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Introduction: The coronavirus disease 2019 (COVID-19) pandemic has revealed a gap in disaster preparedness of health workers globally. Disaster medicine education is a key element to fill this gap., Objectives: This study evaluated the involvement of the European Master in Disaster Medicine (EMDM) Alumni in the current COVID-19 pandemic response and their self-perceived value of the EMDM educational program in accomplishing their tasks during the disaster., Methods: An online survey targeting the EMDM Alumni was conducted from January through March 2021. Quantitative data were described using percentages or means, as appropriate, while qualitative data were categorized using deductive thematic analysis., Results: In total, 259 Alumni completed the survey. Most of the Alumni (88.03%; standard error of the proportion [SEp] = 0.02) participated directly in the COVID-19 pandemic response - nationally or internationally - with different roles and responsibilities at different levels and sectors. Around 25% of the Alumni reported an increase in their tasks and responsibilities due to COVID-19 response, but few worked beyond their main specialization (5.26%) or expertise (2.19%). Moreover, Alumni shifted their role from clinical practice to managerial, public health, education and training, and policymaking roles during COVID-19 ( P <.001). Participants believed that the EMDM study program and the competencies acquired during the course were relevant and useful to perform their tasks during the COVID-19 pandemic response (mean = 5.26; 5.17 standard error of the mean [SEM] = 0.108, 0.107), respectively. Around 36% (SEp = 0.03) of the participants deemed that some contents were not sufficient for COVID-19 response., Conclusion: Most of the EMDM Alumni were involved in the COVID-19 pandemic response, playing diverse roles with an increased level of responsibility compared to those played before the pandemic. Moreover, the Alumni perceived the EMDM curriculum as relevant for accomplishing their tasks. However, they also reported gaps within the curriculum, especially topics related to outbreak and pandemic response. The findings of the study stress the value of investing in disaster medicine education world-wide and of pushing to update and standardize post-graduate disaster medicine curricula.

Heatwaves pose an important risk for population health and are associated with an increased demand for emergency care. To find factors causing such overload, an online Delphi study included 15 experts in emergency medicine, disaster medicine, or public health. One open-ended question was delivered in the first round. After content analysis, the obtained statements were sent to the experts in two rounds to be rated on a 7-point linear scale. Consensus was defined as a standard deviation ≤ 1.0. Thirty-one statements were obtained after content analysis. The experts agreed on 18 statements, mostly focusing on the input section of patient processing and identifying stakeholders, the population, and primary care as targets of potential interventions. Additional dedicated resources and bed capacity were deemed important as per throughput and output sections, respectively. These findings could be used in the future to implement and test solutions to increase emergency healthcare resilience during heatwaves and reduce disaster risk due to climatic change. [ABSTRACT FROM AUTHOR]

The field of discrete-event simulation for medical disaster management is relatively new. In such simulations, human victims are generated using pre-determined transitions from one health state to the next, based on a set of triggers that correspond to treatment or the clinical progression of untreated injuries or diseases. However, this approach does not account for subtle differences in clinical progression. We propose a parameter-based model to characterize the evolution of symptoms at first for physical and nerve agent chemical injuries. We used a Gompertz function to predict the time of death in trauma based on forensic data. Then we separately considered the effects of the chemical warfare agent sarin (GB) being the origin of the chemical injuries for the purpose of modelling a GB attack in a metro station. We emphasize that our approach can be extended to other CBRN threats pending knowledge of clinical progressions available in the literature for the purpose of casualty estimations. The intent is to provide an estimate of time to death without any treatment and overlay this model with a treatment model, improving the evolution of the health state. A modification for non-life-threatening injuries is included without losing generality. Improvement functions modelling medical treatment are proposed. We argue that the availability of injury scores vs mortality can greatly enhance the validity of the model. [ABSTRACT FROM AUTHOR]

Introduction: The proliferation of unmanned aerial vehicle (UAV) technology has the potential to change the situational awareness of medical incident commanders' (ICs') scene assessment of mass gatherings. Mass gatherings occur frequently and the potential for injury at these events is considered higher than the general population. These events have generated mass-casualty incidents (MCIs) in the past. The aim of this study was to compare UAV technology to standard practice (SP) in scene assessment using paramedic students during a mass-gathering event (MGE).Methods: This study was conducted in two phases. Phase One consisted of validation of the videos and accompanying data collection tool. Phase One was completed by 11 experienced paramedics from a provincial Emergency Medical Services (EMS) service. Phase Two was a randomized comparison with 47 paramedic students from the Holland College Paramedicine Program (Charlottetown, Prince Edward Island, Canada) of the two scene assessment systems. For Phase Two, the paramedic students were randomized into a UAV or a SP group. The data collection tool consisted of two board categories: primary importance with 20 variables and secondary importance with 25 variables. After a brief narrative, participants were either shown UAV footage or the ground footage depending on their study group. After completion of the videos, study participants completed the data collection tool.Results: The Phase One validation showed good consensus in answers to most questions (average 79%; range 55%-100%). For Phase Two, a Fisher's exact test was used to compare each variable from the UAV and SP groups using a P value of .05. Phase Two demonstrated a significant difference between the SP and UAV groups in four of 20 primary variables. Additionally, significant differences were found for seven out of 25 secondary variables.Conclusion: This study demonstrated the accurate, safe, and feasible use of a UAV as a tool for scene assessment by paramedic students at an MGE. No observed statistical difference was noted in a majority of both primary and secondary variables using a UAV for scene assessment versus SP. [ABSTRACT FROM AUTHOR]

Introduction: Mass gathering events (MGE), organized or unplanned, can attract sufficient attendees to strain the planning and response resources of the host community, state, or nation, thereby delaying the response to emergencies. MGEs also have the potential to cause a mass casualty incident. But MGE can also lead to improvements in the organization of local emergency medical services or public health that form the legacy of that MGE. Emergency medical teams (EMTs) could be deployed to ensure health security as a surge in MGE. But these EMTs should be built on guiding principles and core standards. However, to the best of our knowledge, there are no standards on medical planning and response during any type of MGE (e.g., sports, religious, or festivals). Method: A systematic review was performed in accordance with current guidelines, using six databases, namely Medline (via the PubMed interface), Scopus, Embase, Cochrane Library, ScienceDirect, and CINAHL, as well as literature sourced by Google Scholar and The Journal of Prehospital and Disaster Medicine. Studies published on minimum standards or medical planning and response during MGE from 2002-2022, written in English, were selected and assessed for eligibility by two reviewers. Results: From a total of 20,159 articles, 138 were screened, and 32 were assessed for eligibility. Two were only abstracts, and the others did not contain any description of minimal standards available for medical planning or response in different types of MGE. Conclusion: No studies were found that describe any form of standards for medical planning and the response of emergency medical teams in different types of mass gathering events (e.g., sports, religious, festivals). There is a need for minimum standards for emergency medical teams deploying as a surge in mass gathering events. [ABSTRACT FROM AUTHOR]

Introduction: In response to the global upward trend of humanitarian emergencies, the humanitarian health workforce has grown substantially in the last decades. Still, humanitarian education and training programs are limited in availability, geographical locations, and teaching methods, and are too expensive for local respondents. To address these gaps, an e-learning tool for humanitarian public health has been developed and evaluated. Method: Action research was used to develop the e-Learning tool. Rapid prototyping–a modified analysis, design, development, implementation, and evaluation (ADDIE) model, was used to identify the content and instructional design. This iterative process involved consultations and feedback from public health and disaster medicine instructors and students at different levels and training programs from within and outside CRIMEDIM. Qualitative data were analyzed using thematic analysis. Quantitative data were appropriately summarized. Pre/post-test change in knowledge score was tested with paired t-test. Results: Although different levels of training are needed, targeting health professionals at the entry-level in the humanitarian field is identified as a priority. Scenario-based e-Simulation covers health needs assessment, essential health services, communicable diseases standards, and the health system was developed and evaluated. Trainees were highly satisfied by the clear objectives, the realism of the simulated scenarios, quizzes, and interactivity. In the 1-7 numerical scale, the median for overall experience satisfaction was 6.3 (IQR=5.3-7, N=35). The mean of the post-test score was 7.71, which was significantly higher than the mean of the pre-test score of 5.88. The large effect size of 1.179 indicates the training effectiveness. Poor internet was identified as a potential barrier to delivering the training. Conclusion: This participatory study resulted in the development of effective Scenario-based e-Simulation. Offline mode of training will be adapted for trainees with poor internet connection settings. Successful factors in instructional design will be used to inform the development of advanced training in the field. [ABSTRACT FROM AUTHOR]

Background/Introduction: The humanitarian health field has grown rapidly in the last decades. However, education and training programs are still limited in number, especially where it is needed most. Additionally, the cost of the training is too expensive for local humanitarian health respondents. If developed appropriately, E-Learning can potentially address these gaps. Objectives: Develop an effective E-Learning tool for humanitarian public health training. Method/Description: The tool was developed using an institutional-based, action research method. Rapid prototyping - a modified analysis, design, development, implementation, and evaluation (ADDIE) model - was used to identify the content and instructional design. This iterative process involved consultations and feedback from public health and disaster medicine instructors and students at different levels and training programs. Different methods were used to collect and analyze data, such as literature and courses reviews, observation, interviews, and questionnaires. Results/Outcomes: Four scenario-based E-Simulations - targeting entry-level humanitarian health professionals - were developed and piloted based on identified needs. Formative evaluation clarified training objectives and structure. Trainees were satisfied by the simulated scenario, interactivity, questions, and timely feedback. Poor internet was identified as a potential barrier to delivering the training in the humanitarian context. Conclusion: Clear objectives and quality content are the prerequisites for training effectiveness. Yet, instructional design is a critical element that can enhance training effectiveness. The tool's offline mode is being adapted to improve access in poor internet connection settings. A summative evaluation will be conducted to measure the training's effectiveness. Furthermore, successful factors in instructional design will be used to inform the development of advanced training in the field. [ABSTRACT FROM AUTHOR]