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The Ethical Principles in Ethical Guidance Documents during the COVID-19 Pandemic in the United Kingdom and the Republic of Ireland: A Qualitative Systematic Review 英国和爱尔兰共和国 COVID-19 大流行期间伦理指导文件中的伦理原则:定性系统回顾
IF 2.2 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-05-03 DOI: 10.1017/s1049023x24000396
Kesidha Raajakesary, Lucy Galvin, Kate Prendiville, Sarah Newport, Calum MacAnulty, Ghaiath Hussein
{"title":"The Ethical Principles in Ethical Guidance Documents during the COVID-19 Pandemic in the United Kingdom and the Republic of Ireland: A Qualitative Systematic Review","authors":"Kesidha Raajakesary, Lucy Galvin, Kate Prendiville, Sarah Newport, Calum MacAnulty, Ghaiath Hussein","doi":"10.1017/s1049023x24000396","DOIUrl":"https://doi.org/10.1017/s1049023x24000396","url":null,"abstract":"Background: The sudden onset of the coronavirus disease 2019 (COVID-19) pandemic was accompanied by a myriad of ethical issues that prompted the issuing of various ethical guidance documents for health care professionals in clinical, research, and public health settings throughout the United Kingdom (UK) of Great Britain and Northern Ireland and the Republic of Ireland. The aim of this review was to identify the main principles in ethical guidance documents published in the UK and Ireland during the COVID-19 pandemic. Methods: This review used a qualitative systematic review methodology with thematic synthesis to analyze the included ethics-related guidance documents, as defined in this review, published in the UK and Ireland from March 2020 through March 2022. The search included a general search in Google Scholar and a targeted search on the websites of the relevant professional bodies and public health authorities in the two countries. The ethical principles in these documents were analyzed using the constant comparative method (CCM). Results: Forty-four guidance documents met the inclusion and exclusion criteria. Ten main ethical principles were identified, namely: fairness, honesty, minimizing harm, proportionality, responsibility, autonomy, respect, informed decision making, duty of care, and reciprocity. Conclusion: The guidelines did not present the ethical principles in equal detail. Some principles lacked definitions, leaving them vulnerable to misinterpretation by the documents’ end users. Priority was frequently given to collectivist ethics over individualistic approaches. Further clarity is required in future ethical guidance documents to better guide health care professionals in similar situations.","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"89 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834003","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}
引用次数: 0
The Impact of Alcohol-Related Presentations to Emergency Departments on Days with a Public Holiday or Sporting Event: A Retrospective Cohort Study 公共节假日或体育赛事当天急诊科接诊酒精相关病例的影响:回顾性队列研究
IF 2.2 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-05-02 DOI: 10.1017/s1049023x24000232
Stephanie Rae Hagan, Julia Crilly, Jamie Ranse
{"title":"The Impact of Alcohol-Related Presentations to Emergency Departments on Days with a Public Holiday or Sporting Event: A Retrospective Cohort Study","authors":"Stephanie Rae Hagan, Julia Crilly, Jamie Ranse","doi":"10.1017/s1049023x24000232","DOIUrl":"https://doi.org/10.1017/s1049023x24000232","url":null,"abstract":"Introduction: The consumption of alcohol within the Australian community continues to rise, impacting care delivery in already over-burdened emergency departments (EDs). Study Objective: This study aimed to examine the impact of alcohol-related presentations (ARPs) to EDs on days with a public holiday or sporting event. Methods: A retrospective cohort study was undertaken using routinely collected health data pertaining to patient presentations diagnosed with an alcohol-related disorder (ICD-10-AM code F10) to two EDs in Queensland, Australia from January 1, 2016 – December 31, 2020. Descriptive and inferential statistics were used to describe and compare ARPs on event days versus non-event days and uncomplicated versus other ARPs on event days only. Results: Of all 5,792 ARPs, nine percent (n = 529) occurred on public holidays or sporting event days. When compared by day type, type of presentation, mode of arrival, and day of week differed between event and non-event days. On event days, uncomplicated ARPs differed to other ARPs, with uncomplicated ARPs being younger, having shorter median length-of-stay (LOS), and less likely to be admitted to hospital. Conclusions: In this multi-site study, public holidays and sporting events had a noteworthy impact on ARPs to EDs. Focused refinement on the clinical management of uncomplicated ARPs is warranted to inform future resource allocation, including on event days.","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"28 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834005","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}
引用次数: 0
Brain Injury Associated Shock: An Under-Recognized and Challenging Prehospital Phenomenon 脑损伤相关休克:一种认识不足且极具挑战性的院前现象
IF 2.2 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-04-29 DOI: 10.1017/s1049023x24000359
Christopher Partyka, Alexander Alexiou, John Williams, Jimmy Bliss, Matthew Miller, Ian Ferguson
{"title":"Brain Injury Associated Shock: An Under-Recognized and Challenging Prehospital Phenomenon","authors":"Christopher Partyka, Alexander Alexiou, John Williams, Jimmy Bliss, Matthew Miller, Ian Ferguson","doi":"10.1017/s1049023x24000359","DOIUrl":"https://doi.org/10.1017/s1049023x24000359","url":null,"abstract":"<span>Objective:</span><p>Hemodynamic collapse in multi-trauma patients with severe traumatic brain injury (TBI) poses both a diagnostic and therapeutic challenge for prehospital clinicians. Brain injury associated shock (BIAS), likely resulting from catecholamine storm, can cause both ventricular dysfunction and vasoplegia but may present clinically in a manner similar to hemorrhagic shock. Despite different treatment strategies, few studies exist describing this phenomenon in the early post-injury phase. This retrospective observational study aimed to describe the frequency of shock in isolated TBI in prehospital trauma patients and to compare their clinical characteristics to those patients with hemorrhagic shock and TBI without shock.</p><span>Methods:</span><p>All prehospital trauma patients intubated by prehospital medical teams from New South Wales Ambulance Aeromedical Operations (NSWA-AO) with an initial Glasgow Coma Scale (GCS) of 12 or less were investigated. Shock was defined as a pre-intubation systolic blood pressure under 90mmHg and the administration of blood products or vasopressors. Injuries were classified from in-hospital computed tomography (CT) reports. From this, three study groups were derived: BIAS, hemorrhagic shock, and isolated TBI without shock. Descriptive statistics were then produced for clinical and treatment variables.</p><span>Results:</span><p>Of 1,292 intubated patients, 423 had an initial GCS of 12 or less, 24 patients (5.7% of the original cohort) had shock with an isolated TBI, and 39 patients had hemorrhagic shock. The hemodynamic parameters were similar amongst these groups, including values of tachycardia, hypotension, and elevated shock index. Prehospital clinical interventions including blood transfusion and total fluids administered were also similar, suggesting they were indistinguishable to prehospital clinicians.</p><span>Conclusions:</span><p>Hemodynamic compromise in the setting of isolated severe TBI is a rare clinical entity. Current prehospital physiological data available to clinicians do not allow for easy delineation between these patients from those with hemorrhagic shock.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"2016 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140809255","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}
引用次数: 0
After the Türkiye Earthquake: The Experience of a Pediatric Emergency Department in a University Hospital Distant from the Disaster Area 图尔基耶地震后:远离灾区的大学医院儿科急诊室的经验
IF 2.2 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-04-29 DOI: 10.1017/s1049023x24000347
Burcu Akbaba, Hande Yiğit, Emre Güngör, Mustafa O. Kaynak, Hafize H. Kahya, Ahmet Z. Birbilen, Selman Kesici, Ali Düzova, Benan Bayrakçı, Özlem Tekşam
{"title":"After the Türkiye Earthquake: The Experience of a Pediatric Emergency Department in a University Hospital Distant from the Disaster Area","authors":"Burcu Akbaba, Hande Yiğit, Emre Güngör, Mustafa O. Kaynak, Hafize H. Kahya, Ahmet Z. Birbilen, Selman Kesici, Ali Düzova, Benan Bayrakçı, Özlem Tekşam","doi":"10.1017/s1049023x24000347","DOIUrl":"https://doi.org/10.1017/s1049023x24000347","url":null,"abstract":"<span>Introduction:</span><p>Earthquakes rank among the most deadly natural disasters, and children are particularly affected due to their inherent vulnerability. Following an earthquake, there is a substantial increase in visits to emergency services. These visits stem not only from patients seeking care for physical traumas resulting from the earthquake and its subsequent complications, but also from individuals affected by the circumstances created by the disaster.</p><span>Study Objective:</span><p>This study aims to determine the characteristics and outcomes of children who presented to the pediatric emergency department (PED) after the earthquake and to evaluate children who had crush injuries at a referral tertiary university hospital away from the earthquake area.</p><span>Methods:</span><p>The medical records of children who presented to the PED from the earthquake area from February 6 through March 7, 2023 were retrospectively reviewed. Children rescued from under rubble were categorized as Group 1, those affected by earthquake conditions as Group 2, and patients seeking medical attention due to the follow-up of chronic illnesses were considered as Group 3. Patient data, including sociodemographic characteristics, time period under rubble (TPR), laboratory findings, and details of medical and surgical procedures, developing acute kidney injury (AKI), and the requirement for hemodialysis were recorded.</p><span>Results:</span><p>A total of 252 children were enrolled in the study, with 52 (20.6%) in Group 1, 180 (71.4%) in Group 2, and 16 (6.0%) in Group 3. The median age was six (IQR = 1.7-12.1) years. In the first group (n = 52), 46 (85.2%) children experienced crush injuries, 25 children (46.3%) developed crush syndrome, and 14 of them (14/25; 56.0%) required dialysis. In the second group, the most common diagnoses were upper respiratory tract infections (n = 69; 37.9%), acute gastroenteritis (n = 23; 12.6%), simple physical trauma (n = 16; 8.8%), and lower respiratory tract infections (n = 13; 7.1%). For children in the third group, pediatric neurology (n = 5; 33.3%), pediatric oncology (n = 4; 25.0%), and pediatric nephrology (n = 3; 18.8%) were the most frequently referred specialties.</p><span>Conclusion:</span><p>Crush injuries, crush syndrome, and AKI were the most common problems in the early days following the earthquake. Along with these patients, children who were affected by the environmental conditions caused by the earthquake, as well as children with chronic illnesses, also accounted for a significant portion of visits to the PED, even if they were distant from the disaster area.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"18 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140809268","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}
引用次数: 0
Purposeful Sampling: Advantages and Pitfalls 有目的的取样:优势与陷阱
IF 2.2 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-04-22 DOI: 10.1017/s1049023x24000281
Samuel J. Stratton
{"title":"Purposeful Sampling: Advantages and Pitfalls","authors":"Samuel J. Stratton","doi":"10.1017/s1049023x24000281","DOIUrl":"https://doi.org/10.1017/s1049023x24000281","url":null,"abstract":"This editorial monograph explores the advances and pitfalls of the common forms of purposeful sampling. Purposeful sampling is a common research design in qualitative research.","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"2 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635002","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}
引用次数: 0
Quantitative Metrics in Mass-Gathering Studies: A Comprehensive Systematic Review 大规模采集研究中的量化指标:全面系统回顾
IF 2.2 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-04-05 DOI: 10.1017/s1049023x2400027x
Cüneyt Çalışkan, Ahmet Doğan Kuday, Tuğba Özcan, Nihal Dağ, Kerem Kınık
{"title":"Quantitative Metrics in Mass-Gathering Studies: A Comprehensive Systematic Review","authors":"Cüneyt Çalışkan, Ahmet Doğan Kuday, Tuğba Özcan, Nihal Dağ, Kerem Kınık","doi":"10.1017/s1049023x2400027x","DOIUrl":"https://doi.org/10.1017/s1049023x2400027x","url":null,"abstract":"Introduction: Mass gatherings are events where many people come together at a specific location for a specific purpose, such as concerts, sports events, or religious gatherings, within a certain period of time. In mass-gathering studies, many rates and ratios are used to assess the demand for medical resources. Understanding such metrics is crucial for effective planning and intervention efforts. Therefore, this systematic review aims to investigate the usage of rates and ratios reported in mass-gathering studies. Methods: In this systematic review, the PRISMA guidelines were followed. Articles published through December 2023 were searched on Web of Science, Scopus, Cochrane, and PubMed using the specified keywords. Subsequently, articles were screened based on titles, abstracts, and full texts to determine their eligibility for inclusion in the study. Finally, the articles that were related to the study’s aim were evaluated. Results: Out of 745 articles screened, 55 were deemed relevant for inclusion in the study. These included 45 original research articles, three special reports, three case presentations, two brief reports, one short paper, and one field report. A total of 15 metrics were identified, which were subsequently classified into three categories: assessment of population density, assessment of in-event health services, and assessment of out-of-event health services. Conclusion: The findings of this study revealed notable inconsistencies in the reporting of rates and ratios in mass-gathering studies. To address these inconsistencies and to standardize the information reported in mass-gathering studies, a Metrics and Essential Ratios for Gathering Events (MERGE) table was proposed. Future research should promote consistency in terminology and adopt standardized methods for presenting rates and ratios. This would not only enhance comparability but would also contribute to a more nuanced understanding of the dynamics associated with mass gatherings.","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"1 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140577239","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}
引用次数: 0
Bleeding Control Protections Within US Good Samaritan Laws 美国好撒玛利亚人法中的出血控制保护措施
IF 2.2 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-04-04 DOI: 10.1017/s1049023x24000268
Matthew J. Levy, Christopher M. Wend, William P. Flemming, Antoin Lazieh, Andrew J. Rosenblum, Candace M. Pineda, Douglas M. Wolfberg, Jennifer Lee Jenkins, Craig A. Goolsby, Asa M. Margolis
{"title":"Bleeding Control Protections Within US Good Samaritan Laws","authors":"Matthew J. Levy, Christopher M. Wend, William P. Flemming, Antoin Lazieh, Andrew J. Rosenblum, Candace M. Pineda, Douglas M. Wolfberg, Jennifer Lee Jenkins, Craig A. Goolsby, Asa M. Margolis","doi":"10.1017/s1049023x24000268","DOIUrl":"https://doi.org/10.1017/s1049023x24000268","url":null,"abstract":"Introduction: In the United States, all 50 states and the District of Columbia have Good Samaritan Laws (GSLs). Designed to encourage bystanders to aid at the scene of an emergency, GSLs generally limit the risk of civil tort liability if the care is rendered in good faith. Nation-wide, a leading cause of preventable death is uncontrolled external hemorrhage. Public bleeding control initiatives aim to train the public to recognize life-threatening external bleeding, perform life-sustaining interventions (including direct pressure, tourniquet application, and wound packing), and to promote access to bleeding control equipment to ensure a rapid response from bystanders. Methods: This study sought to identify the GSLs in each state and the District of Columbia to identify what type of responder is covered by the law (eg, all laypersons, only trained individuals, or only licensed health care providers) and if bleeding control is explicitly included or excluded in their Good Samaritan coverage. Results: Good Samaritan Laws providing civil liability qualified immunity were identified in all 50 states and the District of Columbia. One state, Oklahoma, specifically includes bleeding control in its GSLs. Six states – Connecticut, Illinois, Kansas, Kentucky, Michigan, and Missouri – have laws that define those covered under Good Samaritan immunity, generally limiting protection to individuals trained in a standard first aid or resuscitation course or health care clinicians. No state explicitly excludes bleeding control from their GSLs, and one state expressly includes it. Conclusion: Nation-wide across the United States, most states have broad bystander coverage within GSLs for emergency medical conditions of all types, including bleeding emergencies, and no state explicitly excludes bleeding control interventions. Some states restrict coverage to those health care personnel or bystanders who have completed a specific training program. Opportunity exists for additional research into those states whose GSLs may not be inclusive of bleeding control interventions.","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"18 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140577241","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}
引用次数: 0
Dhikr and Qur'an Recitation Therapy: An Idea to Recover the Mental Health of Families of the Death Victims of Mount Marapi Eruption in West Sumatra, Indonesia. 诵经和古兰经疗法:印尼西苏门答腊马拉皮火山爆发遇难者家属恢复心理健康的想法。
IF 2.1 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-15 DOI: 10.1017/S1049023X24000220
Rizky Andana Pohan, Marimbun Marimbun, Wan Chalidaziah, Erfan Ramadhani, Ramtia Darma Putri, Palasara Brahmani Laras
{"title":"Dhikr and Qur'an Recitation Therapy: An Idea to Recover the Mental Health of Families of the Death Victims of Mount Marapi Eruption in West Sumatra, Indonesia.","authors":"Rizky Andana Pohan, Marimbun Marimbun, Wan Chalidaziah, Erfan Ramadhani, Ramtia Darma Putri, Palasara Brahmani Laras","doi":"10.1017/S1049023X24000220","DOIUrl":"10.1017/S1049023X24000220","url":null,"abstract":"<p><strong>Background: </strong>Volcanic eruption is one of the most common disasters in Indonesia. One of the most fatal volcanic eruptions in Indonesia in 2023 was the eruption of Mount Marapi in West Sumatra. This caused a psychological impact on the survivors and families of the victims who died.</p><p><strong>Problem: </strong>Psychological interventions are usually only provided to survivors. It is very rare to find psychosocial assistance provided to the families of victims who died, even though they also experience acute and prolonged mental health disorders, such as trauma and even depression. So, we offer the idea of remembrance therapy and reading the Qur'an to restore the mental health of the families of the deceased victims.</p><p><strong>Conclusion: </strong>Dhikr and Qur'an recitation therapy fosters sincerity, patience, and self-acceptance so as to restore mental health in the families of the victims of the Mount Marapi eruption. The therapy serves as a calming factor for the soul because it contains various wisdoms for the calamities experienced. The whole series of therapy is closed with prayer as a form of surrendering the soul to God.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"230-231"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132390","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}
引用次数: 0
Components of an Updated Disaster Medicine Curriculum Included in Emergency Medicine Residency and Emergency Medical Services Fellowship in the United States. 美国急诊医学住院医生和急诊医疗服务研究员课程中包含的最新灾难医学课程的组成部分。
IF 2.1 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-11 DOI: 10.1017/S1049023X24000165
Sara P Sandifer, Bryan J Wexler, Avram Flamm
{"title":"Components of an Updated Disaster Medicine Curriculum Included in Emergency Medicine Residency and Emergency Medical Services Fellowship in the United States.","authors":"Sara P Sandifer, Bryan J Wexler, Avram Flamm","doi":"10.1017/S1049023X24000165","DOIUrl":"10.1017/S1049023X24000165","url":null,"abstract":"<p><strong>Introduction: </strong>Disaster medicine (DM) is a unique field that has undergone significant development as disaster events become increasingly complicated to respond to. However, DM is not recognized by the American Board of Medical Specialties (ABMS) or Accreditation Committee of Graduate Medical Education (ACGME), and therefore lacks board certification. Furthermore, prior studies have shown that there is unique body of DM knowledge not being addressed in emergency medicine (EM) residency or Emergency Medical Services (EMS) fellowship, resulting in fundamental DM topics not being covered amongst graduate medical education (GME) programs most prepared to produce DM physicians. A recently published DM core curriculum addresses this knowledge gap and seeks to promote standardization of DM training.</p><p><strong>Study objective: </strong>The objective of this study is to analyze EM residency and EMS fellowship curricula for the inclusion of DM major curriculum topics and subtopics, using the most recently published DM core curriculum as a control.</p><p><strong>Methods: </strong>Both EM residency and EMS fellowship curricula were analyzed for inclusion of DM curriculum topics and subtopics, using the DM curriculum recommendations published by Wexler, et al as a control. A major curriculum topic was deemed covered if at least one related subtopic was described in the curricula. The included and excluded DM topics and subtopics were analyzed using descriptive statistics.</p><p><strong>Results: </strong>While all the DM major curriculum topics were covered by either EM residency or EMS fellowship, EMS fellowship covered more major curriculum topics (14/15; 93%) than EM residency (12/15; 80%) and EMS fellowship covered more DM curriculum subtopics (58/153; 38%) than EM residency (24/153; 16%). Combined, EM residency and EMS fellowship covered 65 out of 153 (42%) of the DM curriculum subtopics.</p><p><strong>Conclusion: </strong>Although this study finds that all the DM major curriculum topics will be covered in EM residency followed by EMS fellowship, over one-half of the subtopics are not covered by either program (16% and 38%, respectively) or both programs combined (42%). Increasingly relevant subtopics, such as climate change, droughts, and flooding, are amongst those not covered by either curriculum. Even amongst the DM topics included in GME curricula, an emphasis on themes such as mass treatment, preparedness, and mitigation is likely under-represented. Accreditation from ACGME for DM fellowship would further promote uniform implementation of the updated core curriculum and ensure optimal training of disaster-ready physicians.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"218-223"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094537","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}
引用次数: 0
Glastonbury Festival: Medical Care at the World's Largest Greenfield Music Festival. 格拉斯顿伯里音乐节:世界最大绿地音乐节上的医疗服务。
IF 2.1 4区 医学
Prehospital and Disaster Medicine Pub Date : 2024-04-01 Epub Date: 2024-04-02 DOI: 10.1017/S1049023X24000256
Jack F Bennett, David J Cottrell
{"title":"Glastonbury Festival: Medical Care at the World's Largest Greenfield Music Festival.","authors":"Jack F Bennett, David J Cottrell","doi":"10.1017/S1049023X24000256","DOIUrl":"10.1017/S1049023X24000256","url":null,"abstract":"<p><strong>Introduction: </strong>Music festivals have become an increasingly popular form of mass-gathering event, drawing an increasing number of attendees across the world each year. While festivals exist to provide guests with an enjoyable experience, there have been instances of serious illness, injury, and in some cases death. Large crowds, prolonged exposure to loud music, and high rates of drug and alcohol consumption can pose a dangerous environment for guests as well as those looking after them.</p><p><strong>Methods: </strong>A retrospective review of electronic patient records (EPRs) at the 2022 Glastonbury Festival was undertaken. All patients who attended medical services on-site during the festival and immediately after were included. Patient demographics, diagnosis, treatment received, and discharge destination were obtained and analyzed.</p><p><strong>Results: </strong>A total of 2,828 patients received on-site medical care. The patient presentation rate (PPR) was 13.47 and the transport-to-hospital rate (TTHR) was 0.30 per 1,000 guests. The most common diagnoses were joint injuries, gastrointestinal conditions, and blisters. Only 164 patients (5.48%) were diagnosed as being intoxicated. Overall, 552 patients (19.52%) were prescribed a medication to take away and 268 (9.48%) had a dressing for a minor wound. One patient (0.04%) underwent a general anesthetic and no patients required cardiopulmonary resuscitation. Most patients were discharged back to the festival site (2,563; 90.66%).</p><p><strong>Discussion: </strong>Minor conditions were responsible for many presentations and most patients only required mild or non-invasive interventions, after which they could be safely discharged back to the festival. Older adults were diagnosed with a different frequency of conditions compared to the overall study population, something not reported previously. Intoxicated patients only accounted for a very small amount of the medical workload.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"170-177"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11035920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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