In many developing countries nurses are the front-line of care, yet do not receive appropriate theoretical or clinical skills related to disaster and emergency medicine. The ICN/WHO have outlined disaster nursing competencies for improving disaster nursing globally. These can serve as a basis for strengthening nursing through increased participation in training programs. In Mumbai, India during December 2010, MEMEX II occurred: a 7 day training in disaster preparedness and humanitarian response. This was the first time nurses were included in a separate disaster nursing track to improve skills and knowledge.

Through Cornell and Columbia Universities; faculty, Indian nurses clinical competencies and disaster theory were strengthened through training in clinical trauma management, CPR, disaster preparedness and drills, public health evaluation, and the disaster cycle. 700 participants from medical, education, government and private/public entities collaborated in the training program, culminating in a large scale disaster drill and needs assessment workshop for high-level stakeholders.

Nurses improved emergency clinical skills and gained theoretical disaster knowledge for the first time. Nurses located at the disaster event site gained important insight into the role of Emergency Medical Services, police, fire, and civilian defense during disaster response. Triage skills were improved and an evaluation component enabled vital information to be collected for hospital preparedness. A video was made for future training and for evaluation purposes. Nurses planned to establish coordination networks amongst the 9 hospitals present to regularly review disaster preparedness plans.

Strengthening nursing competencies in disaster planning and emergency response is vital to advancing nursing in developing countries and building capacity through global networking. Through a multi-disciplinary approach, professional networks can be formed, disaster plans reviewed and clinical skills improved. Nursing input is vital to hospital and community preparedness and nurses must be included in training programs and needs assessments.

There are many health challenges faced by those returning from military service. Posttraumatic stress disorder (PTSD) is a serious problem in veterans. PTSD is a risk factor for suicide in veterans. Standard treatments include medication and talk therapy. Non-traditional treatments include civil service and leadership training.

Assess the effectiveness of Veteran Focused Train-the-Trainer (TTT) Community Disaster Response and First Aid (DRAFA) Programs in promoting health, wellness, reintegration, and decreasing PTSD symptoms of veterans.

A longitudinal cohort study was conducted using a convenience sample of veterans living in Denver, Colorado or Reno, Nevada. The sample size was over 50 (N=50+), with 25+ case-matched veterans at each location. This is an ongoing project lasting through the end of 2020. Inclusion criteria selected veterans interested in DRAFA training and education. Exclusion criteria disqualified those who are not a veteran or those unable to perform physical tasks required by curriculum. The null hypothesis was that there is no relationship between the DRAFA TTT program and the health, well-being, and reintegration of veterans back into their communities. Statistical tools used were SPSS Statistics (Version 25) and NVivo 12-12.2.0.3262. Research activities were conducted under the auspices of the University of Colorado and guided by the principles of the Institutional Review Board (IRB).

Results are being evaluated using a mixed methods impact model. The main outcomes measured health, wellness, and reintegration using Veterans RAND-12 Health Quality of Life Survey, the Military to Civilian Reintegration Survey, and a satisfaction survey. Preliminary analysis may indicate a correlation between participation in the DRAFA TTT program and improved health/wellness outcomes, better reintegration into society, and decreased PTSD.

There is growing evidence that expedited structured reintegration programs in community preparedness and disaster leadership roles for veterans alleviate PTSD symptoms and improves quality of life.

Heart attacks (HAs) present clinically with varying symptoms, which are not always described by patients as chest pain (CP) or chest discomfort (CD). Emergency Medical Dispatchers (EMDs) select the CP/CD dispatch protocol for non-chest pain HA symptoms or classic HA complaint of CP/CD. Nevertheless, it is still unknown how often callers report HA symptoms other than CP/CD.

The objective of this study was to characterize the caller’s descriptions of the primary HA symptoms, descriptions of the other HA symptoms, and the use of a case entry (CE) question clarifier.

A retrospective descriptive study analyzed randomly selected EMD audios (where CD/CD protocol was used) from five accredited emergency communication centers in the United States. Several Quality Performance Review (QPR) experts reviewed the audios and recorded callers’ initial problem descriptions, the use of and responses to the CE question clarifier, including the EMD-assigned final determinant code.

A total of 1,261 audios were reviewed. The clarifier was used only 8.5% of the time. The CP/CD symptoms were mentioned alone or with other problems 87.0% of the time. Overall, CP symptom was mentioned alone 70.8%, HA alone 4.0%, and CD symptom alone 1.4% of the time.

9-1-1 callers report potential HA cases using a variety of terms and descriptions—most commonly CP. Other less-common symptoms associated with a HA may be mentioned. Therefore, EMDs must be well-trained to be prepared to probe the caller with a clarifying query to elicit more specific information when “having a heart attack” is the only complaint initially mentioned.

RCHIS is an Electronic Medical Record (EMR) and Health Information System (HIS) that has been purpose built for use by Red Cross Red Crescent (RCRC) Emergency Response Units (ERUs), which are the equivalent of Type 1 (fixed and mobile) and Type 2 facilities in the Emergency Medical Teams (EMT) classification.

To share the main lessons learned from the pilot to inform development and implementation of similar systems in other EMTs.

A three-day, in-person super user training was held with 13 participants: nine first aid volunteers, two nurses, and two medical doctors; seven delegates had experience using an EMR. These super users served as trainers for staff at the pilot.

The pilot occurred with the Portuguese Red Cross (PRC) for the Peregrinação de Fátima, where 200,000 people were in attendance. The PRC was part of a wider coordination cell with the civil defense authority, who required live reporting from the three clinics PRC had set up.

77 user accounts and 243 patient files were created during the four-day pilot.

The delegates shared feedback directly and through a survey. 88% stated that RCHIS was very easy to use with the majority of delegates requiring less than 30 minutes of training. 95% of delegates stated that they had sufficient training to use RCHIS to its full extent.

The civil defense authority was able to utilize the real-time reporting to assist in their operational response.

The first RCHIS pilot was very successful from both a technical and organizational perspective.

Sengkang General Hospital (SKH) is a part of the national network of hospitals to respond to civil emergencies including hazardous material (Hazmat) incidents in Singapore. The HDS course aims to train our staff on basic knowledge of the effects of hazardous material exposure and the operations of the HDS.

HDS course was planned in three phases:

Phase one aimed to train all DEM personnel so as to have a critical mass of personnel equipped to operate the HDS upon immediate notice. Phase two involves hospital staff from non-emergency departments. Material and simulations for phase two was simplified to focus on the skills and prompt decontamination. Phase three aims to test out capabilities of HDS and review processes through department simulations and hospital.

155 staff have completed HDS training since 2019, amongst them, 23 as instructors. 67.7% found the demonstrations, skills and practices exceeded expectations. 69% were able to apply skills taught during simulation and overall, 71.2% were able to understand topics covered in the modules.

SKH was at the forefront of battling Covid-19 and resources were tight. We have resumed trainings to complete Phase two. We aim to train more than 35% of manpower in non-emergency departments to achieve higher recall.

Training for national emergencies is challenging. HDS is located right outside the emergency department and has advantages of allowing smooth traffic to decontaminate patients and prompt treatment. However, training can get disrupted with incoming ambulances, patient influx and lack of resources.

SKH aims to be well prepared in handling pandemics and still maintain its capabilities in assisting in national emergencies. There are plans for hospital simulation exercises for all relevant stakeholders and internal and external reviews are required to improve decontamination systems and processes. It is important to continue training hospital personnel to support HDS during crises.

Heatwaves are the leading weather-related causes of deaths globally. Since the mid 20th century, the frequency and intensity of heatwaves has increased with recent reports projecting a substantial warming in temperature extremes by the end of the 21st century.

In this cross-sectional study, we attempted to assess public perception and knowledge on heatwaves. Data was collected across Pakistan among a sample of people aged 18 years and above using an online survey questionnaire. Health Belief Model (HBM) constructs were used to assess risk perception using a total of 14 statements while knowledge was measured using 12 statements. The Unadjusted Odd Ratio (UOR) and Adjusted Odd Ratio (AOR) of 95% Confidence Intervals (CI) were employed through binary logistic regression. A total of twelve variables were included in the model (11 categorical and 1 continuous).

Out of the 686 participants, the majority of the people (57.73) showed high heatwaves risk perception and a high level of heatwave knowledge (59.91). The results of the multivariate regression model (AOR) showed that participants within the Secondary and/or higher Secondary (Grade 9th to Grade 12th) were less likely (OR=0.304) perceiving heatwaves risk compared to the reference group (Basic/Elementary Level i.e., (Grade 1st to Grade 8th)). As the number of participants who lives with others and who heard about heatwaves increases, the participants are more likely to perceive high heatwaves risk. For instance, participants who lives with others and have heard about heatwaves perceived heatwaves risk 1.982 and 1.816 times higher respectively than those who live alone and those who have not heard about heatwaves before.

HBM can be useful in designing interventions aimed at increasing people’s adaptive behaviors during heat waves. This study provides useful insights to the policymakers across Pakistan in understanding the public’s perception that can lead to informed decision-making.

The pandemic caused by the SARS-CoV-2 virus, which has been rapidly developing globally since the beginning of 2020, has forced individual states to take many restrictive decisions aimed at stopping the pandemic and controlling the crisis situation. In Poland, the strategy of fighting the pandemic in the initial phase covered the entire country and was based primarily on preventive mechanisms to identify and quell the pandemic.

A retrospective analysis was conducted incorporating media and a literature review. This retrospective analysis was performed using legal acts and press resources and other media reports to investigate every province of Poland.

This research describes one element of the state security system tasks, that of securing an appropriate number of hospital beds for COVID-19 patients. The process focused first on establishing both the purpose and tasks of dedicated hospitals followed by discussions of the potential problems related to the functioning of these specialized facilities for patients infected with SARS-COV-2 virus. Primary attention was given to ensuring both the security of the crisis situation and the diligent monitoring of the current epidemic

In order to effectively use human and infrastructural resources, it was crucial to implement objective, unified methods of organization and management, as well as ongoing evaluation of the results of the conducted activity.

Advances in technology can drastically improve the ability of providers to care for survivors of a disaster. Research into new applications of technology in the Disaster Medicine space, and dissemination of new technological achievements are vital to saving lives. This presentation discusses several recently proven technologies in the field of disaster medicine which deserve further dissemination, as well as promising technologies currently being studied.

An overview of the current uses and upcoming research on several technologies will be definitive in future disaster responses.

Unmanned Aerial Vehicles (UAVs) and Telemedicine have been well studied and are proven game changers in field disaster response. Artificial intelligence continues to be studied and aid real-time, strategic and tactical decision making in the field. Virtual reality simulation has now advanced to be a feasible, cost effective and effective method of training disaster responders as well as for training the lay public in disaster risk reduction. Artificial Intelligence is also being studied for uses in the hospital and in all forms of Emergency Management, and is likely to be intricately tied to the future of the field.

As new technologies are developed, it is important for Disaster medicine practitioners to consider how they can be applied to the field. Advocating for applying new technologies to disaster medicine, and for dissemination of proven technologies is a vital part of advancing the field of disaster preparedness and response.

3880 fracture patients are admitted in the Emergency Department of Saiful Anwar General Hospital from January to August 2009. It signifies to the second place of the cause of patients' admission. Most cases are motorcyclist victims from road traffic accident. Driving license is encouraged by the government to reduce the number of road traffic accident victims.

This study utilizes observational with cross sectional study and purposive sampling to correlate the relationship between status of motorcycle driving license ownership and the obedience of traffic law, the relationship between the patterns of motorcycle driving license ownership and the obedience of traffic law, and the relationship between the obedience towards traffic law and the gradation of open fractures among motorcyclist victims in accordance with Sardjito Scoring system.

Most patients have no driving license. And those who has driving license, mostly have never undergone driving license test. Patients with open fractures of cruris come with severe Sardjito scoring system, open fractures of antebrachii with moderate Sardjito scoring system, and open fractures of femur with moderate Sardjito scoring system.

It is strongly related between the ownership of driving license and road traffic accidents. The most road traffic accidents cases of are open fractures of cruris, open fractures of antebrachii, and open fractures of femur respectively. High obedience and strict use of personal protective equipment (safety helmet, glove, and jacket) would be effective in mitigating road traffic accident injuries.