American journal of disaster medicine最新文献

{"title":"Disaster preparedness for vulnerable populations during a pandemic: Part 4: Pandemics: Planning for those with access and functional needs in a pandemic.","authors":"Sharon E Mace, Constance J Doyle, Paul D Biddinger, Stuart Bradin, Sara Burdash, Roxanna Lefort, Samantha Noll, Mitchell R Moriber, Angela Cornelius","doi":"10.5055/ajdm.0526","DOIUrl":"https://doi.org/10.5055/ajdm.0526","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.</p><p><strong>Design: </strong>The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and communications, medical care, independence, supervision, and transportation (CMIST). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.</p><p><strong>Results: </strong>Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.</p><p><strong>Conclusions: </strong>Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"21 2","pages":"149-159"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Field's mall shooting: Post-traumatic stress reactions among survivors-Does diagnostic manual make a difference?","authors":"Ask Elklit, Asger Munk Packness, Natasha Hedegaard Dahl","doi":"10.5055/ajdm.0529","DOIUrl":"https://doi.org/10.5055/ajdm.0529","url":null,"abstract":"<p><strong>Background: </strong>Recently, in addition to the increasing number of terrorist attacks and school shootings, mass shootings in public places by psychiatric patients have become more common.</p><p><strong>Objective: </strong>To investigate the psychological sequelae following a mall shooting at Fields in Copenhagen according to two diagnostic manuals.</p><p><strong>Method: </strong>A sample of 85 adults who were present during the shooting were assessed half a year later for post-traumatic stress disorder (PTSD) with two questionnaires based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases, 11th Revision (ICD-11), respectively, together with measures of comorbid disorders, psychological factors, and social support. Hierarchical multiple regression analyses were performed to study the effects of demographics, trauma exposure, and psychological factors on PTSD.</p><p><strong>Results: </strong>The number of participants who met the ICD-11 criteria for PTSD (29.7 percent) was higher than the ones who met the similar/who met the corresponding criteria according to DSM-IV (20.0 percent). The final regression model included gender, injury, sick leave, self-efficacy, and dissociation. It explained 68.1 percent of the variation of PTSD based on ICD-11 and 72.8 percent of the variation based on DSM-IV.</p><p><strong>Conclusion: </strong>The present study expands disaster research with finding close similarities between two diagnostic systems and aligns disaster research on findings of the role of gender, injury, and psychological factors. The results also point to the need for a proactive approach to intervention.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"21 2","pages":"173-187"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparedness for sexual violence at mass gatherings: A scoping review of medical and operational implications for emergency and disaster response systems.","authors":"Piercarla Martinez, Julia Campos, Sheryl Martinez, Dana Mathew","doi":"10.5055/ajdm.0532","DOIUrl":"https://doi.org/10.5055/ajdm.0532","url":null,"abstract":"<p><strong>Introduction: </strong>Mass gatherings create complex operational challenges for emergency and disaster medical systems. While preparedness planning often emphasizes trauma, intoxication, and environmental illness, sexual violence represents an underrecognized but significant medical and operational concern with direct implications on emergency medical services (EMS) operations. These incidents not only threaten individual safety but also strain on-site medical and psychosocial response systems. Findings are discussed in the context of disaster preparedness and prehospital operations.</p><p><strong>Objective: </strong>To synthesize the prevalence, risk factors, reporting patterns, and prevention/response strategies for sexual violence at mass gatherings, and to translate these findings into actionable implications for EMS systems and event medical planning.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews methodology, we searched nine databases (MEDLINE, Embase, Scopus, Web of Science, PsycINFO, EBSCOhost, PubMed, Science Direct, CINAHL) and gray literature for studies addressing sexual violence at events with >1,000 attendees. Two reviewers independently screened records; discrepancies were adjudicated by a third reviewer. Sixteen studies met eligibility criteria. Data were extracted on prevalence, risk factors, reporting behaviors, and prevention or response strategies. Findings were analyzed thematically to identify implications for EMS preparedness and patient care.</p><p><strong>Results: </strong>Sexual violence was consistently underrecognized and underreported at mass gatherings. Six major themes emerged: (1) substance use, (2) environmental vulnerabilities, (3) risk concentration among young women, (4) bystander inaction, (5) normalization of harassment, and (6) limited effectiveness of prevention strategies. Victims often disclosed informally to friends or event staff rather than law enforcement or EMS clinicians. Across studies, opportunities emerged for EMS systems to strengthen preparedness through trauma-informed training, private treatment areas, surveillance integration, and referral pathways to sexual assault response services.</p><p><strong>Conclusion: </strong>EMS clinicians and event medical teams play a critical role in identifying, treating, and referring victims of sexual violence during mass gatherings. Event medical planning should explicitly anticipate sexual violence cases by incorporating trauma-informed training, private and secure treatment areas, and referral pathways to sexual assault response networks. By embedding these practices within incident command and preparedness frameworks, EMS agencies can play a proactive role in protecting vulnerable populations and enhancing survivor outcomes at high-risk events. These changes will strengthen both clinical care and overall safety at mass gatherings.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"21 2","pages":"201-217"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disaster preparedness for vulnerable populations during a pandemic: Part 1: Pandemics: Overview, history, and vulnerability for a pandemic.","authors":"Sharon E Mace, Constance J Doyle, Paul D Biddinger, Stuart Bradin, Sara Burdash, Roxanna Lefort, Samantha Noll, Mitchell R Moriber, Angela Cornelius","doi":"10.5055/ajdm.0531","DOIUrl":"10.5055/ajdm.0531","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of the literature on disaster preparedness regarding surge capacity, with a particular focus on vulnerable populations during a pandemic.</p><p><strong>Design: </strong>The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCNs) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern, disaster, COVID-19, vulnerable population, individuals with access and functional needs, special healthcare needs (SHCN), surge capacity, and CMIST (communications, medical care, independence, supervision, and transportation). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.</p><p><strong>Results: </strong>Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.</p><p><strong>Conclusions: </strong>Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population, but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"21 2","pages":"109-118"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terrorist attacks on American fast-food restaurants: A counterterrorism medicine analysis.","authors":"Tejas S Athni, Derrick Tin, Gregory R Ciottone","doi":"10.5055/ajdm.0534","DOIUrl":"https://doi.org/10.5055/ajdm.0534","url":null,"abstract":"<p><strong>Objective: </strong>Terrorist attacks targeting American fast-food restaurants remain an underexplored threat, given their high volume of civilians, predictable operating hours, and limited security. However, there remains limited data available on the extent and characteristics of these attacks.</p><p><strong>Design: </strong>A retrospective search and descriptive analysis of the Global Terrorism Database was performed, querying attacks targeting American fast-food restaurants between 1970 and 2020. Keywords were used to identify attacks involving the top 15 American fast-food franchises by annual revenue. Attacks were analyzed by geography, modality, weapon type, and perpetrating group.</p><p><strong>Results: </strong>There were 72 reported attacks on American fast-food restaurants, leading to 112 injuries and 26 deaths. McDonalds (45.8 percent) and Kentucky Fried Chicken (26.4 percent) were the most frequently targeted establishments. Most attacks took place in the United States (US) (19.4 percent). A disproportionate share of deaths occurred in the Middle East/North Africa (30.8 percent), while a large proportion of nonfatal injuries occurred in East Asia (27.7 percent). Bombing accounted for the majority of attacks (59.7 percent), deaths (76.9 percent), and injuries (99.1 percent). Vehicle-based explosives were used in only 4.2 percent of attacks but carried an outsized share of deaths (42.3 percent) and injuries (30.4 percent). The Animal Liberation Front (ALF) (11.1 percent) and Tupac Amaru Revolutionary Movement (6.9 percent) were the most commonly identified perpetrators. In the US, animal rights extremist groups such as the ALF and the Earth Liberation Front together accounted for most domestic attacks (50.0 percent).</p><p><strong>Conclusions: </strong>American fast-food restaurants are an uncommon but symbolic target for terrorist attacks, leading to deaths, injuries, and damage worldwide. Future efforts should seek to prioritize corporate investment in protective infrastructure upgrades, integrate real-time threat intelligence systems, conduct routine emergency response drills, and expand public health initiatives such as tourniquet access and \"Stop the Bleed\" training.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"21 2","pages":"161-172"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disaster preparedness for vulnerable populations during a pandemic: Part 3: Surge capacity and communications in a pandemic.","authors":"Sharon E Mace, Constance J Doyle, Paul D Biddinger, Stuart Bradin, Sara Burdash, Roxanna Lefort, Samantha Noll, Mitchell R Moriber, Angela Cornelius","doi":"10.5055/ajdm.0525","DOIUrl":"10.5055/ajdm.0525","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.</p><p><strong>Design: </strong>The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, COVID-19, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and communications, medical care, independence, supervision, and transportation (CMIST). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.</p><p><strong>Results: </strong>Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.</p><p><strong>Conclusions: </strong>Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"21 2","pages":"133-148"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disaster preparedness for vulnerable populations during a pandemic: Part 2: The origins of a pandemic: Emerging infectious diseases, bioterrorism, and laboratory accidents.","authors":"Sharon E Mace, Constance J Doyle, Paul D Biddinger, Stuart Bradin, Sara Burdash, Roxanna Lefort, Samantha Noll, Mitchell R Moriber, Angela Cornelius","doi":"10.5055/ajdm.0527","DOIUrl":"10.5055/ajdm.0527","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.</p><p><strong>Design: </strong>The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, COVID-19, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and CMIST (communications, medical care, independence, supervision, and transportation). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.</p><p><strong>Results: </strong>Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are -possible.</p><p><strong>Conclusions: </strong>Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"21 2","pages":"119-131"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric disaster preparedness and health disparities: Gaps, future goals, and recommendations.","authors":"Chelsea D Hicks, Colton Hasson, Sanaiya Bhatt, Larissa Chiari-Keith, Christopher Newton, Rita V Burke","doi":"10.5055/ajdm.0533","DOIUrl":"https://doi.org/10.5055/ajdm.0533","url":null,"abstract":"<p><strong>Objective: </strong>The healthcare disparity focus group within the Western Regional Alliance for Pediatric Emergency Management aimed to identify barriers to optimal care for children affected by disasters and potential opportunities for improvement.</p><p><strong>Methods: </strong>The study was conducted in six focus groups during the summer of 2023. A survey was distributed to individuals in emergency management and disaster medicine to collect demographic data. The survey also assessed the total number of trainings that participants attended. The focus group discussions were led by experienced qualitative researchers. Participants could also respond to the questions during the meetings on a digital note-taking platform. These discussions were then transcribed and analyzed using ATLAS.ti. The data from the survey were analyzed using SPSS, Windows Version 29.0.</p><p><strong>Results: </strong>The survey included 49 people. The focus group meetings revealed multiple themes and subthemes that reflected the challenges that emergency management and disaster medicine professionals face when combating health disparities and raising awareness for pediatric populations. The challenges that these professionals face include funding, communication, gaps in knowledge, gaps in technology, and a lack of emergency preparedness plans. The focus groups also highlighted facilitators to preparedness, team cohesion, engagement, and the presence of certain grants to help with funding as ways to combat health disparities and raise awareness for pediatric populations during emergencies.</p><p><strong>Conclusion: </strong>The results of the focus groups can effectively be utilized to assess the challenges emergency management and disaster medicine professionals experience. The results highlight the need to prioritize funding, communication, and addressing gaps in knowledge, gaps in technology, and a lack of emergency preparedness plans. The results can be used to explore different approaches to improve health disparities through awareness initiatives as a forefront priority for pediatric populations.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"21 2","pages":"189-199"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Surgical Skills for Exposure in Trauma (ASSET) course improves military surgeon confidence.","authors":"Rebecca A Saberi, Graham B Parker, Noreen Mohsin, Gareth P Gilna, Alessia C Cioci, Eva M Urrechaga, Mark D Buzzelli, Carl I Schulman, Kenneth G Proctor, George D Garcia","doi":"10.5055/ajdm.0469","DOIUrl":"10.5055/ajdm.0469","url":null,"abstract":"<p><strong>Objective: </strong>Active duty military surgeons often have limited trauma surgery experience prior to deployment. Consequently, military-civilian training programs have been developed at high-volume trauma centers to evaluate and maintain proficiencies. Advanced Surgical Skills for Exposure in Trauma (ASSET) was incorporated into the predeployment curriculum at the Army Trauma Training Detachment in 2011. This is the first study to assess whether military surgeons demonstrated improved knowledge and increased confidence after taking ASSET.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Quaternary care hospital.</p><p><strong>Patients and participants: </strong>Attending military surgeons who completed ASSET between July 2011 and October 2020.</p><p><strong>Main outcome measure(s): </strong>Pre- and post-course self-reported comfort level with procedures was converted from a five-point Likert scale to a percentage and compared using paired t-tests.</p><p><strong>Results: </strong>In 188 military surgeons, the median time in practice was 3 (1-8) years, with specialties in general surgery (52 percent), orthopedic surgery (29 percent), trauma (7 percent), and other disciplines (12 percent). The completed self-evaluation response rate was 80 percent (n = 151). The self-reported comfort level for all body regions improved following course completion (p < 0.001): chest (27 percent), neck (23 percent), upper extremity (22 percent), lower extremity (21 percent), and abdomen/pelvis (19 percent). The overall score on the competency test improved after completion of ASSET, with averages increasing from 62 ± 18 percent pretest to 71 ± 13 percent post-test (p < 0.001).</p><p><strong>Conclusions: </strong>After taking the ASSET course, military surgeons demonstrated improved knowledge and increased confidence in the operative skills taught in the course. The ASSET course may provide sustainment of knowledge and confidence if used at regular intervals to maintain trauma skills and deployment readiness.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"19 1","pages":"45-51"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An active shooter in the hospital: A literature survey of simulated training and recommendations for standardized practice and preparedness.","authors":"Adam M Kelmenson, Charles Leithead","doi":"10.5055/ajdm.0492","DOIUrl":"10.5055/ajdm.0492","url":null,"abstract":"<p><strong>Importance: </strong>This article surveys the literature for in-hospital active shooter training models. While most hospital systems utilize computer-based Code Silver training modules, evidence suggests that employees are not adequately prepared for an actual event.</p><p><strong>Objective: </strong>Although several government agencies and case reports advocate for in situ active shooter training, no gold standard simulation training method has yet been implemented across health systems. This literature review seeks to reveal and evaluate the existing training methodologies to progress toward a gold standard active training model.</p><p><strong>Evidence review: </strong>A literature survey across two platforms was conducted with predetermined inclusion and exclusion criteria. The search yielded three articles that conducted and evaluated in situ Code Silver training exercises with analysis of before and after participant performance alongside review of weak points in existing hospital policy.</p><p><strong>Findings: </strong>Across the three identified articles, data from interviews, surveys, and video recordings suggest that participants readiness for an active shooter event increases with simulated training exercises. Furthermore, training exercises allow improvement of hospital policy based on identified weakness.</p><p><strong>Conclusion and relevance: </strong>While the existing body of literature on training for an active shooter event in a healthcare setting is sparse, the data reviewed in this article underscores the importance of real-world training to inform review of current policies. Furthermore, active training models prove superior to computer-based modules for preparation for an in-hospital active shooter event. Development of a gold standard proactive training approach holds the potential to substantially fortify staff readiness and response capabilities across the American healthcare system in anticipation of the growing threat of active shooter incidences.</p>","PeriodicalId":40040,"journal":{"name":"American journal of disaster medicine","volume":"19 4","pages":"299-304"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}