A traffic accident injury is one type of unintentional injury that contributes to the third leading cause of death in Indonesia, according to the WHO 2013 Global Road Safety Report based on Indonesian Police, estimated 37,000-47,000 fatalities annually and 46,000 experiencing severe injuries. The injury surveillance pilot project by the Ministry of the Health Republic of Indonesia in the Fatmawati Hospital Emergency Department is trying to describe the magnitude of injury along with its components and risk factors.

This study aims to determine the risk factors of severe road traffic injury documented by injury surveillance forms in the Fatmawati Hospital Emergency Department from March to July 2016. The research design used was cross-sectional with a number of samples of 600 road traffic injury cases.

The results show risk factors that contributed as predictors for severe road traffic injury are being male, OR 2.03 (95% CI 1.37-3.02); age greater than 30 years old, OR 1.57 (95% CI 1.11 - 2.22); low education (not attending school until high school graduate) with OR 1.59 (95% CI 1.12-2.25); during working days with OR 1.53 (95% CI 1.08 – 2.17), and cyclists with OR 4.84 (95% CI 0.87-29.0).

Based on this research, the Ministry of Health of the Republic of Indonesia needs to continue advocating the use of injury surveillance forms at hospital emergency departments to provide a complete picture of injury characteristics and risk factors and to educate and develop road traffic injury prevention and risk communication for the community.

Disaster research is primarily posthoc analysis, locally focused or within response organizations, overlooking the wellness and safety of first and second responders or the broad multi- and interdisciplinary activities necessary to foster and sustain recovery. A broad framework to span locality, institutional, and professional boundaries supports the development of a true learning community–a health EDRM sector that supports society in recognizing lessons, refining findings, and free and fluid global sharing.

Several organizations joined to create a robust disaster health learning community: CREDO, GloHSA, ICDM, and ECDM, a multi-national, multi-disciplinary collaborative network of patients, universities, societies, regulators, publishing, healthcare, and technology partners designed to foster expert level education and training with shared educational design concepts, milestones, and core curricula that embrace the strength of a standardized base upon which to link unique pillars of excellence of separate functions, institutions, nations, and regions.

The Emergency Disaster Global Health Sciences (EDGHS) model developed by University of Texas Southwestern Medical Center is interactive, open, and responsive. EDGHS addresses critical gaps in applied research by convening leaders across the healthcare and public health continuum to map the way forward, designing and implementing high-quality, evidence-based practical and policy research.

This defines essential public health functions for national contexts, including a focus on emergency preparedness and response, strengthening competency-based education on essential public health functions, and mapping and measurement of occupations delivering EDRM functions, offering an exportable model of global relevance.

Putting disaster prevention into recovery processes is a strategic opportunity to improve the well-being of future generations. The survivability and well-being needs of present and future generations are contingent on knowledge-based, lived experiences of recoverable disaster loss and damage, and the capacity to thrive sustainably. This presentation serves as an invitation to join the growing momentum of creating a learning health EDRM community.

The risks of NBC (Nuclear, Biological and Chemical) or CBRNE (R: radiological, E: explosive) hazards are rapidly increasing even in civilian areas, as well as those of natural disasters (earthquakes, hurricanes, etc.). Therefore, one of the most important and emergent issues for medical staff, especially for general surgeons is the necessity of skills to deal with various mega- or major disasters to help people as well as, protecting themselves. This has been a point of emphasis since 2005, when the Disaster Medicine Compendium was published and continues to be updated today.

The research focuses on NBC/CBRNE hazards: Pandemics such as COVID-19, Monkeypox, influenza, the Tokyo Subway Sarin Incident, and the 2011 Tōhoku Earthquake, followed by Fukushima Plant Incident, Chernobyl, earthquakes with tsunami, such as the 2004 Indian Ocean earthquake, and the September 11 terrorist attacks in the US.

The skills that should be accustomed to are protection, prevention, diminution of toxicity, decontamination, as well as routine medical/surgical treatments. The relevant education is varied and not easily performed. For example, it was found that Japan DMAT or disaster medical assistant teams struggled with a lack of techniques to deal with the nuclear plant hazard during the above-mentioned Fukushima plant accident.

In the event of hazards including NBC/CBRNE, surgical skills are necessary. However, medical teams require training in advance. Surgical methods and other skills, intensive care, and examinations performed wearing PPE or personal protection equipment is important, as well as the safety and security of the medical teams, in addition, to supporting the vulnerable/weak victims, ensured using an Incident Command System.

Environmental degradation and climate change can lead to humanitarian crises and undermine humanitarian operations. Therefore, Emergency Medical Teams should try to reduce environmental impacts.

Collaborative development with companies was started by trimming the weight of tents, improving lights, and introducing renewable energy to our emergency medical unit to reduce greenhouse gas emissions.

The mechanism of the medical tent, and materials was changed. The weight of tents was cut by 30%. The final goal is to develop an 8 x 6 meter tent which is set up by four women.

Light-weight and low-power tent light was created. It is 50% weight and 60% power consumption of our conventional light.

All the power of the emergency clinic was run by renewable energy. introducing a 1 x 2 m, 5,5kg solar panel that produces 350 Wh/day. If 18 panels were put on the tent roof, they produce 6,300 Wh. This is equivalent to the power consumption of a standard household in Japan, and it is estimated this can cover the power consumption of the patient department of the emergency clinic. Experimental tests will now be conducted.

Nowadays, even emergency medical teams are required to reduce their impact on the environment on the field. Therefore, trying to reduce the greenhouse gas emissions from the emergency medical team. The challenge is still on the way, but marching steadily.

In lower- and middle-income countries (LMIC), 45% of deaths could be prevented by implementation of emergency care systems. Prehospital care is critical for emergency medical services (EMS) worldwide, and basic affordable training improves EMS systems. This study conducted a needs assessment in addition to a tailored prehospital training intervention. Subsequent changes in prehospital care as well as patient outcomes were measured.

Thirty providers identified through the prehospital medical command office participated. A prospective, nonrandomized interrupted time-series approach was utilized for a needs assessment and training intervention. Data collected included age, gender, training level, and a knowledge assessment, and was used to create an 18-hour training, with immediate and 11-month posttests. Prehospital process indicators evaluated on-the-ground application of skills, including airway intervention, intravenous fluid administration, and glucose administration. Linked prehospital and hospital care datasets allowed for evaluation of patient outcomes.

Of 30 providers, 60% (n=18) female and 40% (n=12) male, 19 were nurses and 11 were nurse anesthetists. Median age was 36 and median years providing care was 10 (IQR: 7,11). 24 (80%) participants completed immediate and post-test assessments, showing a 56% (95%CI: 36.2, 75.8) relative increase in mean knowledge score across 12 core skills that was maintained across post-tests. 324 of 572 total patients transported to the ED during the study were transported during the pre-training period (56.4%). Prehospital oxygen administration for patients with a saturation level of <95% increased pre- to post-intervention (66.7% to 71.7%; Δ = 5.0%; Δ95%CI: 1.9, 8.1%).

This study is the first LMIC-based prehospital provider training efficacy study that includes analysis of patient outcomes and clinical process indicators. Results offer important insights on Rwanda’s prehospital care system and demonstrate that affordable, tailored educational interventions targeting process indicators have positive impacts on provider knowledge and practice.

Weather significantly affects the distribution of fallout radiation resulting from a nuclear detonation. Prior nuclear detonation models have either utilized a “typical” day for the city of interest or have chosen conditions that optimize fallout radiation. However, models that aid emergency planners should utilize representative weather conditions to capture the most likely distribution of fallout radiation for the region of interest.

Fallout radiation resulting from an improvised nuclear device detonation in Atlanta, Georgia, USA was simulated for each day in 2019 using the Hazard Prediction and Assessment Capability (HPAC) software and weather from Modern-Era Retrospective analysis for Research and Applications, Version 2 (MERRA-2). A partition around medoids cluster analysis was conducted, based on the characteristics of the plumes, population at risk, and estimated proportion of fatalities. A multinomial logistic regression, a decision tree, and a random forest model were then used to predict the cluster from surface-level weather data.

On average, the fallout plume was 160.25km long, had an area of 3,174.44 km2, and was angled 83.5° from due north. The plume on average contained 3,668,173 individuals at risk for exposure and caused 416,8908 casualties. Four clusters were identified to represent the distribution of fallout radiation. The random forest model was best able to predict the cluster using surface-level weather data, with an average accuracy of 57.24% (kappa = 0.385). The variable importance plot suggests north-westerly winds, cloud coverage at detonation, whether it is summer, and average temperature are among the most important variables for classification.

Meaningful representation of the variation in the distribution of fallout radiation is imperative while creating nuclear detonation models. While an analysis of the fallout distribution throughout a calendar year provides important insight, future research may examine longer study periods to better understand the climatological impacts on fallout radiation.

Helicopter emergency medical services (HEMS) personnel provide on-scene trauma care to patients with high mortality risk. The HEMS work context is characterized by an exceptionally high exposure to critical incidents, emotionally demanding patient encounters, and having to perform under pressure with limited resources. The aim of this study was to further our understanding of the factors underlying HEMS personnel wellbeing given their challenging work context.

Sixteen semi-structured interviews were conducted with HEMS personnel from a University Hospital in The Netherlands. Interview topics included work context, personal characteristics, coping, work engagement, and psychosocial support. To analyze the data, a generic qualitative research approach was used inspired by grounded theory, including open, axial and selective coding.

The analysis revealed ten categories that provide insight into factors underlying the wellbeing of HEMS personnel and their work context: team and collaboration, coping, procedures, informal peer support, organizational support and follow-up care, drives and motivations, attitudes, other stressors, potentially traumatic events, and emotional impact. The findings show that HEMS personnel are highly motivated and have a strong team mentality. Various factors are important to their wellbeing, such as job resources and social support. The HEMS work can have an emotional impact but HEMS personnel use various coping strategies to deal with this. The perceived need for organizational support and follow-up care is low among participants.

This study identifies factors and strategies that support the wellbeing of HEMS personnel. It also provides insight into the HEMS work culture and help-seeking behavior in this population. The findings may be beneficial to understand and support employee wellbeing in other emergency services work contexts as well.

The 2014-2016 Ebola Virus Disease (EVD) outbreak in West Africa resulted in 28,000 infected and over 10,000 deaths. Sierra Leone was one of the hardest hit countries. The purpose of this study is to examine the coping strategies employed by those most affected by EVD and its related stressors in Sierra Leone.

228 EVD-infected individuals, EVD-affected individuals, and community leaders were recruited using purposive maximum variation sampling. Key-informant interviews (n=42) and focus group discussions (n=27) were conducted across five districts in Sierra Leone. Data were analyzed and coded inductively by a team of researchers, using Thematic Content Analysis using NVivo (k=0.80 or above for interrater reliability).

Participants described stressors, coping and support on four levels: individual, family, community, and society. On the individual level, theft and spoiled belongings were leading sources of stress while faith and spirituality were main sources of coping and support. On the familial level, lack of financial resources and inability to work emerged as primary stressors, while engaging with family was a main source of support. On the community level, social exclusion emerged as a prominent stressor and community reintegration as a source of support. On the societal level, participants' lack of governmental support and termination of support from NGOs emerged as stressors, and provision of formal material assistance as a source of support.

In a widespread public health crisis, understanding people’s perceptions of the most salient stressors and sources of support can inform future responses. In this study, participants experienced stressors and support across multiple levels of the social ecology, such as grief and faith, household financial pressure and kinship care, and formal material resources for survivors. Results also showed the importance of community-led initiatives that addressed material needs, as well as social acceptance and social support.

The aim of this cross-sectional, descriptive study was to determine the personality traits and motivation of nursing volunteers and their effects on pre-hospitalization emergency care.

Participants were 133 pre-hospital nursing volunteers from Taiwan. This study was performed using self-administered basic demographic information, Eysenck Personality Questionnaire-Revised Short (EPQ-RS), and Volunteer Motivation Scale with Chinese Volunteers (VMS-C). The statistical analysis was performed by SPSS 23.0. The data collections were analyzed by nonparametric statistics, correlation coefficient, covariance analysis, and one-way ANOVA analysis multiple regression analysis.

Our findings showed that having social desirability and extraversion personality had a positive impact on the attitudes of volunteers in terms of the provision of pre-hospital care. The first identified regulation was highlighted in the motivation scale; intrinsic motivation was secondarily emphasized. Pearson correlation coefficient revealed years of service in volunteering seniority, age, gender and nursing seniority were correlated. On the contrary, the job department and six municipalities were negatively correlated. Equivalence with the other relation, participants’ attending hours per month in volunteering and gender were positively related. Inverse correlations were found in age and nursing seniority. Extraversion personality and involvement in specific municipalities were positively correlated.

Emergency Medical Services (EMS) has been developed in Taiwan for more than 20 years and must improve the quality of EMS. These results may be used to improve the quality of the pre-hospital care system and encourage nursing staff to join the system. Nursing volunteers in pre-hospital care are a particularly valuable resource, and satisfy a pivotal role early in the process of pre-hospital care. It is recommended that we provide a good interpersonal environment to maintain the good will of the dedicated, experienced, enthusiastic volunteers in Taiwan.

In Japan, the response to COVID-19 has been a disaster response. In May 2021, the number of patients requiring hospitalization increased rapidly in Sapporo City, Hokkaido. Almost all medical institutions and clinics were overcrowded, and patients were forced to wait at home. Sapporo City requested a response from the Japan Disaster Medical Assistance Team (DMAT).

DMAT collaborated with the Sapporo City Public Health Center to set up a patient waiting station (The Temporary Medical Facility for Hospitalization Waiting) utilizing an unused hotel. DMAT placed the patient under medical care, provided oxygen therapy and other procedures, and coordinated hospitalization referrals. DMAT also organized a doctor home response system for patients who need emergency hospitalization and those who have returned home from The Hospital Waiting Stations.

64% of the patients were admitted to hospitals, 27% back to their homes, 9% were sent to residential care facilities, and 1% were sent to welfare facilities. The doctor home response system was able to redirect 52% of patients requiring emergency hospitalization.

For the rapidly increasing number of patients with COVID-19, DMAT established a temporary medical facility and home visit system and was able to minimize the number of preventable deaths.

Hospitals have had Hospital Disaster Plans (HDP), however, when the COVID-19 pandemic attacked, several hospitals neglected the HDP. They seem to find it difficult to operationalize HDP. The hospital’s problems were also increasingly complex because they must also think about how to break the internal transmission chain and how to deal with the surge in COVID-19 patients besides building a clear incident command system (ICS). This study aimed to carry out documentation and analyze hospital preparedness in dealing with COVID-19 based on the ICS.

This study was documentation research using a qualitative approach. All hospital preparations in "high case" areas in Jakarta and Yogyakarta from April to June 2020 were documented, followed by interviews and document observations. Furthermore, data were analyzed according to the ICS management functions; commander, secretary, operational, logistics, planning, and financial administration.

Since the COVID-19 pandemic, hospitals had developed a separate COVID-19 handling system from the existing HDP documents. The analysis showed the division of tasks and functions of each field in the COVID-19 Task Force already existed, but it had not been described in detail. The communication and procedure flow within the internal and external COVID-19 task force were generally only verbal. In conclusion, related to the readiness to face the surge in COVID-19 patients, the hospitals have not made any plans or supervision for handling COVID-19.

Hospital preparedness in the face of the COVID-19 pandemic based on the Command System has not been maximized. The existing HDP only includes planning for natural disaster management. Furthermore, every health facility established the COVID-19 Task Force. However, the principle of division of tasks, communication, and planning flow in the Task Force still needs to be improved.

Since February 24, 2022, at the time of writing this plan, approximately 400,000+ refugees had entered Moldova and 282,842 had exited Moldova. EMTCC will need to coordinate international medical teams assisting with the increasing refugee numbers crossing into Moldova from southern Ukraine for the MOH and international EMT’s in support of trauma management in Palanca and related borders and referral to health care facilities within Moldova.

This EMTCC operational plan sets objectives and explores trigger points that require actions in the context of International EMT’s, two service levels were trauma triage/stabilization and primary health care.

Odesa was a city located approximately 60 kilometers from the Moldova border crossing of Palanca. Trauma patients reaching the Palanca border would need to be identified in vehicular columns by roving triage teams (EMT 1 M) and expedited through the border. Survivability of severe trauma patients proceeding through the border crossing and expected to transit through to tertiary level care would be low without the intervention of trauma stabilization teams (damage control). The initial positioning of at least 2 trauma stabilization points would require the support, skills, logistics and self sustainability of classified EMT’s or similar. These would also need the additional support of specialized trauma/surgical cells at both Stefan Voda and Causeni Hospitals.

Odessa escalation should have been the worst scenario, but we were able to work with MOH in Moldova to develop a plan to save more lives for trauma patients reaching the Palanca border.

Children younger than 18 years constitute approximately 25% of the US population. During disasters, they are the most vulnerable population and have age-specific vulnerabilities that heighten their risks and magnify their unique needs. These include physiological vulnerability to pathogens, toxins, radioactive isotopes, and harsh conditions. Increased skin permeability, faster metabolism, more active cell division, higher respiratory rate, and higher surface area–to–mass ratio all contribute to greater susceptibility to physical threats. Behavioral/Developmental differences such as more hand-to-mouth contact, under-developed sense of self-preservation, more time spent outdoors, difficulty communicating symptoms and increased vulnerabilities. Children in disasters may develop mental health problems, including acute and post-traumatic stress disorder, and depression. Some children with disabilities are dependent on medical technology.

A US national conference in 2015 determined that significant gaps in pediatric disaster preparedness include transport, space, staffing, equipment, supplies, and training capabilities. To address these gaps the National Pediatric Disaster Coalition (NPDC) was established to advocate for enhanced pediatric disaster preparedness, and advance community healthcare preparedness, mitigation, response, and recovery for infants, children, and families in disasters.

The NPDC consists of subject matter experts, national advisory committees, commissions, agencies, and organizations. It utilizes pediatric SME knowledge to help plan for the allocation of appropriate and essential resources to address pediatric specific needs in disasters. It serves as an information clearinghouse on pediatric disaster preparedness informed by real events, research and evolving best practice. The NPDC disseminates information through organizing and participating in conferences, and web-based training.

Based on the special needs of children in disasters, the NPDC assessed current gaps and has established an effective advocacy and information sharing platform to match resources to pediatric needs during disasters. The NPDC can serve as a model for addressing gaps in the special needs of children and their families during disasters.

Mass casualty incidents (MCI) overwhelm existing resources in the emergency department. The existing method to recall staff in an MCI is text notification through the hospital call center. This study aims to assess the effectiveness of a novel method to recall senior emergency physicians during an MCI.

For this method, upon notification of a MCI, the senior physician on duty will start call tree activation based on four different senior physician job grades. He/she will call the first physician for each grade, who takes over calling and activating the remaining physicians in the same grade with a maximum of two attempts. Each physician receiving the activation call then texts an acknowledgement and estimated time of arrival at the department in the group chat. An unannounced, simulated MCI event was conducted at 02:00 and 14:00 on a weekday. Effectiveness was determined by the proportion of senior physicians available within 60 minutes of activation.

For the 02:00 activation, three of the 25 senior physicians were on clinical duty in the hospital while nine were contactable within 15 minutes and thirteen after 30 minutes. Eleven were able to return to the hospital in 60 minutes or less and one beyond 60 minutes. Nine were local but unable to return and one was overseas.

For the 14:00 activation, four of the 25 senior physicians were on clinical duty in the hospital while 15 were contactable within 15 minutes and six after 30 minutes. Nine were able to return to the hospital in 60 minutes or less and four beyond 60 minutes. Three were local but unable to return and five were overseas.

This method can achieve rapid manpower augmentation with more than half the staff present in the hospital within 60 minutes. Drills involving physical recall should be performed to further test this workflow.

Global disasters have increased over the last century, with growing numbers of people affected. In the Middle East and North Africa, natural disasters have tripled since the 1980s. Education and training for disaster preparedness for healthcare providers can help reduce vulnerability to disasters by improving their knowledge and response effectiveness. Physicians working in the emergency department are integral members of the response to those incidents. Currently, no studies describe how much training or experience in disaster preparedness exists for physicians working in the emergency departments in Kuwait. However, comparable studies in different regions have illustrated the importance of researching this field. This paper aims to assess the disaster preparedness levels of emergency department physicians in Kuwait.

An online survey will be sent to the physicians working in the emergency departments of the seven general hospitals in Kuwait. This survey consists of four domains:

1. 1) Demographics: personal and professional characteristics of participants.

2. 2) Education and training: exploring the involvement of participants in prior formal training courses or exercises in disaster preparedness.

3. 3) Experience: assessing the involvement of participants in the mitigation or response to previous disasters.

4. 4) Knowledge and perception: participant awareness of local hospital plans and systems as well as their attitudes and opinions about disaster preparedness.

Data collection and analysis are planned for completion by March 31, 2023.

The needs assessment is essential to developing educational curriculums for any discipline. In disaster medicine, tailoring the training curriculum is especially important because learners might not have experience in the field due to the high acuity and low frequency of disasters. The results can be used to develop a roadmap for Emergency Physician training in disaster preparedness in Kuwait. In addition, the approach adopted in this paper can be used to assess further disciplines for disaster preparedness.

Over the last 20 years disasters have increasingly involved children, and pediatric disaster medicine research is growing. However, this research is largely reactive, has not been categorized in terms of the disaster cycle, and the quality of the research is variable. To understand the gaps in current literature and highlight areas for future research, we conducted a scoping review of pediatric disaster medicine literature. This work will help create recommendations for future pediatric disaster medicine research.

Using a published framework for scoping reviews, we worked with a medical librarian and a multi-institutional team to define the research question, develop eligibility criteria, and to identify a search strategy. We conducted a comprehensive Medline search from 2001-2022, which was distributed to nine reviewers. Each article was independently screened for inclusion by two reviewers. Discrepancies were resolved by a third reviewer.

Inclusion criteria included articles published in English, related to all stages of the disaster cycle, and disaster education, focused on or included pediatric populations; published in academic, peer-reviewed journals, and policies from professional societies.

967 pediatric disaster medicine articles were imported for screening and 35 duplicates were removed. 932 articles were screened for relevance and 109 were excluded. In 2000, three articles met inclusion criteria and 66 in 2021. We noticed reactive spikes in the number of articles after major disasters. Most articles focused on preparedness and response, with only a few articles on recovery, mitigation, and prevention. Methodology used for most studies was either qualitative or retrospective. Most were single site studies and there were < 10 meta-analyses over the 20 years.

This scoping review describes the trends in and quality of existing pediatric disaster medicine literature. By identifying the gaps in this body of literature, we can better prioritize future research.

Every year many concerts, festivals, public meetings and major events take place in Ireland. Depending on the nature of the event such as: location, the number of attendees, and performers–these events present varying amounts of risk. The Health Service Executive is concerned with managing risks and advocates that event organizers put comprehensive event management plans in place. Healthcare arrangements for outdoor crowd events should be specified in the Event Medical Plan section of the event management plan by the event organizer. As part of the event notification process, event organizers engage with the HSE South Emergency Management Office which in turn liaises with the various care groups across the Cork Kerry region to inform them of events that may impact their service. Historically, event organizers have informed the Emergency Management office of events in a wide variety of formats and varying levels of information.

The HSE South Emergency Management Office engaged with Cork University Hospital (Major Trauma Center) to identify the information hospitals require from various events around the region. In addition, the Emergency Management Office liaised with a subject matter expert in Mass Gatherings from Australia to discuss key indicators/data points healthcare facilities could benefit from knowing in advance of mass gathering events.

A standardized Word document template was developed as a proof of concept that lists key data that healthcare facilities have identified as important for them to be made aware of as part of the notification process. This template now lends itself to be developed into an online editable form to enable event organizers to inform the relevant healthcare facilities of mass gathering events.

Health care facilities require timely and accurate information regarding mass gathering events to ensure appropriate plans and preparations are in place. A standardized notification template would assist in the preparation phase.

Hospital preparedness for a massive influx of victims relies, to a certain extent, on actions, programs, and systems that are created and executed ahead of time, but also on the knowledge, skills, and professional competences of the hospital's staff. This study aims to understand the factors influencing the preparedness of Tunisian University Hospital staff in facing a massive influx of victims.

This is a multi-method qualitative descriptive study, conducted in nine general University Hospitals (UH) in Tunisia; the first component was a phenomenological design via open-ended interviews; the second component was a qualitative observational non-participatory design via field observations.

17 participants were recruited, in an intentional non-probabilistic way. Participants to this study discussed issues related to the material and financial resources of their hospitals; the psychological impact of managing an influx of victims; their training, their involvement in the process, and the norm versus the circumstances in the field. Which led to the conclusion that: "For multiple reasons, the Tunisian University Hospitals are not ready to properly manage a massive influx of victims"

This multi-method qualitative study discussed the factors that affected the preparedness of staff and readiness of UHs included. Factors were mainly resources (material and financial), psychological burden, lack of training, lack of involvement in the process and issues related to evidence-based practice. Data collected supports the idea that more research and more practical interventions need to be performed to increase the preparedness level of Tunisian UHs and their staff.

This contribution is based on the findings from a ‘living’ systematic literature review seeking to understand the short and long term health impact of the COVID-19-pandemic. Emphasis is placed on the prevalence and risk factors of trauma-related mental health outcomes in the context of the pandemic. Especially when it comes to Post Traumatic Stress Disorder (PTSD), it is questionable whether exposure types that are typical to the pandemic match the essence of the disorder. Our objective is to verify whether the international literature sufficiently distinguishes pandemic related exposure from other risk factors such as social demographic characteristics and non-pandemic related exposure to threats and life events.

This part of the ‘living’ systematic literature review is conducted under the umbrella of the Dutch Integrated Health Monitor COVID-19. In order to guide a research-driven data collection, several databases were searched for studies published during the pandemic. At the moment of abstract submission the protocol was published in Prospero and screening was in progress. Observational, quantitative studies including a specified exposure/event and a trauma-related mental health outcome measure are included. The included studies will be categorized based on type of exposure/event. Pooled prevalence will be calculated if studies are sufficiently homogeneous.

In progress.

The results from this literature review are likely going to confirm that a substantial part of the international literature is polluted with studies promising to contain information on PTSD and other trauma-related health effects of the COVID-19 pandemic, yet running short of linking symptomatology to particular types of exposure and risk factors. If this is the case, a risk exists that public health authorities are being recommended to apply preventive and curative trauma-focused interventions based on an ambiguous knowledge base. The results will be presented during the conference.

The 2018 Hokkaido earthquake caused a power outage in all of Hokkaido. In Japan, several hospitals have generators for outages. However, when electricity is lost, several hospitals are disrupted because they are accustomed to having a stable power supply on a daily basis. This study describes the efforts of a hospital that were not accustomed to disaster response to evaluate and implement power-loss countermeasures. The purpose of this study is to measure the usefulness of hospital power-loss countermeasures.

1. 1) Classification of Japan’s existing power-loss countermeasures.

2. 2) Hospital evaluation of the classified power-loss measures.

3. 3) Confirmation of the usefulness of the hospital’s power-loss countermeasures.

Power-loss countermeasures were classified into four categories. 1.) Equipment enhancement: this measure is expensive but can prevent loss of power, 2.) Purchase of goods: this measure is inexpensive and alternative power is available, 3.) Manual creation, and 4.) Training. Training measures can help smoothen the hospital’s response after a loss of power. A hospital evaluated whether those measures were appropriate for that hospital. As a result, some of the measures were immediately put into practice.

This hospital was not accustomed to disaster response, and at first, they did not seem to know where to apply countermeasures. However, after implementing the measures, the hospital announced within its organization that the next step was training. It became clear that by presenting specific measures and evaluation methods, the hospital could create good practices. In the future, web-based evaluation methods should be developed so that all hospitals in Japan can work on measures to counteract power loss.