Medical Reserve Corps’ volunteers underwent stop-the-bleed, triage, and disaster preparedness training to improve victim survival of a mass casualty event.

Volunteer responses to 16 disaster vignettes were recorded as ‘survived’ if correct, or ‘died’ if incorrect. Volunteers’ characteristics were evaluated based on the health outcomes of the vignette victims via logistic regression.

Overall, 69 volunteers evaluated 1104 vignette victims. STB training significantly improved survival from 77.2% to 93.2% (P < 0.001). The training did not improve disaster preparedness (75.5% to 73%) nor triage (33.5% to 35.1%). Volunteer first care provider training in psychological first aid improved victim survival from 10.32 (9.6 - 10.9, 95% CI) to 11.9 (11.28 - 12.5, 95% CI). The odds of survival increased when disaster victims received first care from a volunteer who had a positive perception of the public authority’s truthfulness (1.50, range 1.07 - 2.10); stated a willingness to volunteer (1.65, range 1.2 - 2.26); completed psychological first aid training (1.557, range 1.08 - 2.22); or had 4-or-more years of post-secondary education (1.30, range 1.00 - 1.701).

Psychological first aid training should be a basic requirement for disaster volunteers. Trust in public authority to provide protective public health recommendations increases disaster survival.

The aim of this study was to review the role of public health emergency operations centers in recent public health emergencies and to identify the barriers and enablers influencing the effective use of a public health emergency operations center (PHEOC) in public health emergency management.

A systematic search was conducted in 5 databases and selected grey literature websites.

Forty-two articles, consisting of 28 peer-reviewed studies and 14 grey literature sources matched the inclusion criteria. Results suggest that PHEOCs are used to prepare and respond to a range of public health emergencies, including coronavirus disease (COVID-19). Factors found to influence the use of a PHEOC include the adoption of an incident management system, internal and external communications, data management, workforce capacity, and physical infrastructure.

PHEOCs play an important role in public health emergency management. This review identified several barriers and enablers to using a PHEOC in public health emergency management. Future research should focus on addressing the barriers to using a PHEOC and looking at ways to evaluate the impact of using a PHEOC on public health emergency outcomes.

The UK is one of the epicenters of coronavirus disease (COVID-19) in the world. As of April 14, there have been 93 873 confirmed patients of COVID-19 in the UK and 12 107 deaths with confirmed infection. On April 14, it was reported that COVID-19 was the cause of more than half of the deaths in London.

The present paper addresses the modeling and forecasting of the outbreak of COVID-19 in the UK. This modeling must be accomplished through a 2-part time series model to study the number of confirmed cases and deaths. The period we aimed at a forecast was 46 days from April 15 to May 30, 2020. All the computations and simulations were conducted on Matlab R2015b, and the average curves and confidence intervals were calculated based on 100 simulations of the fitted models.

According to the obtained model, we expect that the cumulative number of confirmed cases will reach 282 000 with an 80% confidence interval (242 000 to 316 500) on May 30, from 93 873 on April 14. In addition, it is expected that, over this period, the number of daily new confirmed cases will fall to the interval 1330 to 6450 with the probability of 0.80 by the point estimation around 3100. Regarding death, our model establishes that the real case fatality rate of the pandemic in the UK approaches 11% (80% confidence interval: 8%–15%). Accordingly, we forecast that the total death in the UK will rise to 35 000 (28 000–50 000 with the probability of 80%).

The drawback of this study is the shortage of observations. Also, to conduct a more exact study, it is possible to take the number of the tests into account as an explanatory variable besides time.

Restrictions to minimize social contact was necessary to prevent the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus but may have impacted individuals’ mental well-being. Emotional responses are modulated by contextual information. Living abroad during the coronavirus disease 2019 (COVID-19) pandemic may have boosted the feeling of isolation as the context is unfamiliar.

This study compared the psychological impact of social distancing in national students (living in a familiar context) versus international students (living in an unfamiliar context).

During March/April 2020 (first lockdown in the Netherlands), 850 university students completed an online survey. Structural equation modeling (SEM) was conducted to compare how students’ responses to the virus were predicted by health anxiety, emotional distress, and personal traits.

Compared with national students, international students showed higher levels in 4 identified factors (COVID-19-related worry, perceived risk of infection, distance from possibly contaminated objects, distance from social situations). The factors were mainly predicted by health anxiety across international students, while emotional distress and individual traits (eg, intolerance of uncertainty) played a role across national students.

In the familiar context, individual characteristics (traits) predicted the responses to the virus, while the unfamiliar context drove individuals’ health-focused responses. Living in a foreign country is associated with psychological burdens and this should be considered by universities for more pronounced social support and clear references to health-related institutions.

The aim of this review is to identify, evaluate, and graphically display gaps in the literature related to scarce health resource allocation in humanitarian aid settings.

A systematic search strategy was utilized in MEDLINE (via Ovid), Scopus, EMBASE, CINAHL Complete, and ProQuest Central. Articles were reviewed by 2 reviewers with a third reviewer remedying any screening conflicts. Articles meeting inclusion criteria underwent data extraction to facilitate evaluation of the scope, nature, and quality of experience-based evidence for health resource allocation in humanitarian settings. Finally, articles were mapped on a matrix to display evidence graphically.

The search strategy identified 6093 individual sources, leaving 4000 for screening after removal of duplicates. Following full-text screening, 12 sources were included. Mapping extracted data according to surge capacity domains demonstrated that all 4 domains were reflected most of all the staff domain. Much of the identified data was presented without adhering to a clear structure or nomenclature. Finally, the mapping suggested potential incompleteness of surge capacity constructs in humanitarian response settings.

Through this review, we identified a gap in evidence available to address challenges associated with scarce resource allocation in humanitarian settings. In addition to presenting the distribution of existing literature, the review demonstrated the relevance of surge capacity and resource allocation principles underpinning the developed framework.

We aimed to compare the prognostic accuracy of shock indexes in terms of mortality in patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia.

Hospitalized patients whose COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) test results were positive, had thoracic computed tomography (CT) scan performed, and had typical thoracic CT findings for COVID-19 were included in the study.

Eight hundred one patients were included in the study. Chronic obstructive pulmonary disease, congestive heart failure, chronic neurological diseases, chronic renal failure, and a history of malignancy were found to be chronic diseases that were significantly associated with mortality in patients with COVID-19 pneumonia. White blood cell, neutrophil, lymphocyte, C reactive protein, creatinine, sodium, aspartate aminotransferase, alanine aminotransferase, total bilirubin, high sensitive troponin, d-dimer, hemoglobin, and platelet had a statistically significant relationship with in-hospital mortality in patients with COVID-19 pneumonia. The area under the curve (AUC) values of shock index (SI), age shock index (aSI), diastolic shock index (dSI), and modified shock index (mSI) calculated to predict mortality were 0.772, 0.745, 0.737, 0.755, and Youden Index J (YJI) values were 0.523, 0.396, 0.436, 0.452, respectively.

The results of this study show that SI, dSI, mSI, and aSI are effective in predicting in-hospital mortality.

The coronavirus disease (COVID-19) pandemic has necessitated e-learning strategies in academic emergency medicine (EM) programs. A study was conducted during the COVID-19 pandemic to understand e-learning in the Indian EM context.

After IEC/IRB approval, we conducted a multicenter national survey validated by experts and underwent multiple reviews by the research team. The final survey was converted into Google Forms for dissemination via email to National Medical Commission (NMC) approved EM residency program as of 2020–2021. Data were exported into Excel format and analyzed.

Residents and faculty comprised 41.5% and 58.5% of 94 respondents. The COVID-19 pandemic’s second wave in India significantly impacted response rates. Internet connectivity was cited as a significant barrier to e-learning, while flexible timings and better engagement were facilitators identified by the survey. The attitude among residents and faculty toward e-learning was also evaluated.

This survey reveals a significant positive shift in medical education from conventional teaching strategies toward e-learning, specifically during the pandemic. It also shows the need for all stakeholders (learners/educators) to better understand e-learning and adapt to its requirements. We need more data on the efficacy of e-learning compared to traditional methods. Until then, innovative hybrid/blended strategies would be the way forward.

This study aimed to evaluate a risk of flooding and landslides among home-care patients, to reveal an extent to which patients require support for evacuation, and to determine whether risk was accurately perceived among the patients.

This is a cross-sectional study targeting the patients who were actively treated at the home-care clinic in Fukui Prefecture, Japan. We collected data on the patients’ sociodemographic and clinical characteristics. Additionally, we collected data on their risk of flooding and landslides through hazard maps and distributed a questionnaire to these patients regarding their risk awareness of flooding and landslides.

Of the 199 eligible home-care patients, 84.9% (169 of 199) were at risk of flooding and/or landslides, and 58.6% (99 of 169) of them needs support during evacuation. Furthermore, of those who were at risk of flooding and/or landslides, 46.0% (45 of 99) had accurate risk assessments. Factors that resulted in inadequate risk awareness of flooding and landslides included: not placing importance on evacuation, not using medical equipment, and living on the first floor.

There was limited risk awareness of flooding and/or landslides among the home-care patients. The information of the risk factors regarding inadequate risk awareness of flooding and landslides should be used to sophisticate flooding and landslides evacuation strategy.

To model performance of the Sequential Organ Failure Assessment (SOFA) score-based ventilator allocation guidelines during the COVID-19 pandemic.

A retrospective cohort study design was used. Study sites included 3 New York City hospitals in a single academic medical center. We included a random sample (205) of adult patients who were intubated (1002) from March 25, 2020, till April 29, 2020. Protocol criteria adapted from the New York State’s 2015 guidelines were applied to determine which patients would have had mechanical ventilation withheld or withdrawn.

117 (57%) patients would have been identified for ventilator withdrawal or withholding based on the triage guidelines. Of those 117 patients, 28 (24%) survived hospitalization. Overall, 65 (32%) patients survived to discharge.

Triage protocols aim to maximize survival by redirecting ventilators to those most likely to survive. Over 50% of this sample would have been identified as candidates for ventilator exclusion. Clinical judgment would therefore still be needed in ventilator reallocation, thus re-introducing bias and moral distress. This data suggests limited utility for SOFA score-based ventilator rationing. It raises the question of whether there is sufficient ethical justification to impose a life-ending decision based on a SOFA scoring method on some patients in order to offer potential benefit to a modest number of others.

Bleeding control measures performed by members of the public can prevent trauma deaths. Equipping public spaces with bleeding control kits facilitates these actions. We modeled a mass casualty incident to investigate the effects of public bleeding control kit location strategies.

We developed a computer simulation of a bomb exploding in a shopping mall. We used evidence and expert opinion to populate the model with parameters such as the number of casualties, the public’s willingness to aid, and injury characteristics. Four alternative placement strategies of public bleeding control kits in the shopping mall were tested: co-located with automated external defibrillators (AEDs) separated by 90-second walking intervals, dispersed throughout the mall at 10 locations, located adjacent to 1 exit, located adjacent to 2 exits.

Placing bleeding control kits at 2 locations co-located with AEDs resulted in the most victims surviving (18.2), followed by 10 kits dispersed evenly throughout the mall (18.0). One or 2 kit locations placed at the mall’s main exits resulted in the fewest surviving victims (15.9 and 16.1, respectively).

Co-locating bleeding control kits with AEDs at 90-second walking intervals results in the best casualty outcomes in a modeled mass casualty incident in a shopping mall.

This study aims to identify the rates of coronavirus disease 2019 (COVID-19) vaccine acceptance, the reasons for receiving and not receiving the vaccine, and the associated factors among pregnant, lactating, and nonpregnant women of reproductive age.

This cross-sectional and analytical study was conducted online in Turkey, at the end of the fourth wave of the COVID-19 pandemic, between February and May 2022. A total of 658 women (230; 35% pregnant) (187; 28.4% lactating) (241; 36.6% nonpregnant) women of reproductive age participated in the study.

Vaccine acceptance rates were found to be 91.7% in nonpregnant women of reproductive age, 77% in lactating women, and 59% in pregnant women (P < 0.05). The highest rate of vaccine hesitancy was observed in pregnant women (31.3%), and vaccine rejection rate was the highest in lactating women (10.2%). Pregnancy (odds ratio [OR] = 3.98; confidence interval [CI] = 1.13-14.10), and the breastfeeding period (OR = 3.84; CI = 1.15-12.78), increased vaccine hesitancy approximately four times.

Lack of knowledge about and confidence in the COVID-19 vaccine is still one of the barriers to vaccine acceptance today. Health-care providers (HCPs) should provide effective counseling to pregnant, lactating, and nonpregnant reproductive-aged women based on current information and guidelines.

The Kahramanmaraş earthquakes struck the north-eastern part of Türkiye and Syria on February 6, 2023. It is well known that timely coordination and provision of emergency medical care in the field is particularly important to save lives after earthquakes. This study aimed to identify the challenges faced by medical responders on the ground.

This exploratory-descriptive qualitative study was conducted in Hatay, the province most affected by the earthquakes. Data were collected through in-depth semi-structured interviews and field observations, and then analyzed using thematic analysis approach.

The study was carried out with 15 first responders from the medical profession. The study revealed 9 themes of challenges faced by medical responders: providing safety and security, human resources management, meeting personal needs, recording data, communication, patient transport, burial procedures, psychological acumen, and logistical problems. Some problems were resolved after 72 h and some continued until day 7.

Inadequate organization of volunteer health workers, communication breakdowns, and logistical problems are some of the main challenges. To address these issues, satellite phones and radio systems can be promoted, as well as disaster-resilient logistical planning and better coordination of volunteers.