The possibility of natural disasters and public health emergencies coupled with the possibility of terrorism support the need to incorporate emergency preparedness into the curricula for every health professional school. Methods: A survey methodology was employed to assess both attitudes towards and knowledge of emergency preparedness amongst health professions students which included the schools of medicine, nursing, dentistry and public health. The survey was piloted to graduating students and then administered prior to institution of a emergency preparedness curriculum and then repeated as an annual survey.

The survey found that 51.8% had been present at a disaster as non-responder while only 12.1% had ever been present as a responder. With regard to baseline class room exposure over 50% reported no exposure to such key concepts as incident command, triage, all-hazards planning, surge and aspects of terrorism. In addition at baseline most students felt they had no competency in emergency preparedness. As an example only 10% of students felt competent with personal protective equipment. While exposure both as a responder and student was low, 82.5% of students felt that emergency preparedness should be a mandatory topic in their education. Lastly, with a minimal curriculum change students showed statistically significant increases on knowledge testing.

While exposure was low for emergency preparedness topics and most did not recognize how information they had been taught might be applicable to emergency preparedness, there was a strong desire for additional training. In addition simple curricular adjustments can lead to significant improvements in knowledge.

Global conversations emphasize strengthening communities’ resilience to disasters. These conversations inspired the Victorian Compendium of Community-Based Resilience Building Case Studies. The Compendium motivates community members to build expertise, reduce program duplication, and save valuable resources. Case study analysis identified critical success factors. Between 2012 and 2018, community groups completed an Expression of Interest to present at the MUDRI Advancing Community Resilience Forums, which provided an opportunity to impart resilience activities and knowledge. It also solved challenges and shared unforeseen learning. Over six years, 72 groups presented. Subsequently, 35 submitted their activity for consideration into the Compendium. Of these 35, 30 were included.

This updated research analyses critical success factors of 30 case studies. Success factors support the key tenet of the Victorian Compendium of Community-Based Resilience Building Case Studies: to promote the sharing of achievable, practical resilience building activities. The online Compendium provides free access for all communities to explore activities before, during, and after disasters.

A thematic analysis identified critical success factors of 30 Compendium case studies.

Case studies revealed unique and valuable learning in diverse settings. The critical success factors included: (1) strong governance, Board support, leadership and trust; (2) partnerships; (3) commitment, adaptability, and stamina; and (4) community-based initiatives. Other success factors included a paid facilitator and local government support, stamina, and celebrating success.

The Compendium represents an Australian first and offers an innovative contribution to resilience practice and research. It enhances other Victorian initiatives such as the Rockefeller funded Resilient Melbourne Strategy, which incorporates the Compendium to bring people together from across sectors to deliver distinct, yet connected actions to strengthen resilience. The Compendium enables diverse communities to adopt or adapt proven resilience activities, thereby preserving valuable resources. It offers the opportunity to extend to a national or international Compendium.

This presentation summarizes our ongoing hybrid sociological-geological field research into the May 12, 2008 Wenchuan earthquake. In this extreme geo-disaster, mortality was 69,226, with 274,643 injuries, and 17,923 missing. The human toll was accompanied by significant destruction of the natural environment and the economy, estimated at US$ 176 billion. A 300 km long surface rupture occurred in the Longmen Mountains along its margin with the Sichuan Basin.

This disaster was caused by the relationships among (1) towns built in on or in proximity to fault lines, (2) the low earthquake-resistance of residences, schools and hospitals, and other buildings, and (3) the concentration of population distributed along rivers lying below steep-sloped mountains. Mortality and devastation were compounded by post-earthquake landslides. The Chinese central government started a national-level response within 2 hours, upgrading it to the highest national emergency level within 10 hours. Most lives were saved by local people. Military rescue units were activated within minutes of the earthquake, and regional militia, local and provincial units such as the Sichuan Seismological Bureau self-activated immediately. By day-two, 20,000 rescue and engineering soldiers had been deployed. Over 15 large medical treatment, epidemic prevention, and psychological intervention teams responded and more than 10 million volunteers took part in relief activities. In spite of mobilization of the nation's resources, emergency relief was frustrated by formidable obstacles such as cloud cover, a destroyed ground transportation network, loss of communication, and continued geo-hazards in the form of landslide-dammed rivers which threatened large downstream urban centers. Expert national planning for recovery began five days post-earthquake; the plan was promulgated by national law in September, 2008. By the second anniversary of the Wenchuan earthquake, most school and residential construction was completed in earthquake-resistant areas.

Climate change is intricately related to human health and impacts acute and chronic diseases leading to increased demands on the health care system.

The University of Colorado Graduate Medical Education (GME) Fellowship in Climate Change and Health Science Policy (CCHSP) aims to train and equip a new generation of clinicians knowledgeable in climate science, proficient in climate health education, and facile with advocacy skills in order to become leaders in health policy.

The CCHSP fellowship is funded by the Living Closer Foundation and hosted through the University of Colorado Department of Emergency Medicine. It is a one to two-year program tailored to the fellow’s specific goals with the opportunity to earn an MPH or MA. Clinical work is supported through the UCHealth network. Site placement occurs at partnering organizations, including the National Institutes of Health, the Centers for Disease Control and Prevention, and fieldwork throughout the world (via Colorado School of Public Health, Harvard FXB Center for Health and Human Rights).

The first fellow was recruited in 2017 and has participated in and completed multiple projects: technical contributor to the US Government’s Fourth National Climate Assessment; advocating for women’s health policy in India; authorship of climate change and health resource documents for the World Bank; climate change leadership within SAEM; advocacy work with local and state governments; multiple research publications.

As climate change continues to impact human health with widespread consequences, we need effective and articulate leaders to affect policy. Although this Fellowship originated in Emergency Medicine, its competencies and structure are replicable for other clinical specialties. Climate change will be one of the core global health challenges for generations. A strong foundation of clinicians who understand its causes and the strategies for adaptation and mitigations are necessary to optimize health outcomes amidst this growing threat.

Invasive blood pressure (IBP) monitoring could be of benefit for certain prehospital patient groups such as trauma and cardiac arrest patients. However, there are disadvantages with using conventional IBP devices. These include time to prepare the transducer kit and flush system as well as the addition of long tubing connected to the patient. It has been suggested to simplify the IBP equipment by replacing the continuous flush system with a syringe and a short stopcock.

In this study, blood pressures measured by a standard IBP (sIBP) transducer kit with continuous flush was compared to a transducer kit connected to a simplified and minimized flush system IBP (mIBP) using only a syringe.

A mechanical, experimental model was used to create arterial pressure pulsations. Measurements were made simultaneously using a sIBP and mIBP device, respectively. This was repeated four times using different mean arterial pressure (MAP): 40, 70, 110, and 140mm Hg. For each series, 16 measurements were taken during 20 minutes. Data were analyzed using Bland-Altman plots. Measurement error greater than five percent was regarded as clinically significant.

Mean bias and standard deviation (SD) for systolic blood pressure (SBP), diastolic blood pressure (DBP), and MAP was -3.05 (SD = 2.07), 0.2 (SD = 0.48), and -0.3 (SD = 0.55) mmHg, respectively. Bland-Altman plots revealed that the bias and SD for systolic pressures was mainly due to an increased under-estimation of pressures in lower ranges. All MAP and 98.4% of diastolic pressure measurements had an error of less than five percent. Systolic pressures in the MAP 40 series all had an error of greater than five percent. All other systolic pressures had an error of less than five percent.

Thus, IBP with the mIBP flush system provides accurate measurement of MAP and DBP in a wide range of physiological pressures. For SBP, there was a tendency to under-estimate pressures, with larger error in lower pressures. Implementation of a simplified flush system could allow further development and potentially simplify the use of IBP for prehospital critical care teams.

KarlssonJ, LindeJ, SvensenC, GellerforsM. Prehospital Invasive Arterial Pressure: Use of a Minimized Flush System. Prehosp Disaster Med. 2018;33(5):490–494.

Many triage algorithms exist for use in mass-casualty incidents (MCIs) involving pediatric patients. Most of these algorithms have not been validated for reliability across users.

Investigators sought to compare inter-rater reliability (IRR) and agreement among five MCI algorithms used in the pediatric population.

A dataset of 253 pediatric (<14 years of age) trauma activations from a Level I trauma center was used to obtain prehospital information and demographics. Three raters were trained on five MCI triage algorithms: Simple Triage and Rapid Treatment (START) and JumpSTART, as appropriate for age (combined as J-START); Sort Assess Life-Saving Intervention Treatment (SALT); Pediatric Triage Tape (PTT); CareFlight (CF); and Sacco Triage Method (STM). Patient outcomes were collected but not available to raters. Each rater triaged the full set of patients into Green, Yellow, Red, or Black categories with each of the five MCI algorithms. The IRR was reported as weighted kappa scores with 95% confidence intervals (CI). Descriptive statistics were used to describe inter-rater and inter-MCI algorithm agreement.

Of the 253 patients, 247 had complete triage assignments among the five algorithms and were included in the study. The IRR was excellent for a majority of the algorithms; however, J-START and CF had the highest reliability with a kappa 0.94 or higher (0.9-1.0, 95% CI for overall weighted kappa). The greatest variability was in SALT among Green and Yellow patients. Overall, J-START and CF had the highest inter-rater and inter-MCI algorithm agreements.

The IRR was excellent for a majority of the algorithms. The SALT algorithm, which contains subjective components, had the lowest IRR when applied to this dataset of pediatric trauma patients. Both J-START and CF demonstrated the best overall reliability and agreement.

There is no universal tool for measuring disaster preparedness in the general population. This study aimed to provide a summary of the domains and psychometric properties of the available scales that assess preparedness for disasters, or one of its main types, among individuals or households.

This study is a systematic review of the literature on disaster preparedness tools. Studies published up to December 2022 were identified through a systematic search of four databases: Google Scholar, PubMed, Scopus, and Web of Science. Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) were used to review and evaluate the psychometric properties. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used to report this article.

Twelve articles met the inclusion criteria. Among them, five scales measured general disaster preparedness, five measured earthquake preparedness, one measured flood preparedness, and one measured bushfire preparedness. The scales had a number of dimensions ranging from one to six. The most common item topics in the included scales were as follows: having an evacuation plan (n = 7), information source (n = 7), fire extinguisher (n = 6), and emergency kit (n = 5). The scales were rated sufficient for content validity (n = 10), structural validity (n = 5), internal consistency (n = 5), and test-re-test reliability (n = 6). One scale was checked for criterion validity and was rated as insufficient according to the COSMIN guidelines.

The findings suggest the need to improve the psychometric properties of the scales, expand their contents, and develop scales relevant to target populations. This study provides useful information for researchers to develop comprehensive assessment tools and valuable sources of items for future scales.