, version 1.4.5

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arp, J.A.; Burnett, R.A.; Carter, R.J.

The Federal Emergency Management Information Systems (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the US Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local areamore » network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication, data distribution, and notification functionality necessary to operate FEMIS in a networked, client/server environment. The UNIX server provides an Oracle relational database management system (RDBMS) services, ARC/INFO GIS (optional) capabilities, and basic file management services. PNNL developed utilities that reside on the server include the Notification Service, the Command Service that executes the evacuation model, and AutoRecovery. To operate FEMIS, the Application Software must have access to a site specific FEMIS emergency management database. Data that pertains to an individual EOC`s jurisdiction is stored on the EOC`s local server. Information that needs to be accessible to all EOCs is automatically distributed by the FEMIS database to the other EOCs at the site.« less

Right service, right place: optimising utilisation of a community nursing service to reduce planned re-presentations to the emergency department

PubMed Central

Lawton, Jessica Kirsten; Kinsman, Leigh; Dalton, Lisa; Walsh, Fay; Bryan, Helen; Williams, Sharon

2017-01-01

Background Congruent with international rising emergency department (ED) demand, a focus on strategies and services to reduce burden on EDs and improve patient outcomes is necessary. Planned re-presentations of non-urgent patients at a regional Australian hospital exceeded 1200 visits during the 2013–2014 financial year. Planned re-presentations perpetuate demand and signify a lack of alternative services for non-urgent patients. The Community Nursing Enhanced Connections Service (CoNECS) collaboratively evolved between acute care and community services in 2014 to reduce planned ED re-presentations. Objective This study aimed to investigate the evolution and impact of a community nursing service to reduce planned re-presentations to a regional Australian ED and identify enablers and barriers to interventionist effectiveness. Methods A mixed-methods approach evaluated the impact of CoNECS. Data from hospital databases including measured numbers of planned ED re-presentations by month, time of day, age, gender and reason were used to calculate referral rates to CoNECS. These results informed two semistructured focus groups with ED and community nurses. The researchers used a theoretical lens, ‘diffusion of innovation’, to understand how this service could inform future interventions. Results Analyses showed that annual ED planned re-presentations decreased by 43% (527 presentations) after implementation. Three themes emerged from the focus groups. These were right service at the right time, nursing uncertainty and system disconnect and medical disengagement. Conclusions CoNECS reduced overall ED planned re-presentations and was sustained longer than many complex service-level interventions. Factors supporting the service were endorsement from senior administration and strong leadership to drive responsive quality improvement strategies. This study identified a promising alternative service outside the ED, highlighting possibilities for other hospital emergency services aiming to reduce planned re-presentations. PMID:29450293

Enabling heterogenous multi-scale database for emergency service functions through geoinformation technologies

NASA Astrophysics Data System (ADS)

Bhanumurthy, V.; Venugopala Rao, K.; Srinivasa Rao, S.; Ram Mohan Rao, K.; Chandra, P. Satya; Vidhyasagar, J.; Diwakar, P. G.; Dadhwal, V. K.

2014-11-01

Geographical Information Science (GIS) is now graduated from traditional desktop system to Internet system. Internet GIS is emerging as one of the most promising technologies for addressing Emergency Management. Web services with different privileges are playing an important role in dissemination of the emergency services to the decision makers. Spatial database is one of the most important components in the successful implementation of Emergency Management. It contains spatial data in the form of raster, vector, linked with non-spatial information. Comprehensive data is required to handle emergency situation in different phases. These database elements comprise core data, hazard specific data, corresponding attribute data, and live data coming from the remote locations. Core data sets are minimum required data including base, thematic, infrastructure layers to handle disasters. Disaster specific information is required to handle a particular disaster situation like flood, cyclone, forest fire, earth quake, land slide, drought. In addition to this Emergency Management require many types of data with spatial and temporal attributes that should be made available to the key players in the right format at right time. The vector database needs to be complemented with required resolution satellite imagery for visualisation and analysis in disaster management. Therefore, the database is interconnected and comprehensive to meet the requirement of an Emergency Management. This kind of integrated, comprehensive and structured database with appropriate information is required to obtain right information at right time for the right people. However, building spatial database for Emergency Management is a challenging task because of the key issues such as availability of data, sharing policies, compatible geospatial standards, data interoperability etc. Therefore, to facilitate using, sharing, and integrating the spatial data, there is a need to define standards to build emergency database systems. These include aspects such as i) data integration procedures namely standard coding scheme, schema, meta data format, spatial format ii) database organisation mechanism covering data management, catalogues, data models iii) database dissemination through a suitable environment, as a standard service for effective service dissemination. National Database for Emergency Management (NDEM) is such a comprehensive database for addressing disasters in India at the national level. This paper explains standards for integrating, organising the multi-scale and multi-source data with effective emergency response using customized user interfaces for NDEM. It presents standard procedure for building comprehensive emergency information systems for enabling emergency specific functions through geospatial technologies.

Sexual Assault Prevention and Response Program Procedures

DTIC Science & Technology

2008-11-01

5.4.3.2. Sexual Assault Examination Process (see Enclosure 6, Healthcare section) 5.4.3.3. Emergency Contraception /Sexually Transmitted...pregnancy, options for emergency contraception , and any necessary follow-up care and/or referral services. E3.2.7.2.3. Assessment for the need...and listen/engage in quiet support, as needed, and provide the victim appropriate emotional support resources. To the extent practicable, accommodate

Israeli Emergency Social and Mental Health Services in the Gulf War: Observations and Experiences of a Mental Health Professional.

ERIC Educational Resources Information Center

Granot, Hayim

1995-01-01

During the Gulf War, Israeli mental health professionals played an invaluable role, but their efforts raise questions about what constitutes an appropriate, supportive response for a population suddenly faced with a hazardous event, whether hostile or not. Discusses the strategies used, with lessons that might enhance the disaster services of any…

42 CFR 457.555 - Maximum allowable cost-sharing charges on targeted low-income children in families with income...

Code of Federal Regulations, 2012 CFR

2012-10-01

... maximum amount of $11.35 for services furnished in a hospital emergency room if those services are not... 42 Public Health 4 2012-10-01 2012-10-01 false Maximum allowable cost-sharing charges on targeted... Requirements: Enrollee Financial Responsibilities § 457.555 Maximum allowable cost-sharing charges on targeted...

42 CFR 51d.3 - Who is eligible for an award under this subpart?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Who is eligible for an award under this subpart? 51d.3 Section 51d.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.3 Who is eligible for an...

42 CFR 51d.3 - Who is eligible for an award under this subpart?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Who is eligible for an award under this subpart? 51d.3 Section 51d.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.3 Who is eligible for an...

42 CFR 51d.3 - Who is eligible for an award under this subpart?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Who is eligible for an award under this subpart? 51d.3 Section 51d.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.3 Who is eligible for an...

42 CFR 51d.3 - Who is eligible for an award under this subpart?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Who is eligible for an award under this subpart? 51d.3 Section 51d.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.3 Who is eligible for an...

42 CFR 51d.3 - Who is eligible for an award under this subpart?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Who is eligible for an award under this subpart? 51d.3 Section 51d.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.3 Who is eligible for an...

The effects of in-service education to promote emergent literacy in child care centers: a feasibility study.

PubMed

Girolametto, Luigi; Weitzman, Elaine; Lefebvre, Pascal; Greenberg, Janice

2007-01-01

The purpose of this study was to determine the feasibility of a 2-day in-service education program for (a) promoting the use of two emergent literacy strategies by early childhood educators and (b) increasing children's responses to these strategies. Sixteen early childhood educators were randomly assigned to an experimental and a control group. The experimental in-service program sought to increase educators' use of abstract utterances and print references. Educators were videotaped with small groups of preschoolers during storybook reading and a post-story craft activity. Pretest and posttest videotapes were coded to yield rates of abstract language, verbal print references, and children's responses. In comparison to the control group, educators in the experimental program used more abstract utterances that elicited talk about emotions and children's past experiences during storybook reading. They also used significantly more print references during a post-story craft activity. In addition, children in the experimental group responded more often with appropriate responses to abstract utterances and print references in comparison to children in the control group. A 2-day in-service education program resulted in short-term behavioral changes in educators' use of abstract language and print references. Suggestions for improving instruction include providing opportunities for classroom practice with feedback, modeling the use of strategies in classroom routines, and long-term mentoring of educators to promote retention of gains.

Applying emergent ubiquitous technologies in health: the need to respond to new challenges of opportunity, expectation, and responsibility.

PubMed

Rigby, Michael

2007-12-01

In spite of their name, 'ubiquitous' technologies are not yet ubiquitous in the true sense of the word, but rather are 'novel', being at the research, pilot, and selective use stages. In future, the proliferation in types of application, the major increase in cases and data volumes, and above all the dependence on ubiquitous technologies to monitor persons at risk, will raise practical, ethical, and liability issues. Equally significantly, it will require health service redesign, including new response services. Health informaticians need to be active in stimulating consideration of all these issues, as part of both social and professional responsibility.

Exploring the views of emergency department staff on the use of videoconferencing for mental health emergencies in southwestern Ontario.

PubMed

Pangka, Kyle R; Chandrasena, Ranjith; Wijeratne, Nishardi; Mann, Miriam

2015-01-01

Patients presenting to a rural emergency department (ED) with mental health symptoms have difficulty accessing services of mental health professionals [1,2]. Videoconferencing (VC) has been found to improve patient access to health services that require specialist care in rural EDs [3,4,5]. Although previous studies highlight the benefit of using VC for patients presenting with mental health emergencies, no study has investigated the current views and use of VC for mental health emergencies in EDs in Southwestern Ontario [3,5,6]. To explore the views of ED staff regarding the use of VC in mental health emergencies, structured telephone interviews were conducted with representatives from EDs in the Erie St. Clair and Southwest Local Health Integration Networks (LHIN). Participants noted that using VC for mental health emergencies may improve patient experience and benefit crisis response teams. VC was perceived by some participants as a means to expedite the direct assessment of a patient presenting with a mental health emergency by a mental health specialist. However several participants stated that using VC for mental health emergencies strains ED resources. Lack of use and difficulty accessing a psychiatrist were identified as potential barriers to implementing the use of VC for mental health emergencies.

Recommended minimal emergency equipment and resources for schools: national consensus group report.

PubMed

Bobo, Nichole; Hallenbeck, Paula; Robinson, Judith

2003-06-01

Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency Medical Services for Children (EMSC), the National Association of School Nurses (NASN) was charged with the task of convening a consensus group to formulate a recommended list of minimal essential emergency equipment and resources that should be present in all schools. This article provides an overview of the issues surrounding minimal emergency equipment needs for schools, presents recommended minimal emergency equipment and resources, and recommendations for further actions.

Systematic review of frequent users of emergency departments in non-US hospitals: state of the art.

PubMed

van Tiel, Sofie; Rood, Pleunie P M; Bertoli-Avella, Aida M; Erasmus, Vicky; Haagsma, Juanita; van Beeck, Ed; Patka, Peter; Polinder, Suzanne

2015-10-01

This review focuses on frequent users (FUs) of the emergency department (ED). Elucidation of the characteristics of frequent ED users will help to improve healthcare services. A systematic review of the literature (from 1999 onwards) on frequent ED users in non-US hospitals was performed. Twenty-two studies were included. FUs are responsible for a wide variety of 1-31% of ED visits depending on the FU definition used. They have a mean age between 40 and 50 years and are older than nonfrequent users. Chronic physical and mental diseases seem to be the main reasons for frequent ED visits. In terms of social characteristics, lacking a partner is more frequently reported among FUs in some studies. The absence of a universal definition for FUs complicates the determination of the burden on emergency healthcare services. FUs are a heterogeneous group of patients with genuine medical needs and high consumption of other healthcare services.

Seeking maternal care at times of conflict: the case of Lebanon.

PubMed

Kabakian-Khasholian, Tamar; Shayboub, Rawan; El-Kak, Faysal

2013-01-01

Providing quality maternity care within the emergency care packages for internally displaced populations in war-affected areas is somewhat challenging, although very essential. In this retrospective study, we describe the experiences and health care seeking behaviors of 1,015 pregnant and postpartum women during the 2006 war in Lebanon. Women reported interruptions in regular maternity care and experienced more complications during this period. Availability of health services and experiences of complications were the most important determinants of health care seeking behaviors. Maternal health services should be a part of any comprehensive emergency responsiveness plan, catering to women's needs in war-affected areas.

Ground Zero recollections of US Public Health Service nurses deployed to New York City in September 2001.

PubMed

Knebel, Ann R; Martinelli, Angela M; Orsega, Susan; Doss, Thomas L; Balingit-Wines, Ana Marie; Konchan, Carol L

2010-06-01

The events of September 11, 2001, set in motion the broadest emergency response ever conducted by the US Department of Health and Human Services. In this article, some of the nurses who deployed to New York City in the aftermath of that horrific attack on the United States offer their recollections of the events. Although Public Health Service Commissioned Corps (PHS CC) officers participated in deployments before 9/11, this particular deployment accelerated the transformation of the PHS CC, because people came to realize the tremendous potential of a uniformed service of 6,000 health care professionals. When not responding to emergencies, PHS CC nurses daily serve the mission of the PHS to protect, promote, and advance the health and safety of the nation. In times of crisis, the PHS CC nurses stand ready to deploy in support of those in need of medical assistance. Published by Elsevier Inc.

Stennis all-hazards network adopted throughout NASA

NASA Image and Video Library

2009-10-13

Stennis Space Center employees Mike McKinion (left), with Erica Lane Enterprises, and Luke Scianna, with the Jacobs Facility Operating Services Contract, monitor the facility and surrounding area on the 'all-hazards network' known as HazNet. The HazNet system at Stennis was developed by a local Mississippi company to help facilitate coordinated response during emergency and disaster situations. The system was installed in the new Emergency Operations Center built at Stennis before being implemented throughout NASA. HazNet was designed by NVision Solutions Inc. of Bay St. Louis, Miss., through NASA's Innovative Partnerships Program. In addition to being used at Stennis, it has been installed at other Gulf Coast communities to help coordinate response during emergencies and such natural disasters as hurricanes.

The relationship of multispectral satellite imagery to immediate fire effects

Treesearch

Andrew T. Hudak; Penelope Morgan; Michael J. Bobbitt; Allstair M. S. Smith; Sarah A. Lewis; Leigh B. Lentile; Peter R. Robichaud; Jess T. Clark; Randy A. McKinley

2007-01-01

The Forest Service Remote Sensing Applications Center (RSAC) and the U.S. Geological Survey Earth Resources Observation and Science (EROS) Data Center produce Burned Area Reflectance Classification (BARC) maps for use by Burned Area Emergency Response (BAER) teams in rapid response to wildfires. BAER teams desire maps indicative of fire effects on soils, but green and...

The Extension Service and Rural/Frontier Disaster Planning, Response, and Recovery

ERIC Educational Resources Information Center

Eighmy, Myron A.; Hall, Thomas E.; Sahr, Eunice

2012-01-01

The purpose of the study reported here was to (a) determine the role of Extension in disaster response, (b) identify the information needs, and (c) disseminate education and training modules through the EDEN. Extension staff should know their county's emergency plan and the role identified for Extension. Extension staff should attend local…

Nursing Home Self-assessment of Implementation of Emergency Preparedness Standards.

PubMed

Lane, Sandi J; McGrady, Elizabeth

2016-08-01

Introduction Disasters often overwhelm a community's capacity to respond and recover, creating a gap between the needs of the community and the resources available to provide services. In the wake of multiple disasters affecting nursing homes in the last decade, increased focus has shifted to this vital component of the health care system. However, the long-term care sector has often fallen through the cracks in both planning and response. Problem Two recent reports (2006 and 2012) published by the US Department of Health and Human Services (DHHS), Office of Inspector General (OIG), elucidate the need for improvements in nursing homes' comprehensive emergency preparedness and response. The Center for Medicare and Medicaid Services (CMS) has developed an emergency preparedness checklist as a guidance tool and proposed emergency preparedness regulations. The purpose of this study was to evaluate the progress made in nursing home preparedness by determining the level of completion of the 70 tasks noted on the checklist. The study objectives were to: (1) determine the preparedness levels of nursing homes in North and South Carolina (USA), and (2) compare these findings with the 2012 OIG's report on nursing home preparedness to identify current gaps. A survey developed from the checklist of items was emailed to 418 North Carolina and 193 South Carolina nursing home administrators during 2014. One hundred seventeen were returned/"bounced back" as not received. Follow-up emails and phone calls were made to encourage participation. Sixty-three completed surveys and 32 partial surveys were received. Responses were compared to data obtained in a 2010 study to determine progress. Progress had been made in many of the overall planning and sheltering-in-place tasks, such as having contact information of local emergency managers as well as specifications for availability of potable water. Yet, gaps still persisted, especially in evacuation standards, interfacing with emergency management officials, establishing back-up evacuation sites and evacuation routes, identification of resident care items, and obtaining copies of state and local emergency planning regulations. Nursing homes have made progress in preparedness tasks, however, gaps persist. Compliance may prove challenging for some nursing homes, but closer integration with emergency management officials certainly is a step in the right direction. Further research that guides evacuation or shelter-in-place decision making is needed in light of persistent challenges in completing these tasks. Lane SJ , McGrady E . Nursing home self-assessment of implementation of emergency preparedness standards. Prehosp Disaster Med. 2016;31(4):422-431.

Emerging challenges in public health protection, food safety and security: veterinary needs in the USDA's Food Safety and Inspection Service.

PubMed

Buntain, Bonnie J

2004-01-01

Meeting the needs of public service practice is a responsibility of the veterinary profession. The United States Department of Agriculture (USDA) Food Safety and Inspection Service (FSIS) has undergone significant change since 1996, when the final rule on Pathogen Reduction and Hazard Analysis and Critical Control Point (HACCP) Systems and its regulations were published in response to food-borne illnesses and deaths due to E. coli 0157:H7 in undercooked hamburgers. As a result, the role of the veterinarian is changing from a focus on carcass inspection (reactive) to scientific-based systems analysis and enforcement (preventive). With a large pool of veterinarians eligible to retire, a critical shortage of field veterinarians is predicted. The purpose of this article is to raise educators' awareness of this need, of the competencies required, and of the challenges and opportunities for veterinarians in the new public health-focused FSIS. An invitation to collaborate with the agency is offered to help meet emerging workforce requirements in public health practice.

CDC's Emergency Management Program activities - worldwide, 2003-2012.

PubMed

2013-09-06

In 2003, recognizing the increasing frequency and complexity of disease outbreaks and disasters and a greater risk for terrorism, CDC established the Emergency Operations Center (EOC), bringing together CDC staff members who respond to public health emergencies to enhance communication and coordination. To complement the physical EOC environment, CDC implemented the Incident Management System (IMS), a staffing structure and set of standard operational protocols and services to support and monitor CDC program-led responses to complex public health emergencies. The EOC and IMS are key components of CDC's Emergency Management Program (EMP), which applies emergency management principles to public health practice. To enumerate activities conducted by the EMP during 2003-2012, CDC analyzed data from daily reports and activity logs. The results of this analysis determined that, during 2003-2012, the EMP fully activated the EOC and IMS on 55 occasions to support responses to infectious disease outbreaks, natural disasters, national security events (e.g., conventions, presidential addresses, and international summits), mass gatherings (e.g., large sports and social events), and man-made disasters. On 109 other occasions, the EMP was used to support emergency responses that did not require full EOC activation, and the EMP also conducted 30 exercises and drills. This report provides an overview of those 194 EMP activities.

National Weather Service, Emergency Medical Services, Scripps Institution of Oceanography/UCSD and California EPA Collaboration on Heat Health Impact and Public Notification for San Diego County

NASA Astrophysics Data System (ADS)

Tardy, A. O.; Corcus, I.; Guirguis, K.

2015-12-01

The National Weather Service (NWS) has issued official heat alerts in the form of either a heat advisory or excessive heat warning product to the public and core partners for many years. This information has traditionally been developed through the use of triggers for heat indices which combine humidity and temperature. The criteria typically used numeric thresholds and did not consider impact from a particular heat episode, nor did it factor seasonality or population acclimation. In 2013, the Scripps Institution of Oceanography, University of California, San Diego in collaboration with the Office of Environmental Health Hazard Assessment, of the California Environmental Protection Agency and the NWS completed a study of heat health impact in California, while the NWS San Diego office began modifying their criteria towards departure from climatological normal with much less dependence on humidity or heat index. The NWS changes were based on initial findings from the California Department of Public Health, EpiCenter California Injury Data Online system which documents heat health impacts. Results from the UCSD study were finalized and published in 2014; they supported the need for significant modification of the traditional criteria. In order to better understand the impacts of heat on community health, medical outcome data were provided by the County of San Diego Emergency Medical Services Branch, which is charged by the County's Public Health Officer to monitor heat-related illness and injury daily from June through September. The data were combined with UCSD research to inform the modification of local NWS heat criteria and establish trigger points to pilot new procedures for the issuance of heat alerts. Finally, practices and procedures were customized for each of the county health departments in the NWS area of responsibility across extreme southwest California counties in collaboration with their Office of Emergency Services. The end result of the collaboration was to better define temperature thresholds relative to local climate, levels of heat related responses and activation, as well as to develop standardized terminology on public notifications. In 2014, the County of San Diego Office of Emergency Services incorporated heat alerts into the emergency push notification system for 2 significant heat waves.

[Nurses and social care workers in emergency teams in Norway].

PubMed

Hilpüsch, Frank; Parschat, Petra; Fenes, Sissel; Aaraas, Ivar J; Gilbert, Mads

2011-01-07

The Norwegian counties Troms and Finnmark are dominated by large areas with widespread habitation and rather long response times for ambulances and doctors. We wished to investigate the extent to which the municipal preparedness in these counties use employees from the municipal nursing and social care services and if these are part of local emergency teams. In the autumn of 2008, we sent a questionnaire to the district medical officers and the leaders for municipal nursing and social care services in all 44 municipalities in Troms and Finnmark. The answers were analyzed manually. 41 municipalities responded. In 34 of these the municipal nurses and social care workers practice emergency medicine procedures. The content in these training sessions is much more comprehensive than that in a typical first aid course. In three of four municipalities ambulance personnel do not participate in this training. In 31 municipalities the inhabitants contact nurses and social care workers directly if they are acutely ill. In only 10 of the municipalities the nurses and social care workers are organized in local teams including a doctor and an ambulance. In the districts, nursing and social care services are a resource in an emergency medicine context. The potential within these professions can be exploited better and be an important supplement in emergencies. In emergencies, cooperation across disciplines requires a clear organizational and economical structure, local basis and leadership.

[Estimating and reporting aggression in relation to personal characteristics of emergency service workers].

PubMed

Penterman, E J M; van der Staak, C P F; Nijman, H L I

2014-01-01

Research on aggression in mental health care has focused mainly on patient characteristics, whereas very little research has been done on the characteristics of the care providers in their reporting of aggression. To study the characteristics of the care providers of an emergency service in relation to the reporting of aggression. All emergency service workers( n = 21) in the Uden-Veghel region were asked to complete a neo-pi-r form. Before 576 outreach contacts had been made with patients in psychiatric crises, the Checklist of Risks in the Crisis-team (crc) was also completed and in cases where the patient exhibited aggressive behaviour, a soas-r form was filled in, following contact with the patient. Significant differences were found between the psychiatric emergency service workers with regard to the mean estimates of the likelihood that they would experience aggression during the consultation and with regard to the proportion of patient contacts for which emergency workers reported aggression. There were indications that the level of conscientiousness of the emergency service workers was positively associated with a higher chance that they would report aggressive behaviour following the consultation. Furthermore, altruism was found to be negatively associated with the likelihood, as predicted by the service workers, that they would be confronted with aggression during contact with the patient. Possibly, workers who scored high on conscientiousness and who work thoroughly and in a orderly and systematic manner and who keep to the rules are less flexible in their response to the patient during the interaction. As a result, the patient became irritated more quickly. On the other hand, it could be that conscientious workers completed the form-filling more carefully when aggression had to be reported and as a result they made higher preliminary estimates of the likelihood of aggression and a reported a larger number of incidents of actual aggression.

The changing UK careers landscape: tidal waves, turbulence and transformation

PubMed Central

Hughes, Deirdre

2013-01-01

This article explores how the UK careers landscape in each of the four home nations is changing in response to neo-liberal policies. In this context, careers services are increasingly under pressure to demonstrate their added value, impact and returns on investment. As fiscal arrangements tighten and governments state their preferences and priorities for national careers services, differing strategic responses are beginning to emerge. A quasi-market, experimental approach is now the dominant discourse in England, in contrast to differing and complementary arrangements in Northern Ireland, Scotland and Wales. The article suggests that insofar as these developments are transforming national careers services, they are also creating significant challenges which require new forms of policy imagery and imagination for high-impact, all-age careers services. PMID:23847391

Inter-association Task Force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement.

PubMed

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-01-01

To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishment of an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of on-site responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.

Inter Association Task Force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement.

PubMed

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-01-01

To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishing an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination, and integration of on-site responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.

Inter-association task force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement.

PubMed

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-04-01

To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishing an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of onsite responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.

Inter-Association Task Force Recommendations on Emergency Preparedness and Management of Sudden Cardiac Arrest in High School and College Athletic Programs: A Consensus Statement

PubMed Central

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-01-01

Objective: To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. Background: Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Recommendations: Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishment of an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of on-site responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated. PMID:17597956

Handbook. Disaster Response Staff Officer’s Handbook: Observations, Insights, and Lessons

DTIC Science & Technology

2010-12-01

Agriculture, and the Federal Emergency Management Agency under ESF #6, Mass Care , in the support of the Pets Evacuation and Transportation Standards Act...in local hospitals, nursing homes, and extended care facilities, those with special needs, household pets , and service animals. Significant...household pets and service animals will require appropriate care , sheltering, medical attention, and transportation. • A catastrophic incident will

Ecological mechanisms underpinning climate adaptation services.

PubMed

Lavorel, Sandra; Colloff, Matthew J; McIntyre, Sue; Doherty, Michael D; Murphy, Helen T; Metcalfe, Daniel J; Dunlop, Michael; Williams, Richard J; Wise, Russell M; Williams, Kristen J

2015-01-01

Ecosystem services are typically valued for their immediate material or cultural benefits to human wellbeing, supported by regulating and supporting services. Under climate change, with more frequent stresses and novel shocks, 'climate adaptation services', are defined as the benefits to people from increased social ability to respond to change, provided by the capability of ecosystems to moderate and adapt to climate change and variability. They broaden the ecosystem services framework to assist decision makers in planning for an uncertain future with new choices and options. We present a generic framework for operationalising the adaptation services concept. Four steps guide the identification of intrinsic ecological mechanisms that facilitate the maintenance and emergence of ecosystem services during periods of change, and so materialise as adaptation services. We applied this framework for four contrasted Australian ecosystems. Comparative analyses enabled by the operational framework suggest that adaptation services that emerge during trajectories of ecological change are supported by common mechanisms: vegetation structural diversity, the role of keystone species or functional groups, response diversity and landscape connectivity, which underpin the persistence of function and the reassembly of ecological communities under severe climate change and variability. Such understanding should guide ecosystem management towards adaptation planning. © 2014 John Wiley & Sons Ltd.

Prepared for the future? Evaluating the costs and benefits of voluntary work for natural disaster management under a changing climate - data on recent flood events, stakeholder needs and policy applications

NASA Astrophysics Data System (ADS)

Pfurtscheller, Clemens; Brucker, Anja; Seebauer, Sebastian

2014-05-01

Voluntary emergency and relief services, such as fire brigades or rescue organisations, form the backbone of disaster management in most of European countries. In Austria, disaster management relies on the cooperation between governmental and non-governmental institutions: When a disaster occurs, the volunteer organizations act as auxiliaries to the responsible disaster management authority. The assessment of costs and benefits of these emergency services is a crucial component of risk and disaster management strategies, since public means are getting scarcer and these costs can reach critical levels for low-income municipalities. As extreme events and emergency operations are likely to increase due to climate change, the efficient allocation of public budgets for risk and disaster management becomes more important. Hence, both, the costs and the benefits must be known, but voluntary and professional work is hardly documented and assessed comprehensively. Whereas the costs of emergency services can be calculated using market values and an analysis of public and institutional budgets, the benefits of voluntary efforts cannot be assessed easily. We present empirical data on costs of voluntary and professional emergency services during the floods of 2002, 2005 and 2013 in Austria and Germany on different scales, obtained from public authorities, fire brigades and by means of public surveys. From these results, we derive a calculation framework and data requirements for assessing costs of emergency services. To consider the different stakeholders needs of administration, emergency institutions and voluntary members, we carried out workshops, first to identify future challenges in voluntary work for disaster management instigated by climate change and second, to develop approaches how the voluntary system can be uphold when facing increasing adverse impacts of natural hazards. The empirical results as well as the workshop outcome shall be translated into policy recommendations and research needs to derive strategies for strengthening resilience at the local and regional level and to design appropriate incentives.

City-scale accessibility of emergency responders operating during flood events

NASA Astrophysics Data System (ADS)

Green, Daniel; Yu, Dapeng; Pattison, Ian; Wilby, Robert; Bosher, Lee; Patel, Ramila; Thompson, Philip; Trowell, Keith; Draycon, Julia; Halse, Martin; Yang, Lili; Ryley, Tim

2017-01-01

Emergency responders often have to operate and respond to emergency situations during dynamic weather conditions, including floods. This paper demonstrates a novel method using existing tools and datasets to evaluate emergency responder accessibility during flood events within the city of Leicester, UK. Accessibility was quantified using the 8 and 10 min legislative targets for emergency provision for the ambulance and fire and rescue services respectively under "normal" no-flood conditions, as well as flood scenarios of various magnitudes (1 in 20-year, 1 in 100-year and 1 in 1000-year recurrence intervals), with both surface water and fluvial flood conditions considered. Flood restrictions were processed based on previous hydrodynamic inundation modelling undertaken and inputted into a Network Analysis framework as restrictions for surface water and fluvial flood events. Surface water flooding was shown to cause more disruption to emergency responders operating within the city due to its widespread and spatially distributed footprint when compared to fluvial flood events of comparable magnitude. Fire and rescue 10 min accessibility was shown to decrease from 100, 66.5, 39.8 and 26.2 % under the no-flood, 1 in 20-year, 1 in 100-year and 1 in 1000-year surface water flood scenarios respectively. Furthermore, total inaccessibility was shown to increase with flood magnitude from 6.0 % under the 1 in 20-year scenario to 31.0 % under the 1 in 100-year flood scenario. Additionally, the evolution of emergency service accessibility throughout a surface water flood event is outlined, demonstrating the rapid impact on emergency service accessibility within the first 15 min of the surface water flood event, with a reduction in service coverage and overlap being observed for the ambulance service during a 1 in 100-year flood event. The study provides evidence to guide strategic planning for decision makers prior to and during emergency response to flood events at the city scale. It also provides a readily transferable method for exploring the impacts of natural hazards or disruptions in other cities or regions based on historic, scenario-based events or real-time forecasting, if such data are available.

Decision Support System for the Response to Infectious Disease Emergencies Based on WebGIS and Mobile Services in China

PubMed Central

Gao, Su-qing; Wang, Zhen; Gao, Hong-wei; Liu, Peng; Wang, Ze-rui; Li, Yan-li; Zhu, Xu-guang; Li, Xin-lou; Xu, Bo; Li, Yin-jun; Yang, Hong; de Vlas, Sake J.; Shi, Tao-xing; Cao, Wu-chun

2013-01-01

Background For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Methodology/Principal Findings Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. Conclusions/Significance The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts. PMID:23372780

Emergency Medical Services Utilization in EMS Priority Conditions in Beirut, Lebanon.

PubMed

El Sayed, Mazen; Tamim, Hani; Chehadeh, Ahel Al-Hajj; Kazzi, Amin A

2016-12-01

Early activation and use of Emergency Medical Services (EMS) are associated with improved patient outcomes in EMS priority conditions in developed EMS systems. This study describes patterns of EMS use and identifies predictors of EMS utilization in EMS priority conditions in Lebanon METHODS: This was a cross-sectional study of a random sample of adult patients presenting to the emergency department (ED) of a tertiary care center in Beirut with the following EMS priority conditions: chest pain, major trauma, respiratory distress, cardiac arrest, respiratory arrest, and airway obstruction. Patient/proxy survey (20 questions) and chart review were completed. The responses to survey questions were "disagree," "neutral," or "agree" and were scored as one, two, or three with three corresponding to higher likelihood of EMS use. A total scale score ranging from 20 to 60 was created and transformed from 0% to 100%. Data were analyzed based on mode of presentation (EMS vs other). Among the 481 patients enrolled, only 112 (23.3%) used EMS. Mean age for study population was 63.7 years (SD=18.8 years) with 56.5% males. Mean clinical severity score (Emergency Severity Index [ESI]) was 2.5 (SD=0.7) and mean pain score was 3.1 (SD=3.5) at ED presentation. Over one-half (58.8%) needed admission to hospital with 21.8% to an intensive care unit care level and with a mortality rate of 7.3%. Significant associations were found between EMS use and the following variables: severity of illness, degree of pain, familiarity with EMS activation, previous EMS use, perceived EMS benefit, availability of EMS services, trust in EMS response times and treatment, advice from family, and unavailability of immediate private mode of transport (P≤.05). Functional screening, or requiring full assistance (OR=4.77; 95% CI, 1.85-12.29); acute symptoms onset ≤ one hour (OR=2.14; 95% CI, 1.08-4.26); and higher scale scores (OR=2.99; 95% CI, 2.20-4.07) were significant predictors of EMS use. Patients with lower clinical severity (OR=0.53; 95% CI, 0.35-0.81) and those with chest pain (OR=0.05; 95% CI, 0.02-0.12) or respiratory distress (OR=0.15; 95% CI, 0.07-0.31) using cardiac arrest as a reference were less likely to use EMS. Emergency Medical Services use in EMS priority conditions in Lebanon is low. Several predictors of EMS use were identified. Emergency Medical Services initiatives addressing underutilization should result from this proposed assessment of the perspective of the EMS system's end user. El Sayed M , Tamim H , Al-Hajj Chehadeh A , Kazzi AA . Emergency Medical Services utilization in EMS priority conditions in Beirut, Lebanon. Prehosp Disaster Med. 2016;31(6):621-627.

Surgeons without borders: a brief history of surgery at Médecins Sans Frontières.

PubMed

Chu, Kathryn; Rosseel, Peter; Trelles, Miguel; Gielis, Pierre

2010-03-01

Médecins Sans Frontières (MSF) is a humanitarian organization that performs emergency and elective surgical services in both conflict and non-conflict settings in over 70 countries. In 2006 MSF surgeons departed on approximately 125 missions, and over 64,000 surgical interventions were carried out in some 20 countries worldwide. Historically, the majority of MSF surgical projects began in response to conflicts or natural disasters. During an emergency response, MSF has resources to set up major operating facilities within 48 h in remote areas. One of MSF strengths is its supply chain. Large pre-packaged surgical kits, veritable "operating theatres to go," can be readied in enormous crates and quickly loaded onto planes. In more stable contexts, MSF has also strengthened the delivery of surgical services within a country's public health system. The MSF surgeon is the generalist in the broadest sense and performs vascular, obstetrical, orthopaedic, and other specialized surgical procedures. The organization aims to provide surgical services only temporarily. When there is a decrease in acute needs a program will be closed, or more importantly, turned over to the Ministry of Health or another non-governmental organization. The long-term solution to alleviating the global burden of surgical disease lies in building up a domestic surgical workforce capable of responding to the major causes of surgery-related morbidity and mortality. However, given that even countries with the resources of the United States suffer from an insufficiency of surgeons, the need for international emergency organizations to provide surgical assistance during acute emergencies will remain for the foreseeable future.

USGS Provision of Near Real Time Remotely Sensed Imagery for Emergency Response

NASA Astrophysics Data System (ADS)

Jones, B. K.

2014-12-01

The use of remotely sensed imagery in the aftermath of a disaster can have an important impact on the effectiveness of the response for many types of disasters such as floods, earthquakes, volcanic eruptions, landslides, and other natural or human-induced disasters. Ideally, responders in areas that are commonly affected by disasters would have access to archived remote sensing imagery plus the ability to easily obtain the new post event data products. The cost of obtaining and storing the data and the lack of trained professionals who can process the data into a mapping product oftentimes prevent this from happening. USGS Emergency Operations provides remote sensing and geospatial support to emergency managers by providing access to satellite images from numerous domestic and international space agencies including those affiliated with the International Charter Space and Major Disasters and their space-based assets and by hosting and distributing thousands of near real time event related images and map products through the Hazards Data Distribution System (HDDS). These data may include digital elevation models, hydrographic models, base satellite images, vector data layers such as roads, aerial photographs, and other pre and post disaster data. These layers are incorporated into a Web-based browser and data delivery service, the Hazards Data Distribution System (HDDS). The HDDS can be made accessible either to the general public or to specific response agencies. The HDDS concept anticipates customer requirements and provides rapid delivery of data and services. This presentation will provide an overview of remotely sensed imagery that is currently available to support emergency response operations and examples of products that have been created for past events that have provided near real time situational awareness for responding agencies.

Emerging Opportunities for School Psychologists to Enhance our Remediation Procedure Evidence Base as We Apply Response to Intervention

ERIC Educational Resources Information Center

Skinner, Christopher H.; McCleary, Daniel F.; Skolits, Gary L.; Poncy, Brian C.; Cates, Gary L.

2013-01-01

The success of Response-to-Intervention (RTI) and similar models of service delivery is dependent on educators being able to apply effective and efficient remedial procedures. In the process of implementing problem-solving RTI models, school psychologists have an opportunity to contribute to and enhance the quality of our remedial-procedure…

Response to Intervention (RtI) in the Social, Emotional, and Behavioral Domains: Current Challenges and Emerging Possibilities

ERIC Educational Resources Information Center

Saeki, Elina; Jimerson, Shane R.; Earhart, James; Hart, Shelley R.; Renshaw, Tyler; Singh, Renee D.; Stewart, Kaitlyn

2011-01-01

As many schools move toward a three-tier model that incorporates a Response to Intervention (RtI) service delivery model in the social, emotional, and behavioral domains, school psychologists may provide leadership. The decision-making process for filtering students through multiple tiers of support and intervention and examining change is an area…

Demand Response at the Naval Postgraduate School

DTIC Science & Technology

2008-12-01

service, cost avoidance of starting extra power plants during emergencies, and reduction of negative environmental impact . The illustration below...on. Refraining from starting a peak performance plant means less pollution and lower environmental impact . Operations at the Naval Postgraduate...affect the environment. F. STEP 5: MONETIZE ALL IMPACTS The environmental impact that a Demand Response program has is an intangible one. Over

Changing the Paradigm: Implementation of Combined Law Enforcement, Fire, and Emergency Medical Service (EMS) Cross-Disciplinary Response to Hostile Events

DTIC Science & Technology

2014-12-01

Mumbai , India; and Aw-ora Movie Theatre in Colorado require ftrst responders to incorporate methods and tactics that integrate operations and challenge...Cross-Disciplinaty Team, PAGES Cross-Disciplinary Response, Culture Change, Marauding Terrorist Fireatms Attack, Integrated 127 Response Framework...Columbine High School; Virginia Tech University; Mumbai , India; and Aurora Movie Theatre in Colorado require first responders to incorporate methods and

Old Fire/Grand Prix Fire, California

NASA Image and Video Library

2003-11-19

On November 18, 2003, the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA's Terra satellite acquired this image of the Old Fire/Grand Prix fire east of Los Angeles. The image is being processed by NASA's Wildfire Response Team and will be sent to the United States Department of Agriculture's Forest Service Remote Sensing Applications Center (RSAC) which provides interpretation services to Burned Area Emergency Response (BAER) teams to assist in mapping the severity of the burned areas. The image combines data from the visible and infrared wavelength regions to highlight the burned areas. http://photojournal.jpl.nasa.gov/catalog/PIA04879

EPA'S GROUND WATER TECHNICAL SUPPORT CENTER

EPA Science Inventory

The purpose and the services provided by EPA's Ground Water Technical Support Center (GWTSC) will be presented. In 1987 the Office of Solid Waste and Emergency Response, Regional Waste Management Offices, and ORD established the Technical Support Project (TSP)

The purpos...

An Overview Of The Ecosystem Services Research Program Decision Support Framework

EPA Science Inventory

There is an increasing understanding that top-down regulatory and technology driven responses are not sufficient to address current and emerging environmental challenges such as climate change, sustainable communities, and environmental justice. Such problems require ways to dee...

ERCMExpress. Volume 2, Issue 2

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

This issue of the Emergency Response and Crisis Management (ERCM) Technical Assistance Center's "ERCMExpress" introduces the National Clearinghouse for Educational Facilities (NCEF), a free public service that provides information on planning, designing, funding, building, improving and maintaining safe, healthy, high-performance schools. NCEF is…

Emerging technological and cultural shifts advancing drylands research and management

USDA-ARS?s Scientific Manuscript database

Sustainable provisioning of ecosystem services in dryland landscapes is complicated by extreme conditions that constrain biological responses to perturbation, vast spatial and temporal complexity, and uncertainty regarding the resilience of these ecosystems to management practices and climate change...

78 FR 6141 - Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-29

... use a telecommunications device for the deaf (TDD) may call the Federal Information Relay Service.... SUPPLEMENTARY INFORMATION: Title of Collection: Antarctic emergency response plan and environmental protection... information on their environmental protection obligations under the Antarctic Conservation Act. Expected...

Zika virus infection in Brazil and human rights obligations.

PubMed

Diniz, Debora; Gumieri, Sinara; Bevilacqua, Beatriz Galli; Cook, Rebecca J; Dickens, Bernard M

2017-01-01

The February 2016 WHO declaration that congenital Zika virus syndrome constitutes a Public Health Emergency of International Concern reacted to the outbreak of the syndrome in Brazil. Public health emergencies can justify a spectrum of human rights responses, but in Brazil, the emergency exposed prevailing inequities in the national healthcare system. The government's urging to contain the syndrome, which is associated with microcephaly among newborns, is confounded by lack of reproductive health services. Women with low incomes in particular have little access to such health services. The emergency also illuminates the harm of restrictive abortion legislation, and the potential violation of human rights regarding women's health and under the UN Conventions on the Rights of the Child and on the Rights of Persons with Disabilities. Suggestions have been proposed by which the government can remedy the widespread healthcare inequities among the national population that are instructive for other countries where congenital Zika virus syndrome is prevalent. © 2016 International Federation of Gynecology and Obstetrics.

The physician in the face of death in the emergency room

PubMed Central

Aredes, Janaína de Souza; Giacomin, Karla Cristina; Firmo, Josélia Oliveira Araújo

2018-01-01

ABSTRACT OBJECTIVE: To analyze how physicians, as part of a sociocultural group, handle the different types of death, in a metropolitan emergency service. METHODS: This is an ethnography carried out in one of the largest emergency services in Latin America. We have collected the data for nine months with participant observation and interviews with 43 physicians of different specialties – 25 men and 18 women, aged between 28 and 69 years. RESULTS: The analysis, guided by the model of Signs, Meanings, and Actions, shows a vast mosaic of situations and issues that permeate the medical care in an emergency unit. The results indicate that physicians may consider one death more difficult than another, depending on the criteria: age, identification or not with the patient, circumstances of the death, and medical questioning as to their responsibility in the death process. CONCLUSIONS: For physicians, no death is easy. Each death can be more or less difficult, depending on different criteria that permeate the medical care in an emergency unit, and it reveals different social, ethical, and moral issues. PMID:29668815

The current crisis in emergency care and the impact on disaster preparedness.

PubMed

Cherry, Robert A; Trainer, Marcia

2008-05-01

The Homeland Security Act (HSA) of 2002 provided for the designation of a critical infrastructure protection program. This ultimately led to the designation of emergency services as a targeted critical infrastructure. In the context of an evolving crisis in hospital-based emergency care, the extent to which federal funding has addressed disaster preparedness will be examined. After 9/11, federal plans, procedures and benchmarks were mandated to assure a unified, comprehensive disaster response, ranging from local to federal activation of resources. Nevertheless, insufficient federal funding has contributed to a long-standing counter-trend which has eroded emergency medical care. The causes are complex and multifactorial, but they have converged to present a severely overburdened system that regularly exceeds emergency capacity and capabilities. This constant acute overcrowding, felt in communities all across the country, indicates a nation at risk. Federal funding has not sufficiently prioritized the improvements necessary for an emergency care infrastructure that is critical for an all hazards response to disaster and terrorist emergencies. Currently, the nation is unable to meet presidential preparedness mandates for emergency and disaster care. Federal funding strategies must therefore be re-prioritized and targeted in a way that reasonably and consistently follows need.

A Novel Petri Nets-Based Modeling Method for the Interaction between the Sensor and the Geographic Environment in Emerging Sensor Networks

PubMed Central

Zhang, Feng; Xu, Yuetong; Chou, Jarong

2016-01-01

The service of sensor device in Emerging Sensor Networks (ESNs) is the extension of traditional Web services. Through the sensor network, the service of sensor device can communicate directly with the entity in the geographic environment, and even impact the geographic entity directly. The interaction between the sensor device in ESNs and geographic environment is very complex, and the interaction modeling is a challenging problem. This paper proposed a novel Petri Nets-based modeling method for the interaction between the sensor device and the geographic environment. The feature of the sensor device service in ESNs is more easily affected by the geographic environment than the traditional Web service. Therefore, the response time, the fault-tolerant ability and the resource consumption become important factors in the performance of the whole sensor application system. Thus, this paper classified IoT services as Sensing services and Controlling services according to the interaction between IoT service and geographic entity, and classified GIS services as data services and processing services. Then, this paper designed and analyzed service algebra and Colored Petri Nets model to modeling the geo-feature, IoT service, GIS service and the interaction process between the sensor and the geographic enviroment. At last, the modeling process is discussed by examples. PMID:27681730

Emerging organizational structures in the ambulance industry in the United States.

PubMed

Narad, R A

2000-01-01

This analysis seeks to identify emerging forms of organizations in emergency medical services (EMS) in the United States, to provide examples of them, to relate them to changes in healthcare generally, and to apply a classification scheme. Public policy issues related to these new forms of organizations and lessons from other areas of the healthcare system are identified. Recent changes in the healthcare system in the United States have been marked by modifications in the structure of organizations that provide and pay for health services. New forms of organizations and alliances among existing organizations have emerged in an effort to improve the efficiency of the services provided and to improve organizations' market positions. Reflecting increased competition within EMS and the demands of the changing health-care delivery system, several types of organizations have begun to emerge in EMS that resemble those occurring in health care generally. These include forms of horizontal integration, such as consolidated ambulance services and various models of ambulance service networks; and forms of vertical integration, such as demand management programs and public-private joint ventures. The ultimate end might be complete integration with a carve-out of all non-scheduled care. Although changes in EMS organizations result largely from marketplace decisions by sellers and purchasers, this does not mean that there is no public policy role. While new organizational forms may increase the ambulance industry's efficiency, public policy makers must be concerned about quality and access as well. Some policy responses will promote marketplace changes, others will accept them generally, but will seek to correct problems, and a third group will attempt to restrain the market.

Radiation protection issues on preparedness and response for a severe nuclear accident: experiences of the Fukushima accident.

PubMed

Homma, T; Takahara, S; Kimura, M; Kinase, S

2015-06-01

Radiation protection issues on preparedness and response for a severe nuclear accident are discussed in this paper based on the experiences following the accident at Fukushima Daiichi nuclear power plant. The criteria for use in nuclear emergencies in the Japanese emergency preparedness guide were based on the recommendations of International Commission of Radiological Protection (ICRP) Publications 60 and 63. Although the decision-making process for implementing protective actions relied heavily on computer-based predictive models prior to the accident, urgent protective actions, such as evacuation and sheltering, were implemented effectively based on the plant conditions. As there were no recommendations and criteria for long-term protective actions in the emergency preparedness guide, the recommendations of ICRP Publications 103, 109, and 111 were taken into consideration in determining the temporary relocation of inhabitants of heavily contaminated areas. These recommendations were very useful in deciding the emergency protective actions to take in the early stages of the Fukushima accident. However, some suggestions have been made for improving emergency preparedness and response in the early stages of a severe nuclear accident. © The Chartered Institution of Building Services Engineers 2014.

Significant acceleration of emergency response using smartphone geolocation data and a worldwide emergency call support system.

PubMed

Weinlich, Michael; Kurz, Peter; Blau, Melissa B; Walcher, Felix; Piatek, Stefan

2018-01-01

When patients are disorientated or experience language barriers, it is impossible to activate the emergency response system. In these cases, the delay for receiving appropriate help can extend to several hours. A worldwide emergency call support system (ECSS), including geolocation of modern smartphones (GPS, WLAN and LBS), was established referring to E911 and eCall systems. The system was tested for relevance in quickly forwarding abroad emergency calls to emergency medical services (EMS). To verify that geolocation data from smartphones are exact enough to be used for emergency cases, the accuracy of GPS (global positioning system), Wi-Fi (wireless LAN network) and LBS (location based system) was tested in eleven different countries and compared to actual location. The main objective was analyzed by simulation of emergencies in different countries. The time delay in receiving help in unsuccessful emergency call cases by using the worldwide emergency call support system (ECSS) was measured. GPS is the gold standard to locate patients with an average accuracy of 2.0 ± 3.3 m. Wi-Fi can be used within buildings with an accuracy of 7.0 ± 24.1 m. Using ECSS, the emergency call leads to a successful activation of EMS in 22.8 ± 10.8 min (Median 21 min). The use of a simple app with one button to touch did never cause any delay. The worldwide emergency call support system (ECSS) significantly improves the emergency response in cases of disorientated patients or language barriers. Under circumstances without ECSS, help can be delayed by 2 or more hours and might have relevant lifesaving effects. This is the first time that Wi-Fi geolocation could prove to be a useful improvement in emergencies to enhance GPS, especially within or close to buildings.

Emergency health planning.

PubMed

HARDMAN, A C

1962-12-01

This paper outlines the development of emergency health planning as a function of government. Ten provinces have the basic responsibility for the organization, preparation and operation of medical, nursing, hospital and public health services in an emergency. The Department of National Health and Welfare is responsible for the provision of advice and assistance to the provincial and municipal governments in such matters. Eight provinces have now hired full-time planning staffs to co-ordinate the health planning of the Provincial Departments of Health and Provincial Emergency Measures Organization.Four major programs have been established. The first program provides for the continuity of leadership and guidance by health authorities at the federal, provincial and municipal level. Essential records have been developed and emergency legislation prepared. This program, however, will be of little use unless health services are organized at the municipal level. In this organizational program, advice and assistance have been provided to existing hospitals and departments of health in the conduct of disaster planning. The efforts of these agencies are co-ordinated by municipal health authorities into a community disaster plan. The third program deals with information and education of the general public and the health workers. This program is designed to make the family unit self-sufficient for up to seven days and the health worker prepared to undertake his emergency role. The first three programs are directed to the organization and training of manpower; the fourth program provides the necessary supplies. From the national medical stockpile of $18,000,000, some $12,000,000 has been received, packaged for long-term storage and distributed to regional depots across the country. To ensure their ready availability in time of emergency an agreement has been reached with seven provinces for the release of hospital disaster kits.

Response diversity of wild bees to overwintering temperatures.

PubMed

Fründ, Jochen; Zieger, Sarah L; Tscharntke, Teja

2013-12-01

Biodiversity can provide insurance against environmental change, but only if species differ in their response to environmental conditions (response diversity). Wild bees provide pollination services to wild and crop plants, and response diversity might insure this function against changing climate. To experimentally test the hypothesis that bee species differ in their response to increasing winter temperature, we stored cocoons of nine bee species at different temperatures during the winter (1.5-9.5 °C). Bee species differed significantly in their responses (weight loss, weight at emergence and emergence date). The developmental stage during the winter explained some of these differences. Bee species overwintering as adults generally showed decreased weight and earlier emergence with increasing temperature, whereas bee species overwintering in pre-imaginal stages showed weaker or even opposite responses. This means that winter warming will likely affect some bee species negatively by increasing energy expenditure, while others are less sensitive presumably due to different physiology. Likewise, species phenologies will respond differently to winter warming, potentially affecting plant-pollinator interactions. Responses are not independent of current flight periods: bees active in spring will likely show the strongest phenological advances. Taken together, wild bee diversity provides response diversity to climate change, which may be the basis for an insurance effect.

Institutional frameworks for management of epizoonotic emergencies in six countries in the Eastern Africa region: a situational analysis.

PubMed

Bazeyo, W; Mayega, Roy W; Nabukenya, I; Keyyu, J; Mamuya, S; Tabu, S J; Senna, L; Mohammad, M; Rugigana, E; Alingi, A; Mapatano, M; Kiguli, J; Orach, C G; Burnham, G; Killewo, J

2013-06-01

The Eastern Africa region is a hot-spot for epidemics of emerging zoonotic diseases ('epizoonotics'). However, the region's capacity for response to epidemics of zoonotic origin has not been documented. This paper presents a multi-country situational analysis on the institutional frameworks for management of zoonotic epidemics in the Eastern Africa region. A multi-country assessment of 6 country teams was conducted (Uganda, Kenya, Tanzania, Ethiopia, DRC and Rwanda). It involved a review of records and interviews with key informants from agencies with a stake in the management of zoonotic and disasters in general in the respective countries. Qualitative data were analyzed for key emerging themes. There are many socio-cultural risk factors to epidemic prone zoonotic diseases in the region. Countries have varying levels of preparedness for zoonotic emergencies. All 6 countries have a framework for disaster management. However, technical response to epidemics is managed by the line sectors, with limited Inter-sectoral collaboration. Some sectors were disproportionately more prepared than others. Surveillance systems are mostly passive and inadequate for early detection. All 6 countries have built reasonable capacity to respond to avian influenza, but not other zoonotic emergencies. Most countries lack personnel at the operational levels, and veterinary public health services are ill-facilitated. There is need to strengthen veterinary public health services at all levels, but with a 'one health' approach. There is also need to establish 'risk-based surveillance' hot spots for zoonotic epidemics and to build community resilience 'epizoonotic' diseases.

Burnout and work environments of public health nurses involved in mental health care.

PubMed

Imai, H; Nakao, H; Tsuchiya, M; Kuroda, Y; Katoh, T

2004-09-01

(1) To examine whether prevalence of burnout is higher among community psychiatric nurses working under recently introduced job specific work systems than among public health nurses (PHNs) engaged in other public health services. (2) To identify work environment factors potentially contributing to burnout. Two groups were examined. The psychiatric group comprised 525 PHNs primarily engaged in public mental health services at public health centres (PHCs) that had adopted the job specific work system. The control group comprised 525 PHNs primarily engaged in other health services. Pines' Burnout Scale was used to measure burnout. Respondents were classified by burnout score into three groups: A (mentally stable, no burnout); B (positive signs, risk of burnout); and C (burnout present, action required). Groups B and C were considered representative of "burnout". A questionnaire was also prepared to investigate systems for supporting PHNs working at PHCs and to define emergency mental health service factors contributing to burnout. Final respondents comprised 785 PHNs. Prevalence of burnout was significantly higher in the psychiatric group (59.2%) than in the control group (51.5%). Responses indicating lack of job control and increased annual frequency of emergency overtime services were significantly correlated with prevalence of burnout in the psychiatric group, but not in the control group. Prevalence of burnout is significantly higher for community psychiatric nurses than for PHNs engaged in other services. Overwork in emergency services and lack of job control appear to represent work environment factors contributing to burnout.

Tulsa Oklahoma Oktoberfest Tent Collapse Report

PubMed Central

Deal, Kelly E.; Synovitz, Carolyn K.; Goodloe, Jeffrey M.; King, Brandi; Stewart, Charles E.

2012-01-01

Background. On October 17, 2007, a severe weather event collapsed two large tents and several smaller tents causing 23 injuries requiring evacuation to emergency departments in Tulsa, OK. Methods. This paper is a retrospective analysis of the regional health system's response to this event. Data from the Tulsa Fire Department, The Emergency Medical Services Authority (EMSA), receiving hospitals and coordinating services were reviewed and analyzed. EMS patient care reports were reviewed and analyzed using triage designators assigned in the field, injury severity scores, and critical mortality. Results. EMT's and paramedics from Tulsa Fire Department and EMSA provided care at the scene under unified incident command. Of the 23 patients transported by EMS, four were hospitalized, one with critical spinal injury and one with critical head injury. One patient is still in ongoing rehabilitation. Discussion. Analysis of the 2007 Tulsa Oktoberfest mass casualty incident revealed rapid police/fire/EMS response despite challenges of operations at dark under severe weather conditions and the need to treat a significant number of injured victims. There were no fatalities. Of the patients transported by EMS, a minority sustained critical injuries, with most sustaining injuries amenable to discharge after emergency department care. PMID:22649732

Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses' perceptions in hospitals in Mecca, Saudi Arabia.

PubMed

Alzahrani, Fuad; Kyratsis, Yiannis

2017-04-11

To assess hospital emergency nurses' self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca. Cross-sectional online survey with primary data collection and non-probabilistic purposive sample conducted in late 2014. All 4 public hospitals in Mecca, Saudi Arabia. 106 registered nurses in hospital emergency departments. Awareness, knowledge, skills and perceptions of emergency nurses in Mecca with regard to mass gathering disaster preparedness. 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. Recommendations are suggested to help enhance clinical and educational efforts in disaster preparedness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Pre-hospital management of adults with life-threatening emergencies].

PubMed

Wattel, Francis; Dubois, François

2012-01-01

In France, acute life-threatening situations are handled by the French Secours a Personne (assistance to persons) and emergency medical facilities. An unequivocal success, this early management of life-threatening emergency situations relies upon centralized call reception, medical dispatching, and immediate on-site emergency medical care. We describe the different emergency care providers and steps involved in the response to emergency situations. Each call centre (Samu, phone number 15; Sapeurs-Pompiers, 18) provides a response tailored to the nature of incoming calls for assistance. A check-list of grounds for an "automatic response" by the SDIS (Service Départemental d'Incendie et de Secours--the French fire brigade) is in use, ensuring that firefighters are often the first on the spot, while the knowledge and skills of the dispatching physician are essential to ascertain the patient's needs, to preserve life and vital functions, and to ensure the patient is sent to the appropriate emergency healthcare facility. In life-threatening emergency situations, patients must be brought straight to the appropriate reference emergency healthcare facility, as quickly as possible, without prior admittance to an emergency department. This is the procedure for extremely acute emergency situations in the following areas: trauma (multiple trauma and/or uncontrolled bleeding, spinal cord trauma), delivery bleeding, other life-threatening situations such as ischemic heart disease, cardiac arrest (sudden death), cerebrovascular stroke and ensuing brain damage, some acute respiratory situations such as anaphylactic shock, foreign-body inhalation, electrocution, drowning, drug overdose, certain forms of poisoning, and conditions requiring initial hyperbaric oxygen (diving accidents, acute carbon monoxide and smoke poisoning). The reasons for suboptimal emergency care in life-threatening situations are currently a major issue, with medical facilities being reduced in some areas, fewer voluntary firemen, hospital reorganization, tight funding, difficulties of medical dispatching, and the varying skills of "first-on-the-scene "emergency workers. Grievances include late emergency responses, inappropriate medical care, and dispatching to the wrong facility. This raises the question of equal opportunity for all in a country with widely varying geographic features and population density. Improvement in the system's efficiency will require a series of objectives to be met in varied and complementary--Enhanced functional coordination, by speeding up the deployment of the ANTARES digital radio-frequency transmission network (Adaptation Nationale des Transmissions Aux Risques Et aux Secours).--Implementation of a network of emergency services with varying degrees of emergency healthcare management related to the technical nature of the facilities. Three levels of emergency healthcare must be made available: level 1 is provided by local hospitals, level 2 includes support facilities available in general hospitals (not necessarily the nearest hospital), and level 3 provides specialized healthcare in large and/or training hospitals with specialized departments. Life-threatening emergency situations are to be handled by level 2 or 3 facilities. Specific facilities must be selected as reference centers. In France, the ARS (Agences Régionales de Santé) is in charge of this procedure, as it provide funding for healthcare continuity--Reducing inequalities in access to emergency care. This will involve improving the network of SDIS brigades, making local medical facilities more responsive, delegating more medical procedures, on-site telemedicine, providing more helicopters equipped with healthcare facilities, more automated external defibrillators, and more dedicated neuro-vascular units.--First aid training must be made widely available. The French National Academy of Medicine has approved ten recommendations regarding organization and facilities.

76 FR 63353 - Proposed Information Collection (Payment and Reimbursement for Emergency Services for Non Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... (Payment and Reimbursement for Emergency Services for Non Service-Connected Conditions in Non-VA Facilities... to determine a claimant's eligibility for reimbursement or payment for emergency medical treatment at... information technology. Title: Payment and Reimbursement for Emergency Services for Non Service-Connected...

Site specific wave parameters for Texas coastal bridges : final report.

DOT National Transportation Integrated Search

2010-04-01

There are about 20 coastal bridges located in hurricane evacuation routes in the State of Texas that are : vulnerable to hurricane surge and wave action. Damage to these bridges could hamper emergency response : and other services, and also cause tre...

Stochastic Coloured Petrinet Based Healthcare Infrastructure Interdependency Model

NASA Astrophysics Data System (ADS)

Nukavarapu, Nivedita; Durbha, Surya

2016-06-01

The Healthcare Critical Infrastructure (HCI) protects all sectors of the society from hazards such as terrorism, infectious disease outbreaks, and natural disasters. HCI plays a significant role in response and recovery across all other sectors in the event of a natural or manmade disaster. However, for its continuity of operations and service delivery HCI is dependent on other interdependent Critical Infrastructures (CI) such as Communications, Electric Supply, Emergency Services, Transportation Systems, and Water Supply System. During a mass casualty due to disasters such as floods, a major challenge that arises for the HCI is to respond to the crisis in a timely manner in an uncertain and variable environment. To address this issue the HCI should be disaster prepared, by fully understanding the complexities and interdependencies that exist in a hospital, emergency department or emergency response event. Modelling and simulation of a disaster scenario with these complexities would help in training and providing an opportunity for all the stakeholders to work together in a coordinated response to a disaster. The paper would present interdependencies related to HCI based on Stochastic Coloured Petri Nets (SCPN) modelling and simulation approach, given a flood scenario as the disaster which would disrupt the infrastructure nodes. The entire model would be integrated with Geographic information based decision support system to visualize the dynamic behaviour of the interdependency of the Healthcare and related CI network in a geographically based environment.

Emergency motorcycle: has it a place in a medical emergency system?

PubMed

Soares-Oliveira, Miguel; Egipto, Paula; Costa, Isabel; Cunha-Ribeiro, Luis Manuel

2007-07-01

In an emergency medical service system, response time is an important factor in determining the prognosis of a victim. There are well-documented increases in response time in urban areas, mainly during rush hour. Because prehospital emergency care is required to be efficient and swift, alternative measures to achieve this goal should be addressed. We report our experience with a medical emergency motorcycle (MEM) and propose major criteria for dispatching it. This work presents a prospective analysis of the data relating to MEM calls from July 2004 to December 2005. The analyzed parameters were age, sex, reason for call, action, and need for subsequent transport. A comparison was made of the need to activate more means and, if so, whether the MEM was the first to arrive. There were 1972 calls. The average time of arrival at destination was 4.4 +/- 2.5 minutes. The main action consisted of administration of oxygen (n = 626), immobilization (n = 118), and control of hemorrhage (n = 101). In 63% of cases, MEM arrived before other emergency vehicles. In 355 cases (18%), there was no need for transport. The MEM can intervene in a wide variety of clinical situations and a quick response is guaranteed. Moreover, in specific situations, MEM safely and efficiently permits better management of emergency vehicles. We propose that it should be dispatched mainly in the following situations: true life-threatening cases and uncertain need for an ambulance.

GIO-EMS and International Collaboration in Satellite based Emergency Mapping

NASA Astrophysics Data System (ADS)

Kucera, Jan; Lemoine, Guido; Broglia, Marco

2013-04-01

During the last decade, satellite based emergency mapping has developed into a mature operational stage. The European Union's GMES Initial Operations - Emergency Management Service (GIO-EMS), is operational since April 2012. It's set up differs from other mechanisms (for example from the International Charter "Space and Major Disasters"), as it extends fast satellite tasking and delivery with the value adding map production as a single service, which is available, free of charge, to the authorized users of the service. Maps and vector datasets with standard characteristics and formats ranging from post-disaster damage assessment to recovery and disaster prevention are covered by this initiative. Main users of the service are European civil protection authorities and international organizations active in humanitarian aid. All non-sensitive outputs of the service are accessible to the public. The European Commission's in-house science service Joint Research Centre (JRC) is the technical and administrative supervisor of the GIO-EMS. The EC's DG ECHO Monitoring and Information Centre acts as the service's focal point and DG ENTR is responsible for overall service governance. GIO-EMS also aims to contribute to the synergy with similar existing mechanisms at national and international level. The usage of satellite data for emergency mapping has increased during the last years and this trend is expected to continue because of easier accessibility to suitable satellite and other relevant data in the near future. Furthermore, the data and analyses coming from volunteer emergency mapping communities are expected to further enrich the content of such cartographic products. In the case of major disasters the parallel activity of more providers is likely to generate non-optimal use of resources, e.g. unnecessary duplication; whereas coordination may lead to reduced time needed to cover the disaster area. Furthermore the abundant number of geospatial products of different characteristics and quality can become confusing for users. The urgent need for a better coordination has led to establishment of the International Working Group on Satellite Based Emergency Mapping (IWG-SEM). Members of the IWG-SEM, which include JRC, USGS, DLR-ZKI, SERVIR, Sentinel Asia, UNOSAT, UN-SPIDER, GEO, ITHACA and SERTIT have recognized the need to establish the best practice between operational satellite-based emergency mapping programs. The group intends to: • work with the appropriate organizations on definition of professional standards for emergency mapping, guidelines for product generation and reviewing relevant technical standards and protocols • facilitate communication and collaboration during the major emergencies • stimulate coordination of expertise and capacities. The existence of the group and the cooperation among members already brought benefits during recent disasters in Africa and Europe in 2012 in terms of faster and effective satellite data provision and better product generation.

Personalization, Personalized Learning and the Reform of Social Policy: The Prospect of Molecular Governance in the Digitized Society

ERIC Educational Resources Information Center

Peters, Michael A.

2009-01-01

This article argues that personalized learning has emerged in the last decade as a special instance of a more generalized response to the problem of the reorganization of the State in response to globalization and the end of the effectiveness of the industrial mass production model in the delivery of public services. The article examines…

Fuel Cell Backup Power System for Grid Service and Micro-Grid in Telecommunication Applications: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ma, Zhiwen; Eichman, Joshua D; Kurtz, Jennifer M

This paper presents the feasibility and economics of using fuel cell backup power systems in telecommunication cell towers to provide grid services (e.g., ancillary services, demand response). The fuel cells are able to provide power for the cell tower during emergency conditions. This study evaluates the strategic integration of clean, efficient, and reliable fuel cell systems with the grid for improved economic benefits. The backup systems have potential as enhanced capability through information exchanges with the power grid to add value as grid services that depend on location and time. The economic analysis has been focused on the potential revenuemore » for distributed telecommunications fuel cell backup units to provide value-added power supply. This paper shows case studies on current fuel cell backup power locations and regional grid service programs. The grid service benefits and system configurations for different operation modes provide opportunities for expanding backup fuel cell applications responsive to grid needs.« less

Association between Enhanced Access Services in Pediatric Primary Care and Utilization of Emergency Departments: A National Parent Survey

PubMed Central

Zickafoose, Joseph S.; DeCamp, Lisa R.; Prosser, Lisa A.

2013-01-01

Objectives To measure the prevalence of enhanced access services in pediatric primary care and to assess whether enhanced access services are associated with lower emergency department (ED) utilization. Study design Internet-based survey of a national sample of parents (n=820, response rate 41%). We estimated the prevalence of reported enhanced access services and ED use in the prior 12 months. We then used multivariate negative binomial regression to assess associations between enhanced access services and ED use. Results The majority of parents reported access to advice by telephone during office hours (80%), same-day sick visits (79%), and advice by telephone outside office hours (54%). Fewer than one-half of parents reported access to their child’s primary care office on weekends (47%), after 5:00 pm on any night (23%), or by email (13%). Substantial proportions of parents reported that they did not know if these services were available (7-56%, depending on service). Office hours after 5:00 pm on ≥5 nights a week was the only service significantly associated with ED utilization in multivariate analysis (adjusted incidence rate ratio: 0.51 [95% CI 0.28-0.92]). Conclusions The majority of parents report enhanced access to their child’s primary care office during office hours, but many parents do not have access or do not know if they have access outside of regular office hours. Extended office hours may be the most effective practice change to reduce emergency department use. Primary care practices should prioritize the most effective enhanced access services and communicate existing services to families. PMID:23759421

Multispectral, hyperspectral, and LiDAR remote sensing and geographic information fusion for improved earthquake response

NASA Astrophysics Data System (ADS)

Kruse, F. A.; Kim, A. M.; Runyon, S. C.; Carlisle, Sarah C.; Clasen, C. C.; Esterline, C. H.; Jalobeanu, A.; Metcalf, J. P.; Basgall, P. L.; Trask, D. M.; Olsen, R. C.

2014-06-01

The Naval Postgraduate School (NPS) Remote Sensing Center (RSC) and research partners have completed a remote sensing pilot project in support of California post-earthquake-event emergency response. The project goals were to dovetail emergency management requirements with remote sensing capabilities to develop prototype map products for improved earthquake response. NPS coordinated with emergency management services and first responders to compile information about essential elements of information (EEI) requirements. A wide variety of remote sensing datasets including multispectral imagery (MSI), hyperspectral imagery (HSI), and LiDAR were assembled by NPS for the purpose of building imagery baseline data; and to demonstrate the use of remote sensing to derive ground surface information for use in planning, conducting, and monitoring post-earthquake emergency response. Worldview-2 data were converted to reflectance, orthorectified, and mosaicked for most of Monterey County; CA. Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data acquired at two spatial resolutions were atmospherically corrected and analyzed in conjunction with the MSI data. LiDAR data at point densities from 1.4 pts/m2 to over 40 points/ m2 were analyzed to determine digital surface models. The multimodal data were then used to develop change detection approaches and products and other supporting information. Analysis results from these data along with other geographic information were used to identify and generate multi-tiered products tied to the level of post-event communications infrastructure (internet access + cell, cell only, no internet/cell). Technology transfer of these capabilities to local and state emergency response organizations gives emergency responders new tools in support of post-disaster operational scenarios.

Strategic responses to fiscal constraints: a health policy analysis of hospital-based ambulatory physical therapy services in the Greater Toronto Area (GTA).

PubMed

Landry, Michel D; Verrier, Molly C; Williams, A Paul; Zakus, David; Deber, Raisa B

2009-01-01

Ambulatory physical therapy (PT) services in Canada are required to be insured under the Canada Health Act, but only if delivered within hospitals. The present study analyzed strategic responses used by hospitals in the Greater Toronto Area (GTA) to deliver PT services in an environment of fiscal constraint. Key informant interviews (n = 47) were conducted with participants from all hospitals located within the GTA. Two primary strategic responses were identified: (1) "load shedding" through the elimination or reduction of services, and (2) "privatization" through contracting out or creating internal for-profit subsidiary clinics. All hospitals reported reductions in service delivery between 1996 and 2003, and 15.0% (7/47 hospitals) fully eliminated ambulatory services. Although only one of 47 hospitals contracted out services, another 15.0% (7/47) reported that for-profit subsidiary clinics were created within the hospital in order to access other more profitable forms of quasi-public and private funding. Strategic restructuring of services, aimed primarily at cost containment, may have yielded short-term financial savings but has also created a ripple effect across the continuum of care. Moreover, the rise of for-profit subsidiary clinics operating within not-for-profit hospitals has emerged without much public debate and with little research to evaluate its impact.

[An emergency team working closely with the patient].

PubMed

Selma, Toufik; Chermak, Mustapha; Limani, Mohammed; Rochard, Jacques; Wendlandt, Jérôme; Hernandez, Angélique

2015-01-01

ERIC 77 is a rapid response team for emergency psychiatric situations. This cross-sector service based at Marne-la-Vallée general hospital represents a supplementary network in psychiatric patient care. The analysis of the professionals receiving calls as well as the link with the sector are critical in determining the success of patient care. Each risk is measured in order to provide adapted and personalised care. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Purchasing and Using Personal Emergency Response Systems (PERS): how decisions are made by community-dwelling seniors in Canada.

PubMed

McKenna, Alexandra C; Kloseck, Marita; Crilly, Richard; Polgar, Jan

2015-07-11

As the demographic of older people continues to grow, health services that support independence among community-dwelling seniors have become increasingly important. Personal Emergency Response Systems (PERS) are medical alert systems, designed to serve as a safety net for seniors living alone. Health care professionals often recommend that seniors in danger of falls or other medical emergencies obtain a PERS. The purpose of the study was to investigate the experience of seniors living with and using a PERS in their daily lives, using a qualitative grounded theory approach. Five focus groups and 10 semi-structured interviews, with a total of 30 participants, were completed using a grounded theory approach. All participants were PERS subscribers over the age of 80, living alone in a naturally occurring retirement community (NORC) with high health service utilization in a major urban centre in Ontario. Constant comparative analysis was used to develop themes and ultimately a model of why and how seniors obtain and use the PERS. Two core themes, unpredictability and decision-making around PERS activation, emerged as major features of the theoretical model. Being able to get help and the psychological value of PERS informed the context of living with a PERS. A number of theoretical conclusions related to unpredictability and the decision-making process around activating PERS were generated.

Characteristics and triage of a maritime disaster: an accidental passenger ship collision in Korea.

PubMed

Ryu, Ji Ho; Yeom, Seok Ran; Jeong, Jin Woo; Kim, Yong In; Cho, Suck Ju

2010-06-01

The aim of this study was to analyze the characteristics of and responses to a maritime disaster, by reviewing the events surrounding the accidental collision of a high-speed passenger ship in South Korea. Of the 215 boarded passengers on a high-speed passenger ship sailing from Fukuoka to Busan, we retrospectively examined information of 114 victims of the ship's collision with a whale on 12 April 2007. We referenced reports from the on-site disaster medical assistance team members; recorded notifications to the Busan 1339 Emergency Medical Information Centre, from the scene of the accident and data from the ship's insurer. The 114 victims were transported to 20 different hospitals. Many patients were transported to nearby local hospitals from the scene of the accident; other patients were transported to more distant hospitals. Eighty-five patients were transported to hospitals through mobile emergency support units, whereas the other patients were transported directly by fire officers from the 119 Fire Officer Centre. One patient died in the transport. In conclusion, our national emergency medical service and disaster response system each suffer from many problems - especially a lack of cooperation among related departments and insufficient communication therein. The onboard planning and practice of a disaster plan is required, and a reliable information system between the scene of a maritime disaster and our emergency medical service system should be developed.

[Mistakes and omissions in judicial reports prepared in emergency services].

PubMed

Turla, Ahmet; Aydin, Berna; Sataloğlu, Neva

2009-03-01

We aimed in this study to determine any mistakes or omissions made while preparing judicial reports, which contribute to the judicial process. In this study, we evaluated as samples 351 judicial reports of victims who applied to the Emergency Service of Ondokuz Mayis University between January 1, 2005 and December 31, 2005 with respect to the judicial facts, and we recorded any mistakes or omissions of data in these reports. We determined that there was no record of age in 6% of the judicial reports, of examination time in 71.8%, of traumatic lesion or not in 30.5%, of the state of consciousness in 58.7%, and of the presence or not of life-threatening risks in 2.6%. The name of the physician who prepared the report was not provided in 8.0% of the reports. The most important omission is that none of the reports had the name, surname or signature of the person who had taken the prepared report. We concluded that, after graduation, it is necessary for physicians, who are responsible for both treating the patients and writing judicial reports, to attend in-service training programs. They must also be properly advised regarding their responsibilities in judicial cases.

DOC/WSNSO (Department of Commerce/Weather Service Nuclear Support Office) operational support to Federal Radiological Monitoring and Assessment Center

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mueller, P.

1989-01-01

The National Weather Service (NWS) is an agency of the Department of Commerce. The NWS has hundreds of weather offices throughout the United States. The Weather Service Nuclear Support Office (WSNSO) is a highly specialized unit of NWS that provides direct support to the U.S. Department of Energy's (DOE's) underground nuclear testing program. The WSNSO has been associated with the DOE for >33 yr. As a result of the unique relationship with the DOE, all WSNSO emergency response meteorologists and meteorological technicians are allowed access to classified material. Meteorological phenomena play a significant role during a Federal Radiological Monitoring andmore » Assessment Center (FRMAC) event, and WSNSO meteorologists provide direct support to ARAC. The marriage of state-of-the-art computer systems together with proven technology provides the on-scene WSNSO meteorologist with essentially a portable fully equipped, fully functional, advanced NWS weather station. The WSNSO's emergency response personnel and hardware are at the ready and can be mobilized within 2 h. WSNSO can provide on-scene weather forecasts and critical weather data collection whenever and wherever necessary.« less

Public perceptions of hospital responsibilities to those presenting without medical injury or illness during a disaster.

PubMed

Charney, Rachel L; Rebmann, Terri; Esguerra, Cybill R; Lai, Charlene W; Dalawari, Preeti

2013-10-01

During natural and manmade disasters, the hospital is perceived as a central rallying and care site for the public, for both those with and without emergency medical needs. The expectations of the public may outstrip hospital plans and abilities to provide nonmedical assistance. Our objective was to determine the public expectations of the hospital during disasters regarding resource provision. A survey was distributed to adult patients or family members at three emergency departments (EDs). Respondents were asked to evaluate hospital responsibility to provide nine resources to those without emergency medical needs, including vaccination, medication refill or replacement, food and water, grief/stress counseling, Federal Emergency Management Agency (FEMA) access assistance, short/long-term shelter, family reunification, and hospital. Additionally, respondents answered questions regarding prior disaster experience and demographics. There were 961 respondents (66.9% were female, 47.5% were white, and 44.6% were black). Respondents agreed or strongly agreed that the hospital should provide the following services: event-specific vaccination (84%), medication refill/replacement (76.5%), food and water (61%), grief or stress counseling (53%), FEMA access assistance (52%), short-term shelter (51%), family reunification (50%), long-term shelter (38%), and hospital transportation (29%). Those 36-45 years of age were less likely to expect services (p < 0.05) and non-whites and those with a family member with a medical condition requiring electricity were more likely to expect services (p < 0.001 and p < 0.05, respectively). There were no differences based on frequency of ED use, sex, income, or prior disaster experience. There is a high public expectation that hospitals will provide significant nonmedical disaster relief. Understanding these expectations is essential to appropriate community disaster planning. Copyright © 2013 Elsevier Inc. All rights reserved.

Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study.

PubMed

McCann, Terence V; Lubman, Dan I

2012-08-01

Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service's funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people's consciousness, while the appointment system would benefit from providing more timely appointments with therapists. The service's funding model is important in enabling access initially to young people from low socioeconomic backgrounds, but the government needs to reassess the model for those who require additional support.

32 CFR 644.486 - Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or...

Code of Federal Regulations, 2014 CFR

2014-07-01

... which the Government otherwise has no interest, such as a wing, and in which a defense contractor... address of a responsible officer of the using service to join with the DE concerned as a representative of...

32 CFR 644.486 - Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or...

Code of Federal Regulations, 2013 CFR

2013-07-01

... which the Government otherwise has no interest, such as a wing, and in which a defense contractor... address of a responsible officer of the using service to join with the DE concerned as a representative of...

32 CFR 644.486 - Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or...

Code of Federal Regulations, 2011 CFR

2011-07-01

... which the Government otherwise has no interest, such as a wing, and in which a defense contractor... address of a responsible officer of the using service to join with the DE concerned as a representative of...

32 CFR 644.486 - Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or...

Code of Federal Regulations, 2012 CFR

2012-07-01

... which the Government otherwise has no interest, such as a wing, and in which a defense contractor... address of a responsible officer of the using service to join with the DE concerned as a representative of...

A Framework for Facilitating Ecosystem Services-based Decision-making and the Development of Decision-making Tools

EPA Science Inventory

There is an increasing understanding that top-down regulatory and technology driven responses are not sufficient to address current and emerging environmental challenges such as climate change, sustainable communities, and environmental justice. The vast majority of environmenta...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

Response, Emergency Staging, Communications, Uniform Management, and Evacuation (R.E.S.C.U.M.E.) : concept of operations.

DOT National Transportation Integrated Search

1997-01-01

The purpose of the Federal Highway Administration (FHWA)s mainstreaming program is to organize and manage the deployment of Intelligent Transportation Systems (ITS) for Commercial Vehicle Operations (CVO). ITS/CVO services are streamlining t...

41 CFR 105-53.120 - Address and telephone numbers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Civil Rights; Office of Citizen Services and Innovative Technologies; Office of the Chief Information Officer; Office of Emergency Response and Recovery; Office of the Chief Financial Officer; Chief... Utilization; Office of General Counsel; Office of the Chief People Officer; Office of Communications and...

Chief Information Officers on Campus.

ERIC Educational Resources Information Center

Woodsworth, Anne; And Others

1987-01-01

Describes changes in management structures on college campuses that have led to the emergence of the position of chief information officer (CIO) to improve information services. The merging of new information technologies with traditional resources is discussed, the responsibilities of CIOs are described, and possible future developments are…

41 CFR 105-53.120 - Address and telephone numbers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Civil Rights; Office of Citizen Services and Innovative Technologies; Office of the Chief Information Officer; Office of Emergency Response and Recovery; Office of the Chief Financial Officer; Chief... Utilization; Office of General Counsel; Office of the Chief People Officer; Office of Communications and...

75 FR 18551 - Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-12

... telecommunications device for the deaf (TDD) may call the Federal Information Relay Service (FIRS) at 1-800-877-8339... Collection: Antarctic emergency response plan and environmental protection information. OMB Approval Number... environmental protection obligations under the Antarctic Conservation Act. Expected Respondents. Respondents may...

A proposed emergency management program for acute care facilities in response to a highly virulent infectious disease.

PubMed

Petinaux, Bruno; Ferguson, Brandy; Walker, Milena; Lee, Yeo-Jin; Little, Gary; Parenti, David; Simon, Gary

2016-01-01

To address the organizational complexities associated with a highly virulent infectious disease (HVID) hazard, such as Ebola Virus Disease (EVD), an acute care facility should institute an emergency management program rooted in the fundamentals of mitigation, preparedness, response, and recovery. This program must address all known facets of the care of a patient with HVID, from unannounced arrival to discharge. The implementation of such a program not only serves to mitigate the risks from an unrecognized exposure but also serves to prepare the organization and its staff to provide for a safe response, and ensure a full recovery. Much of this program is based on education, training, and infection control measures along with resourcing for appropriate personal protective equipment which is instrumental in ensuring an organized and safe response of the acute care facility in the service to the community. This emergency management program approach can serve as a model in the care of not only current HVIDs such as EVD but also future presentations in our healthcare setting.

Response to bio-terrorism directed against animals.

PubMed

Williams, J L; Sheesley, D

2000-01-01

The Animal and Plant Health Inspection Service (APHIS) has a long history of rapid direction, control, and eradication of devastating diseases. Our immediate response mechanisms to diseases such as avian influenza, Venezuelan equine encephalomyelitis, and Newcastle disease, have long been recognized by the global emergency response community as models of control and eradication. APHIS and the U.S. livestock industries, in partnership with the Animal Agriculture Coalition, re-evaluated the Nation's animal health emergency preparedness and response systems. The group identified areas that negatively impact, biologically and/or economically, the Nation's animal and food production industries. To counter the increased risks including bioterrorism, APHIS plans to establish a world-class "Center of Excellence for Animal Health Emergency Management." APHIS, Intelligence agencies, other Federal departments, State governments, and industries are working together to provide accurate information on the foreign and domestic threats posed to the U.S. agricultural sector by biological weapons. Additionally, the same agencies and organizations are evaluating, updating, and improving the coordination and training mechanisms necessary to respond in the even of a widespread pest or disease outbreak.

Uncertainty analysis of accident notification time and emergency medical service response time in work zone traffic accidents.

PubMed

Meng, Qiang; Weng, Jinxian

2013-01-01

Taking into account the uncertainty caused by exogenous factors, the accident notification time (ANT) and emergency medical service (EMS) response time were modeled as 2 random variables following the lognormal distribution. Their mean values and standard deviations were respectively formulated as the functions of environmental variables including crash time, road type, weekend, holiday, light condition, weather, and work zone type. Work zone traffic accident data from the Fatality Analysis Report System between 2002 and 2009 were utilized to determine the distributions of the ANT and the EMS arrival time in the United States. A mixed logistic regression model, taking into account the uncertainty associated with the ANT and the EMS response time, was developed to estimate the risk of death. The results showed that the uncertainty of the ANT was primarily influenced by crash time and road type, whereas the uncertainty of EMS response time is greatly affected by road type, weather, and light conditions. In addition, work zone accidents occurring during a holiday and in poor light conditions were found to be statistically associated with a longer mean ANT and longer EMS response time. The results also show that shortening the ANT was a more effective approach in reducing the risk of death than the EMS response time in work zones. To shorten the ANT and the EMS response time, work zone activities are suggested to be undertaken during non-holidays, during the daytime, and in good weather and light conditions.

Determinants of Paramedic Response Readiness for CBRNE Threats

PubMed Central

Jones, Alison; Smith, George; Nelson, Jenny; Agho, Kingsley; Taylor, Melanie; Raphael, Beverley

2010-01-01

Paramedics play a pivotal role in the response to major emergencies. Recent evidence indicates that their confidence and willingness to respond to chemical, biological, radiological, nuclear, and explosives-related (CBRNE) incidents differs from that relating to their “routine” emergency work. To further investigate the factors underpinning their readiness to respond to CBRNE incidents, paramedics in New South Wales (NSW), Australia, were asked to complete a validated online survey instrument. Univariate and multivariate analyses were performed to examine associated factors determining readiness. The sample of 663 respondents was weighted to reflect the NSW paramedic population as a whole. The univariate analysis indicated that gender, length of service, deployment concern, perceived personal resilience, CBRNE training, and incident experience were significantly associated with perceived CBRNE response readiness. In the initial multivariate analysis, significantly higher response readiness was associated with male gender, university education, and greater length of service (10-15 years). In the final multivariate model, the combined effect of training/incident experience negated the significant effects observed in the initial model and, importantly, showed that those with recent training reported higher readiness, irrespective of incident experience. Those with lower concern regarding CBRNE deployment and those with higher personal resilience were significantly more likely to report higher readiness (Adjusted Relative Risk [ARR] = 0.91, 95% CI: 0.84-0.99; ARR = 1.40, 95% CI: 1.11-1.72, respectively). These findings will assist emergency medical planners in recognizing occupational and dispositional factors associated with enhanced CBRNE readiness and highlight the important role of training in redressing potential readiness differences associated with these factors. PMID:20569060

National health and medical services response to incidents of chemical and biological terrorism.

PubMed

Tucker, J B

1997-08-06

In response to the growing threat of terrorism with chemical and biological weapons, the US government has developed a national concept of operations for emergency health and medical services response. This capability was developed and tested for the first time during the Atlanta Olympic Games in the summer of 1996. In the event of a chemical or biological terrorist incident that exceeded local and state-level response capabilities, federal agencies would provide specialized teams and equipment to help manage the consequences of the attack and treat, decontaminate, and evacuate casualties. The US Congress has also established a Domestic Preparedness Program that provides for enhanced training of local first-responders and the formation of metropolitan medical strike teams in major cities around the country. While these national response capabilities are promising, their implementation to date has been problematic and their ultimate effectiveness is uncertain.

Emergency medicine in the Veterans Health Administration-results from a nationwide survey.

PubMed

Ward, Michael J; Collins, Sean P; Pines, Jesse M; Dill, Curt; Tyndall, Gary; Kessler, Chad S

2015-07-01

We describe emergency physician staffing, capabilities, and academic practices in US Veterans Health Administration (VHA) emergency departments (EDs). As part of an ongoing process improvement effort for the VHA emergency care system, VHA-wide surveys are conducted among ED medical directors every 3 years. Web-based surveys of VHA ED directors were conducted in 2013 on clinical operations and academic program development. We describe the results from the 2013 survey. When available, we compare responses with the previously administered survey from 2010. A total of 118 of 118 ED directors filled out the survey in 2013 (100% response rate). Respondents reported that 45.5% of VHA emergency physicians are board certified in emergency medicine, and 95% spend most their time in direct patient care. Clinical care is also provided by part-time (<0.5 full-time employee equivalent) emergency physicians in 59.3% of EDs. More than half of EDs (57%) provide on-site tissue plasminogen activator for acute ischemic stroke patients, and only 39% can administer tissue plasminogen activator 24 hours per day, 7 days per week. Less than half (48.3%) of EDs have emergency Obstetrics and Gynecology consultation availability. Most VHA EDs (78.8%) have a university affiliation, but only 21.5% participated in the respective academic emergency medicine program. Veterans Health Administration emergency physicians have primarily clinical responsibilities, and less than half have formal emergency medicine board certification. Despite most VHA EDs having university affiliations, traditional academic activities (eg, teaching and research) are performed in only 1 in 3 VHA EDs. Less than half of VHA EDs have availability of consulting services, including advanced stroke care and women's health. Published by Elsevier Inc.

[Current situation and development trend of Chinese medicine information research].

PubMed

Dong, Yan; Cui, Meng

2013-04-01

Literature resource service was the main service that Chinese medicine (CM) information offered. But in recent years users have started to request the health information knowledge service. The CM information researches and application service mainly included: (1) the need of strength studies on theory, application of technology, information retrieval, and information standard development; (2) Information studies need to support clinical decision making, new drug research; (3) Quick response based on the network monitoring and support to emergency countermeasures. CM information researches have the following treads: (1) developing the theory system structure of CM information; (2) studying the methodology system of CM information; (3) knowledge discovery and knowledge innovation.

The Health Science Librarian: A Member of the Health Care Team Responsive to Emerging Trends.

ERIC Educational Resources Information Center

Roach, Agnes A.

1979-01-01

Considers the role of medical librarians as it contributes to the effectiveness of patient care teams, and discusses the training and certification of clinical librarians, the development of library health care services, and the activities of medical information networks. (FM)

78 FR 21164 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-09

... the deaf (TDD) may call the Federal Information Relay Service (FIRS) at 1-800-877-8339 between 8:00 a... Collection: Antarctic emergency response plan and environmental protection information. OMB Approval Number... expedition to provide expedition members with information on their environmental protection obligations under...

Decision Analysis for a Sustainable Environment, Economy, and Society: A Participatory Framework for Ecosystem Services-Based Decision-Making

EPA Science Inventory

There is an increasing understanding that top-down regulatory and technology driven responses are not sufficient to address current and emerging environmental challenges such as climate change, sustainable communities, and environmental justice. The vast majority of environmenta...

The Current Crisis in Emergency Care and the Impact on Disaster Preparedness

PubMed Central

Cherry, Robert A; Trainer, Marcia

2008-01-01

Background The Homeland Security Act (HSA) of 2002 provided for the designation of a critical infrastructure protection program. This ultimately led to the designation of emergency services as a targeted critical infrastructure. In the context of an evolving crisis in hospital-based emergency care, the extent to which federal funding has addressed disaster preparedness will be examined. Discussion After 9/11, federal plans, procedures and benchmarks were mandated to assure a unified, comprehensive disaster response, ranging from local to federal activation of resources. Nevertheless, insufficient federal funding has contributed to a long-standing counter-trend which has eroded emergency medical care. The causes are complex and multifactorial, but they have converged to present a severely overburdened system that regularly exceeds emergency capacity and capabilities. This constant acute overcrowding, felt in communities all across the country, indicates a nation at risk. Federal funding has not sufficiently prioritized the improvements necessary for an emergency care infrastructure that is critical for an all hazards response to disaster and terrorist emergencies. Summary Currently, the nation is unable to meet presidential preparedness mandates for emergency and disaster care. Federal funding strategies must therefore be re-prioritized and targeted in a way that reasonably and consistently follows need. PMID:18452615

Dedicated pediatric behavioral health unit: serving the unique and individual needs of children in behavioral health crisis.

PubMed

Grover, Purva; Lee, Timothy

2013-02-01

Pediatric mental health emergencies are an increasing part of emergency medical practice because emergency departments have become the safety net for a fragmented mental health infrastructure that is experiencing critical shortages in services in all sectors. The emergency services for behavioral health unit at Akron Children's Hospital is an innovative model for delivering care to pediatric patients with mental health emergencies. A multidisciplinary team using the expertise of emergency services, psychiatry, social work, parent advisory counsel, security services, and engineering/architecture developed the emergency services for behavioral health unit blueprint, process, and staffing model.

[Fatal incidents by crowd crush during mass events. (Un)preventable phenomenon?].

PubMed

Wagner, U; Fälker, A; Wenzel, V

2013-01-01

Crowd crushes with dozens or even hundreds of casualties have occurred several times at the Hajj in Saudi Arabia and also in soccer stadiums in Western Europe. As fatal accidents after human stampedes during mass events occur very rarely and are usually accompanied by many years of criminal court proceedings in order to identify underlying responsible mechanisms and culprits, it is very difficult to draw conclusions and formulate precautions from an emergency medical point of view. This study analyzed a fatal crowd crush which occurred on 4 December 1999 following the "Air & Style" snowboard contest with approximately 22,000 people attending in the Bergisel stadium in Innsbruck, Austria. Firstly, focused interviews were conducted with professional rescuers, police and physicians and secondly publicly available court records dealing with this incident in the district court of Innsbruck, Austria were analyzed. During the snowboard contest 87 emergency medical technicians, 6 emergency physicians, 1 leading emergency physician, 21 policemen and 140 security personnel were present. Following the accident additionally some 100 emergency medical technicians, 36 emergency medical service vehicles and 4 physician-staffed emergency medical service vehicles responded to the scene. The deadly crowd crush resulting in 6 fatalities, 4 patients still in a vegetative state and 38 injured, was due to a severe crowd accumulation at one stadium exit, which was not recognized and dispersed in time. Construction of the exit in line with darkness, steep slope and slippery surface contributed adversely to this dangerous situation, although panic did not occur at any time. Unfortunately, there is no patent remedy to completely prevent fatal accidents by a crowd crush at mass events. If planning is initiated early, sufficient material and personnel reserves are kept in reserve and despite conflicting interests of the organizers, the host community, security, police and emergency medical services, a joint concept is designed and followed, the risk of a severe incident can be kept to a minimum. Each involved party including the spectators have to be aware of their responsibility in order to contribute to the success and safety of the mass event. A comprehensive and critical review of all facts and implementation of conclusions implies a time and financial burden but has a positive impact on the success and safety of mass events.

The Role of the Technical Specialist in Disaster Response and Recovery

NASA Astrophysics Data System (ADS)

Curtis, J. C.

2017-12-01

Technical Specialists provide scientific expertise for making operational decisions during natural hazards emergencies. Technical Specialists are important members of any Incident Management Team (IMT) as is described in in the National Incident Management System (NIMS) that has been designed to respond to emergencies. Safety for the responders and the threatened population is the foremost consideration in command decisions and objectives, and the Technical Specialist is on scene and in the command post to support and promote safety while aiding decisions for incident objectives. The Technical Specialist's expertise can also support plans, logistics, and even finance as well as operations. This presentation will provide actual examples of the value of on-scene Technical Specialists, using National Weather Service "Decision Support Meteorologists" and "Incident Meteorologists". These examples will demonstrate the critical role of scientists that are trained in advising and presenting life-critical analysis and forecasts during emergencies. A case will be made for local, state, and/or a national registry of trained and deployment-ready scientists that can support emergency response.

Emergency management response to a warning-level Alaska-source tsunami impacting California: Chapter J in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Miller, Kevin M.; Long, Kate

2013-01-01

This chapter is directed towards two audiences: Firstly, it targets nonemergency management readers, providing them with insight on the process and challenges facing emergency managers in responding to tsunami Warning, particularly given this “short fuse” scenario. It is called “short fuse” because there is only a 5.5-hour window following the earthquake before arrival of the tsunami within which to evaluate the threat, disseminate alert and warning messages, and respond. This action initiates a period when crisis communication is of paramount importance. An additional dynamic that is important to note is that within 15 minutes of the earthquake, the National Oceanic and Atmospheric Administration (NOAA) and the National Weather Service (NWS) will issue alert bulletins for the entire Pacific Coast. This is one-half the time actually presented by recent tsunamis from Japan, Chile, and Samoa. Second, the chapter provides emergency managers at all levels with insights into key considerations they may need to address in order to augment their existing plans and effectively respond to tsunami events. We look at emergency management response to the tsunami threat from three perspectives:“Top Down” (Threat analysis and Alert/Warning information from the Federal agency charged with Alert and Warning) “Bottom Up” (Emergency management’s Incident Command approach to responding to emergencies and disasters based on the needs of impacted local jurisdictions) “Across Time” (From the initiating earthquake event through emergency response) We focus on these questions: What are the government roles, relationships, and products that support Tsunami Alert and Warning dissemination? (Emergency Planning and Preparedness.) What roles, relationships, and products support emergency management response to Tsunami Warning and impact? (Engendering prudent public safety response.) What are the key emergency management activities, considerations, and challenges brought out by the SAFRR tsunami scenario? (Real emergencies) How do these activities, considerations, and challenges play out as the tsunami event unfolds across the “life” of the event? (Lessons)

Bridging cultures: Nonprofit, church, and emergency management agency collaboration after the May 2013 Oklahoma tornado outbreak.

PubMed

Murphy, Haley; Pudlo, Jason

Community-based organizations, such as nonprofit organizations (NPOs) and churches, play an important role in helping individuals and communities bounce back after a disaster. The nature of disasters requires organizations across sectors to partner together to provide recovery services; however, collaboration is difficult even in times of stability and requires trust and communication to be built through prior collaborative relationships. These prior relationships rarely exist between the majority of the nonprofit sector, churches, and existing emergency management structures. Furthermore, these organizations often have very different cultures, values, and norms that can further hinder successful postdisaster collaboration. The authors use data collected from interviews with nonprofit and church leaders involved in recovery efforts after a series of devastating storms impacted central Oklahoma in 2013 to understand how well nonprofit and church leaders perceive their organizations collaborated with each other and with government and emergency management agencies in response and recovery efforts. Interview data suggest that NPOs and churches without a primary or secondary mission of disaster response and recovery have a difficult time collaborating with organizations involved in existing emergency management structures. The authors suggest that nonprofits with a primary or secondary purpose in disaster response are a potential bridge between other nonprofits and emergency management agencies.

Differences Between US and UK Adults in Stroke Preparedness

PubMed Central

Ford, Gary A.; Morgenstern, Lewis B.; White, Martin; Sniehotta, Falko F.; Mackintosh, Joan E.; Gellert, Paul; Skolarus, Lesli E.

2015-01-01

Background and Purpose— Although time-dependent treatment is available, most people delay contacting emergency medical services for stroke. Given differences in the healthcare system and public health campaigns, exploring between-country differences in stroke preparedness may identify novel ways to increase acute stroke treatment. Methods— A survey was mailed to population-based samples in Ingham County, Michigan, US (n=2500), and Newcastle upon Tyne, UK (n=2500). Surveys included stroke perceptions and stroke/nonstroke scenarios to assess recognition and response to stroke. Between-country differences and associations with stroke preparedness were examined using t tests and linear mixed models. Results— Overall response rate was 27.4%. The mean age of participants was 55 years, and 58% were female. US participants were better in recognizing stroke (70% versus 63%, d=0.27) and were more likely to call emergency medical services (55% versus 52%, d=0.11). After controlling for demographics and comorbidities, US participants remained more likely to recognize stroke but were not more likely to respond appropriately. A greater belief that medical treatment can help with stroke and understanding of stroke was associated with improved stroke recognition and response. Conclusions— Overall, stroke recognition and response were moderate. US participants were modestly better at recognizing stroke, although there was little difference in response to stroke. Future stroke awareness interventions could focus more on stroke outcome expectations and developing a greater understanding of stroke among the public. PMID:26419968

42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Special rules for ambulance services, emergency and... § 422.113 Special rules for ambulance services, emergency and urgently needed services, and maintenance... equivalent, where other means of transportation would endanger the beneficiary's health. (b) Emergency and...

42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Special rules for ambulance services, emergency and... § 422.113 Special rules for ambulance services, emergency and urgently needed services, and maintenance... equivalent, where other means of transportation would endanger the beneficiary's health. (b) Emergency and...

Emergency Medical Services Program Guide.

ERIC Educational Resources Information Center

Georgia Univ., Athens. Dept. of Vocational Education.

This program guide contains the standard emergency medical services curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level workers in the emergency medical services field, and includes job skills in six emergency medical services divisions outlined in the national curriculum:…

77 FR 46802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

...-0100] National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory... Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services Advisory Council. SUMMARY: The... NEMSAC is to provide a nationally recognized council of emergency medical services representatives and...

The Evolution of the Federal Monitoring and Assessment Center

DOE Office of Scientific and Technical Information (OSTI.GOV)

NSTec Aerial Measurement System

2012-07-31

The Federal Radiological Monitoring and Assessment Center (FRMAC) is a federal emergency response asset whose assistance may be requested by the Department of Homeland Security (DHS), the Department of Defense (DoD), the Environmental Protection Agency (EPA), the Nuclear Regulatory Commission (NRC), and state and local agencies to respond to a nuclear or radiological incident. It is an interagency organization with representation from the Department of Energy’s National Nuclear Security Administration (DOE/NNSA), the Department of Defense (DoD), the Environmental Protection Agency (EPA), the Department of Health and Human Services (HHS), the Federal Bureau of Investigation (FBI), and other federal agencies. FRMAC,more » in its present form, was created in 1987 when the radiological support mission was assigned to the DOE’s Nevada Operations Office by DOE Headquarters. The FRMAC asset, including its predecessor entities, was created, grew, and evolved to function as a response to radiological incidents. Radiological emergency response exercises showed the need for a coordinated approach to managing federal emergency monitoring and assessment activities. The mission of FRMAC is to coordinate and manage all federal radiological environmental monitoring and assessment activities during a nuclear or radiological incident within the United States in support of state,local, tribal governments, DHS, and the federal coordinating agency. Radiological emergency response professionals with the DOE’s national laboratories support the Radiological Assistance Program (RAP), National Atmospheric Release Advisory Center (NARAC), the Aerial MeasuringSystem (AMS), and the Radiation Emergency Assistance Center/Training Site (REAC/TS). These teams support the FRMAC to provide: Atmospheric transport modeling; Radiation monitoring; Radiological analysis and data assessments; and Medical advice for radiation injuries In support of field operations, the FRMAC provides geographic information systems, communications, mechanical, electrical, logistics, and administrative support. The size of the FRMAC is tailored to the incident and is comprised of emergency response professionals drawn from across the federal government. State and local emergency response teams may also integrate their operations with FRMAC, but are not required to.« less

Domestic preparedness: the grand illusion.

PubMed

Maniscalco, P M

2001-04-01

The problems posed by terrorism to not only the emergency response community, but to national security at large can be overwhelming. Adoption of what would be considered prudent and effective business practices by implementing a disciplined and effectively structured central strategy cannot be overencouraged. The emerging strategy must take into account the existing emergency response infrastructures and build upon existing capacity in an effort to achieve greater readiness. This technique is no different than the training and issuance of radiological response equipment to emergency responders in the 1950s by the then Civil Defense Agency. The training that is offered, especially to EMS providers, needs to be institutionalized to ensure that our peers, on a regular basis, revisit curriculum content. Incorporating a training module within the existing DOT NHTSA initial and refresher EMT and paramedic educational curricula could easily achieve this goal. Implementing fiscal support to the local emergency response agencies in a sustainable manner is a must. The costs associated with training, equipping and servicing the equipment and medication stores are budget-busters. This is a threat to national security and, as such, the federal government needs to rise to the challenge of supporting the local response organizations that will meet this threat head-on during the aftermath of an attack. As previously mentioned, when the U.S. faced its last large national security threat (Soviet nuclear missiles), we witnessed the materialization of a comprehensive agenda that provided most of the attributes we desire with the contemporary problem of terrorism. There is no single solution to the problem of terrorism. In fact, it will take many individuals and functional areas to come together and stop viewing the threat as a "cash cow." The improved response capacity for acts of terrorism will have an inevitable "spillover benefit" of better trained and equipped emergency responders for everyday emergencies; which will inevitably be our "payday."

Emergency Medical Services

MedlinePlus

... need help right away, you should use emergency medical services. These services use specially trained people and ... emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They ...

The CHAP-EMS health promotion program: a qualitative study on participants' views of the role of paramedics.

PubMed

Brydges, Madison; Denton, Margaret; Agarwal, Gina

2016-08-24

Expanded roles for paramedics, commonly termed community paramedicine, are becoming increasingly common. Paramedics working in community paramedicine roles represent a distinct departure away from the traditional emergency paradigm of paramedic services. Despite this, little research has addressed how community paramedics are perceived by their clients. This study took an interpretivist qualitative approach to examine participants' perceptions of paramedics providing a community paramedicine program, named the Community Health Assessment Program through Emergency Medical Services (CHAP-EMS). Both participant observation and semi-structured interviews conducted with program participants were used to gain insight into the on-the-ground experiences of the program. Thematic analysis was employed to analyze all data. Three themes emerged: i) Caring and trusting relationships; ii) paramedics as health advocates; iii) the added value of EMS skills. Paramedics were perceived by residents as having dual identities: first in a novel role as health advocates and secondly in a traditional role as emergency experts despite lacking contextual features associated with emergency response. From this exploratory, qualitative study we present an emerging framework in which to conceptualize paramedic roles in community paramedicine settings. Future research should address the saliency of these roles in different contexts and how these roles relate to paramedic practice.

78 FR 49332 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

...-0091] National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory... Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services Advisory Council. SUMMARY: The... emergency medical services representatives and consumers, is to advise and consult with DOT and the Federal...

New York City Department of Health response to terrorist attack, September 11, 2001.

PubMed

2001-09-28

In response to two jet aircraft crashing into and causing the collapse of the 110-storied World Trade Center (WTC) towers and the subsequent destruction of nearby portions of lower Manhattan, the New York City Department of Health (NYCDOH) immediately activated its emergency response protocol, including the mobilization of an Emergency Operations Center. Surveillance, clinical, environmental, sheltering, laboratory, management information systems, and operations were among the preestablished emergency committees. Because of its proximity to the WTC site, an emergency clinic was established at NYCDOH for triage and treatment of injured persons. NYCDOH focused its initial efforts on assessing the public health and medical impact of the attack and the resources needed to respond to it such as the care and management of large numbers of persons injured or killed by the crash; subsequent fire and building collapse; the health and safety of rescue workers; the environmental health risks (e.g., asbestos, smoke, dust, or chemical inhalation); other illnesses related to the disruption of the physical infrastructure (e.g., waterborne and foodborne diseases); and mental health concerns. Despite the evacuation and relocation of NYCDOH's headquarters, the department continued essential public health services, including death registration.

Building Team Belay

DTIC Science & Technology

2014-09-01

information, including suggestions for reducing this burden, to Washington headquarters Services, Directorate for Information Operations and Reports... remunerations actuating one to conform to group mores.6 4 Institute of Medicine, Building a... remunerations actuating one to conform to group mores. The social support that is elemental among “home” emergency response teams can be viewed and

Work and Family Resource Kit.

ERIC Educational Resources Information Center

Women's Bureau (DOL), Washington, DC.

This kit is designed to help employers understand the range of family needs emerging in the workplace and the numerous options for a company response. An introduction discusses the need for child care services, dependent care problems, and how employers respond and benefit. Sections address the following: selecting the right option in relation to…

Reconstructing Teacher Education: A Praxeological Approach to Pre-Service Teacher Education

ERIC Educational Resources Information Center

Winterbottom, Christian; Mazzocco, Philip J.

2016-01-01

Praxeological-learning has emerged as a potential theoretical framework that has considerable potential to support and improve teacher education preparation programs. This article presents a study with participative research on early childhood with four groups of students. In response to new twenty-first century Teaching Standards and enhanced…

75 FR 34451 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... Response Network (LRN) was established by the Department of Health and Human Services, Centers for Disease... LRN's mission is to maintain an integrated national and international network of laboratories that can respond to acts of biological, chemical, or radiological terrorism and other public health emergencies...

21 CFR 312.54 - Emergency research under § 50.24 of this chapter.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... 312.54 Section 312.54 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE INVESTIGATIONAL NEW DRUG APPLICATION Responsibilities of Sponsors....24(a) of this chapter or because of other relevant ethical concerns. The sponsor promptly shall...

21 CFR 312.54 - Emergency research under § 50.24 of this chapter.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... 312.54 Section 312.54 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE INVESTIGATIONAL NEW DRUG APPLICATION Responsibilities of Sponsors....24(a) of this chapter or because of other relevant ethical concerns. The sponsor promptly shall...

21 CFR 312.54 - Emergency research under § 50.24 of this chapter.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... 312.54 Section 312.54 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE INVESTIGATIONAL NEW DRUG APPLICATION Responsibilities of Sponsors....24(a) of this chapter or because of other relevant ethical concerns. The sponsor promptly shall...

21 CFR 312.54 - Emergency research under § 50.24 of this chapter.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... 312.54 Section 312.54 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE INVESTIGATIONAL NEW DRUG APPLICATION Responsibilities of Sponsors....24(a) of this chapter or because of other relevant ethical concerns. The sponsor promptly shall...

77 FR 13257 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

... Service Title: Emergency Management Response System (EMRS). OMB Control Number: 0579-0071. Summary of... Regulatory Affairs, Office of Management and Budget (OMB), [email protected] or fax (202) 395-5806... displays a currently valid OMB control number and the agency informs potential persons who are to respond...

National Response Framework

DTIC Science & Technology

2013-05-01

Infrastructure Critical infrastructure—such as privately owned transportation and transit, telecommunications , utilities, financial institutions...Food Incident Department of Agriculture ( USDA ) The Secretary of Agriculture has the authority to declare an extraordinary emergency and take...bilateral agreements are already established. For example, the USDA /Forest Service and Department of the Interior have joint bilateral agreements

Transfusion service disaster planning.

PubMed

Bundy, K L; Foss, M L; Stubbs, J R

2008-01-01

The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is "in charge," planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.

The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: a systematic review.

PubMed

Jennings, Natasha; Clifford, Stuart; Fox, Amanda R; O'Connell, Jane; Gardner, Glenn

2015-01-01

To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. The delivery of quality care in the emergency department is emerging as one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. A comprehensive search of four electronic databases from 2006 to 2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. A three step approach was used. Following a comprehensive search, two reviewers assessed all identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data were extracted using standardised tools. Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding outcomes of a cost benefit analysis. Synthesis of the available research attempts to provide an evidence base for emergency nurse practitioner service to guide healthcare leaders, policy makers and clinicians in reform of emergency service provision. The findings suggest that further high quality research is required for comparative measures of clinical and service effectiveness of emergency nurse practitioner service. In the context of increased health service demand and the need to provide timely and effective care to patients, such measures will assist in evidence based health service planning. Copyright © 2014 Elsevier Ltd. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lesperance, Ann M.; Miller, James S.

The ability to ensure adequate numbers of medical staff represents a crucial part of the medical response to any disaster. However, healthcare worker absenteeism during disasters, especially in the event of an attack of biological terrorism or an epidemic such as pandemic influenza, is a serious concern. Though a significant rate of absenteeism is often included as a baseline assumption in emergency planning, published reports on strategies to minimize absenteeism are comparatively few. This report documents interviews with managers and emergency response planners at hospitals and public health agencies and reviews existing survey data on healthcare worker absenteeism and studiesmore » of disasters to glean lessons about the needs of healthcare workers during those disasters. Based on this research, expected rates of absenteeism and individual determinants of absenteeism are presented along with recommendations of steps that hospitals, emergency medical services departments, public health organizations, and government agencies can take to meet the needs of healthcare workers and minimize absenteeism during a biological event.« less

Update on sideline and event preparation for management of sudden cardiac arrest in athletes.

PubMed

Harmon, Kimberly G; Drezner, Jonathan A

2007-06-01

Sudden death in athletes occurs approximately once every 3 days in the United States. Each school or venue should have an emergency action plan that is coordinated with local emergency medical services (EMS). Access to early defibrillation to treat sudden cardiac arrest (SCA) is critical. If EMS response times are greater than 3 to 5 minutes from collapse to first shock, an on-site automated external defibrillator (AED) should be available. Delays in recognition of SCA in athletes occur commonly. Any collapsed and unresponsive athlete should be considered to be in cardiac arrest and an AED should be applied for rhythm analysis as soon as possible. Cardiopulmonary resuscitation should be provided while waiting for an AED and interruptions in chest compressions should be minimized. Rehearsal of the emergency action plan with potential first responders is essential to ensuring an efficient response to SCA in athletics.

Report on the 2010 Chilean earthquake and tsunami response

USGS Publications Warehouse

,

2011-01-01

In July 2010, in an effort to reduce future catastrophic natural disaster losses for California, the American Red Cross coordinated and sent a delegation of 20 multidisciplinary experts on earthquake response and recovery to Chile. The primary goal was to understand how the Chilean society and relevant organizations responded to the magnitude 8.8 Maule earthquake that struck the region on February 27, 2010, as well as how an application of these lessons could better prepare California communities, response partners and state emergency partners for a comparable situation. Similarities in building codes, socioeconomic conditions, and broad extent of the strong shaking make the Chilean earthquake a very close analog to the impact of future great earthquakes on California. To withstand and recover from natural and human-caused disasters, it is essential for citizens and communities to work together to anticipate threats, limit effects, and rapidly restore functionality after a crisis. The delegation was hosted by the Chilean Red Cross and received extensive briefings from both national and local Red Cross officials. During nine days in Chile, the delegation also met with officials at the national, regional, and local government levels. Technical briefings were received from the President’s Emergency Committee, emergency managers from ONEMI (comparable to FEMA), structural engineers, a seismologist, hospital administrators, firefighters, and the United Nations team in Chile. Cities visited include Santiago, Talca, Constitución, Concepción, Talcahuano, Tumbes, and Cauquenes. The American Red Cross Multidisciplinary Team consisted of subject matter experts, who carried out special investigations in five Teams on the (1) science and engineering findings, (2) medical services, (3) emergency services, (4) volunteer management, and (5) executive and management issues (see appendix A for a full list of participants and their titles and teams). While developing this delegation, it was clear that a multidisciplinary approach was required to properly analyze the emergency response, technical, and social components of this disaster. A diverse and knowledgeable delegation was necessary to analyze the Chilean response in a way that would be beneficial to preparedness in California, as well as improve mitigation efforts around the United States. By most standards, the Maule earthquake was a catastrophe for Chile. The economic losses totaled $30 billion USD or 17% of the GDP of the country. Twelve million people, or ¾ of the population of the country, were in areas that felt strong shaking. Yet only 521 fatalities have been confirmed, with 56 people still missing and presumed dead in the tsunami. The Science and Technology Team evaluated the impacts of the earthquake on built environment with implications for the United States. The fires following the earthquake were minimal in part because of the shutdown of the national electrical grid early in the shaking. Only five engineer-designed buildings were destroyed during the earthquake; however, over 350,000 housing units were destroyed. Chile has a law that holds building owners liable for the first 10 years of a building’s existence for any losses resulting from inadequate application of the building code during construction. This law was cited by many our team met with as a prime reason for the strong performance of the built environment. Overall, this earthquake demonstrated that strict building codes and standards could greatly reduce losses in even the largest earthquakes. In the immediate response to the earthquake and tsunami, first responders, emergency personnel, and search and rescue teams handled many challenges. Loss of communications was significant; many lives were lost and effective coordination to support life-sustaining efforts was gravely impacted due to a lack of inter- and intra-agency coordination. The Health and Medical Services Team sought to understand the medical disaster response strategies and operations of Chilean agencies, including perceived or actual failures in disaster preparation that impacted the medical disaster response; post-disaster health and medical interventions to save lives and limit suffering; and the lessons learned by public health and medical personnel as a result of their experiences. Despite devastating damage to the health care and civic infrastructure, the health care response to the Chilean earthquake appeared highly successful due to several factors. Like other first responders, the medical community had the ability and resourcefulness to respond without centralized control in the early response phase. The health care community maintained patient care under austere conditions, despite many obstacles that could have prevented such care. National and international resources were rapidly mobilized to support the medical response. The Emergency Services Team sought to collect information on all phases of emergency management (preparedness, mitigation, response, and recovery) and determine what worked well and what could be improved upon. The Chileans reported being surprised that they were not as ready for this event as they thought they were. The use of mass care sheltering was limited, given the scope of the disaster, because of the resiliency of the population. The impacts of the earthquake and the tsunami were quite different, as were the needs of urban and rural dwellers, necessitating different response activities. The Volunteer Services Team examined the challenges faced in mobilizing a large number of volunteers to assist in the aftermath of a disaster of this scale. One of the greatest challenges expressed was difficulty in communication; the need for redundancy in communication mechanisms was cited. The flexibility and ability to work autonomously by the frontline volunteers was a significant factor in effective response. It was also important for volunteer leadership to know the emergency plans. These plans need to be flexible, include alternative options, and be completed in conjunction with local officials and other volunteers. The Executive/Red Cross Management Team took a broad look at the impacts of the earthquake and the implications for California. Some of the most important preparation for the disaster came from relationships formed before the event. The communities with strong connections between different government services generally fared well. The initial response and resilience of individuals and communities was another important component. Communication system failures limited the ability of a central government to assist impacted communities, or to issue tsunami warnings. It also delayed the response since the government did not know (in some case for several days) the impact and needs of local governments. In general, plans for congregate care shelters existed but were little used as most people chose to stay at damaged homes or with relatives. Looting was a surprise to response officials as well as social scientists, but both public and private sector organizations, including NGOs (Non-Governmental Organizations), must consider security for damaged businesses as a priority in California’s multihazard planning. Class and ethnic divisions that become heightened during some cases of actual or perceived injustice may also emerge in natural disasters in California. Several factors contributed overall to the low casualty rate and rapid recovery. A major factor is the strong building code in Chile and its comprehensive enforcement. In particular, Chile has a law that holds building owners accountable for losses in a building they build for 10 years. A second factor was the limited number of fires after the earthquake. In the last few California earthquakes, 60% of the fires were started by electrical problems, so the rarity of fires may have been affected by the shut down of the electricity grid early in the earthquake. Third, in many areas, the local emergency response was very effective. The most effective regions had close coordination between emergency management, fire, and police and were empowered to respond without communication with the capital. The fourth factor was the overall high level of knowledge about earthquakes and tsunamis by much of the population that helped them respond more appropriately after the event.

Convenience, quality and choice: Patient and service-provider perspectives for treating primary care complaints in urgent care settings.

PubMed

Sturgeon, David

2017-11-01

To investigate why patients chose to attend two, nurse-led, minor injury units (MIUs) to access primary healthcare services rather than attend their GP practice. Since the 1980's, healthcare organisations in the UK and elsewhere have implemented an increasingly consumer-orientated model of healthcare provision. As a result, patients with non-urgent presentations are attending Emergency Departments (EDs) and other urgent care facilities in growing numbers. A comparative case study approach was adopted and between October 2014 and May 2015 the researcher was embedded as a participant observer as part of the emergency nurse practitioner team at two, nurse-led, MIUs (site A and B). During this time, 40 patients, 17 service-providers and 1 senior manager were interviewed. Patients and service-providers at both sites identified convenience and quality of care as the principle reasons patients presented for primary healthcare services at MIUs rather than their GP practice. Service-providers were aware that by providing treatment, they established a precedent and a sense of expectation for future care. Patients are acting rationally and predictably in response to healthcare policy promises regarding choice, expectation created by service-providers, and local demographic factors. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Strategic Responses to Fiscal Constraints: A Health Policy Analysis of Hospital-Based Ambulatory Physical Therapy Services in the Greater Toronto Area (GTA)

PubMed Central

Verrier, Molly C.; Williams, A. Paul; Zakus, David; Deber, Raisa B.

2009-01-01

ABSTRACT Purpose: Ambulatory physical therapy (PT) services in Canada are required to be insured under the Canada Health Act, but only if delivered within hospitals. The present study analyzed strategic responses used by hospitals in the Greater Toronto Area (GTA) to deliver PT services in an environment of fiscal constraint. Methods: Key informant interviews (n = 47) were conducted with participants from all hospitals located within the GTA. Results: Two primary strategic responses were identified: (1) “load shedding” through the elimination or reduction of services, and (2) “privatization” through contracting out or creating internal for-profit subsidiary clinics. All hospitals reported reductions in service delivery between 1996 and 2003, and 15.0% (7/47 hospitals) fully eliminated ambulatory services. Although only one of 47 hospitals contracted out services, another 15.0% (7/47) reported that for-profit subsidiary clinics were created within the hospital in order to access other more profitable forms of quasi-public and private funding. Conclusions: Strategic restructuring of services, aimed primarily at cost containment, may have yielded short-term financial savings but has also created a ripple effect across the continuum of care. Moreover, the rise of for-profit subsidiary clinics operating within not-for-profit hospitals has emerged without much public debate and with little research to evaluate its impact. PMID:20808483

USGS Emergency Response and the Hazards Data Distribution System (HDDS)

NASA Astrophysics Data System (ADS)

Jones, B. K.; Lamb, R.

2013-12-01

Remotely sensed datasets such as satellite imagery and aerial photography can be an invaluable resource to support the response and recovery from many types of emergency events such as floods, earthquakes, landslides, wildfires, and other natural or human-induced disasters. When disaster strikes there is often an urgent need and high demand for rapid acquisition and coordinated distribution of pre- and post-event geospatial products and remotely sensed imagery. These products and images are necessary to record change, analyze impacts, and facilitate response to the rapidly changing conditions on the ground. The coordinated and timely provision of relevant imagery and other datasets is one important component of the USGS support for domestic and international emergency response activities. The USGS Hazards Data Distribution System (HDDS) serves as a single, consolidated point-of-access for relevant satellite and aerial image datasets during an emergency event response. The HDDS provides data visibility and immediate download services through a complementary pair of graphical map-based and traditional directory-based interfaces. This system allows emergency response personnel to rapidly select and obtain pre-event ('baseline') and post-event emergency response imagery from many different sources. These datasets will typically include images that are acquired directly by USGS, but may also include many other types of images that are collected and contributed by partner agencies and organizations during the course of an emergency event response. Over the past decade, USGS Emergency Response and HDDS have supported hundreds of domestic and international disaster events by providing critically needed pre- and post-event remotely sensed imagery and other related geospatial products as required by the emergency response community. Some of the larger national events supported by HDDS have included Hurricane Sandy (2012), the Deepwater Horizon Oil Spill (2010), and Hurricane Katrina (2005). Some of the major international events supported by HDDS have included the Japan earthquake and tsunami (2011), the historic flood event in Pakistan (2010), and the earthquake in Haiti (2010). This presentation will provide an overview of the USGS HDDS system, and the various types and sources of remotely sensed imagery that are distributed through this system. There will be particular focus on recent upgrades to the HDDS interface. There will also be a brief discussion of the USGS role in the International Charter 'Space and Major Disasters' and the satellite imagery that can be made available through this mechanism in the case of major disasters.

[Structure, organization and capacity problems in emergency medical services, emergency admission and intensive care units].

PubMed

Dick, W

1994-01-01

Emergency medicine is subjected worldwide to financial stringencies and organizational evaluations of cost-effectiveness. The various links in the chain of survival are affected differently. Bystander assistance or bystander CPR is available in only 30% of the emergencies, response intervals--if at all required by legislation--are observed to only a limited degree or are too extended for survival in cardiac arrest. A single emergency telephone number is lacking. Too many different phone numbers for emergency reporting result in confusion and delays. Organizational realities are not fully overcome and impair efficiency. The position of the emergency physician in the EMS System is inadequately defined, the qualification of too many emergency physicians are unsatisfactory. In spite of this, emergency physicians are frequently forced to answer out-of-hospital emergency calls. Conflicts between emergency physicians and EMTs may be overcome by providing both groups with comparable qualifications as well as by providing an explicit definition of emergency competence. A further source of conflict occurs at the juncture of prehospital and inhospital emergency care in the emergency department. Deficiencies on either side play a decisive role. At least in principle there are solutions to the deficiencies in the EMSS and in intensive care medicine. They are among others: Adequate financial compensation of emergency personnel, availability of sufficient numbers of highly qualified personnel, availability of a central receiving area with an adjacent emergency ward, constant information flow to the dispatch center on the number of available emergency beds, maintaining 5% of all beds as emergency beds, establishing intermediate care facilities. Efficiency of emergency physician activities can be demonstrated in polytraumatized patients or in patients with ventricular fibrillation or acute myocardial infarction, in patients with acute myocardial insufficiency and other emergency clinical pictures. Cost effectiveness is clearly in favor of emergency medicine. Future developments will be characterized by the consequences of new health care legislation and by effects of financial stringencies on the emergency medical services.

Factors influencing the suicide intervention skills of emergency medical services providers.

PubMed

Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

2017-01-01

Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers' ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. EMS: Emergency medical services; SIRI: Suicide intervention response inventory.

[Out of hospital emergencies towards a safety culture].

PubMed

Cano-del Pozo, M I; Obón-Azuara, B; Valderrama-Rodríguez, M; Revilla-López, C; Brosed-Yuste, C; Fajardo-Trasobares, E; Garcés-Baquero, P; Mateo-Clavería, J; Molina-Estrada, I; Perona-Flores, N; Salcedo-de Dios, S; Tomé-Rey, A

2014-01-01

The aim of this study is to measure the degree of safety culture (CS) among healthcare professional workers of an out-of-hospital Emergency Medical Service. Most patient safety studies have been conducted in relation to the hospital rather than pre-hospital Emergency Medical Services. The objective is to analyze the dimensions with lower scores in order to plan futures strategies. A descriptive study using the AHRQ (Agency for Healthcare Research and Quality) questionnaire. The questionnaire was delivered to all healthcare professionals workers of 061 Advanced Life Support Units of Aragón, during the month of August 2013. The response rate was 55%. Main strengths detected: an adequate number of staff (96%), good working conditions (89%), tasks supported from immediate superior (77%), teamwork climate (74%), and non-punitive environment to report adverse events (68%). Areas for improvement: insufficient training in patient safety (53%) and lack of feedback of incidents reported (50%). The opportunities for improvement identified focus on the training of professionals in order to ensure safer care, while extending the safety culture. Also, the implementation of a system of notification and registration of adverse events in the service is deemed necessary. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Telehealth technologies and applications for terrorism response: a report of the 2002 coastal North Carolina domestic preparedness training exercise.

PubMed

Simmons, Scott C; Murphy, Timothy A; Blanarovich, Adrian; Workman, Florence T; Rosenthal, David A; Carbone, Matthew

2003-01-01

Effective response to natural or man-made disasters (i.e., terrorism) is predicated on the ability to communicate among the many organizations involved. Disaster response exercises enable disaster planners and responders to test procedures and technologies and incorporate the lessons learned from past disasters or exercises. On May 31 and June 1, 2002, one such exercise event took place at the Camp Lejeune Marine Corps Base in Jacksonville, North Carolina. During the exercise, East Carolina University tested: (1) in-place Telehealth networks and (2) rapidly deployable communications, networking, and data collection technologies such as satellite communications, local wireless networking, on-scene video, and clinical and environmental data acquisition and telemetry. Exercise participants included local, county, state, and military emergency medical services (EMS), emergency management, specialized response units, and local fire and police units. The technologies and operations concepts tested at the exercise and recommendations for using telehealth to improve disaster response are described.

Telehealth Technologies and Applications for Terrorism Response: A Report of the 2002 Coastal North Carolina Domestic Preparedness Training Exercise

PubMed Central

Simmons, Scott C.; Murphy, Timothy A.; Blanarovich, Adrian; Workman, Florence T.; Rosenthal, David A.; Carbone, Matthew

2003-01-01

Effective response to natural or man-made disasters (i.e., terrorism) is predicated on the ability to communicate among the many organizations involved. Disaster response exercises enable disaster planners and responders to test procedures and technologies and incorporate the lessons learned from past disasters or exercises. On May 31 and June 1, 2002, one such exercise event took place at the Camp Lejeune Marine Corps Base in Jacksonville, North Carolina. During the exercise, East Carolina University tested: (1) in-place Telehealth networks and (2) rapidly deployable communications, networking, and data collection technologies such as satellite communications, local wireless networking, on-scene video, and clinical and environmental data acquisition and telemetry. Exercise participants included local, county, state, and military emergency medical services (EMS), emergency management, specialized response units, and local fire and police units. The technologies and operations concepts tested at the exercise and recommendations for using telehealth to improve disaster response are described. PMID:12595406

Human resources for health: lessons from the cholera outbreak in Papua New Guinea

PubMed Central

Bieb, Sibauk; Clark, Geoff; Miller, Geoff; MacIntyre, Raina; Zwi, Anthony

2013-01-01

Issue Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals. Context Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services. Action We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt. Outcome Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population. Discussion In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency. PMID:24319607

Human resources for health: lessons from the cholera outbreak in Papua New Guinea.

PubMed

Rosewell, Alexander; Bieb, Sibauk; Clark, Geoff; Miller, Geoff; MacIntyre, Raina; Zwi, Anthony

2013-01-01

Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals. Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services. We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt. Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population. In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency.

Innovations in healthcare finance lessons from the 401(k) model.

PubMed

Myers, Chris; Lineen, Jason

2008-10-01

*Escalating health benefit expenses are leading employers to shift more of the costs to their employees. *Global financial services companies and startup entrepreneurs are competing to develop private-sector solutions to capitalize on the ailing and mis-aligned healthcare financing system. *Emerging innovations are targeting insured individuals who are facing increasing responsibility for first-dollar coverage. *Healthcare providers should view patients as individual "price-sensitive payers" as new tools enable them to shop around for services based on cost and quality.

CBE awarded to DoH officer (england).

PubMed

2000-02-01

Julie Hartley-Jones, Department of Health (England) nursing officer with responsibilities for acute and specialist services including A & E, has been awarded a CBE in the New Year's honours list. Ms Hartley-Jones, who was awarded her CBE for services to renal nursing, is also a former president of the European Dialysis and Transplant Nurses Association/European Renal Care Association. She recently spoke at the RCN A & E Nursing Association Conference on 'Making a Difference' and has a keen interest in emergency nursing issues.

Multiple Response System: Evaluation of Policy Change in North Carolina's Child Welfare System.

PubMed

Lawrence, C Nicole; Rosanbalm, Katie D; Dodge, Kenneth A

2011-11-01

Systemic challenges within child welfare have prompted many states to explore new strategies aimed at protecting children while meeting the needs of families, but doing so within the confines of shrinking budgets. Differential Response has emerged as a promising practice for low or moderate risk cases of child maltreatment. This mixed methods evaluation explored various aspects of North Carolina's differential response system, known as the Multiple Response System (MRS), including: child safety, timeliness of response and case decision, frontloading of services, case distribution, implementation of Child and Family Teams, collaboration with community-based service providers and Shared Parenting. Utilizing Child Protective Services (CPS) administrative data, researchers found that compared to matched control counties, MRS: had a positive impact on child safety evidenced by a decline in the rates of substantiations and re-assessments; temporarily disrupted timeliness of response in pilot counties but had no effect on time to case decision; and increased the number of upfront services provided to families during assessment. Qualitative data collected through focus groups with providers and phone interviews with families provided important information on key MRS strategies, highlighting aspects that families and social workers like as well as identifying areas for improvement. This information is useful for continuous quality improvement efforts, particularly related to the development of training and technical assistance programs at the state and local level.

Alcohol as a Factor in 911 Calls in Denver.

PubMed

Joseph, Daniel; Vogel, Jody A; Smith, C Sam; Barrett, Whitney; Bryskiewicz, Gary; Eberhardt, Aaron; Edwards, David; Rappaport, Lara; Colwell, Christopher B; McVaney, Kevin E

2018-02-08

Excessive alcohol consumption is associated with a substantial number of emergency department visits annually and is responsible for a significant number of lives lost each year in the United States. However, a minimal amount is known about the impact of alcohol on the EMS system. The primary objective was to determine the proportion of 9-1-1 calls in Denver, Colorado in which (1) alcohol was a contributing factor or (2) the individual receiving EMS services had recently ingested alcohol. The secondary objectives were to compare the characteristics of EMS calls and to estimate the associated costs. This was a prospective observational cohort study of EMS calls for adults from July 1, 2012, to June 30, 2014. Primary outcomes for the study were alcohol as a contributing factor to the EMS call and recent alcohol consumption by the patient receiving EMS services. Logistic regression was utilized to determine the associations between EMS call characteristics and the outcomes. Cost was estimated using historic data. During the study period, 169,642 EMS calls were completed by the Denver Health Paramedic Division. Of these 71% were medical and 29% were trauma-related. The median age was 45 (interquartile range [IQR] 29-59) years, and 55% were male. 50,383 calls (30%) had alcohol consumption, and 49,165 (29%) had alcohol as a contributing factor. Alcohol related calls were associated with male sex, traumatic injuries including head trauma, emergent response, use of airway adjuncts, cardiac monitoring, glucose measurement, use of restraints, use of spinal precautions, and administration of medications for sedation. Estimated costs to the EMS system due to alcohol intoxication exceeded $14 million dollars over the study period and required in excess of 37 thousand hours of paramedic time. Compared to 9-1-1 calls that do not involve alcohol, alcohol-related calls are more likely to involve male patients, emergent response, traumatic injuries, advanced monitoring, airway adjuncts, and medications for sedation. This represents a significant burden on the emergency system and society. Further studies are needed to evaluate whether additional interventions such as social services could be used to lessen this burden.

How Do Patients Perceive and Expect Quality of Surgery, Diagnostics, and Emergency Services in Tertiary Care Hospitals? An Evidence of Gap Analysis From Pakistan.

PubMed

Fatima, Iram; Humayun, Ayesha; Anwar, Muhammad Imran; Iftikhar, Adil; Aslam, Muhammad; Shafiq, Muhammad

2017-07-01

Service quality is one of the important gears to appraise services and determine the gray areas that need improvement. In countries with a resource-poor health system, the first step of measuring quality is yet to be taken. This study seeks to inform policy makers in developing contextual service quality models by identifying service quality gaps in tertiary care teaching hospitals using patients' perspective. A cross-sectional study was performed using multistage cluster sampling, and a modified version of the SERVQUAL (SERV-service, QUAL-quality) instrument was administered to determine patient's expectations and perceptions. A total of 817 completed questionnaires were obtained from patients and/or their attendants using convenience sampling. Data analysis revealed statistically significant negative quality gaps between expectations and perceptions of tangibility, reliability, empathy, assurance, responsiveness, and communication. The difference in mean expectation and perception for responsiveness across the sexes was significant ( p < 0.003; p < 0.037, respectively) as well as in perception of communication ( p < 0.026). Other dimensions and overall hospital expected and perceived quality were independent of sex. Educational status showed significant difference in expectation and perception in responsiveness ( p < 0.005), but the perception of each dimension was significantly different in different educational categories (assurance: p < 0.001; empathy: p < 0.001; reliability: p < 0.001; tangibility: p < 0.001; responsiveness: p < 0.001; communication: p < 0.001; and for overall service quality: p < 0.001). Age and service departments showed no relationship with any of the perceived or expected dimension of service quality of hospitals. Tertiary care hospitals failed to meet patients' expectations in all major areas of service quality, posing a question of how hospitals implement and evaluate their quality assurance policy.

A standardized method of preventing and managing emergencies within the context of evidence-based therapy implementation.

PubMed

Urgelles, Jessica; Donohue, Brad; Wilks, Chelsey; Van Hasselt, Vincent B; Azrin, Nathan H

2012-07-01

Families served within child welfare settings evidence a wide range of emergencies or unexpected crises or circumstances that may lead to danger and make it difficult for them to focus on treatment planning. Mental health treatment providers are often unprepared to effectively manage emergencies during implementation of evidence-based prescribed therapy sessions. In this study, the authors empirically developed a standardized intervention to assist mental health providers in emergency prevention and management (EPM) with their clients. EPM includes assessment of emergent conditions and a self-control procedure that may be utilized by consumers to prevent or resolve emergencies. EPM responses of 26 mothers referred by Child Protective Services for 6 months of evidence-supported treatment were examined. Relevant to clinical utility, the results indicated that providers implemented EPM in a little more than half (56.9%) of their treatment sessions, and all emergencies assessed in EPM were endorsed by at least 8% of the sample throughout their treatment. EPM was implemented with fidelity according to service providers, and corroborated by blind raters. Participants were found to be compliant and satisfied with EPM. The average number of emergencies endorsed over the course of EPM administrations was negatively correlated with the frequency of EPM administrations, suggesting that EPM may have helped reduce emergencies. Pretreatment factors (e.g., household income, child abuse potential, family functioning, parental stress, child behavior problems, number of days child removed from home) and hard drug use (but not marijuana or alcohol) during treatment were associated with the number of emergencies reported by participants.

An emergency dental service for students: 4-year findings.

PubMed

Sinclair, J; Wilson, N H

1997-06-01

To describe the arrangements for the provision of emergency dental services for students at the University of Manchester and to report data collected during the first four and a half years of the student emergency dental services (SEDS) unit based at the University Dental Hospital of Manchester. Data pertaining to every student attending SEDS since its inception were collected by means of questionnaire including provision to record diagnoses, treatment needs and the emergency care provided. The incidence of dental emergencies within the student population served by SEDS has been found to be 39 emergencies per 1000 students per annum, with the service being most heavily used by overseas students. Caries, pulpal pathology and failed restorations account for 46 per cent of the presenting emergencies, with pericoronitis (19 per cent) and other emergencies of periodontal origin (14 per cent) being common place. It is concluded that a student emergency dental service may be found to be an important element of student medical and related welfare services.

Helicopter-based emergency medical services for a sparsely populated region: A study of 42,500 dispatches.

PubMed

Østerås, Ø; Brattebø, G; Heltne, J-K

2016-05-01

The Helicopter Emergency Medical Service (HEMS) in Norway is operated day and night, despite challenging geography and weather. In Western Norway, three ambulance helicopters, with a rapid response car as an alternative, cover close to 1 million inhabitants in an area of 45,000 km(2) . Our objective was to assess patterns of emergency medical problems and treatments in HEMS in a geographically large, but sparsely populated region. Data from all HEMS dispatches during 2004-2013 were assessed retrospectively. Information was analyzed with respect to patient treatment and characteristics, in addition to variations in services use during the day, week, and seasons. A total of 42,456 dispatches were analyzed. One third of the patients encountered were severely ill or injured, and two thirds of these received advanced treatment. Median activation time and on-scene time in primary helicopter missions were 5 and 11 min, respectively. Most patients (95%) were reached within 45 min by helicopter or rapid response car. Patterns of use did not change. More than one third of all dispatches were declined or aborted, mostly due to no longer medical indication, bad weather conditions, or competing missions. One third of the patients encountered were severely ill or injured, and more than two thirds of these received advanced treatment. HEMS use did not change over the 10-year period, however HEMS use peaked during daytime, weekends, and the summer. More than one third of all dispatches were declined or aborted. © 2015 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Research on Disaster Early Warning and Disaster Relief Integrated Service System Based on Block Data Theory

NASA Astrophysics Data System (ADS)

Yang, J.; Zhang, H.; Wang, C.; Tang, D.

2018-04-01

With the continuous development of social economy, the interaction between mankind and nature has become increasingly evident. Disastrous global catastrophes have occurred from time to time, causing huge losses to people's lives and property. All governments recognize the importance of the establishment of disaster early warning and release mechanisms, and it is also an urgent issue to improve the comprehensive service level of emergency response and disaster relief. However, disaster early warning and emergency relief information is usually generated by different departments, and the diverse data sources, difficult integration, and limited release speed have always been difficult issues to be solved. Block data is the aggregation of various distributed (point data) and segmentation (data) big data on a specific platform and make them happen continuous polymerization effect, block data theory is a good solution to cross-sectoral, cross-platform Disaster information data sharing and integration problems. This paper attempts to discuss the integrated service mechanism of disaster information aggregation and disaster relief based on block data theory and introduces a location-based integrated service system for disaster early warning and disaster relief.

Did Harvey Learn from Katrina? Initial Observations of the Response to Companion Animals during Hurricane Harvey

PubMed Central

2018-01-01

Simple Summary When Hurricane Harvey struck the Gulf states in 2017, a large-scale rescue effort was launched by officials and citizens to rescue both people and animals. Over a decade since Hurricane Katrina (2005), this study explores whether the reforms to afford better protection to companion animals such as the Pet Emergency and Transportation Standards Act 2006 have made a difference. Key officials from various organizations within the state of Texas were interviewed and it was found that though there has been a cultural shift to better protect animals in a disaster, formal coordination and planning mechanisms need further attention. This study also uncovered the first empirical observation of disaster hoarding where such persons used the disaster to replenish their animal stocks. This study will be of interest to those involved in emergency management and animal welfare. Abstract The aftermath of Hurricane Katrina in 2005 became the genesis of animal emergency management and created significant reforms in the US particularly the passage of the Pets Emergency and Transportation Standards Act in 2006 that required state and local emergency management arrangements to be pet- and service animal-inclusive. More than a decade later Hurricane Harvey struck the Gulf states with all 68 directly related deaths occurring in the state of Texas. In this study, six key officials involved in the response underwent a semi-structured interview to investigate the impact of the PETS Act on preparedness and response. Though the results have limitations due to the low sample size, it was found that the PETS Act and the lessons of Hurricane Katrina had contributed to a positive cultural shift to including pets (companion animals) in emergency response. However, there was a general theme that plans required under the PETS Act were under-developed and many of the animal response lessons from previous emergencies remain unresolved. The study also observed the first empirical case of disaster hoarding which highlights the need for animal law enforcement agencies to be active in emergency response. PMID:29601478

Effects of international football matches on ambulance call profiles and volumes during the 2006 World Cup.

PubMed

Deakin, Charles D; Thompson, Fizz; Gibson, Caroline; Green, Mark

2007-06-01

Prompt ambulance attendance is aimed at improving patient care. With finite resources struggling to meet performance targets, unforeseen demand precludes the ability to tailor resources to cope with increased call volumes, and can have a marked detrimental effect on performance and hence patient care. The effects of the 2006 World Cup football matches on call volumes and profiles were analysed to understand how public events can influence demands on the ambulance service. All emergency calls to the Hampshire Ambulance Service NHS Trust (currently the Hampshire Division of South Central Ambulance Service, Winchester, UK) during the first weekend of the 2006 World Cup football matches were analysed by call volume and classification of call (call type). On the day of the first football match, call volume was over 50% higher than that on a typical Saturday, with distinct peaks before and after the inaugural match. Call profile analysis showed increases in alcohol-related emergencies, including collapse, unconsciousness, assault and road traffic accidents. The increase in assaults was particularly marked at the end of each match and increased again into the late evening. A detailed mapping of call volumes and profiles during the World Cup football shows a significant increase in overall emergency calls, mostly alcohol related. Mapping of limited resources to these patterns will allow improved responses to emergency calls.

Effects of international football matches on ambulance call profiles and volumes during the 2006 World Cup

PubMed Central

Deakin, Charles D; Thompson, Fizz; Gibson, Caroline; Green, Mark

2007-01-01

Background Prompt ambulance attendance is aimed at improving patient care. With finite resources struggling to meet performance targets, unforeseen demand precludes the ability to tailor resources to cope with increased call volumes, and can have a marked detrimental effect on performance and hence patient care. The effects of the 2006 World Cup football matches on call volumes and profiles were analysed to understand how public events can influence demands on the ambulance service. Methods All emergency calls to the Hampshire Ambulance Service NHS Trust (currently the Hampshire Division of South Central Ambulance Service, Winchester, UK) during the first weekend of the 2006 World Cup football matches were analysed by call volume and classification of call (call type). Results On the day of the first football match, call volume was over 50% higher than that on a typical Saturday, with distinct peaks before and after the inaugural match. Call profile analysis showed increases in alcohol‐related emergencies, including collapse, unconsciousness, assault and road traffic accidents. The increase in assaults was particularly marked at the end of each match and increased again into the late evening. Conclusion A detailed mapping of call volumes and profiles during the World Cup football shows a significant increase in overall emergency calls, mostly alcohol related. Mapping of limited resources to these patterns will allow improved responses to emergency calls. PMID:17513536

An integrative fuzzy Kansei engineering and Kano model for logistics services

NASA Astrophysics Data System (ADS)

Hartono, M.; Chuan, T. K.; Prayogo, D. N.; Santoso, A.

2017-11-01

Nowadays, customer emotional needs (known as Kansei) in product and especially in services become a major concern. One of the emerging services is the logistics services. In obtaining a global competitive advantage, logistics services should understand and satisfy their customer affective impressions (Kansei). How to capture, model and analyze the customer emotions has been well structured by Kansei Engineering, equipped with Kano model to strengthen its methodology. However, its methodology lacks of the dynamics of customer perception. More specifically, there is a criticism of perceived scores on user preferences, in both perceived service quality and Kansei response, whether they represent an exact numerical value. Thus, this paper is proposed to discuss an approach of fuzzy Kansei in logistics service experiences. A case study in IT-based logistics services involving 100 subjects has been conducted. Its findings including the service gaps accompanied with prioritized improvement initiatives are discussed.

Mental and social health during and after acute emergencies: emerging consensus?

PubMed Central

van Ommeren, Mark; Saxena, Shekhar; Saraceno, Benedetto

2005-01-01

Mental health care programmes during and after acute emergencies in resource-poor countries have been considered controversial. There is no agreement on the public health value of the post-traumatic stress disorder concept and no agreement on the appropriateness of vertical (separate) trauma-focused services. A range of social and mental health intervention strategies and principles seem, however, to have the broad support of expert opinion. Despite continuing debate, there is emerging agreement on what entails good public health practice in respect of mental health. In terms of early interventions, this agreement is exemplified by the recent inclusion of a "mental and social aspects of health" standard in the Sphere handbook's revision on minimal standards in disaster response. This affirmation of emerging agreement is important and should give clear messages to health planners. PMID:15682252

Expanding protection motivation theory: investigating an application to animal owners and emergency responders in bushfire emergencies.

PubMed

Westcott, Rachel; Ronan, Kevin; Bambrick, Hilary; Taylor, Melanie

2017-04-26

Protection Motivation Theory (PMT) was developed by Rogers in 1975, to describe how individuals are motivated to react in a self-protective way towards a perceived health threat. Rogers expected the use of PMT to diversify over time, which has proved true over four decades. The purpose of this paper is to explore how PMT can be used and expanded to inform and improve public safety strategies in natural hazards. As global climate change impacts on the Australian environment, natural hazards seem to be increasing in scale and frequency, and Emergency Services' public education campaigns have necessarily escalated to keep pace with perceived public threat. Of concern, is that the awareness-preparedness gap in residents' survival plans is narrowing disproportionately slowly compared to the magnitude of resources applied to rectify this trend. Practical applications of adaptable social theory could be used to help resolve this dilemma. PMT has been used to describe human behaviour in individuals, families, and the parent-child unit. It has been applied to floods in Europe and wildfire and earthquake in the United States. This paper seeks to determine if an application of PMT can be useful for achieving other-directed human protection across a novel demographic spectrum in natural hazards, specifically, animal owners and emergency responders in bushfire emergencies. These groups could benefit from such an approach: owners to build and fortify their response- and self-efficacy, and to help translate knowledge into safer behaviour, and responders to gain a better understanding of a diverse demographic with animal ownership as its common denominator, and with whom they will be likely to engage in contemporary natural hazard management. Mutual collaboration between these groups could lead to a synergy of reciprocated response efficacy, and safer, less traumatic outcomes. Emergency services' community education programs have made significant progress over the last decade, but public safety remains suboptimal while the magnitude of the awareness-preparedness gap persists. This paper examines an expanded, other-directed application of PMT to expand and enhance safer mitigation and response behaviour strategies for communities threatened by bushfire, which may ultimately help save human life.

Informed consumer or unlucky visitor? A profile of German patients who received dental services abroad.

PubMed

Panteli, Dimitra; Augustin, Uta; Röttger, Julia; Struckmann, Verena; Verheyen, Frank; Wagner, Caroline; Busse, Reinhard

2015-10-01

A common characteristic of sending countries in cross-border dental care is that of high costs and/or high copayments for dental services. This study aims to provide an insight into the characteristics of German patients receiving planned and emergency (unplanned) dental care abroad and their satisfaction with received services. The Europabefragung is a postal survey carried out by Techniker Krankenkasse for patients who are treated in EU/EEA countries. This study uses data from the Europabefragung 2012. The survey was sent to 45 189 individuals; descriptive statistics for the subset of respondents who received emergency (unplanned) or planned dental treatment are presented. There were 18 339 responses to the questionnaire, out of which 17 543 were deemed valid; 1416 respondents had received emergency (unplanned) (78%) or planned (22%) dental care and were included in the analysis. There were clear differences between unplanned and planned treatments regarding country and type of treatment as well as satisfaction with different aspects of treatment and the need for follow-up care. Overall, satisfaction with treatment was high for both groups; individuals who had received planned treatment were more satisfied on all aspects of care and reported a need for follow-up care less frequently. While German patients who received both emergency (unplanned) and planned services abroad are mostly satisfied with their experience, some concerns arise with regard to continuity of care. Types of information provided to patients seeking care abroad and dissemination modalities should be carefully planned. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

ARkStorm@Tahoe: Stakeholder perspectives on vulnerabilities and preparedness for an extreme storm event in the greater Lake Tahoe, Reno, and Carson City region

USGS Publications Warehouse

Albano, Christine M.; Cox, Dale A.; Dettinger, Michael; Shaller, Kevin; Welborn, Toby L.; McCarthy, Maureen

2014-01-01

Atmospheric rivers (ARs) are strongly linked to extreme winter precipitation events in the Western U.S., accounting for 80 percent of extreme floods in the Sierra Nevada and surrounding lowlands. In 2010, the U.S. Geological Survey developed the ARkStorm extreme storm scenario for California to quantify risks from extreme winter storms and to allow stakeholders to better explore and mitigate potential impacts. To explore impacts on natural resources and communities in montane and adjacent environments, we downscaled the scenario to the greater Lake Tahoe, Reno and Carson City region of northern Nevada and California. This ArkStorm@Tahoe scenario was presented at six stakeholder meetings, each with a different geographic and subject matter focus. Discussions were facilitated by the ARkStorm@Tahoe team to identify social and ecological vulnerabilities to extreme winter storms, science and information needs, and proactive measures that might minimize impacts from this type of event. Information collected in these meetings was used to develop a tabletop emergency response exercise and set of recommendations for increasing resilience to extreme winter storm events in both Tahoe and the downstream communities of Northern Nevada.Over 300 individuals participated in ARkStorm@Tahoe stakeholder meetings and the emergency response exercise, including representatives from emergency response, natural resource and ecosystem management, health and human services, public utilities, and businesses. Interruption of transportation, communications, and lack of power and backup fuel supplies were identified as the most likely and primary points of failure across multiple sectors and geographies, as these interruptions have cascading effects on natural and human systems by impeding emergency response efforts. Other key issues that arose in discussions included contamination risks to water supplies and aquatic ecosystems, especially in the Tahoe Basin and Pyramid Lake, interagency coordination, credentialing, flood management, and coordination of health and human services during such an event. Mitigation options were identified for each of the key issues. Several science needs were identified, particularly the need for improved flood inundation maps. Finally, key lessons learned were identified and may help to increase preparedness, response and recovery from extreme storms in the future.

78 FR 44523 - Burned Area Emergency Response, Forest Service

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

..., Fish, Wildlife, Air and Rare Plants, Mail Stop 1121, 1400 Independence Ave. SW., Washington, DC 20250... interim directive may do so in the Office of the Director, Watershed, Fish, Wildlife, Air and Rare Plants..., Fish Wildlife, Air and Rare Plants Staff, 333 Broadway SE., Albuquerque, NM 87102, 505-842-3141 or...

Ditchin' the Master's Gardening Tools for Our Own: Growing a Womanist Methodology from the Grassroots

ERIC Educational Resources Information Center

Marr, Vanessa L.

2014-01-01

This essay explores the autoethnographic possibilities of critical service-learning research and the emerging realities of a community-centered womanist methodological response. Drawing from Alice Walker's definition of "womanist" as a commitment to "survival and wholeness of entire people, male 'and' female," the author argues…

The Role of the Critical Incident Stress Debriefing (CISD) Process in Disaster Counseling.

ERIC Educational Resources Information Center

Everly, George S., Jr.

1995-01-01

Posttraumatic stress is an occupational hazard for certain high-risk groups such as personnel in emergency services, public safety, and disaster response. Critical Incident Stress Debriefing (CISD) represents a structured group intervention designed for the mitigation of posttraumatic stress. Provides an introduction to and an overview of the CISD…

75 FR 28206 - Establishment of an Emergency Response Interoperability Center

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-20

..., industry representatives, and service providers. 0 4. Section 0.392 is amended by revising the introductory... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 0 [GN Docket No. 09-51; PS Docket No. 06-229; FCC 10... Commission. ACTION: Final rule. SUMMARY: This Order amends Part 0 of the Commission's rules to establish...

76 FR 10898 - Public Safety and Homeland Security Bureau; Federal Advisory Committee Act; Emergency Response...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-28

... Street, SW., Washington, DC 20554. FOR FURTHER INFORMATION CONTACT: Gene Fullano, Designated Federal... written comments before the meeting to Gene Fullano, the FCC's Designated Federal Official for the PSAC, by e-mail to [email protected] or U.S. Postal Service Mail to Gene Fullano, Associate Chief...

KSC-2014-3749

NASA Image and Video Library

2014-06-20

CAPE CANAVERAL, Fla. – Patrol boats from the Protective Services branch NASA's Kennedy Space Center in Florida operate in the Indian River Lagoon during a training exercise. The training session focused on safely entering the water, something the Emergency Response Team and security branch could be required to perform in certain situations at the center. Photo credit: NASA/ Dan Casper

Essential Leadership: School Boards in New York State. A Position Paper.

ERIC Educational Resources Information Center

New York State School Boards Association, Albany.

For effective schools, leadership is vital. As the structure of American education evolved, a model of how a local school board should function emerged. The model is briefly summarized and research on educational leadership, challenges of school board service in New York State, and responsibilities of school boards are discussed. Key leadership…

New Realities in the Management of Student Affairs: Emerging Specialist Roles and Structures for Changing Times

ERIC Educational Resources Information Center

Tull, Ashley, Ed.; Kuk, Linda, Ed.

2012-01-01

Student affairs organizations are at a crossroads. They face expanding enrollments; a concomitant increase need for often more complex services; changing demographics; a growing cohort of non-traditional and first-generation students; shifting and more demanding responsibilities; and increased expectations from the greater campus community,…

Rights and Responsibilities of Participants in Networked Communities.

ERIC Educational Resources Information Center

Denning, Dorothy E., Ed.; Lin, Herbert S., Ed.

This report is based on a November 1992 workshop and a February 1993 public forum which discussed some of the social issues raised by the emergence of electronic communities. The workshop examined user, provider, and other perspectives on different types of networked communities, including those on the Internet, commercial information services,…

The 2012 derecho: emergency medical services and hospital response.

PubMed

Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B

2014-10-01

During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.

Flood-tracking chart for the Withlacoochee and Little River Basins in south-central Georgia and northern Florida

USGS Publications Warehouse

Gotvald, Anthony J.; McCallum, Brian E.; Painter, Jaime A.

2014-01-01

The U.S. Geological Survey (USGS), in cooperation with other Federal, State, and local agencies, operates a flood-monitoring system in the Withlacoochee and Little River Basins. This system is a network of automated river stage stations (ten are shown on page 2 of this publication) that transmit stage data through satellite telemetry to the USGS in Atlanta, Georgia and the National Weather Service (NWS) in Peachtree City, Georgia. During floods, the public and emergency response agencies use this information to make decisions about road closures, evacuations, and other public safety issues. This Withlacoochee and Little River Basins flood-tracking chart can be used by local citizens and emergency response personnel to record the latest river stage and predicted flood-crest information along the Withlacoochee River, Little River, and Okapilco Creek in south-central Georgia and northern Florida. By comparing the current stage (water-surface level above a datum) and predicted flood crest to the recorded peak stages of previous floods, emergency response personnel and residents can make informed decisions concerning the threat to life and property.

The role of the emergency physician in emergency medical services for children.

PubMed

Gausche-Hill, Marianne; Johnson, Ramon W; Warden, Craig R; Brennan, John A

2003-08-01

Emergency physicians have a duty to advance the care of pediatric patients in the emergency medical services (EMS) system. This policy resource and education paper, designed to support the American College of Emergency Physicians policy paper "The Role of the Emergency Physician in Emergency Medical Services for Children," describes the development of the federal EMS for Children Program, the importance of the integration of EMS for children into EMS systems, and the role of the emergency physician in EMS for children.

The role of the emergency services in the optimisation of primary angioplasty: experience from London and the Heart Attack Team.

PubMed

Dalby, Miles; Whitbread, Mark

2013-08-22

Early ambulance services often confined their activities to a "scoop and run" approach, conveying sick patients quickly to the nearest emergency department. With the advent of modern ST-elevation myocardial infarction (STEMI) management and primary percutaneous coronary intervention (PPCI), the role of the emergency medical service (EMS) has expanded significantly. This review discusses the critical and evolving collaboration between the EMS and the heart attack centre. Speed of reperfusion is a major determinant of outcome in STEMI and, whilst the patient delay (symptom to call time) has a central role in this, system delay (first medical contact to balloon time) is linked to mortality and is used to measure the response of a PPCI programme and is a key element of contemporary guidelines. In addition to rapid diagnosis and transfer to the heart attack centre, the EMS has to deliver a growing number of established treatments including resuscitation and drug therapy. EMS also continually needs to develop expertise in new techniques such as advanced management of cardiac arrest patients, including automated cardiopulmonary resuscitation, and will need to deliver newer therapies if trials support their use, including cooling and preconditioning. Ultimately, the EMS has a central role in the management of STEMI patients which needs to be fully aligned with the heart attack centres. This integration of services is perhaps best regarded as the Heart Attack Team.

Terrorism in Turkey.

PubMed

Rodoplu, Ulkumen; Arnold, Jeffrey; Ersoy, Gurkan

2003-01-01

Over the past two decades, terrorism has exacted an enormous toll on the Republic of Turkey, a secular democracy with a 99.8% Muslim population. From 1984 to 2000, an estimated 30,000 to 35,000 Turkish citizens were killed by a nearly continuous stream of terrorism-related events. During this period, the Partiya Karekerren Kurdistan (PKK), a Kurdish separatist group (re-named KADEK in 2002), was responsible for the vast majority of terrorism-related events (and casualties), which disproportionately affected the eastern and southeastern regions of Turkey, in which the PKK has focused its activities. Most terrorist attacks over the past two decades have been bombings or shootings that produced < 10 casualties per event. From 1984 to 2003, 15 terrorist attacks produced > or = 30 casualties (eight shootings, five bombings, and two arsons). The maximum number of casualties produced by any of these events was 93 in the Hotel Madimak arson attack by the Turkish Islamic Movement in 1993. This pattern suggests that terrorist attacks in Turkey rarely required more than local systems of emergency medical response, except in rural areas where Emergency Medical Services (EMS) are routinely provided by regional military resources. The last decade has seen the development of several key systems of local emergency response in Turkey, including the establishment of the medical specialty of Emergency Medicine, the establishment of training programs for EMS providers, the spread of a generic, Turkish hospital emergency plan based on the Hospital Emergency Incident Command System, and the spread of advanced training in trauma care modeled after Advanced Trauma Life Support.

Risk management of emergency service vehicle crashes in the United States fire service: process, outputs, and recommendations.

PubMed

Bui, David P; Pollack Porter, Keshia; Griffin, Stephanie; French, Dustin D; Jung, Alesia M; Crothers, Stephen; Burgess, Jefferey L

2017-11-17

Emergency service vehicle crashes (ESVCs) are a leading cause of death in the United States fire service. Risk management (RM) is a proactive process for identifying occupational risks and reducing hazards and unwanted events through an iterative process of scoping hazards, risk assessment, and implementing controls. We describe the process, outputs, and lessons learned from the application of a proactive RM process to reduce ESVCs in US fire departments. Three fire departments representative of urban, suburban, and rural geographies, participated in a facilitated RM process delivered through focus groups and stakeholder discussion. Crash reports from department databases were reviewed to characterize the context, circumstances, hazards and risks of ESVCs. Identified risks were ranked using a risk matrix that considered risk likelihood and severity. Department-specific control measures were selected based on group consensus. Interviews, and focus groups were used to assess acceptability and utility of the RM process and perceived facilitators and barriers of implementation. Three to six RM meetings were conducted at each fire department. There were 7.4 crashes per 100 personnel in the urban department and 10.5 per 100 personnel in the suburban department; the rural department experienced zero crashes. All departments identified emergency response, backing, on scene struck by, driver distraction, vehicle/road visibility, and driver training as high or medium concerns. Additional high priority risks varied by department; the urban department prioritized turning and rear ending crashes; the suburban firefighters prioritized inclement weather/road environment and low visibility related crashes; and the rural volunteer fire department prioritized exiting station, vehicle failure, and inclement weather/road environment related incidents. Selected controls included new policies and standard operating procedures to reduce emergency response, cameras to enhance driver visibility while backing, and increased training frequency and enhanced training. The RM process was generally acceptable to department participants and considered useful. All departments reported that the focused and systematic analysis of crashes was particularly helpful. Implementation of controls was a commonly cited challenge. Proactive RM of ESVCs in three US fire departments was positively received and supported the establishment of interventions tailored to each department's needs and priorities.

Pit Latrine Emptying Behavior and Demand for Sanitation Services in Dar Es Salaam, Tanzania

PubMed Central

Jenkins, Marion W.; Cumming, Oliver; Cairncross, Sandy

2015-01-01

Pit latrines are the main form of sanitation in unplanned areas in many rapidly growing developing cities. Understanding demand for pit latrine fecal sludge management (FSM) services in these communities is important for designing demand-responsive sanitation services and policies to improve public health. We examine latrine emptying knowledge, attitudes, behavior, trends and rates of safe/unsafe emptying, and measure demand for a new hygienic latrine emptying service in unplanned communities in Dar Es Salaam (Dar), Tanzania, using data from a cross-sectional survey at 662 residential properties in 35 unplanned sub-wards across Dar, where 97% had pit latrines. A picture emerges of expensive and poor FSM service options for latrine owners, resulting in widespread fecal sludge exposure that is likely to increase unless addressed. Households delay emptying as long as possible, use full pits beyond what is safe, face high costs even for unhygienic emptying, and resort to unsafe practices like ‘flooding out’. We measured strong interest in and willingness to pay (WTP) for the new pit emptying service at 96% of residences; 57% were WTP ≥U.S. $17 to remove ≥200 L of sludge. Emerging policy recommendations for safe FSM in unplanned urban communities in Dar and elsewhere are discussed. PMID:25734790

A Strategy to Enhance Student Experiences in Public Health Emergency Preparedness and Response: Medical Reserve Corps Nursing Student Summer Externship.

PubMed

Stein, Loren Nell Melton

Development of the public health nursing workforce is crucial to advancing our nation's health. Many organizations, including the American Association of Colleges of Nursing, Centers for Disease Control and Prevention, and the US Department of Health and Human Services, have identified the need for strengthening academia's connection to public health and tailoring experiences to enhance workforce competency. The Oklahoma Medical Reserve Corps (OKMRC) Nursing Student Summer Externship was developed as a strategy to provide nursing students with strengthened knowledge and skills in disaster response through a structured summer volunteer experience with nurse educators within the OKMRC. The Medical Reserve Corps is a national organization with more than 200 000 volunteers dedicated to strengthening public health, improving emergency response capabilities, and building community resiliency. In the summer of 2015, the OKMRC offered a 10-week public health emergency preparedness and response externship pilot program to 8 nursing students. In the summer of 2016, the program expanded to include 3 Oklahoma baccalaureate nursing programs. Students completed trainings and participated in activities designed to provide a broad base of knowledge, an awareness of the local disaster plans, and leadership skills to assist their communities with preparedness and disaster response.

New York State Public Health System Response to Hurricane Sandy: Lessons From the Field.

PubMed

Shipp Hilts, Asante; Mack, Stephanie; Eidson, Millicent; Nguyen, Trang; Birkhead, Guthrie S

2016-06-01

The aim of this study was to conduct interviews with public health staff who responded to Hurricane Sandy and to analyze their feedback to assess response strengths and challenges and recommend improvements for future disaster preparedness and response. Qualitative analysis was conducted of information from individual confidential interviews with 35 staff from 3 local health departments in New York State (NYS) impacted by Hurricane Sandy and the NYS Department of Health. Staff were asked about their experiences during Hurricane Sandy and their recommendations for improvements. Open coding was used to analyze interview transcripts for reoccurring themes, which were labeled as strengths, challenges, or recommendations and then categorized into public health preparedness capabilities. The most commonly cited strengths, challenges, and recommendations related to the Hurricane Sandy public health response in NYS were within the emergency operations coordination preparedness capability, which includes the abilities of health department staff to partner among government agencies, coordinate with emergency operation centers, conduct routine conference calls with partners, and manage resources. Health departments should ensure that emergency planning includes protocols to coordinate backup staffing, delineation of services that can be halted during disasters, clear guidelines to coordinate resources across agencies, and training for transitioning into unfamiliar disaster response roles. (Disaster Med Public Health Preparedness. 2016;10:443-453).

Population density and racial differences in the performance of emergency medical services.

PubMed

David, Guy; Harrington, Scott E

2010-07-01

This paper analyzes the existence and scope of possible racial differences/disparities in the provision of emergency medical services (EMS) response capability (time from dispatch to arrival at the scene and level of training of the responding team) using data on approximately 120,000 cardiac incidents in the state of Mississippi during 1995-2004. The conceptual framework and empirical analysis focus on the likely effects of population density on the efficient production of EMS as a local public good subject to congestion, and on the need to control adequately for population density to avoid bias in testing for racial differences. Models that control for aggregate population density at the county-level indicate "reverse" disparities: faster estimated response times for African-Americans than for whites. When a refined county-level measure of population density is used that incorporates differences in African-American and white population density by Census tract, the reverse disparity in response times disappears. There also is little or no evidence of race-related differences in the certification level of EMS responders. However, there is evidence that, controlling for response time, African-Americans on average were significantly more likely to be deceased than whites upon EMS arrival at the scene. The overall results are germane to the debate over the scope of conditioning variables that should be included when testing for racial disparities in health care.

47 CFR 97.407 - Radio amateur civil emergency service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 97.407 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AMATEUR RADIO SERVICE Providing Emergency Communications § 97.407 Radio amateur civil emergency... available to stations transmitting communications in RACES on a shared basis with the amateur service. In...

E-DECIDER: Using Earth Science Data and Modeling Tools to Develop Decision Support for Earthquake Disaster Response

NASA Astrophysics Data System (ADS)

Glasscoe, Margaret T.; Wang, Jun; Pierce, Marlon E.; Yoder, Mark R.; Parker, Jay W.; Burl, Michael C.; Stough, Timothy M.; Granat, Robert A.; Donnellan, Andrea; Rundle, John B.; Ma, Yu; Bawden, Gerald W.; Yuen, Karen

2015-08-01

Earthquake Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response (E-DECIDER) is a NASA-funded project developing new capabilities for decision making utilizing remote sensing data and modeling software to provide decision support for earthquake disaster management and response. E-DECIDER incorporates the earthquake forecasting methodology and geophysical modeling tools developed through NASA's QuakeSim project. Remote sensing and geodetic data, in conjunction with modeling and forecasting tools allows us to provide both long-term planning information for disaster management decision makers as well as short-term information following earthquake events (i.e. identifying areas where the greatest deformation and damage has occurred and emergency services may need to be focused). This in turn is delivered through standards-compliant web services for desktop and hand-held devices.

Clinical decision-making described by Swedish prehospital emergency care nurse students - An exploratory study.

PubMed

Nilsson, Tomas; Lindström, Veronica

2016-07-01

The purpose of this study was to explore the PECN students' clinical decision-making during a seven-week clinical rotation in the ambulance services. Developing expertise in prehospital emergency care practices requires both theoretical and empirical learning. A prehospital emergency care nurse (PECN) is a Registered Nurse (RN) with one year of additional training in emergency care. There has been little investigation of how PECN students describe their decision-making during a clinical rotation. A qualitative study design was used, and 12 logbooks written by the Swedish PECN students were analysed using content analysis. The students wrote about 997 patient encounters - ambulance assignments during their clinical rotation. Four themes emerged as crucial for the students' decision-making: knowing the patient, the context-situation awareness in the ambulance service, collaboration, and evaluation. Based on the themes, students made decisions on how to respond to patients' illnesses. The PECN students used several variables in their decision-making. The decision- making was an on-going process during the whole ambulance assignment. The university has the responsibility to guide the students during their transition from an RN to a PECN. The findings of the study can support the educators and clinical supervisors in developing the programme of study for becoming a PECN. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hurricane preparedness: Current procedures at Blue Cross Blue Shield of Florida.

PubMed

Devaney, Everett

2008-01-01

This paper discusses experience, methodology and recommendations for successful business continuity and disaster recovery planning for health care organisations. Hurricanes, tornadoes and other natural disasters are a regular occurrence in Florida. Low-lying coastal areas are at increased risk, with populations in inland areas as far as 200-300 miles with potential to suffer heavy damage. This case study shows how one institution, Blue Cross Blue Shield of Florida, provides and maintains emergency response plans for critical functions, services or processes before, during and after a disaster, in support of its 8.3 million customers, its stakeholders and colleagues such as providers and vendors. Even though modern tracking gives fair warning regarding hurricanes, the use of specific and tested emergency response planning is critical to allow business continuity decision-making well before disaster strikes. This study examines how functional units within a health care organisation can plan and prepare to protect the public who depend on their services and resources, as well as minimise the risk to employees and business stakeholders. Coordination of a Contingency Response Team (within the functional units) and an Enterprise Operations Centre must be well managed to minimise adverse customer service disruptions and at the same time minimise impact to the company. Decision making and communications are strictly organised to protect stakeholders, make temporary business rule changes, allow for alternative business processes and handle benefit decisions, following methodology known, tested and used in past scenarios. In summary, the paper explores key points to achieve active and engaged business continuity in the face of natural disasters - (1) planning & coordination, (2) monitoring, (3) response/activation and (4) recovery.

Building a durable response to HIV/AIDS: implications for health systems.

PubMed

Atun, Rifat; Bataringaya, Jacqueline

2011-08-01

The remarkable rise in investments for HIV control programs in 2003-2010 enabled an unprecedented expansion of access to HIV services in low-income and middle-income countries. By the end of 2010, more than 5.2 million people were receiving antiretroviral therapy (ART), which transformed HIV infection, once a death sentence, into a long-term illness. The rapid expansion in the number of persons receiving ART means that health systems must continue to provide acute life-saving care for those with advanced HIV/AIDS although also providing chronic care services to expanding cohorts of more stable patients who are doing well on ART. This expansion also means a transition from an emergency response to the epidemic, characterized by a public health approach, to a more integrated and durable approach to HIV prevention, care, and treatment services that fosters individualized care for those requiring long-term antiretroviral treatment. Yet most low-income and middle-income countries, which have weak health systems, are poorly prepared to make this transition. In this article, we highlight the challenges health systems face in developing a sustained and durable response to HIV/AIDS. The article analyses the readiness of health systems to combine rapid expansion of ART access with long-term treatment and continuity of care for a growing cohort of patients. We argue that effective management of a transition from an emergency AIDS response to long-term programatic strategies will require a paradigm shift that enables leveraging investments in HIV to build sustainable health systems for managing large cohorts of patients receiving ART although meeting the immediate needs of those who remain without access to HIV treatment and care.

75 FR 27917 - Emergency Medical Services Week, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-18

... Part III The President Proclamation 8519--Emergency Medical Services Week, 2010 Executive Order... Medical Services Week, 2010 By the President of the United States of America A Proclamation Every day of... enhancing our country's preparedness and resilience. During Emergency Medical Services Week, we recommit to...

Consultant-based otolaryngology emergency service: a five-year experience.

PubMed

Barnes, M L; Hussain, S S M

2011-12-01

To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

Emergency response facilities including primary and secondary prevention strategies across 79 professional football clubs in England.

PubMed

Malhotra, Aneil; Dhutia, Harshil; Gati, Sabiha; Yeo, Tee-Joo; Finocchiaro, Gherardo; Keteepe-Arachi, Tracey; Richards, Thomas; Walker, Mike; Birt, Robin; Stuckey, David; Robinson, Laurence; Tome, Maite; Beasley, Ian; Papadakis, Michael; Sharma, Sanjay

2017-06-14

To assess the emergency response planning and prevention strategies for sudden cardiac arrest (SCA) across a wide range of professional football clubs in England. A written survey was sent to all professional clubs in the English football league, namely the Premiership, Championship, League 1 and League 2. Outcomes included: (1) number of clubs performing cardiac screening and frequency of screening; (2) emergency planning and documentation; (3) automated external defibrillator (AED) training and availability; and (4) provision of emergency services at sporting venues. 79 clubs (86%) responded to the survey. 100% clubs participated in cardiac screening. All clubs had AEDs available on match days and during training sessions. 100% Premiership clubs provided AED training to designated staff. In contrast, 30% of lower division clubs with AEDs available did not provide formal training. Most clubs (n=66; 83%) reported the existence of an emergency action plan for SCA but formal documentation was variable. All clubs in the Premiership and League 1 provided an ambulance equipped for medical emergencies on match days compared with 75% of clubs in the Championship and 66% in League 2. The majority of football clubs in England have satisfactory prevention strategies and emergency response planning in line with European recommendations. Additional improvements such as increasing awareness of European guidelines for emergency planning, AED training and mentorship with financial support to lower division clubs are necessary to further enhance cardiovascular safety of athletes and spectators and close the gap between the highest and lower divisions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Understanding the responsibilities and obligations of the modern paediatric surgeon.

PubMed

Beasley, Spencer W

2015-02-01

The modern paediatric surgeon needs to be competent in multiple domains that extend well beyond their clinical and technical expertise. This article, based on the Journal of Pediatric Surgery Lecture at the BAPS Congress (2014), explores some of these less well understood responsibilities and obligations, including professionalism, leadership, effective clinical teaching, and research. The consequence of falling short in these areas includes risks to our profession as a whole as well as compromising our ability to provide our patients with the best clinical care. Paediatric surgeons have a responsibility to influence the configuration of services to improve the quality of care and equity of access to specialist services for all children in their region. Evidence presented shows how a well-organised and funded regional paediatric surgical service allows children to receive quality treatment closer to home and is reflected in better clinical outcomes, less unnecessary surgery, and fewer complications. A paradigm for support to emerging countries as they increase the capacity and infrastructure of their paediatric surgical services is proposed. The way we judge ourselves and others should relate to our performance across the full scope of roles that a responsible and committed paediatric surgeon is expected to display. Copyright © 2015 Elsevier Inc. All rights reserved.

Mental health services for children in the first two years after the 1995 Oklahoma City terrorist bombing.

PubMed

Pfefferbaum, B; Call, J A; Sconzo, G M

1999-07-01

Nineteen infants and children were killed in the 1995 terrorist bombing in Oklahoma City, and many were injured. More than 200 children lost one or both parents. These casualties focused attention on children in the disaster response efforts. This paper describes the development and implementation of a school-based mental health program that provided accessible services to children affected by the bombing, with an emphasis on normalization. A clinical needs assessment of all children in the Oklahoma City public school system was carried out, and clinicians provided emergency and crisis services, counseling, and support groups.

An evaluation of the quality of Emergency Nurse Practitioner services for patients presenting with minor injuries to one rural urgent care centre in the UK: a descriptive study.

PubMed

McDevitt, Joe; Melby, Vidar

2015-02-01

To evaluate the quality of the emergency nurse practitioner service provided to people presenting to a rural urgent care centre with minor injuries. The three objectives that were focused were an evaluation of the safety and effectiveness of the emergency nurse practitioner service, an assessment of patients' satisfaction with the emergency nurse practitioner service and a determination of factors that may enhance the quality of the emergency nurse practitioner service. Urgent care centres have become increasingly prevalent across the UK. Emergency nurse practitioner services at these rural urgent care centres remain largely unevaluated. This study attempts to redress this deficit by evaluating the quality of an emergency nurse practitioner service in relation to the care of patients presenting with minor injuries to a rural urgent care centre. This descriptive study used a case-note review and a survey design with one open-ended exploratory question. Patient views were collected using a self-completed questionnaire and a data extraction tool to survey patients' case notes retrospectively. Despite comparatively low total length-of-stay times, most patients felt they had enough time to discuss things fully with the emergency nurse practitioner. Although emergency nurse practitioners routinely impart injury advice, feedback from some patients suggests a need for the provision of more in-depth information regarding their injury. The vast majority (97·3%) of patients felt that the quality of the emergency nurse practitioner service was of a high standard. Contrary to some other studies, the findings in this study indicate that patient satisfaction is not influenced by waiting times. Emergency nurse practitioners in rural urgent care centres have the potential to deliver a safe and effective quality service that is reflected in high levels of patient satisfaction. This study provides some evidence to support the continued expansion of the emergency nurse practitioner service in rural settings in the UK. © 2014 John Wiley & Sons Ltd.

Modeling relief demands in an emergency supply chain system under large-scale disasters based on a queuing network.

PubMed

He, Xinhua; Hu, Wenfa

2014-01-01

This paper presents a multiple-rescue model for an emergency supply chain system under uncertainties in large-scale affected area of disasters. The proposed methodology takes into consideration that the rescue demands caused by a large-scale disaster are scattered in several locations; the servers are arranged in multiple echelons (resource depots, distribution centers, and rescue center sites) located in different places but are coordinated within one emergency supply chain system; depending on the types of rescue demands, one or more distinct servers dispatch emergency resources in different vehicle routes, and emergency rescue services queue in multiple rescue-demand locations. This emergency system is modeled as a minimal queuing response time model of location and allocation. A solution to this complex mathematical problem is developed based on genetic algorithm. Finally, a case study of an emergency supply chain system operating in Shanghai is discussed. The results demonstrate the robustness and applicability of the proposed model.

Modeling Relief Demands in an Emergency Supply Chain System under Large-Scale Disasters Based on a Queuing Network

PubMed Central

He, Xinhua

2014-01-01

This paper presents a multiple-rescue model for an emergency supply chain system under uncertainties in large-scale affected area of disasters. The proposed methodology takes into consideration that the rescue demands caused by a large-scale disaster are scattered in several locations; the servers are arranged in multiple echelons (resource depots, distribution centers, and rescue center sites) located in different places but are coordinated within one emergency supply chain system; depending on the types of rescue demands, one or more distinct servers dispatch emergency resources in different vehicle routes, and emergency rescue services queue in multiple rescue-demand locations. This emergency system is modeled as a minimal queuing response time model of location and allocation. A solution to this complex mathematical problem is developed based on genetic algorithm. Finally, a case study of an emergency supply chain system operating in Shanghai is discussed. The results demonstrate the robustness and applicability of the proposed model. PMID:24688367

Using an emergency response infrastructure to help women who experience gender-based violence in Gujarat, India.

PubMed

Newberry, Jennifer A; Mahadevan, Swaminatha; Gohil, Narendrasinh; Jamshed, Roma; Prajapati, Jashvant; Rao, Gv Ramana; Strehlow, Matthew

2016-05-01

Many women who experience gender-based violence may never seek any formal help because they do not feel safe or confident that they will receive help if they try. A public-private-academic partnership in Gujarat, India, established a toll-free telephone helpline - called 181 Abhayam - for women experiencing gender-based violence. The partnership used existing emergency response service infrastructure to link women to phone counselling, nongovernmental organizations (NGOs) and government programmes. In India, the lifetime prevalence of gender-based violence is 37.2%, but less than 1% of women will ever seek help beyond their family or friends. Before implementation of the helpline, there were no toll-free helplines or centralized coordinating systems for government programmes, NGOs and emergency response services. In February 2014, the helpline was launched across Gujarat. In the first 10 months, the helpline assisted 9767 individuals, of which 8654 identified themselves as women. Of all calls, 79% (7694) required an intervention by phone or in person on the day they called and 43% (4190) of calls were by or for women experiencing violence. Despite previous data that showed women experiencing gender-based violence rarely sought help from formal sources, women in Gujarat did use the helpline for concerns across the spectrum of gender-based violence. However, for evaluating the impact of the helpline, the operational definitions of concern categories need to be further clarified. The initial triage system for incoming calls was advantageous for handling high call volumes, but may have contributed to dropped calls.

Post‐war development of emergency medicine in Kosovo

PubMed Central

O'Hanlon, K P

2007-01-01

Objectives To (1) investigate emergency medical care priorities in Kosovo, (2) assess Kosovo's post‐war development of emergency medical services and (3) identify expectations. Methods An instrument with seven open‐ended questions, approved by the institutional review board, was designed for in‐person interviews (preferred) or written survey. The survey was administered in October 2003 at the Kosovo University Clinical Center, Pristina, Kosovo, and one regional hospital. Targeted participants were emergency care providers, clinical consultants and health policy consultants. Surveys were conducted by interview with simultaneous interpretation by a native Albanian speaker, an orthopaedic surgeon or in written Albanian form. The responses were evaluated quantitatively and qualitatively. Results 13 respondents participated in the study: 10 gave interviews and 3 provided written response; 7 were emergency care providers, 4 were emergency care consultants and 2 were health policy consultants. Emergency care priorities were defined as trauma, cardiac disease and suicide. Most respondents believed that emergency medicine as a specialised field was a post‐war development. The international community was credited with the provision of infrastructure, supplies and training. Most respondents denied any harm from international assistance. However, some respondents described instances of inappropriate international investment. Ongoing needs are training of providers and equipping of facilities and vehicles. Improved hospital management, political administration and international involvement are thought to be necessary for continued development. Conclusions Survey respondents agreed on priorities in emergency care, credited the international community with development to date, and identified administrative structures and international training support as the keys to ongoing development. PMID:17183036

Novel and emerging strategies for longitudinal data collection.

PubMed

Udtha, Malini; Nomie, Krystle; Yu, Erica; Sanner, Jennifer

2015-03-01

To describe novel and emerging strategies practiced globally in research to improve longitudinal data collection. In research studies, numerous strategies such as telephone interviews, postal mailing, online questionnaires, and electronic mail are traditionally utilized in longitudinal data collection. However, due to technological advances, novel and emerging strategies have been applied to longitudinal data collection, such as two-way short message service, smartphone applications (or "apps"), retrieval capabilities applied to the electronic medical record, and an adapted cloud interface. In this review, traditional longitudinal data collection strategies are briefly described, emerging and novel strategies are detailed and explored, and information regarding the impact of novel methods on participant response rates, the timeliness of participant responses, and cost is provided. We further discuss how these novel and emerging strategies affect longitudinal data collection and advance research, specifically nursing research. Evidence suggests that the novel and emerging longitudinal data collection strategies discussed in this review are valuable approaches to consider. These strategies facilitate collecting longitudinal research data to better understand a variety of health-related conditions. Future studies, including nursing research, should consider using novel and emerging strategies to advance longitudinal data collection. A better understanding of novel and emerging longitudinal data collection strategies will ultimately improve longitudinal data collection as well as foster research efforts. Nurse researchers, along with all researchers, must be aware of and consider implementing novel and emerging strategies to ensure future healthcare research success. © 2014 Sigma Theta Tau International.

Clinical handover of patients arriving by ambulance to the emergency department - a literature review.

PubMed

Bost, Nerolie; Crilly, Julia; Wallis, Marianne; Patterson, Elizabeth; Chaboyer, Wendy

2010-10-01

To provide a critical review of research on clinical handover between the ambulance service and emergency department (ED) in hospitals. Data base and hand searches were conducted using the keywords ambulance, handover, handoff, emergency department, emergency room, ER, communication, and clinical handover. Data were extracted, summarised and critically assessed to provide evidence of current clinical handover processes. From 252 documents, eight studies fitted the inclusion criteria of clinical handover and the ambulance to ED patient transfer. Three themes were identified in the review: (1) important information may be missed during clinical handover; (2) structured handovers that include both written and verbal components may improve information exchange; (3) multidisciplinary education about the clinical handover process may encourage teamwork, a shared common language and a framework for minimum patient information to be transferred from the ambulance service to the hospital ED. Knowledge gaps exist concerning handover information, consequences of poor handover, transfer of responsibility, staff perception of handovers, staff training and evaluation of recommended strategies to improve clinical handover. Evidence of strategies being implemented and further research is required to examine the ongoing effects of implementing the strategies. Copyright © 2009 Elsevier Ltd. All rights reserved.

Products and processes of agri-scientific service-learning: adding harmony to Dopico and Garcia-Vázquez

NASA Astrophysics Data System (ADS)

Boggs, George L.

2011-06-01

This forum response adds a conceptualization of harmony to Dopico and Vázquez' investigation of pedagogy that combines citizen science, environmental and cross-cultural research, and service-learning. Placing many appropriate and significant aspects of culturally situated science education in an authentically relational context beyond the classroom, this paper calls attention to insightful contributions and new directions for research, such as the process of inducing or eluding nihilism regarding ecological issues. How can such a question be researched effectively in order to learn about the family of pedagogies emerging in response to the need for more ecologically conscious and relationally authentic teaching across many disciplines? In this paper, I use a Vygotskian framework and an abbreviated case study of agricultural service-learning from my research, drawing attention to the importance of students' culturally-mediated construction of setting as they interact in older and newer ways.

42 CFR 447.54 - Maximum allowable and nominal charges.

Code of Federal Regulations, 2013 CFR

2013-10-01

... nonemergency services furnished in a hospital emergency room. (c) Institutional services. For institutional... hospital emergency department. (a) The agency may impose cost sharing for non-emergency services provided... exempt from cost sharing under § 447.56(a), the agency may impose cost sharing for non-emergency use of...

38 CFR 17.1002 - Substantive conditions for payment or reimbursement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services for Nonservice.... Payment or reimbursement under 38 U.S.C. 1725 for emergency services may be made only if all of the following conditions are met: (a) The emergency services were provided in a hospital emergency department or...

Use of SMS-Based Surveys in the Rapid Response to the Ebola Outbreak in Liberia: Opening Community Dialogue.

PubMed

Berman, Amanda; Figueroa, Maria Elena; Storey, J Douglas

2017-01-01

During an emerging health crisis like the 2014 Ebola outbreak in West Africa, communicating with communities to learn from them and to provide timely information can be a challenge. Insight into community thinking, however, is crucial for developing appropriate communication content and strategies and for monitoring the progress of the emergency response. In November 2014, the Health Communication Capacity Collaborative partnered with GeoPoll to implement a Short Message Service (SMS)-based survey that could create a link with affected communities and help guide the communication response to Ebola. The ideation metatheory of communication and behavior change guided the design of the survey questionnaire, which produced critical insights into trusted sources of information, knowledge of transmission modes, and perceived risks-all factors relevant to the design of an effective communication response that further catalyzed ongoing community actions. The use of GeoPoll's infrastructure for data collection proved a crucial source of almost-real-time data. It allowed for rapid data collection and processing under chaotic field conditions. Though not a replacement for standard survey methodologies, SMS surveys can provide quick answers within a larger research process to decide on immediate steps for communication strategies when the demand for speedy emergency response is high. They can also help frame additional research as the response evolves and overall monitor the pulse of the situation at any point in time.

28 CFR 115.182 - Access to emergency medical services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Access to emergency medical services. 115...

28 CFR 115.182 - Access to emergency medical services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Access to emergency medical services. 115...

28 CFR 115.182 - Access to emergency medical services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Access to emergency medical services. 115...

Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study

PubMed Central

2012-01-01

Background Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Method Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Results Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service’s funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Conclusions Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people’s consciousness, while the appointment system would benefit from providing more timely appointments with therapists. The service’s funding model is important in enabling access initially to young people from low socioeconomic backgrounds, but the government needs to reassess the model for those who require additional support. PMID:22853550

Safeguarding production agriculture and natural ecosystems against biological terrorism. A U.S. Department of Agriculture emergency response framework.

PubMed

Sequeira, R

1999-01-01

Foreign pest introductions and outbreaks represent threats to agricultural productivity and ecosystems, and, thus, to the health and national security of the United States. It is advisable to identify relevant techniques and bring all appropriate strategies to bear on the problem of controlling accidentally and intentionally introduced pest outbreaks. Recent political shifts indicate that the U.S. may be at increased risk for biological terrorism. The existing emergency-response strategies of the Animal and Plant Health Inspection Services (APHIS) will evolve to expand activities in coordination with other emergency management agencies. APHIS will evolve its information superstructure to include extensive application of simulation models for forecasting, meteorological databases and analysis, systems analysis, geographic information systems, satellite image analysis, remote sensing, and the training of specialized cadres within the emergency-response framework capable of managing the necessary information processing and analysis. Finally, the threat of key pests ranked according to perceived risk will be assessed with mathematical models and "what-if" scenarios analyzed to determine impact and mitigation practices. An infrastructure will be maintained that periodically surveys ports and inland regions for the presence of exotic pest threats and will identify trend abnormalities. This survey and monitoring effort will include cooperation from industry groups, federal and state organizations, and academic institutions.

Electric Water Heater Modeling and Control Strategies for Demand Response

DOE Office of Scientific and Technical Information (OSTI.GOV)

Diao, Ruisheng; Lu, Shuai; Elizondo, Marcelo A.

2012-07-22

Abstract— Demand response (DR) has a great potential to provide balancing services at normal operating conditions and emergency support when a power system is subject to disturbances. Effective control strategies can significantly relieve the balancing burden of conventional generators and reduce investment on generation and transmission expansion. This paper is aimed at modeling electric water heaters (EWH) in households and tests their response to control strategies to implement DR. The open-loop response of EWH to a centralized signal is studied by adjusting temperature settings to provide regulation services; and two types of decentralized controllers are tested to provide frequency supportmore » following generator trips. EWH models are included in a simulation platform in DIgSILENT to perform electromechanical simulation, which contains 147 households in a distribution feeder. Simulation results show the dependence of EWH response on water heater usage . These results provide insight suggestions on the need of control strategies to achieve better performance for demand response implementation. Index Terms— Centralized control, decentralized control, demand response, electrical water heater, smart grid« less

Tourism guide cloud service quality: What actually delights customers?

PubMed

Lin, Shu-Ping; Yang, Chen-Lung; Pi, Han-Chung; Ho, Thao-Minh

2016-01-01

The emergence of advanced IT and cloud services has beneficially supported the information-intensive tourism industry, simultaneously caused extreme competitions in attracting customers through building efficient service platforms. On response, numerous nations have implemented cloud platforms to provide value-added sightseeing information and personal intelligent service experiences. Despite these efforts, customers' actual perspectives have yet been sufficiently understood. To bridge the gap, this study attempts to investigate what aspects of tourism cloud services actually delight customers' satisfaction and loyalty. 336 valid survey questionnaire answers were analyzed using structural equation modeling method. The results prove positive impacts of function quality, enjoyment, multiple visual aids, and information quality on customers' satisfaction as well as of enjoyment and satisfaction on use loyalty. The findings hope to provide helpful references of customer use behaviors for enhancing cloud service quality in order to achieve better organizational competitiveness.

Governing the implementation of Emergency Obstetric Care: experiences of Rural District Health Managers, Tanzania

PubMed Central

2014-01-01

Background Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. Methods The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Results Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development. Conclusion The study revealed that implementing EmOC is a process accompanied by challenges that require an approach with multiple partners to address them and that, for effective partnership, the roles and responsibilities of each partner should be well stipulated in a clear working framework within the district health system. Partnerships strengthen health system governance and therefore ensure effective implementation of health policies at a local level. PMID:25086597

Governing the implementation of emergency obstetric care: experiences of rural district health managers, Tanzania.

PubMed

Mkoka, Dickson Ally; Kiwara, Angwara; Goicolea, Isabel; Hurtig, Anna-Karin

2014-08-03

Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development. The study revealed that implementing EmOC is a process accompanied by challenges that require an approach with multiple partners to address them and that, for effective partnership, the roles and responsibilities of each partner should be well stipulated in a clear working framework within the district health system. Partnerships strengthen health system governance and therefore ensure effective implementation of health policies at a local level.

[Retrospect of tuberculosis control in Brazil].

PubMed

Hijjar, Miguel Aiub; Gerhardt, Germano; Teixeira, Gilmário M; Procópio, Maria José

2007-09-01

The aim of the study was to look back on the course of action involving measures of tuberculosis control in Brazil since the end of the 19th century, covering the history of social struggles and pointing out institutions and people that have dedicated themselves to looking for solutions to these issues. The Brazilian response to tuberculosis started in society with the Ligas Contra a Tuberculose (Leagues Against Tuberculosis), promoting scientific advances, such as the BCG vaccination, which begun in 1927. From the public power, the Inspetoria de Profilaxia da TB (TB Prophylaxis Inspection Service - 1920), the Serviço Nacional de Tuberculose (National Service of Tuberculosis - 1940), and the Campanha Nacional Contra a Tuberculose (National Campaign Against Tuberculosis - 1946), coordinated national policies such as chemotherapy, beginning with the discovery of streptomycin in 1944. The emergence of bacterial resistance led to the development of several therapeutic schemes. The Scheme 1 (rifampycin, hydrazide and pyrazinamid), which was the main one in 1979 and is still used nowadays, had a great epidemiological effect. The WHO declared TB a public health emergency in 1993. In response, Brazil developed some strategies; the first one was the Plano Emergencial para Controle da Tuberculose (Emergency Plan for Tuberculosis Control - 1994), prioritizing 230 municipalities. The current prospects are an effective municipalization of actions and their greater integration with the Programas de Agentes Comunitários e Saúde da Família (Humanitarian Agents and Family Health Programs).

The use of UAS in disaster response operations

NASA Astrophysics Data System (ADS)

Gkotsis, I.; Eftychidis, G.; Kolios, P.

2017-09-01

The use of UAS by the emergency services has been received with great interest since UAS provide both informant and helper support in a flexible, effective and efficient manner. This is due to the fact that, UAS can strengthen the operational capabilities related to: prevention (e.g., patrolling of large and hard to reach areas), early detection (e.g., mapping of vulnerable elements), disaster preparedness (e.g., incident inspection), response (mapping damages, search and rescue, provide an ad hoc communication network, monitor evacuation, etc). Through PREDICATE, a project concerning civilian use of drones, the necessary methodologies to guide the selection and operational use of UAS in emergencies, are developed. To guide UAS selection, the project performed a detailed needs assessment in cooperation with civil protection and law enforcement agencies. As a result of this assessment, currently available technologies and market solutions were reviewed leading to the development of an online user-friendly tool to support selection of UAS based on operational requirements. To guide the use of UAS, PREDICATE developed an intelligent path planning toolkit to automate the operation of UAS and ease their use for the various civil protection operations. By employing the aforementioned tools, emergency services will be able to better understand how to select and make use of UAS for watch-keeping and patrolling of their own disaster-prone Regions of Interest. The research, innovation and applicability behind both these tools is detailed in this work.

42 CFR 447.52 - Cost sharing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... agency imposes cost sharing under § 447.54, the process by which hospital emergency room services are... State option, cost sharing imposed for any service (other than for drugs and non-emergency services... group under § 447.56(a), and (iii) For cost sharing imposed for non-emergency services furnished in an...

Strengthening Emergency Care Systems to Mitigate Public Health Challenges Arising from Influxes of Individuals with Different Socio-Cultural Backgrounds to a Level One Emergency Center in South East Europe.

PubMed

Twomey, Michèle; Šijački, Ana; Krummrey, Gert; Welzel, Tyson; Exadaktylos, Aristomenis K; Ercegovac, Marko

2018-03-12

Emergency center visits are mostly unscheduled, undifferentiated, and unpredictable. A standardized triage process is an opportunity to obtain real-time data that paints a picture of the variation in acuity found in emergency centers. This is particularly pertinent as the influx of people seeking asylum or in transit mostly present with emergency care needs or first seek help at an emergency center. Triage not only reduces the risk of missing or losing a patient that may be deteriorating in the waiting room but also enables a time-critical response in the emergency care service provision. As part of a joint emergency care system strengthening and patient safety initiative, the Serbian Ministry of Health in collaboration with the Centre of Excellence in Emergency Medicine (CEEM) introduced a standardized triage process at the Clinical Centre of Serbia (CCS). This paper describes four crucial stages that were considered for the integration of a standardized triage process into acute care pathways.

Service life evaluation of rigid explosive transfer lines

NASA Technical Reports Server (NTRS)

Bement, L. J.; Kayser, E. G.; Schimmel, M. L.

1983-01-01

This paper describes a joint Army/NASA-sponsored research program on the service life evaluation of rigid explosive transfer lines. These transfer lines are used to initiate emergency crew escape functions on a wide variety of military and NASA aircraft. The purpose of this program was to determine quantitatively the effects of service, age, and degradation on rigid explosive transfer lines to allow responsible, conservative, service life determination. More than 800 transfer lines were removed from the U.S. Army AH-1G and AH-1S, the U.S. Air Force B-1 and F-111, and the U.S. Navy F-14 aircraft for testing. The results indicated that the lines were not adversely affected by age, service, or a repeat of the thermal qualification tests on full-service lines. Extension of the service life of rigid explosive transfer lines should be considered, since considerable cost savings could be realized with no measurable decrease in system reliability.

Facilitating The Medical Response Into An Active Shooter Hot Zone

DTIC Science & Technology

2016-06-01

before receiving care because most jurisdictions have a policy in place that stipulates emergency medical services ( EMS ) wait to enter a scene until law...people who most need it, and consequently, there can be a greater loss of life. How can a combined LE and EMS response, based on combat medical care... EMS entry teams, will provide better patient viability prior to hospital care. This will not be a critique of right and wrong, as the responders did

GSA committees: Progress through service the Annual Program Committee

USGS Publications Warehouse

Costa, J.E.

2007-01-01

The GSA's Annual Program Committee (APC) is directly responsible for the GSA's meeting and other responsibilities especially before the main event. It decides on the locations, the number and content of the technical sessions, annual membership surveys, hospitality for the guests, field trips and more. In addition, it pays significant attention to creative thinking about geoscience discoveries and directions as well as identify new and emerging areas of earth science. APC is also looking for new ideas, approaches and directions.

Pediatric Neurocritical Care: A Short Survey of Current Perceptions and Practices.

PubMed

Murphy, Sarah A; Bell, Michael J; Clark, Maureen E; Whalen, Michael J; Noviski, Natan

2015-10-01

Although attention to neurologic injuries and illnesses in pediatric critical care is not new, a sub-specialized field of pediatric neurocritical care has only recently been recognized. Pediatric neurocritical care is an emerging area of clinical and investigative focus. Little is known about the prevalence of specialized pediatric neurocritical care services nor about perceptions regarding how it is impacting medical practice. This survey sought to capture perceptions about an emerging area of specialized pediatric neurocritical care among practitioners in intersecting disciplines, including pediatric intensivists, pediatric neurologits and pediatric neurosurgeons. A web-based survey was distributed via email to members of relevant professional societies and groups. Survey responses were analyzed using descriptive statistics. Differences in responses between groups of respondents were analyzed using Chi-squared analysis where appropriate. Specialized clinical PNCC programs were not uncommon among the survey respondents with 20% currently having a PNCC service at their institution. Despite familiarity with this area of sub-specialization among the survey respondents, the survey did not find consensus regarding its value. Overall, 46% of respondents believed that a specialized clinical PNCC service improves the quality of care of critically ill children. Support for PNCC sub-specialization was more common among pediatric neurologists and pediatric neurosurgeons than pediatric intensivists. This survey found support across specialties for creating PNCC training pathways for both pediatric intensivists and pediatric neurologists with an interest in this specialized field. PNCC programs are not uncommon; however, there is not clear agreement on the optimal role or benefit of this area of practice sub-specialization. A broader dialog should be undertaken regarding the emerging practice of pediatric neurocritical care, the potential benefits and drawbacks of this partitioning of neurology and critical care medicine practice, economic and other practical factors, the organization of clinical support services, and the formalization of training and certification pathways for sub-specialization.

Business continuity in blood services: two case studies from events with potentially catastrophic effect on the national provision of blood components.

PubMed

Morgan, S J; Rackham, R A; Penny, S; Lawson, J R; Walsh, R J; Ismay, S L

2015-02-01

NHS Blood and Transplant (NHSBT) and the Australian Red Cross Blood Service (ARCBS) are national blood establishments providing blood components to England and North Wales, and Australia, respectively. In 2012, both services experienced potentially catastrophic challenges to key assets. NHSBT suffered a flood that closed the largest blood-manufacturing centre in Europe, whilst ARCBS experienced the failure of a data centre network switch that rendered the national blood management system inaccessible for 42 h. This paper describes both crisis events, including the immediate actions, recovery procedures and lessons learned. Both incidents triggered emergency response plans. These included hospital reprovisioning and recovery from the incident. Once normal services had been restored, both events were subjected to root cause analysis (RCA) and production of 'lessons learned' reports. In both scenarios, the key enablers of rapid recovery were established emergency plans, clear leadership and the support of a flexible workforce. Product issues to hospitals were unaffected, and there were no abnormal trends in hospital complaints. RCA identified the importance of risk mitigations that require co-operation with external organizations. Reviews of both events identified opportunities to enhance business resilience through prior identification of external risks and improvements to contingency plans, for example by implementing mass messaging to staff and other stakeholders. Blood establishment emergency plans tend to focus on responding to mass casualty events. However, consolidation of manufacturing to fewer sites combined with a reliance on national IT systems increases the impact of loss of function. Blood services should develop business continuity plans which include prevention of such losses, and the maintenance of services and disaster recovery. © 2014 International Society of Blood Transfusion.

Comparison of emergency medical services systems across Pan-Asian countries: a Web-based survey.

PubMed

Shin, Sang Do; Ong, Marcus Eng Hock; Tanaka, Hideharu; Ma, Matthew Huei-Ming; Nishiuchi, Tatsuya; Alsakaf, Omer; Karim, Sarah Abdul; Khunkhlai, Nalinas; Lin, Chih-Hao; Song, Kyoung Jun; Ryoo, Hyun Wook; Ryu, Hyun Ho; Tham, Lai Peng; Cone, David C

2012-01-01

There are great variations in out-of-hospital cardiac arrest (OHCA) survival outcomes among different countries and different emergency medical services (EMS) systems. The impact of different systems and their contribution to enhanced survival are poorly understood. This paper compares the EMS systems of several Asian sites making up the Pan-Asian Resuscitation Outcomes Study (PAROS) network. Some preliminary cardiac arrest outcomes are also reported. This is a cross-sectional descriptive survey study addressing population demographics, service levels, provider characteristics, system operations, budget and finance, medical direction (leadership), and oversight. Most of the systems are single-tiered. Fire-based EMS systems are predominant. Bangkok and Kuala Lumpur have hospital-based systems. Service level is relatively low, from basic to intermediate in most of the communities. Korea, Japan, Singapore, and Bangkok have intermediate emergency medical technician (EMT) service levels, while Taiwan and Dubai have paramedic service levels. Medical direction and oversight have not been systemically established, except in some communities. Systems are mostly dependent on public funding. We found variations in available resources in terms of ambulances and providers. The number of ambulances is 0.3 to 3.2 per 100,000 population, and most ambulances are basic life support (BLS) vehicles. The number of human resources ranges from 4.0 per 100,000 population in Singapore to 55.7 per 100,000 population in Taipei. Average response times vary between 5.1 minutes (Tainan) and 22.5 minutes (Kuala Lumpur). We found substantial variation in 11 communities across the PAROS EMS systems. This study will provide the foundation for understanding subsequent studies arising from the PAROS effort.

40 CFR Appendix III to Part 310 - Form: Application for Reimbursement to Local Governments for Emergency Response to Hazardous...

Code of Federal Regulations, 2010 CFR

2010-07-01

... sampling supplies. EQ Equipment EQ1: Replacement—for durable equipment declared a total loss as a result of... equipment or supplies Passenger and nonpassenger vehicle rental costs will be considered for private...: Utilities—for power, water, electricity and other services exclusive of transportation and communications...

Understanding the LCA and ISO water footprint: A response to Hoekstra (2016) “A critique on the water-scarcity weighted water footprint in LCA”

EPA Science Inventory

Water footprinting has emerged as an important approach to assess water use related effects from consumption of goods and services. Assessment methods are proposed by two different communities, the Water Footprint Network (WFN) and the Life Cycle Assessment (LCA) community. The p...

Legal Implications of an Employer Competency Certification Program. Technical Education and Training Research Report Series.

ERIC Educational Resources Information Center

Sage, James E.; And Others

Local and state government agencies and private companies providing hazardous material emergency response services are attempting to meet the minimum training requirements for their employees as specified in federal law. However, none of the employers in a pilot survey met the requirements of the federal law for employer certification of employee…

Challenge of N95 Filtering Facepiece Respirators with Viable H1N1 Influenza Aerosols (Postprint)

DTIC Science & Technology

2013-05-01

Response, US Department of Health and Human Services. references 1. Tellier R. Aerosol transmission of influenza A virus: a review of new studies. J R...5. Tellier R. Review of aerosol transmission of influenza A virus. Emerg Infect Dis 2006;12:1657–1662. 6. Bridges CB, Kuehnert MJ, Hall CB

Flood-inundation maps for the Schoharie Creek at Prattsville, New York, 2014

USGS Publications Warehouse

Nystrom, Elizabeth A.

2016-02-18

These flood-inundation maps, along with near-real-time stage data from USGS streamgages and forecasted stage data from the National Weather Service, can provide emergency management personnel and residents with information that is critical for flood response activities such as evacuations and road closures as well as for postflood recovery efforts.

Using PBL to Prepare Educators and Emergency Managers to Plan for Severe Weather

ERIC Educational Resources Information Center

Stalker, Sarah L.; Cullen, Theresa A.; Kloesel, Kevin

2015-01-01

Within the past 10 years severe weather has been responsible for an annual average of 278 fatalities in the United States (National Weather Service, 2013). During severe weather special populations are populations of high concentrations of people that cannot respond quickly. Schools show both of these characteristics. The average lead time for…

Protecting marine parks and sanctuaries from aquatic nuisance species releases from ballast during emergency response events

Treesearch

Phyllis A. Green

2011-01-01

Commercial shipping activities that release aquatic invasive species are recognized globally as a dominant transport vector for marine invasions. Aquatic nuisance species (ANS) introductions have resulted in billions of dollars of damages and immeasurable biological devastation within the Great Lakes. National Park Service managers are working with United States...

50 CFR 18.128 - What are the mitigation, monitoring, and reporting requirements?

Code of Federal Regulations, 2014 CFR

2014-10-01

... approaches, such as temporal or spatial limitations in response to the presence of marine mammals in a... contacted for guidance. The Service will evaluate these instances on a case-by-case basis to determine the... circumstances, other than an emergency, should any vessel approach within an 805-m (0.5-mi) radius of walruses...

50 CFR 18.128 - What are the mitigation, monitoring, and reporting requirements?

Code of Federal Regulations, 2011 CFR

2011-10-01

... approaches, such as temporal or spatial limitations in response to the presence of marine mammals in a... contacted for guidance. The Service will evaluate these instances on a case-by-case basis to determine the... circumstances, other than an emergency, should any vessel approach within an 805-m (0.5-mi) radius of walruses...

50 CFR 18.128 - What are the mitigation, monitoring, and reporting requirements?

Code of Federal Regulations, 2012 CFR

2012-10-01

... approaches, such as temporal or spatial limitations in response to the presence of marine mammals in a... contacted for guidance. The Service will evaluate these instances on a case-by-case basis to determine the... circumstances, other than an emergency, should any vessel approach within an 805-m (0.5-mi) radius of walruses...

50 CFR 18.128 - What are the mitigation, monitoring, and reporting requirements?

Code of Federal Regulations, 2013 CFR

2013-10-01

... approaches, such as temporal or spatial limitations in response to the presence of marine mammals in a... contacted for guidance. The Service will evaluate these instances on a case-by-case basis to determine the... circumstances, other than an emergency, should any vessel approach within an 805-m (0.5-mi) radius of walruses...

76 FR 23810 - Public Safety and Homeland Security Bureau; Federal Advisory Committee Act; Emergency Response...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

...., Washington, DC 20554. FOR FURTHER INFORMATION CONTACT: Gene Fullano, Designated Federal Official for PSAC at... accommodate. The public may submit written comments before the meeting to Gene Fullano, the FCC's Designated Federal Official for the PSAC, by e-mail to [email protected] or U.S. Postal Service Mail to Gene...

Long-term vegetation changes in a temperate forest impacted by climate change

Treesearch

Lauren E. Oakes; Paul E. Hennon; Kevin L. O' Hara; Rodolfo Dirzo

2014-01-01

Pervasive forest mortality is expected to increase in future decades as a result of increasing temperatures. Climate-induced forest dieback can have consequences on ecosystem services, potentially mediated by changes in forest structure and understory community composition that emerge in response to tree death. Although many dieback events around the world have been...

Coming in from the Margins: Faculty Development's Emerging Organizational Development Role in Institutional Change

ERIC Educational Resources Information Center

Schroeder, Connie

2010-01-01

Recognizing that a necessary and significant role change is underway in faculty development, this book calls for centers to merge their traditional responsibilities and services with a leadership role as organizational developers. Failing to define and outline the dimensions and expertise of this new role puts centers at risk of not only…

Higher Education and Peacebuilding--A Bridge between Communities?

ERIC Educational Resources Information Center

Rasheed, Rebeen A.; Munoz, Alexander

2016-01-01

As the Syrian civil war enters its fifth year, with over four million refugees and no solution in the near future, the international community must better consider long-term planning in regards to the plight of refugees and services to support them, not just short-term emergency responses. Critically, higher education is all too often ignored when…

Mentor Service Themes Emergent in a Holistic, Undergraduate Peer-Mentoring Experience

ERIC Educational Resources Information Center

Ward, Elijah G.; Thomas, Earl E.; Disch, William B.

2014-01-01

Little research has focused carefully on the means by which peer mentors foster development in undergraduate protégés. Two faculty members developed a holistic, peer-mentoring project in which 26 upperclassmen mentored 74 underclassmen at a midsize, 4-year institution. Mentor journal notes, open-ended protégé responses, and participant…

Using remote sensing to monitor post-fire watershed recovery as a tool for management

Treesearch

Jess Clark; Marc Stamer; Kevin Cooper; Carolyn Napper; Terri Hogue; Alicia Kinoshita

2013-01-01

Post-fire watershed recovery is influenced by numerous variables but one of the most important factors is the rate of re-establishment of vegetative cover. Burned Area Emergency Response (BAER) teams, along with other agencies (Natural Resource Conservation Service, state, counties, cities, etc.), prescribe temporary post-fire mitigation treatments based on expected...

42 CFR 51d.7 - What are the limitations on how award funds may be used?

Code of Federal Regulations, 2013 CFR

2013-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.7 What are the limitations... provided by the institution or entity providing mental health or substance abuse treatment and integral to... or facilities; (4) Any mental health or substance abuse services not directly related to the mental...

42 CFR 51d.7 - What are the limitations on how award funds may be used?

Code of Federal Regulations, 2011 CFR

2011-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.7 What are the limitations... provided by the institution or entity providing mental health or substance abuse treatment and integral to... or facilities; (4) Any mental health or substance abuse services not directly related to the mental...

42 CFR 51d.7 - What are the limitations on how award funds may be used?

Code of Federal Regulations, 2014 CFR

2014-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.7 What are the limitations... provided by the institution or entity providing mental health or substance abuse treatment and integral to... or facilities; (4) Any mental health or substance abuse services not directly related to the mental...

42 CFR 51d.7 - What are the limitations on how award funds may be used?

Code of Federal Regulations, 2012 CFR

2012-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.7 What are the limitations... provided by the institution or entity providing mental health or substance abuse treatment and integral to... or facilities; (4) Any mental health or substance abuse services not directly related to the mental...

42 CFR 51d.7 - What are the limitations on how award funds may be used?

Code of Federal Regulations, 2010 CFR

2010-10-01

... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.7 What are the limitations... provided by the institution or entity providing mental health or substance abuse treatment and integral to... or facilities; (4) Any mental health or substance abuse services not directly related to the mental...

Nursing service innovation: A case study examining emergency nurse practitioner service sustainability.

PubMed

Fox, Amanda; Gardner, Glenn; Osborne, Sonya

2018-02-01

This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, ). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. © 2017 John Wiley & Sons Ltd.

47 CFR 74.690 - Transition of the 1990-2025 MHz band from the Broadcast Auxiliary Service to emerging technologies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Broadcast Auxiliary Service to emerging technologies. 74.690 Section 74.690 Telecommunication FEDERAL... of the 1990-2025 MHz band from the Broadcast Auxiliary Service to emerging technologies. (a) New Entrants are collectively defined as those licensees proposing to use emerging technologies to implement...

Health literacy and health care spending and utilization in a consumer-driven health plan.

PubMed

Hardie, Nancy A; Kyanko, Kelly; Busch, Susan; Losasso, Anthony T; Levin, Regina A

2011-01-01

We examined health literacy and health care spending and utilization by linking responses of three health literacy questions to 2006 claims data of enrollees new to consumer-driven health plans (n = 4,130). Better health literacy on all four health literacy measures (three item responses and their sum) was associated with lower total health care spending, specifically, lower emergency department and inpatient admission spending (p < .05). Similarly, fewer inpatient admissions and emergency department visits were associated with higher adequate health literacy scores and better self-reports of the ability to read and learn about medical conditions (p-value <.05). Members with lower health literacy scores appear to use services more appropriate for advanced health conditions, although office visit rates were similar across the range of health literacy scores.

An International Disaster Management SensorWeb Consisting of Space-based and Insitu Sensors

NASA Astrophysics Data System (ADS)

Mandl, D.; Frye, S. W.; Policelli, F. S.; Cappelaere, P. G.

2009-12-01

For the past year, NASA along with partners consisting of the United Nations Space-based Information for Disaster and Emergency Response (UN-SPIDER) office, the Canadian Space Agency, the Ukraine Space Research Institute (SRI), Taiwan National Space Program Office (NSPO) and in conjunction with the Committee on Earth Observing Satellite (CEOS) Working Group on Information Systems and Services (WGISS) have been conducting a pilot project to automate the process of obtaining sensor data for the purpose of flood management and emergency response. This includes experimenting with flood prediction models based on numerous meteorological satellites and a global hydrological model and then automatically triggering follow up high resolution satellite imagery with rapid delivery of data products. This presentation will provide a overview of the effort, recent accomplishments and future plans.