Prehospital and Disaster Medicine最新文献

{"title":"Emergency Medical Team Deployment in Response to Cyclones Judy and Kevin in Vanuatu: Coordination, Challenges, and Outcomes - CORRIGENDUM.","authors":"Jimmy Obed, Sharin Vile, Sandy Moses, Samuel Kemuel, Philippe Guyant","doi":"10.1017/S1049023X25101416","DOIUrl":"https://doi.org/10.1017/S1049023X25101416","url":null,"abstract":"","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293328","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":"Assessing the Predictive Value of mREMS in Patients with Trauma from the Syrian Civil War: A Retrospective Epidemiological Study.","authors":"Kürşat Kaan Kerimoğlu, Mustafa Bolatkale, Ahmet Cagdas Acara","doi":"10.1017/S1049023X25101428","DOIUrl":"https://doi.org/10.1017/S1049023X25101428","url":null,"abstract":"<p><strong>Introduction: </strong>The Syrian Civil War (SCW) began in 2011 and has resulted in numerous cases of war-related civilian injuries. The modified Rapid Emergency Medicine Score (mREMS) is widely used as an effective tool for assessing clinical status and mortality risk, particularly in intensive care units (ICUs) and emergency departments (EDs). However, to date, no study has evaluated the ability of mREMS to predict mortality in patients injured during the SCW.</p><p><strong>Study objective: </strong>The primary objective of this study was to evaluate the performance of mREMS in predicting in-hospital mortality among adult trauma patients injured during the SCW. The secondary objective was to analyze the epidemiological characteristics of both adult and pediatric populations affected by the SCW.</p><p><strong>Methods: </strong>This single-center, retrospective observational study included patients who were injured during the SCW and presented to the ED from January 2012 through January 2016. Data from 4,074 adult patients and 1,379 pediatric patients were analyzed. The diagnostic and prognostic performance of the mREMS was specifically assessed in the adult cohort. Additionally, an epidemiological evaluation of the demographic and clinical characteristics of both cohorts was conducted.</p><p><strong>Results: </strong>Among the 4,074 adult patients included in the study, a total of 3,657 (89.8%) were male and 417 (10.2%) were female. In-hospital mortality occurred in 484 patients (11.9%). Adult patients admitted to the ICU exhibited a mortality rate 7.6-times higher than those who were not admitted (odds ratio [OR] = 7.6; 95% confidence interval [CI], 6.2-9.3). The analysis of the mREMS revealed a median score of eight for survivors and fourteen for non-survivors, demonstrating a statistically significant difference (P < .001).</p><p><strong>Conclusion: </strong>The present study demonstrated that the majority of civilians injured during the SCW were young males. Furthermore, this study's findings indicated that the mREMS exhibits excellent performance in predicting in-hospital mortality among trauma patients injured during the SCW.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239478","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":"Virtual Reality Simulation for Assessment of Hemorrhage Control and SALT Triage Performance: A Comparison of Prehospital to In-Hospital Emergency Responders.","authors":"Nicholas Kman, David Way, Ashish R Panchal, Jeremy Patterson, Jillian McGrath, Douglas Danforth, Ashutosh Mani, Dave Babbitt, Jacob Hyde, Brian Pippin, Ewart de Visser, Jennifer McVay","doi":"10.1017/S1049023X25101349","DOIUrl":"10.1017/S1049023X25101349","url":null,"abstract":"<p><strong>Introduction: </strong>Targeted identification, effective triage, and rapid hemorrhage control are essential for optimal outcomes of mass-casualty incidents (MCIs). An important aspect of Emergency Medical Service (EMS) care is field triage, but this skill is difficult to teach, assess, and research.</p><p><strong>Study objective: </strong>This study assessed triage efficacy and hemorrhage control of emergency responders from different professions who used the Sort, Assess, Life-Saving Treatment (SALT) triage algorithm in a virtual reality (VR) simulation of a terrorist subway bombing.</p><p><strong>Methods: </strong>After a brief just-in-time training session on the SALT triage algorithm, participants applied this learning in First <i>VR</i>esponder, a high-fidelity VR simulator (Tactical Triage Technologies, LLC; Powell, Ohio USA). Participants encountered eleven virtual patients in a virtual scene of a subway station that had experienced an explosion. Patients represented individuals with injuries of varying severity. Metrics assessed included triage accuracy and treatment efficiency, including time to control life-threatening hemorrhage. Independent Mann-Whitney analyses were used to compare two professional groups on key performance variables.</p><p><strong>Results: </strong>The study assessed 282 participants from the ranks of EMS clinicians and medical trainees. Most (94%) participants correctly executed both global SALT sort commands. Participants triaged and treated the entire scene in a mean time of 7.8 decimal minutes, (95%CI, 7.6-8.1; SD = 1.9 decimal minutes) with a patient triage accuracy rate of 75.8% (95%CI, 74.0-77.6; SD = 15.0%). Approximately three-quarters (77%) of participants successfully controlled all life-threatening hemorrhage, within a mean time of 5.3 decimal minutes (95%CI, 5.1-5.5; SD = 1.7 decimal minutes). Mean time to hemorrhage control per patient was 0.349 decimal minutes (SD = 0.349 decimal minutes). Overall, EMS clinicians were more accurate with triage (P ≤ .001) and were faster at triage, total hemorrhage control (P < .01), and hemorrhage control per patient (P < .004) than medical trainees.</p><p><strong>Conclusions: </strong>Through assessments using VR simulation, it was observed that more experienced individuals from the paramedic (PM) workforce out-performed less experienced medical trainees. The study also observed that the medical trainees performed acceptably, even though their only formal training in SALT triage was a 30-minute, just-in-time lecture. Both of these findings are important for establishing evidence that VR can serve as a valid platform for assessing the complex skills of triage and treatment of an MCI, including the assessment of rapid hemorrhage control.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"191-198"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016107","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":"Introducing the Prehospital and Disaster Medicine Special Collection on Evidence-Based Artificial Intelligence in Prehospital and Disaster Medicine.","authors":"Jeffrey Michael Franc","doi":"10.1017/S1049023X25101337","DOIUrl":"10.1017/S1049023X25101337","url":null,"abstract":"<p><p>Recent changes in artificial intelligence (AI) applications have made the technology accessible for practitioners in prehospital and disaster medicine in a way that was nearly unthinkable a few years ago. Initial anecdotal use of this technology has been met with enthusiasm and excitement. However, evidence-based research in the field is often lacking. The PDM Special Collection on Evidence-Based Artificial Intelligence in <i>Prehospital and Disaster Medicine</i> introduces a new forum for dissemination of innovative, high-impact research.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"40 4","pages":"189-190"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041092","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":"How the Understated Role of Rehabilitation Within Emergency Responses Can Be Addressed: A Call to Action from the IFRC Technical Working Group - CORRIGENDUM.","authors":"Jennifer Allen BKin, Marie Gedeon","doi":"10.1017/S1049023X25101271","DOIUrl":"10.1017/S1049023X25101271","url":null,"abstract":"","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"239"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691332","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":"Emergency Care Interventions for Victims of Explosive Ordnance Reduce Mortality: A Modeling Study.","authors":"Hannah B H Wild, Benjamin Q Huynh, Sebastian Kasack, Alex Munyambabazi, Yves Sanou, Yves Nacanabo, Moumini Niaone, Aparna Cheran, Emilie Calvello Hynes, Nicolas Meda, Adam Kushner, Barclay T Stewart","doi":"10.1017/S1049023X25101283","DOIUrl":"10.1017/S1049023X25101283","url":null,"abstract":"<p><strong>Background: </strong>Modern conflicts are characterized by wide-spread use of conventional explosive ordnance (EO), improvised explosive devices (IEDs), and other air-launched explosives. In contrast to advances in military medicine and high-income civilian trauma systems since the United States-led wars in Afghanistan and Iraq, the mortality rate among civilian EO casualties has not decreased in decades. Although humanitarian mine action (HMA) stakeholders have extensive presence and medical capabilities in EO-affected settings, coordination between HMA and health actors has not been leveraged systematically.</p><p><strong>Methods: </strong>Data from a prior systematic review of emergency care interventions feasible within the context of HMA activities and low-resource health care systems were used to model mortality reduction among EO victims. Interventions were categorized using the World Health Organization (WHO) Emergency Care System Framework sites of \"scene,\" \"transport,\" and \"facility.\" The cumulative impact of the interventions on EO-related mortality was estimated using pooled effect estimates and simulation modeling.</p><p><strong>Results: </strong>The meta-analysis included 16 reports from 13 countries, representing 127,505 injured persons. Pooled effect estimates across subcategories of emergency care interventions were 0.42 for layperson transportation (95%CI, 0.24-0.74), 0.79 for prehospital notification systems (95%CI, 0.51-1.19), 0.52 for prehospital trauma care training courses (95%CI, 0.46-0.59), 0.67 for facility-based trauma care training courses (95%CI, 0.48-0.92), and 0.66 for facility-based trauma team organization and activation protocols (95%CI, 0.45-0.97). A 68% reduction in mortality (95%UI, 57%-79%) was observed when implementing the full set of interventions in a region with no prior implemented interventions.</p><p><strong>Conclusion: </strong>Enhanced coordination between HMA and health actors to implement a structured set of emergency care interventions holds potential to significantly reduce preventable death among civilian EO casualties.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"204-213"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883543","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":"Terrorist Attacks Against Health Care Facilities, Health Care Workers, and First Responders: A Scoping Review.","authors":"Mitch Lommen, Dennis G Barten, Kyra Heuvelings, Harald G De Cauwer, Frits van Osch, Derrick Tin, Gregory Ciottone","doi":"10.1017/S1049023X25101313","DOIUrl":"10.1017/S1049023X25101313","url":null,"abstract":"<p><strong>Introduction: </strong>Since 2001, the world has encountered an increase in terrorist attacks on civilian targets, during which conventional as well as unconventional modalities are being used. Terrorist attacks put immediate strains on health care systems, whilst they may also directly threaten the safety of first responders, health care workers, and health care facilities.</p><p><strong>Study objective: </strong>This scoping review aimed to systematically map the existing research on terrorist attacks targeting health care facilities, health care workers, and first responders, and to identify opportunities to improve future research and health care response to terrorist attacks.</p><p><strong>Methods: </strong>A scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. A systematic search for relevant literature was conducted through electronic databases including PubMed, Cochrane, and Embase. Inclusion and exclusion criteria were applied to check eligibility. Extracted data from the articles included the title, first author, year of publication, journal, study design, number of attacks, number of injured, number of fatalities, target type, and weapon modalities. Furthermore, methodological quality assessment was performed.</p><p><strong>Results: </strong>The initial search within three major databases yielded 4,656 articles, including 2,777, 1,843, and 36 articles from PubMed, Embase, and Cochrane Library, respectively. Finally, 11 studies were included, which were all database reviews.</p><p><strong>Conclusions: </strong>This scoping review included 11 studies focusing on terrorist attacks against health care facilities, health care workers, and first responders. Nearly all studies were exclusively based on the Global Terrorism Database (GTD). An increase of attacks on health care-related targets was consistently reported by all studies in this review, but there were significant discrepancies in reported outcomes. In order to improve counter-terrorism preparedness and the future protection of health care workers, counter-terrorism medicine (CTM) research may benefit from a more standardized and transparent approach to document and analyze terrorist attacks, as well as the inclusion of additional databases other than the GTD.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"224-231"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966140","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":"Psychiatric Diagnoses in Prehospital Emergency Care and Sociodemographic Characteristics of the Incident Location at the District Level.","authors":"Valesca Sophie Deutsch, Yacin Keller, Jochen Hardt, Katja Petrowski","doi":"10.1017/S1049023X25101325","DOIUrl":"10.1017/S1049023X25101325","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to analyze the prevalence of psychiatric symptoms in prehospital emergency care and the characteristics of this patient group as well as the association with deprivation in the district, self-assessment of health status, and the frequency of emergency calls due to or accompanied by psychiatric diagnoses.</p><p><strong>Methods: </strong>A retrospective cross-sectional study descriptively and analytically evaluated all ground-based Emergency Medical Service and rescue service incidents dispatched by the Integrated Regional Control Center (IRLS) in the period from January 1, 2021 through December 31, 2021. In addition to the clinical parameters and the demographic data of the patients, the sociodemographic characteristics of the incident location at the district level, unemployment rate, net equivalent household income, and the proportion of single-person households, as well as personal assessment of mental health and overall well-being, were included in the study.</p><p><strong>Results: </strong>A total of 68,345 deployment protocols were examined. Of these, 6.4% were emergency incidents due to or involving psychiatric diagnoses. Emergency physician (EP) involvement in these operations was 56.1%. RM Andersen's Behavioral Model of Health Services Use (1968) was used as a theoretical reference model for the description, analysis, and explanation of the use of health-related care. The analyses showed that interventions due to or involving psychiatric diagnoses without emergency doctor alerts were more frequent in urban districts with a high proportion of single-person households and a high net equivalized houshold income.</p><p><strong>Conclusion: </strong>The accumulation in individual city districts and the factors identified by Andersen point to opportunities to target preventive measures to avoid emergencies involving psychiatric diagnoses in order to use limited resources efficiently.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"214-223"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016097","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":"An Exploration of the Impacts of the 2019 Floods in Townsville, Australia on Community Pharmacy Operations.","authors":"Judith Singleton, Elizabeth McCourt, Kaitlyn Watson, Alexander Letts","doi":"10.1017/S1049023X25101301","DOIUrl":"10.1017/S1049023X25101301","url":null,"abstract":"<p><p>Between January 29 and February 11, 2019, the Townsville region in Australia experienced a major flooding event. This study explored impacts on affected community pharmacies. Semi-structured phone interviews were conducted with six pharmacists who worked in affected Townsville community pharmacies during this flood. De-identified transcript data were analyzed using reflexive thematic analysis. The thematic analysis yielded six themes - \"financial impact on pharmacy owners,\" \"engagement with Local Disaster Coordination Center (LDCC) important,\" \"workload pressures,\" \"preparedness,\" \"medication supply impacts,\" and \"communication and collaboration.\" Financial impacts to owners included loss of property (two pharmacies were completely flooded), purchase or hire costs of generators when power was lost, and loss of revenue from complete or early closure of pharmacies and when patients could not pay or did not have a prescription and did not return to the pharmacy after the event. Engagement with the LDCC assisted pharmacy responsiveness. Medication supply issues were experienced by patients whose houses had flooded, or who had left their prescriptions with pharmacies that had flooded. Opioid Replacement Therapy (ORT) program patients were also impacted due to communication difficulties between them, their clinics, and their pharmacies. Increased customer numbers by those whose regular pharmacy was closed, reduced staff numbers, and austere working conditions increased workload pressures. Pharmacists collaborated to consolidate resources with those whose pharmacy had closed, working in pharmacies that were open. This research highlights a critical need for improved flood preparedness among Townsville pharmacists. Regardless, they collaborated to ensure there were minimal critical medication delays.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"232-238"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966120","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":"Stayin' Alive: Examining Gender-Based Differences in Bystander Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest.","authors":"Abagayle E Bierowski, Julie A Calabrese, Patrice J Baptista, Paul C Comber, Alexander Kuc, Aman Shah, Gerard Carroll","doi":"10.1017/S1049023X25101295","DOIUrl":"10.1017/S1049023X25101295","url":null,"abstract":"<p><strong>Introduction: </strong>Many factors influence the likelihood of bystander cardiopulmonary resuscitation (BCPR) after out-of-hospital cardiac arrest (OHCA), but gender disparities in prehospital care remain under-examined, particularly in relation to the bystander's connection to the patient.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the association between gender and the likelihood of receiving BCPR in OHCA. The primary outcome of the study was to examine differences in BCPR rates among men and women who experienced OHCA. The secondary outcome was to investigate whether bystanders were more likely to provide CPR based on their relationship to the victim, comparing \"true\" layperson CPR to CPR administered by family members or friends and how these rates differed between men and women.</p><p><strong>Methods: </strong>This retrospective prehospital chart review included all encounters from a single urban Emergency Medical Services (EMS) agency with a cardiac arrest prior to EMS arrival from January 1, 2017 through June 30, 2022 (n = 701). For each encounter, the presence or absence of BCPR was recorded, along with the relation of the bystander to the patient. \"True\" BCPR was defined as CPR performed by a layperson unknown to the patient. Patients were excluded if they exhibited signs of obvious death, were physically inaccessible to bystanders, had CPR initiated by trained facility staff or police, had a do not resuscitate (DNR) order present on EMS arrival, received CPR but were not in cardiac arrest, or were younger than 18 years old (n = 174). Odds ratios (OR) with 95% confidence intervals (CI) were used to evaluate data, with statistical significance defined at <i>P</i> < .05.</p><p><strong>Results: </strong>The study examined 701 cardiac arrest encounters: 250 female (35.7%) and 451 male (64.3%). Overall, men (n = 123; 27.3%) were more likely to receive BCPR than women (n = 48; 19.2%); OR = 1.58; 95%CI, 1.08-2.30; P = .02. Among those who received BCPR, women were significantly more likely to have received it from someone they knew (83.3% versus 65.9%; OR = 2.59; 95%CI, 1.11-6.04; P = .03) while men were more likely to receive \"true\" layperson BCPR.</p><p><strong>Conclusions: </strong>This study identifies significant gender disparities in prehospital BCPR and highlights an association between the bystander's relationship to the patient and the likelihood of intervention.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"199-203"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822342","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}