Brazil has 200 million descendants of African, Portuguese, Indigenous, German, Italian, and other peoples who have built their identities. The Federal Constitution was rewritten in 1988 to include a Social Protection System. Between 2000 and 2016, the federal government was governed by the Workers’ Party. This party invested in the creation of inclusive public policies and affirmative actions built through collective processes of citizenship that guaranteed better living conditions for the population. In one decade, it went from being underdeveloped to developing. In 2016, the elected president of the Workers’ Party was withdrawn from power through impeachment. In the next election, right-wing conservatives excluded speech, attacked minorities (e.g. LGBT population), and defended the traditional family.

To understand the retreat of Brazilian public policies in a country that set public social policies, compensatory policies, and affirmative actions guaranteeing citizenship of men and women.

Qualitative research with analysis and reflection on the regression of universalist public policies and affirmative policies with the creation of quotas.

The creation of affirmative actions was guaranteed. Vacancies in public tenders for the black population led to the establishment of 50% quotas for blacks in universities, and the creation of a universal health system, or universal expanded health indicators. The federal government created a group of SUS analysis by reducing actions.

Social inequality in Brazil is one of the worst in the world. 16 million people live below the poverty line (OXFAM, 2017). In recent decades, the population that was expanding and strengthening access to services, health, education, and social assistance network has seen a reduction of public policies. The importance of research that points to this reduction of rights is fundamental for documenting what has already been achieved.

The rationale for undertaking this study was to investigate how characteristics of population health relate to and impact disaster risk, resilience, vulnerability, impact, and recovery. The multi-disciplinary environment that contextualizes disaster practice can influence determinants of health. Robust health determinants, or lack thereof, may influence the outcomes of disaster events affecting an individual or a community.

To investigate how the social determinants of health inform community perceptions of disaster risk.

Community perception of disaster risk in reference to the social determinants of health was assessed in this study. Individual interviews with participants from a community were conducted, all of whom were permanent community residents. Thematic analysis was conducted using narrative inquiry to gather firsthand insights on their perceptions of how characteristics of population health relate to and impact an individual’s disaster risk.

Analysis demonstrated commonality between interviewees in perceptions of the influence of the social determinants of health on individual disaster risk by determinant type. Interviewees sensed a strong correlation between low community connection and disaster risk vulnerability. Specific populations thought to have low community connection were perceived to be socially isolated, resulting in low knowledge or awareness of the surrounding disaster risks, or how to prepare and respond to disasters. In addition, they had reduced access to communication and support in time of need.

The importance of a strong social community connection was a feature of this research. Further research on how health determinants can enable disaster risk awareness and disaster risk communication is warranted.

Traditional belief holds that the human appendix is a vestigial organ devoid of any purpose, and consequently, surgical appendectomy has been the “gold standard” treatment for suspected appendicitis. Prophylactic (preventative) appendectomy remains the policy of the Australian Antarctic Division for wintering medical practitioners and has been discussed in the context of long-duration non-orbital space flight.

New research around appendiceal function, increasing adoption of non-surgical treatment modalities for acute appendicitis, and emerging research on the long-term consequences of appendicectomy have recently enabled researchers to challenge this paradigm.

This novel project set out to test the hypothesis that a “one size fits all” prophylactic appendectomy policy may not be in the best interest of individual expeditioners, and utilized a “mindmap” to identify several key areas for a scoping literature review. This enabled disparate research to be drawn together in an innovative way.

A growing body of research has discovered that the appendix plays an important role in the gut immune system and maintaining gut health. It acts as a reservoir of good bacteria that repopulates the gut after pathogenic challenge. This is particularly important for people with impaired immune systems, such as those that occur in extreme environments. Appendicitis can often be successfully treated with intravenous antibiotics. Prophylactic appendectomy is not without risk, as 1:4 to 1:3 people will encounter some sort of postoperative complication. After an appendectomy, there is an increased risk of many serious medical conditions, including intra-abdominal adhesions, ischaemic heart disease, inflammatory and irritable bowel diseases, rheumatoid arthritis, and many others.

The increased morbidity and mortality associated with appendectomy is costly for individuals (the burden of disease) and society (health economics). It also poses a currently unappreciated health risk for long-term off-world expeditions.

Use of Point-of-Care Ultrasound (US) has grown considerably in resource-limited and wilderness environments because of a combination of features, including portability, durability, and safety. However, the optimal method of powering US devices in such environments is not well established.

This project has the following aims:

1. 1. Develop a solar power generation and storage system that maximizes power capacity and minimizes weight while being easily transportable by a single person.

2. 2. Test the system in a real-world environment to evaluate actual performance relative to stated performance.

3. 3. Determine the approximate US scan-time where solar systems would outperform pre-charged batteries with respect to weight.

We developed multiple solar collecting systems using a combination of polycrystalline, monocrystalline, and thin-film solar arrays paired with different powerbanks and tested them using a variety of US systems. From this, the duration of usage was calculated, which makes the solar power generation system a superior option to pre-charged batteries.

Lithium-ion energy storage was found to be superior to lead-acid batteries for multiple reasons, most prominently, weight. Several models of US systems were tested revealing that portable US systems consume between 30 to 50 watts. Tri-fold monocrystalline solar panels coupled with lithium-ion powerbanks provided the best combination of weight and transportability. Total weight of the combined solar array, powerbank, and US system is 10 kilograms and easily packs into a backpack carrier. It was found that systems using solar generating capacity become superior to pre-charged powerbanks in regard to weight at approximately 14 hours of scanning time.

While these results are not fully generalizable due to seasonal and geographic variability as well as the type of US system used, use of solar generating capacity to power US systems is optimal for extended durations of use in resource-limited environments.

Japan experienced several major disasters in 2018.

Evaluation of medical response was conducted and problems determined to solve for future response.

An evaluation conducted on DMAT responding report of Northern Osaka Earthquake, West Japan Torrential Rain Disaster, Typhoon Jebi, and Hokkaido Iburi East Earthquake.

DMAT responded 58 teams for Osaka Northern Earthquake, 119 teams for West Japan Torrential Rain Disaster, 17 teams for Typhoon Jebi, 67 teams for Hokkaido Iburi East Earthquake. At the Osaka Northern Earthquake, by comparing the report of seismic diagnosis, results and, a magnitude of each region, hospital damage was evaluated. At the West Japan Torrential Rain Disaster, a flood hazard map was used to expect inundation at hospitals. At the Hokkaido Iburi East Earthquake, information of hospital generator was gathered and planned assistance for loss of power. Water supply cessation in the West Japan Torrential Rain Disaster and loss of power in the Hokkaido Iburi East Earthquake influenced hospital functionality. More precise preparation for hospital management in the event of a loss of power and water supply situation required in not only in local government but also each hospital. For the West Japan Torrential Rain Disaster, we experienced the same type of major disasters in the past, but could not manage accordingly. For the Hokkaido Iburi East Earthquake, we applied what was learned from the West Japan Torrential Rain Disaster.

Disaster medical operation was supposed to be managed with information from the Emergency Medical Information System (EMIS). However, 2018 disasters provided lessons that require a full understanding of disaster prior information and expected disaster damage information to manage disaster assistance. To accomplish effective disaster assistance, information must be gathered of supplies and assistance required by hospitals. An effective system to facilitate lessons learned needs to be developed

The Asia Pacific Conference on Disaster Medicine (APCDM) started in 1988 in Osaka, Japan, and the 14th conference was held from October 16-182, 2018, in Kobe.

To give a rundown of the 14th APCDM and a proposal for WADEM.

Retrospective analysis of participants, the category of presentations, and deliverables.

With “Building Bridges for Disaster Preparedness and Response” as its main theme, the 14th APCDM was held near the epicenter of the 1995 Great Hanshin Earthquake in Kobe. The total number of participants was 524 from 35 countries, not only from Asia and the Pacific but also Europe and the Americas. Its program had 10 lectures by distinguished speakers such as WADEM Board members and WHO (World Health Organization), four symposia, two panel, oral and 99 poster presentations. “Preparedness” and “Education and Training” were the categories with the largest number of presentations. The presidential lecture outlined improvements made in Japan since the Great Hanshin Earthquake (disaster base hospitals, disaster medical assistance teams, emergency medical information system, and disaster medical coordinators) and emphasized the importance of standardizing components for better disaster management. This idea was echoed in symposia and round-table discussions, where experts from WHO, JICA (Japan International Cooperation Agency), and ASEAN (The Association of Southeast Asian Nations) countries discussed other components such as SPEED (Surveillance in Post Extreme Emergency and Disasters) and standardization of Emergency Medical Teams.

Each country in the disaster-prone Asia-Pacific region has a different disaster management system. However, participants agreed in this conference that we can cope with disasters more efficiently by sharing the standardized components, from both academic and practical points of view. APCDM must provide these deliverables to WADEM, so both conferences can cooperate and contribute to disaster preparedness and prevention in the new era.

Main functions of the Russian Federation in disasters and emergencies are loaded on All-Russian Center for Disaster Medicine of Ministry Health (ARCDM). The principal strategies of the staff are to play leading roles in preparedness, emergency response, evacuation, recovery of health systems, and education.

Our presentation includes selection, classification, analysis, and statistics. There about 80 territorial Disaster Medicine Centers working under the leadership of ARCDM. One experience from the Moscow Territory Disaster Medicine Center will be presented.

At the operational and informational department, there are nine special medical emergency teams (three with helicopters). Time of arrival takes between seven and ten minutes, and transport to the hospital takes about five to seven minutes with 33 landing places for helicopters. The operational and control department uses an early warning system. About 1,300 exercises were organized in these centers and hospitals. We will discuss the examples of medical care delivery to the injured in metro Slaviynskie, Basar park Pobedi, Narofominskay, two major fires, and hurricanes. The mobile field hospital worked in more than 12 countries and in many territories in the Russian Federation over 25 years.

The last year was very difficult due to the Football World Cup, working hard as a collaborating center in emergencies, and working in the framework of a memorandum with China. Preparedness for an international event next May, which includes a field drill with participants from emergency medical teams of Health Ministries of CIS Countries and from State Health of China. We invite others to observe or join this event. Thus, we have some difficulties and problems, but we must increase solidarity and collaboration due to the scale, frequency, and number of losses in emergencies and disasters. Humanity could be able to cope with emergencies if we take into account these issues.

Cultural awareness is the understanding of differences in cultures, and openness to these differences. It is a vital step in the development of cultural sensitivity and becoming operationally effective when working within different cultures. The benefits of Cultural Awareness have become apparent in recent decades, including within governments, militaries, and corporations. Many organizations have developed Cultural Awareness training for their staff to improve cross-cultural cooperation. However, there has not been a large movement toward cultural sensitivity training among Non-Governmental Organizations (NGOs) who provide aid across a number of countries and cultures. Cultural Awareness can be a useful tool which enables an NGO to better serve the populations with which they engage.

To evaluate the presence within International NGOs of Cultural Awareness Training to employees and volunteers.

Ten of the largest international NGOs were identified. Their websites were evaluated for any mention of training in Cultural Awareness available to their employees and volunteers. All 10 were then contacted via their public email addresses to find out if they provide any form of Cultural Awareness training.

Of the ten NGOs identified, none have any publicly available Cultural Awareness training on their websites. One NGO deals with cultural awareness by only hiring local staff, who are already a part of the prevalent culture of the area. None of the others who responded have any cultural awareness training which they provide.

Cultural awareness is a vital tool when acting internationally. Large NGOs, which operate in a wide range of cultures, have an obligation to act in a culturally aware and accepting manner. Most large NGOs currently lack cultural awareness training for their employees and volunteers. It is time for these NGOs to develop, and begin to employ, cultural awareness training to better prepare their staff to serve international populations.

Medical errors are a reality for Emergency Medical Technicians (EMT’s) working in a prehospital, high-stress environment. A “medical error” can be defined as a mistake or system failure which results in improper care of a patient’s injury.

To study the frequency, severity, types, and causes of medical errors committed by Abu Dhabi Police Ambulance (ADPA) crews, and how to prevent these errors. The study is retrospective. All the data was collected using the Electronic Patient Care Report (EPCR) of all the patient treated and transported by ADPA crew from January to October 2018. After the EPCR auditing and monitoring, the medical errors were identified and discussed by a medical committee.

The total number of studied EPCR (trauma and medical cases) was 36.000. The medical errors identified were 265 cases (0.74%). 134 cases (51%) were moderate (can cause side effects), 115 cases (43%) were minor, and 16 cases (6%) were critical (can lead to death). The most common type of medical errors were cognitive errors. The causes were skill-based errors 27 times (10%) with 16 intravenous failures, 10 intraosseous failures, and one dislodged endotracheal tube after orotracheal intubation. The rule-based errors were committed five times (2%) when the Paramedics did not follow ACLS Algorithm, three times shockable cardiac arrest and two times Pulseless Electrical Activity. The knowledge-based errors were drug indications errors five times (2%). The three EMT’s levels in ADPA (Basic, Intermediate, and advanced) committed medical errors. The question to ask is not who made the mistake, but why the mistake was made. Preventing ADPA crew errors requires a systematic approach to modify the conditions that contribute to errors. The strategies are developing more awareness of cognitive errors by education and incorporating simulation into training.

Advanced Practice Providers (APP) are utilized in the United States National Disaster Medical System (NDMS) and consist of Certified Registered Nurse Anesthetists (CRNA), Nurse Practitioners (NP), and Physician Assistants (PA). They fill a critical role as Medical Officers in the Federal Disaster Medical Response on both Disaster Medical Assistance Teams (DMAT), Trauma & Critical Care Teams (TCCT), and United States Public Health Service (USPHS). DMAT teams and components of TCCT and USPHS responded to National Security Special Events, multiple natural disasters over the past two years including prolonged hurricane response in 2017 and 2018. The APPs were heavily utilized in key roles throughout the responses with much success.

To explain how APPs are a vital component to US Federal Disaster Medical Response and are able to fill a multitude of roles as Medical Officers.

We used qualitative data from APPs in the US NDMS system illustrating what roles they filled during recent disaster responses.

The APPs were key components to the US NDMS response to disasters in the US and US territories by providing direct medical care as APPs, aid in medical evacuation, triage, healthcare administration, and medical infrastructure evaluations.

The APP is essential in the US Federal Disaster Medical Response and future research would be to obtain quantitative data on APPs in the U.S. NDMS. With increasing natural and man-made disasters affecting more people across the world annually, the increasing global population, and expected international health care worker shortages, APPs can be part of the overall solution to Medical Officer shortfalls and other key components in future disaster responses throughout the world. As APPs are not widely utilized worldwide, there will need to be education on what APP training is and how they can be utilized in areas not familiar with their abilities.

The Disaster Psychiatric Assistant Team (DPAT) is Japan’s original mental health care dispatched team during disasters. Established in 2013, this team has been involved in the response to many disaster-related mental issues.

We Aimed to evaluate the DPAT activity in response to the past 4 disasters (Ontake volcano, Hiroshima flood, Joso flood, and Kumamoto earthquake), using the disaster mental health information support system (DMHISS).

DMHISS data from the four disasters was extracted. Descriptive statistics were performed from the obtained dataset and the characteristics of the disaster victims from each disaster were compared and examined.

About 2,400 cases were obtained and tabulated to from the database. Based on descriptive statistics, the DPAT support objectives, activities and activity periods Aim to establish (1) the characteristics of the affected areas (population composition, psychiatric medical condition), (2) the scale and content of the disaster (the injured, building damage, number of evacuees), and (3) the activity ability. The number of counseling cases peaked several days after the disaster onset, and the importance of the DPAT activity during the acute phase was confirmed. The time course of the consultation number, which is a measure of the termination, could be predicted from the disaster scale and content. These results suggest that DPAT activity may be a guideline for local disasters for one month and for wide-reaching disasters for two months or longer.

It is suggested that the timing of activity and the termination period could be estimated from factors including the type of disaster, the size of the disaster, and the number of evacuees using the disaster mental health medical activities from four disasters. It should be considered necessary to accumulate data and examine indicators related to the DPAT activity.

Emergency situations (ES) are situations within a certain territory, which have arisen because of an accident, a dangerous natural phenomenon, natural disaster, or other that may cause or have caused human casualties, damage to human health or the environment, significant material losses, and unbalance of living conditions of people. Important characteristics of ES are suddenness and involvement of a significant number of victims who need first aid and emergency medical care. These characteristics determined the organization of the Unified State System for Emergency Prevention and Elimination of the Russian Federation.

To study the structure of ES in Russia. By the scale of spread and damage caused, ES can be local, municipal, inter-municipal, regional, interregional, or federal, by the source of origin – technogenic, natural, biological, or social. The terrorist acts are usually allocated in a separate group of ES. The structure of ES, according to the EMERCOM of Russia in 2005-2017, is as follows:

1. 1. Technogenic (59.61%)

2. 2. Natural (29.42%)

3. 3. Biological and social (9.91%)

4. 4. Major terrorist acts (1.06%)

Statistical analysis was conducted. According to the EMERCOM of Russia, every year in 2005-2017 there were 422.5 ± 46.5 ES, resulting in the death of 796 ± 56 people. Polynomial trends in the number of ES and deaths, according to the EMERCOM of Russia, (with significant coefficients of determination R2 = 0.85 and R2 = 0.64, respectively) show a decrease in the number of ES and deaths.

The resulting analysis of the structure and number of ES, the number of deaths, the risk of being in an emergency, and the individual risk of death in an emergency can predict the forces and means necessary for the elimination of the consequences of ES.

Classroom instruction of disaster medicine for medical students is complicated and lacks attraction. Nowadays a novel method, which is named Game-Based Learning (GBL), has been used in other fields and received good feedback.

To apply GBL to the teaching process of disaster medicine and discuss the effect of its application.

A computer game was devised based on a syllabus of disaster medicine and employed it in classes of disaster medicine for medical students. Then a questionnaire about the application of GBL in education was used inquiring the demands of medical students for the designing of GBL in disaster medicine, including their platform and game mode preferences. Feedback was collected and data was analyzed after the class.

201 questionnaires were issued, and the valid rate was 100%. From the responses, 77% of medical students considered the application of GBL in education on disaster medicine was necessary, and 73% of the respondents thought it was practical. Furthermore, over 90% of medical students expressed their expectation for the adoption of GBL. According to another survey of 51 medical students we conducted, after attending a class about knowledge of injury classification with one board game adopted, most of the students believed GBL was better than traditional methods of teaching.

There is a high approbation degree among medical students to the adoption of GBL in the teaching process of disaster medicine, which suggests a great possibility for the application of GBL in medical education. It is concluded that GBL can be used in the teaching process of disaster medicine.

Current literature suggests that a large percentage of the health workforce may be unwilling to work during a disaster. The willingness of pharmacists to work during a disaster is under-researched internationally and non-existent in Australia.

To determine if Australian pharmacists are willing to work in a disaster and the factors that affect the willingness to work.

A 13-question survey was developed from the current literature and released nationally through professional organizations and social media.

Sixty Australian pharmacists completed the survey. Most participants believed their pharmacy was an essential service for their community. Pharmacists reported they would be likely to report to work during a pandemic or biological disaster (73%) or natural disaster (78%). The two major factors likely to prevent pharmacists from working in a disaster are family and safety concerns. Pharmacists perceived that their duty of care to their patients would make them likely to work during a disaster. Most pharmacists noted they would work even if they were expected to work outside their scope of practice, or if their place of work lacked electricity or was damaged.

Depending on the disaster, up to 27% of the pharmacy workforce may be unwilling to work in a disaster. Family and safety concerns were the primary barriers to pharmacists reporting to work in the aftermath of a disaster. Providing guidelines on how pharmacists can prepare their family for a disaster may assist in ensuring pharmacists are willing to work. The pharmacists surveyed demonstrated a strong commitment to their duty of care with the majority stating they would be likely to work in austere work environments. This research raises questions of the safety of pharmacists working outside their scope and in austere environments and whether it is safe for them, their patients, and the broader community.

In the South African environment, the possibility of lack in the disaster response education and training fraternity was attempted to be mitigated with legislation. The National Disaster Management Framework (2005:162-169) states that national, provincial, and municipal organs of state need to plan, organize, and implement training programs relevant to their respective areas of responsibility. The South African Disaster Management Act (South Africa, 2002:19) encourages a broad-based culture of risk avoidance and the promotion of disaster management education and training throughout South Africa.

As an organ of the state and a role-player in disaster management the Free State Emergency Medical Services (FS EMS) is responsible for making strategic decisions. Managers and supervisors are obliged to be trained and educated in disaster management. The study ascertained whether managers and supervisors are being trained and educated in disaster management as required by legislation.

The project made use of quantitative data whereby fifty EMS managers and supervisors in the Free State Provincial Government (FSPG) were assessed by using a questionnaire.

The study found that 66% of the respondents did not receive training to equip them to fulfill their disaster management functions. The remaining 34% indicated that they did receive aspects of disaster management training.

Based on the quantitative scores for the different indicators, the research found that there are shortcomings in disaster management qualifications and training among the EMS supervisors and managers in the FSPG EMS. However, the findings make it clear that there are several positive aspects in the already established practice of disaster management education and training in the FS EMS. The results indicated that there is an opportunity for revision and improvement that will contribute and empower the FS EMS managers and supervisors to meet legislative requirements towards disaster management training and education.

Salmonellae are gram-negative motile bacilli. The transmission of salmonellae to a susceptible host usually occurs from the consumption of contaminated foods. Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, but can be severe enough to require hospitalization.

Describe a hospital kitchen based mass foodborne infection.

Descriptive analysis of the foodborne infection event.

310 health personnel were contaminated from lunch that was cooked at our hospital kitchen. On that day 70 patients came to the emergency department for complaints of vomiting, fever, and diarrhea. During the next two days, we canceled all planned surgical operations. At the second day, we followed 80 patients and third day 150 patients came to our emergency services. Our emergency services and ıntensive care units were blocked because of personnel illness. We examined all patients, got blood tests and stool stains and cultures. Because of this mass casualty contamination, our infection control committee gave formal information that suspicious of Salmonellosis. 13 of 310 infected health personnel were hospitalized. They got intravenous saline and electrolytes support like calcium and potassium. After two days we got Results of stool cultures, there was inoculation of Salmonella types. None of them died.

We realized that we are not ready for mass casualty incidents like this contamination. Because our patient flow was really blocked. We had to call in new doctors and nurses from different hospital staffs. The event was similar to bioterrorism conditions and we suddenly have to put in place hospital disaster plans at the beginning of decontamination. This situation made us to recognize bioterrorism agents like Salmonella types. We have to raise awareness of the community about chemical, biological, radiological and nuclear agents attacks.

St. John Ambulance Victoria provides first aid and medical services at a variety of mass gathering events (MGEs) throughout Victoria. Volunteer healthcare professionals and students (termed “volunteers”) form Medical Assistance Teams (MAT) at these MGEs. MAT deployments manage a variety of patient presentations which include critically ill patients. This reduces high acuity patient transfers to the hospital and, where possible, avoid ambulance and hospital utilization.

To determine the effectiveness of interdisciplinary prehospital simulation workshops in preparing volunteers for MAT deployment at MGEs.

A one-day, simulation-based training session within the MAT environment was implemented to introduce volunteers to the management of various scenarios faced at MGEs. All volunteers were provided an orientation to the equipment and setting up MAT deployments at MGEs. Volunteers then participated in interdisciplinary group-based scenarios such as cardiac arrest management, drug intoxication, spinal injuries, agitated patients, and airway management. To determine the effectiveness of this training session, volunteers were invited to participate in a post-training survey, comprising of Likert scores and open-ended responses.

Seventeen volunteers attended the training session with 10 (58.8%) completing the post-training survey. Volunteers were satisfied with environment familiarization in the MAT (Average 4.47/5.00) and found the simulation-based training helpful (Average 3.67/4.00). The induction overall was well-received (4.60/5.00) with volunteers feeling more confident in being deployed at MGEs (4.20/5.00).

The results of the simulation-based training session were positive with volunteers receptive to the need for a training day prior to MAT deployment at MGEs. The simulation session enables volunteers to be comfortable with working in MAT and managing a diverse range of patients at MGEs. This session is likely to improve interdisciplinary communication and teamwork in the MAT. Future research is aimed at following these volunteers after several MAT deployments to improve the training session for future participants.

One of the improvements in Ethiopia’s emergency medical system was the introduction of a five-level Emergency Triage System (ETS) in January 2015 that was piloted in selected Addis Ababa hospitals.

To assess the effect of this intervention on the head injury mortality in Tikur Anbessa Specialized Hospital (TASH) Emergency Department (ED).

Data were retrospectively collected from all medical records of head injury patients seen in Adult TASH- ED over two 6 months periods, before and after the new Emergency Triage System implementation: 01/04/2014 – 30/09/2014 versus 01/04/2016 – 30/09/2016. An inclusion criterion was age above 13 for the records that could be retrieved. Exclusion criterion was “patient declared dead on arrival.” Mortality and patterns of head injury were compared pre- and post-intervention. Chi-square was used for the analysis using STATA 14.

A total of 522 Head injury patients were analyzed in the ED in both the pre- 258 and post-264 intervention study periods. Among head injury admission in the ED in both study periods, the highest number of patients were Road Traffic Accident/RTA/ victims, males and young age (<30). Mortality rate among head injury patients decreased from a pre-intervention 44 (17.05%) to post-intervention 27 (10.2%) (OR=0.55 9. 5% CI (0.32, 0.95), p=0.02). The median age of death was 45 years in pre- and 40 years in the post-intervention period, with ages ranging from 13 to 85 and 13 to 96 years, respectively. The proportion of deaths from moderate head injury decreased significantly from 14.0% in pre-intervention to 6.3% in the post-intervention period, respectively (p<0.001).

The Emergency Triage System at TASH-ED has decreased mortality caused by head injury. This could increase life years saved and productivity in a cost-effective and easily achievable way in resource-poor settings.

With the development of the economy and the expansion of the hazardous chemicals industry in one city, it is necessary for the city to establish an evaluation model of emergency medical rescue capability for hazardous chemicals production, storage, and exposure risk.

Establish an emergency medical rescue capacity evaluation model for secondary and higher hospitals in a city to deal with exposure risks of hazardous chemicals.

1. 1. Develop an expert consultation form

2. 2. Develop a survey on the status quo of emergency medical rescue capacity of hospitals in secondary and above hospitals in response to exposure and risk of hazardous chemicals production and storage.

3. 3. Calculate the weights of the first, second, and third-grade indicators, and establish a comprehensive evaluation model for the rescue capacity assessment of Chengdu hospitals.

Five levels of first-level indicators were obtained, namely, the weights of the five indicators of “centralized admission ability,” “hospital comprehensive ability,” “emergency management ability,” “material equipment capability,” and “health emergency team” were 0.2884, 0.2219, 0.1938, 0.1507, and 0.1453, respectively.

The establishment of an emergency medical rescue capacity evaluation model for the risk of exposure and storage of hazardous chemicals in secondary and higher hospitals in a city is related to five capabilities, the most important of which is the ability to focus on admission.

The Out of Hospital Cardiac Arrest (OHCA) procedures constitute one of the most quantifiable indicators of the quality of Emergency Medical Services (EMS). In Poland, HEMS teams perform such procedures both during primary missions and when they support EMS teams.

To carry out a retrospective analysis of OHCA related calls received from January 1, 2011, to December 31, 2016.

During the relevant period there were 2,447 OHCA related calls. Of those, 308 cases were excluded from the analysis because no cardiac arrest was confirmed or the patients showed signs of death that prevented any emergency procedures.

The Return of Spontaneous Circulation (ROSC) was achieved in 1,119 cases. Resuscitation was clearly much more effective if CPR procedures were commenced prior to the arrival of the HEMS team. The groups in which higher survival rates were obtained included women, patients younger than 40 and patients who had signs of shockable rhythms. The use of HEMS team allowed for faster transport of patients to relevant specialist institutions, specifically if an invasive cardiological intervention was needed.

The use of HEMS teams in OHCA related calls indicates that such actions are highly effective both in primary missions and when HEMS teams support other EMS terms. An additional advantage is the possibility of quick transportation to a relevant specialist medical center.