Prehospital and Disaster Medicine最新文献

{"title":"Starting a Prehospital Medication for Opioid Use Disorder Program.","authors":"David C Seaberg, Jamie McKinnon, Lyn Haselton, Doug Gallo, Jason Kolb, Mary Moran, Suman Vellanki, Amy Raubenolt, Erin Simon, Nicholas Jouriles","doi":"10.1017/S1049023X24000475","DOIUrl":"https://doi.org/10.1017/S1049023X24000475","url":null,"abstract":"<p><strong>Background: </strong>Over 2.7 million people have an opioid use disorder (OUD). Opioid-related deaths have steadily increased over the last decade. Although emergency department (ED)-based medication for OUD (MOUD) has been successful in initiating treatment for patients, there still is a need for improved access. This study describes the development of a prehospital MOUD program.</p><p><strong>Methods: </strong>An interdisciplinary team expanded a MOUD program into the prehospital setting through the local city fire department Quick Response Team (QRT) to identify patients appropriate for MOUD treatment. The QRT consisted of a paramedic, social worker, and police officer. This team visited eligible patients (i.e., history of an opioid overdose and received prehospital care the previous week). The implementation team developed a prehospital MOUD protocol and a two-hour training course for QRT personnel. Implementation also required a signed contract between local hospitals and the fire department. A drug license was necessary for the QRT vehicle to carry buprenorphine/naloxone, and a process to restock the vehicle was created. Pamphlets were created to provide to patients. A clinical algorithm was created for substance use disorder (SUD) care coordinators to provide a transition of care for patients. Metrics to evaluate the program included the number of patients seen, the number enrolled in an MOUD program, and the number of naloxone kits dispensed. Data were entered into iPads designated for the QRT and uploaded into the Research Electronic Data Capture (REDCap) program.</p><p><strong>Results: </strong>Over the six-month pilot, the QRT made 348 visits. Of these, the QRT successfully contacted 83 individuals, and no individuals elected to be evaluated for new MOUD treatment. Nine fatal opioid overdoses occurred during the study period. A total of 55 naloxone kits were distributed, and all patients received MOUD information pamphlets.</p><p><strong>Conclusions: </strong>A prehospital MOUD program can be established to expand access to early treatment and continuity of care for patients with OUD. The program was well-received by the local city fire department and QRT. There is a plan to expand the prehospital MOUD program to other local fire departments with QRTs.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-4"},"PeriodicalIF":2.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morbidity and Mortality of Drowning Children in Jerusalem District - Retrospective Analysis.","authors":"Maor Chavkin, Lea Ohana Sarna Cahan, Itai Shavit, Rebecca Brooks, Michal Sadeh, Saar Hashavya, Itai Gross, David Rekhtman","doi":"10.1017/S1049023X24000645","DOIUrl":"https://doi.org/10.1017/S1049023X24000645","url":null,"abstract":"<p><strong>Background: </strong>Drowning persists as a preventable pediatric cause of severe morbidity and mortality. This study aims to investigate the risk factors, circumstances, and medical consequences associated with pediatric drowning incidents in order to identify patterns that can inform targeted interventions.</p><p><strong>Methods: </strong>This was a retrospective analysis of a cohort of pediatric drowning cases. The study encompassed children aged 0-18 years who presented to the pediatric emergency departments (PEDs) of Hadassah Medical Centers in Jerusalem from January 1, 2004 through April 30, 2023. Inclusion criteria were individuals with main registration diagnosis containing the terms \"drowning\" or \"submersion.\"</p><p><strong>Results: </strong>Analysis revealed 129 cases of pediatric drowning, males comprising 66% of the cohort. The average age was 4.9 years (SD = 4.5). Predominantly, drownings occurred in private (38%) or public pools (27.1%). Forty-eight percent of children required hospitalization in intensive care. Notably, children from the Arab minority were significantly younger at the time of drowning (3.8 years; P = .04) and were at elevated risk of severe neurologic outcomes necessitating rehabilitation (P = .03). Incidents occurring on weekends were associated with younger victim ages (3.5 years; P = .04) and with increased likelihood of outcomes necessitating rehabilitation (P = .04). Conversely, children from families with four or more siblings were notably older at the time of drowning (5.3 years; P = .01). No other statistically significant differences were observed among demographic groups.</p><p><strong>Conclusions: </strong>Strategies aimed at promoting child health and preventing drowning must surmount feasibility barriers. Intervention efforts should be tailored to populations at heightened risk, including younger children, minority groups, and incidents occurring during weekends.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-6"},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: Prehospital Surgical Cricothyrotomy in a Ground-Based 9-1-1 EMS System: A Retrospective Review.","authors":"Kaelan Gobeil Odai","doi":"10.1017/S1049023X24000682","DOIUrl":"https://doi.org/10.1017/S1049023X24000682","url":null,"abstract":"","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-2"},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning from Hindsight: Examining Autonomic, Inflammatory, and Endocrine Stress Biomarkers and Mental Health in Healthy Terrorism Survivors Many Years Later.","authors":"Phebe Tucker, Betty Pfefferbaum, Carol S North, Yan Daniel Zhao, Pascal Nitiema, Rachel Zettl, Haekyung Jeon-Slaughter","doi":"10.1017/S1049023X24000360","DOIUrl":"https://doi.org/10.1017/S1049023X24000360","url":null,"abstract":"<p><strong>Introduction: </strong>Terrorism and trauma survivors often experience changes in biomarkers of autonomic, inflammatory and hypothalamic-pituitary-adrenal (HPA) axis assessed at various times. Research suggests interactions of these systems in chronic stress.</p><p><strong>Study objective: </strong>This unprecedented retrospective study explores long-term stress biomarkers in three systems in terrorism survivors.</p><p><strong>Methods: </strong>Sixty healthy, direct terrorism survivors were compared to non-exposed community members for cardiovascular reactivity to a trauma script, morning salivary cortisol, interleukin 1-β (IL-1β), and interleukin 2-R (IL-2R). Survivors' biomarkers were correlated with psychiatric symptoms and diagnoses and reported functioning and well-being seven years after the Oklahoma City (OKC) bombing.Main outcome measures were the Diagnostic Interview Schedule (DIS) Disaster Supplement for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnoses, Impact of Events Scale-Revised (IES-R), Beck Depression Inventory-II (BDI-II), Distress and Functioning Scale (DAF), and General Physical Well-Being Scale.</p><p><strong>Results: </strong>Survivors had higher inflammatory IL-1β, lower anti-inflammatory IL-2R, lower cortisol, higher resting diastolic blood pressure (BP), and less cardiovascular reactivity to a trauma script than comparisons. Survivors' mean posttraumatic stress (PTS) symptom levels did not differ from comparisons, but survivors reported worse well-being. None of survivors' biomarkers correlated with PTS or depressive symptoms or diagnoses or reported functioning.</p><p><strong>Conclusions: </strong>Alterations of biological stress measures in cardiovascular, inflammatory, and cortisol systems coexisted as an apparent generalized long-term response to terrorism rather than related to specific gauges of mental health. Potential interactions of biomarkers long after trauma exposure is discussed considering relevant research. Longer-term follow-up could determine whether biomarkers continue to differ or correlate with subjective measures, or if they accompany health problems over time. Given recent international terrorism, understanding long-term sequelae among direct survivors is increasingly relevant.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Tragedy: Illuminating Challenges in Disaster Management and Mental Health Support in Resource-Constrained Environments.","authors":"Syed Muhammad Aqeel Abidi","doi":"10.1017/S1049023X24000657","DOIUrl":"https://doi.org/10.1017/S1049023X24000657","url":null,"abstract":"<p><p>In the aftermath of the 2022 Pakistan flooding, disaster management faced critical challenges, particularly in mental health support. This study analyzed an incident where eighteen internally displaced individuals lost their lives in a bus fire. The current approach involves a comprehensive analysis of the incident, exploring the difficulties encountered in managing relief efforts, and providing mental health support. The study aims were to evaluate existing mental health support mechanisms, to identify challenges in disaster management, and to propose recommendations for future preparedness. Recommendations include enhancing disaster response training, integrating mental health services into primary health care, and prioritizing community resilience. These insights contribute to a deeper understanding of disaster management in resource-constrained regions.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-3"},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates to Article Categories for Prehospital and Disaster Medicine.","authors":"Jeffrey Michael Franc","doi":"10.1017/S1049023X24000633","DOIUrl":"https://doi.org/10.1017/S1049023X24000633","url":null,"abstract":"<p><p>For 2025, <i>Prehospital and Disaster Medicine</i> will be updating the available article categories. These changes assure that article categories are better aligned with the recently updated <i>Prehospital and Disaster Medicine</i> mission statement. The updated article categories will facilitate the publication of innovative, high-impact, evidence-based research in both prehospital and Disaster Medicine.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-3"},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ethical Principles in Ethical Guidance Documents during the COVID-19 Pandemic in the United Kingdom and the Republic of Ireland: A Qualitative Review - CORRIGENDUM.","authors":"Kesidha Raajakesary, Lucy Galvin, Kate Prendiville, Sarah Newport, Calum MacAnulty, Ghaiath Hussein","doi":"10.1017/S1049023X24000694","DOIUrl":"https://doi.org/10.1017/S1049023X24000694","url":null,"abstract":"","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1"},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude, and Practice of Providing First Aid by Commercial Motorcyclists: A Cross-Sectional Study.","authors":"Christine Ufashingabire Minani, Kim Lam Soh, Rosliza Abdul Manaf, Kulanthayan Kc Mani, Theogene Twagirumugabe","doi":"10.1017/S1049023X24000451","DOIUrl":"https://doi.org/10.1017/S1049023X24000451","url":null,"abstract":"<p><strong>Introduction: </strong>The mortality and morbidity due to road traffic crashes (RTCs) are increasing drastically world-wide. Poor prehospital care management contributes to dismal patient outcomes, especially in low- and middle-income countries (LMICs). This study aimed to assess the knowledge, attitude, and self-reported practice (KAP) of providing first aid for RTC victims by commercial motorcyclists. In addition, it determined the relationship between sociodemographic characteristics and the level of KAP, then the predicting factors of outcome variables.</p><p><strong>Methods: </strong>A cross-sectional study of 200 randomly selected commercial motorcyclists was conducted in May 2021. A chi-square test and multivariate analysis were used to analyze data.</p><p><strong>Results: </strong>The findings showed that most participants had a poor knowledge level (87.5 %), positive attitudes (74.5%), and poor self-reported practice (51.5%). Previous first-aid training and knowing an emergency call number for the police were predictors of good knowledge (AOR = 3.7064; 95% CI, 1.379-9.956 and AOR = 6.132; 95% CI,1.735-21.669, respectively). Previous first-aid training was also a predictor of positive attitudes (AOR = 3.087; 95% CI, 1.033-9.225). Moreover, the likelihood of having an excellent self-reported practice was less among participants under 40 years of age (AOR = 0.404; 95% CI, 0.182-0.897) and those who cared for up to five victims (AOR = 0.523; 95% CI, 0.282-0.969). Contrary, previous first-aid training (AOR = 2.410; 95% CI, 1.056-5.499) and educational level from high school and above increased the odds of having good self-reported practice (AOR = 2.533; 95% CI, 1.260-5.092).</p><p><strong>Conclusion: </strong>Considering the study findings, training should be provided to improve the knowledge and skills of commercial motorcyclists since they are among the primary road users in Rwanda and involved in RTCs.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators Toward Disaster Knowledge, Skills, and Preparedness among Emergency Medical Services in Saudi Arabia.","authors":"Yasir Almukhlifi, Gary Crowfoot, Alison Hutton","doi":"10.1017/S1049023X24000670","DOIUrl":"https://doi.org/10.1017/S1049023X24000670","url":null,"abstract":"<p><strong>Introduction: </strong>Disasters pose significant challenges globally, affecting millions of people annually. In Saudi Arabia, floods constitute a prevalent natural disaster, underscoring the necessity for effective disaster preparedness among Emergency Medical Services (EMS) workers. Despite their critical role in disaster response, research on disaster preparedness among EMS workers in Saudi Arabia is limited.</p><p><strong>Study objective/methods: </strong>The study aimed to explore the disaster preparedness among EMS workers in Saudi Arabia. This study applied an explanatory sequential mixed-methods design to explore disaster preparedness among EMS workers in Saudi Arabia, focusing on the qualitative phase. Semi-structured interviews were conducted with 15 EMS workers from National Guard Health Affairs (NGHA) and Ministry of Health (MOH) facilities in Riyadh, Dammam, and Jeddah. Thematic analysis was conducted following Braun and Clarke's six-step process, ensuring data rigor through Schwandt, et al's criteria for trustworthiness.</p><p><strong>Findings: </strong>The demographic characteristics of participants revealed a predominantly young, male workforce with varying levels of experience and educational backgrounds. Thematic analysis identified three key themes: (1) Newly/developed profession, highlighting the challenges faced by young EMS workers in acquiring disaster preparedness; (2) Access to opportunities and workplace resources (government versus military), indicating discrepancies in disaster preparedness support between government and military hospitals; and (3) Workplace policies and procedures, highlighting the need for clearer disaster policies, training opportunities, and role clarity among EMS workers.</p><p><strong>Conclusion: </strong>The study underscores the importance of addressing the unique challenges faced by EMS workers in Saudi Arabia to enhance disaster preparedness. Recommendations include targeted support for young EMS professionals, standardization of disaster training across health care facilities, and improved communication of disaster policies and procedures. These findings have implications for policy and practice in disaster management and EMS training in Saudi Arabia.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training Children for Prehospital Aquatic Interventions: Assessing Throwing Skills Using Traditional and Alternative Materials in a Simulated Water Rescue.","authors":"Lucía Peixoto-Pino, Roberto Barcala-Furelos, Miguel Lorenzo-Martínez, Adrián Gómez-Silva, Javier Rico-Díaz, Antonio Rodríguez-Núñez","doi":"10.1017/S1049023X24000554","DOIUrl":"https://doi.org/10.1017/S1049023X24000554","url":null,"abstract":"<p><strong>Background: </strong>Drowning remains a significant cause of mortality among children world-wide, making prevention strategies crucial. The World Health Organization (WHO) recommends training children in safe rescue techniques, including the use of basic skills such as throwing floating objects. This study aims to address a knowledge gap regarding the throwing capabilities of children aged six to twelve using conventional and alternative water rescue materials.</p><p><strong>Method: </strong>A total of 374 children aged six to twelve years participated in the study, including both males and females. A randomized crossover approach was used to compare throws with conventional rescue material (ring buoy and rescue tube) to an alternative material (polyethylene terephthalate [PET]-bottle). Throwing distance and accuracy were assessed based on age, sex, and the type of rescue tools used.</p><p><strong>Results: </strong>Children of all ages were able to throw the PET-bottle significantly farther than both the ring buoy (P <.001; d = 1.19) and the rescue tube (P <.001; d = 0.60). There were no significant differences (P = .414) in the percentage of children who managed to throw each object accurately.</p><p><strong>Conclusion: </strong>Conventional rescue materials, particularly the ring buoy, may not be well-suited for long-distance throws by children. In contrast, lighter and smaller alternatives, such as PET-bottles, prove to be more adaptable to children's characteristics, enabling them to achieve greater throwing distances. The emphasis on cost-effective and easily accessible alternatives should be implemented in drowning prevention programs or life-saving courses delivered to children.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-6"},"PeriodicalIF":2.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}