https://wmpllc.org/ojs/index.php/ajdm/issue/feedAmerican Journal of Disaster Medicine2023-11-20T18:04:12-05:00Richard A. DeVito, Jr.ajdm@pnpco.comOpen Journal Systems<p><em><strong>American Journal of Disaster Medicine</strong> </em>deals with all aspects of mass casualty medicine and its public health implications.</p><p>With the publication of the <em><strong>American Journal of Disaster Medicine</strong></em>, for the first time, comes real guidance in this important medical specialty, from the foremost experts in mass casualty medicine; including a deadly cocktail of catastrophic events like blast wounds and post explosion injuries, biological weapons contamination and mass physical and psychological trauma that comes in the wake of natural and man-made disasters as well as disease outbreak.</p><p>The journal has one goal: to provide physicians and medical professionals the latest research and essential informational tools they need as they seek to manage the complexities of emergency medical and trauma skills with crisis management in a mass casualty environment.</p><p>Peer reviewed and designed to meet the formidable medical challenges in a post 9/11, post Katrina world, the <strong><em>American Journal of Disaster Medicine</em></strong> addresses all aspects of this important discipline and does so under the watchful eye of a internationally recognized editorial review board led by <strong>Editor-in-Chief Susan M.Briggs, MD, MPH</strong>, Director, International Trauma and Disaster Institute, Massachusetts General Hospital, Boston, MA and Associate Professor of Surgery, Harvard Medical School. Under the guidance of Dr. Briggs, who is also the Supervising Medical Officer, International Medical Surgical Response Teams, National Disaster Medical System, the journal will be interdisciplinary and have a national and international focus in view of the global threats of today's complex disasters.</p><p>Each issue of the <strong><em>American Journal of Disaster Medicine</em></strong> will offer physicians and medical professionals, an academic forum on topics as wide ranging as these:</p><ul><li>Medical preparation for mass gathering events</li><li>Triage in disaster medicine both extra hospital and in hospital</li><li>Toxicological disaster</li><li>Ethics in disaster medicine</li><li>Confined space and medical training</li><li>Military triage translating to civilian disasters</li><li>Medical response to collapsed structures</li><li>Traumatic amputations</li><li>Open brain injuries</li><li>Effectively treating large numbers of injured people</li><li>Evaluating patients for exposure to various chemical, biological and radioactive agents</li><li>indexed in PubMed/Medline</li><li>peer-reviewed</li><li>disaster and emergency medicine</li><li>interdisciplinary</li><li>natural disasters</li><li>disease outbreak</li><li>biological weapons contamination</li><li>psychological trauma</li><li>pandemic flu</li><li>military triage</li></ul><p><em><strong>Subscribe Today!</strong></em></p>https://wmpllc.org/ojs/index.php/ajdm/article/view/3524Victim profiles and revealed issues of type 1 Emergency Medical Team in the first minutes of a mega earthquake in Turkey2023-11-08T13:35:05-05:00Takamitsu Sakamotoajdm@pnpco.comHiroyuki Suzukiajdm@pnpco.comTakashi Machidaajdm@pnpco.comHirokazu Nishimuraajdm@pnpco.comYukihiro Noguchiajdm@pnpco.comTeruyoshi Amagaiajdm@pnpco.com<p><strong><em>Background: </em></strong><em>On February 6, 2023, a series of mega-earthquakes (MEs) struck the southern parts of Turkey and northern Syria. In the first 16 days after the Turkey MEs (TMEs), the Tokushukai Medical Assistant Team (TMAT) backed by its infrastructure visited Turkey to support a local hospital. With the goal of helping local communities and working with local supporters and authorities, Turkey is on a mission to positively impact people’s lives.</em></p> <p><strong><em>Methods: </em></strong><em>Data collected covered the TMAT support period in February 2023. All patients admitted to a hospital were registered through the Minimum Data Set (MDS) of the Emergency Medical Team (EMT) Coordination Cell (EMTCC).</em></p> <p><strong><em>Results: </em></strong><em>A total of 561 patients were hospitalized during the 16-day mission. A review of the MDS data showed a decrease in the number of inpatients. The number of diseases directly related to the disaster was confirmed to be due to a gradual decrease in TME aftershock. However, the number of patients with nondisaster-related disease remained stable.</em></p> <p><strong><em>Conclusion: </em></strong><em>The experience of EMT in the initial relief of MEs that struck Turkey and Syria on February 6, 2023 showed that a mobile type 1 EMT in the early stage while rebuilding the infrastructure is essential. From the analysis of patient profiles, it is clear that knowledge and experience of skin diseases is needed in the first minutes of MEs. In addition, it has become clear that to ensure the quality of MDS for further analysis and to improve the efficiency and effectiveness of EMS, it is essential to have recorders in the EMS. These MDS recorders, called descriptors, must be isolated from the treating medical staff to eliminate subjectivity and ensure data accuracy.</em></p>2023-11-20T00:00:00-05:00Copyright (c) 2023 American Journal of Disaster Medicinehttps://wmpllc.org/ojs/index.php/ajdm/article/view/3525Characteristics of the patients consulted with emergency medicine physicians at a large-scale COVID-19 vaccination center: Prospective observational study2023-11-08T13:42:44-05:00Soichiro Senoajdm@pnpco.comTakashi Nagataajdm@pnpco.comKazuo Imaiajdm@pnpco.comTakeshi Abeajdm@pnpco.comShintaro Yamadaajdm@pnpco.comHitomi Tsunashimaajdm@pnpco.comSeigo Yamadaajdm@pnpco.comAkihito Hagiharaajdm@pnpco.comDaizoh Saitoh ajdm@pnpco.comTakashi Nishiyamaajdm@pnpco.com<p><strong><em>Objective: </em></strong><em>We aimed to clarify the characteristics of patients consulted by the medical staff with emergency medicine (EM) physicians after vaccination and EM physicians transferred to an outside hospital.</em></p> <p><strong><em>Design: </em></strong><em>The Japanese Self-Defense Force established a large-scale coronavirus disease 2019 (COVID-19) vaccination center. Overall, 1,306,928 citizens received the Moderna vaccine, which targeted the first and second vaccinations between May 24, 2021 and November 30, 2021. EM physicians were always available in the emergency room (ER). The medical staff could consult the patients with EM physicians; however, the criteria were ambiguous. We conducted signal detection analysis on the patients who experienced adverse events to detect characteristics.</em></p> <p><strong><em>Results: </em></strong><em>Of the 3,312 patients experienced adverse events after vaccination, the medical staff consulted 344 with EM physicians. The patients whose respiratory rate and systolic blood pressure (BP) were more than 18 per minute and 162 mmHg, respectively, were considerably consulted. In addition, the patients whose systolic BP was more than 186.5 mmHg were transferred to an outside hospital. No patients were seriously ill or died after being transferred to an outside hospital.</em></p> <p><strong><em>Conclusions: </em></strong><em>The medical staff consulted the patients with a high respiratory rate or BP with EM physicians. In addition to BP, the respiratory rate would also be necessary as a finding that suggests a patient’s severity after vaccination. Therefore, it appears safer that EM physicians are always available to ensure the recipients’ safety when running a new large-scale vaccination center against unknown diseases, such as COVID-19.</em></p>2023-11-20T00:00:00-05:00Copyright (c) 2023 American Journal of Disaster Medicinehttps://wmpllc.org/ojs/index.php/ajdm/article/view/3526Terrorist attacks against women’s healthcare facilities 1970-20182023-11-08T13:51:14-05:00Christina Sajakajdm@pnpco.comGregory Jasaniajdm@pnpco.comReem Alfalasiajdm@pnpco.comGarrett Cavaliereajdm@pnpco.comBenjamin Lawnerajdm@pnpco.com<p><strong><em>Introduction: </em></strong><em>Targeted acts of violence against women’s healthcare facilities and healthcare providers are a continued threat to the safety and well-being of those seeking reproductive care as well as those who provide it around the world.</em></p> <p><strong><em>Study objectives: </em></strong><em>This study aims to review and analyze terrorist attacks against facilities and providers who offer women’s healthcare services globally.</em></p> <p><strong><em>Methods: </em></strong><em>A thorough analysis of data coming from the Global Terrorism Database (GTD) was performed. This database is run by the National Consortium for the Study of Terrorism and Responses to Terrorism.</em></p> <p><strong><em>Results: </em></strong><em>Two hundred and seventy-one incidents registered in the GTD between 1970 and 2018 were found to be terrorist attacks on women’s healthcare facilities, the majority of which occurred in the United States. The method of attack or weapons used varied greatly. While the majority of these attacks targeted facilities, a number of attacks focused on individuals, namely, healthcare providers.</em></p> <p><strong><em>Conclusion: </em></strong><em>Facilities and providers associated with women’s healthcare services, particularly reproductive health, remain at risk of terror attack. Although carried out by a variety of groups and with diverse methods, these attacks appear most prevalent, or most reported, in Western society and threaten essential reproductive healthcare.</em></p>2023-11-20T00:00:00-05:00Copyright (c) 2023 American Journal of Disaster Medicinehttps://wmpllc.org/ojs/index.php/ajdm/article/view/3527Assessment of active shooter preparedness in US hospital systems2023-11-08T13:56:09-05:00Dylan Kahlerajdm@pnpco.comSusan Chishimbaajdm@pnpco.comJodi L. Eisenbergajdm@pnpco.comAmy J. Goldbergajdm@pnpco.comTony Reedajdm@pnpco.com<p><strong><em>Background: </em></strong><em>Active shooter events are horrific, unfortunate realities in American hospitals. Protecting patients and staff in an active shooter event is made more difficult in the cases of critically ill and otherwise immobile patients. Previous work has proposed theoretical mitigation strategies for active shooter events. This study assesses American hospitals’ current, active preparedness plans.</em></p> <p><strong><em>Methods: </em></strong><em>This is a survey-based study with questionnaires distributed to leaders in American healthcare. The survey assessed current active shooter protocols with a particular emphasis on managing critically ill patients. Data were summarized with frequency and percentage.</em></p> <p><strong><em>Results: </em></strong><em>The survey was distributed to 294 hospital systems across the United States, and representatives from 60 hospital systems responded. Ninety-eight percent of these hospital systems have an active shooter protocol; 24 percent report a plan to provide care for critically ill patients. Among those hospital systems with a plan for caring for immobile patients, substantial heterogeneity exists in the philosophy and implementation of these protocols. Additionally, 52 percent of hospital systems routinely practice response drills to active shooter events. Notably, hospital systems that had experienced an active shooter event in the past were more likely to practice implementing active shooter protocols.</em></p> <p><strong><em>Conclusions: </em></strong><em>While most hospital systems have an active shooter protocol in place, these plans are infrequently practiced and generally do not include contingency arrangements for the sickest, immobile patients. The results from this study highlight a significant opportunity for improvement in American hospital safety procedures.</em></p>2023-11-20T00:00:00-05:00Copyright (c) 2023 American Journal of Disaster Medicinehttps://wmpllc.org/ojs/index.php/ajdm/article/view/3528Challenges in handling a civilian mass pediatric disaster during flood relief in a partially inundated armed forces medical facility2023-11-08T14:04:44-05:00Saroj Kumar Patnaikajdm@pnpco.comN. S. Lambaajdm@pnpco.comAradhana Anejaajdm@pnpco.comAshish Kumar Guptaajdm@pnpco.com<p><strong><em>Background: </em></strong><em>Armed forces hospitals are often called upon to provide medical aid to civilians during natural calamities. Though children are often the most vulnerable segment of population in these events, research that addresses their unique needs and the role of armed forces hospitals remains sparse.</em></p> <p><strong><em>Objectives: </em></strong><em>We examined pediatric morbidity and mortality at a flooded armed forces hospital. Factors that affected outcomes were identified.</em></p> <p><strong><em>Methods: </em></strong><em>158 patients were evacuated en masse from a children’s hospital in northern India that was submerged by flood to an adjacent partially inundated armed forces hospital specializing in military medicine and adult trauma. The children were provided case-based clinical care as per existing disaster management protocol. Geoclimatic vulnerability factors, morbidity</em>/<em>mortality, and medical and logistical challenges for future intervention were investigated.</em></p> <p><strong><em>Results: </em></strong><em>One pediatrician who provided initial triage was joined by two others after 48 hours. A limited load of adult patients permitted more resources for the children, majority (49 percent) of whom were neonates. Intensive care was necessitated for 32 (20.2 percent) cases, with half managed in adult ICU. Overall in-hospital mortality was 5.7 percent. Experienced staff, cross-specialty multitasking, and innovative and noncensorious leadership were identified as assets amidst resources compromised by flooding. Clear delineation of primary caregiver role of pediatrician at outset, pediatric emergency care training, pediatric triage, resource allocation for thermoregulation, oxygen therapy and ventilation, earmarking centers for transfer of cases, and safe transportation to the centers were identified as areas meriting further attention.</em></p> <p><strong><em>Conclusion: </em></strong><em>Armed forces hospitals in vulnerable geoclimatic zones must address pediatric concerns in disaster management plans.</em></p>2023-11-20T00:00:00-05:00Copyright (c) 2023 American Journal of Disaster Medicinehttps://wmpllc.org/ojs/index.php/ajdm/article/view/3529After action review of the COVID-19 surveillance system in Quang Ninh Province, Vietnam, in 20202023-11-08T14:09:39-05:00Ha-Linh Quachajdm@pnpco.comKhanh Cong Nguyenajdm@pnpco.comThai Quang Phamajdm@pnpco.comNgoc-Anh Hoangajdm@pnpco.comHien Hong Thi Doajdm@pnpco.comDung Thi Nguyenajdm@pnpco.comChu Van Ninhajdm@pnpco.comEmma Fieldajdm@pnpco.comAnh Duc Dangajdm@pnpco.comDuong Nhu Tranajdm@pnpco.comHa Cam Thi Phamajdm@pnpco.comAnh Tu Tranajdm@pnpco.comHien Tran Nguyenajdm@pnpco.comNghia Duy Nguajdm@pnpco.comFlorian Vogtajdm@pnpco.com<p><em>Surveillance is the backbone of any response to an infectious disease outbreak, and comprehensive evaluation of surveillance systems is crucial. However, structured evaluations of surveillance systems during the COVID-19 pandemic are scarce. We conducted an after action review (AAR) of the performance of the COVID-19 surveillance system in Quang Ninh Province, Vietnam, during 2020 using the COVID-19-specific AAR methodology developed by the World Health Organization in combination with guidance from the US Centers for Disease Control and Prevention (CDC). We conducted a stakeholder survey, document reviews, and key informant interviews with staff from Quang Ninh CDC’s COVID-19 surveillance system. The COVID-19 surveillance system was based on the pre-existing surveillance system in the province. The system’s strengths were early preparation for emergency response, strong governance and central coordination, and multidisciplinary collaboration. Stakeholders agreed that the system proved useful and adaptive to the fast-evolving COVID-19 situation but was weakened by overly complex systems, redundant administrative processes, unclear communication channels, and lack of resources. Overall, the surveillance systems in Quang Ninh province proved effective in containing COVID-19 and adaptive in a fast-changing epidemiological context. Several recommendations were made based on identified areas of concern that are of relevance for COVID-19 surveillance systems in Vietnam and similar settings.</em></p>2023-11-20T00:00:00-05:00Copyright (c) 2023 American Journal of Disaster Medicinehttps://wmpllc.org/ojs/index.php/ajdm/article/view/3531Volume 18, Number 12023-11-08T14:30:57-05:00American Journal of Disaster Medicineajdm@pnpco.com<p>-</p>2023-11-20T00:00:00-05:00Copyright (c) 2023 American Journal of Disaster Medicinehttps://wmpllc.org/ojs/index.php/ajdm/article/view/3530Emergency medical services preparedness in mass casualty incidents: A systematic review2023-11-08T14:21:37-05:00Vahid Saadatmandajdm@pnpco.comMilad Ahmadi Marzalehajdm@pnpco.comHamid Reza Abbasiajdm@pnpco.comMahmoud Reza Peyraviajdm@pnpco.comNasrin Shokrpourajdm@pnpco.com<p><strong><em>Objective: </em></strong><em>The role of emergency medical services (EMS) preparedness in mass casualty incidents (MCIs) is crucial. MCIs are increasing worldwide, and EMS must enhance preparedness for them. For this purpose, the main components of EMS preparedness should be identified. This study aimed to describe the components of EMS preparedness in response to MCIs.</em></p> <p><strong><em>Design and setting: </em></strong><em>This systematic review was conducted based on the Preferred Reporting Item for Systematic Reviews and Meta-analyses guideline. The articles published from January 1970 to February 2022 were searched to discover the main components of EMS preparedness in MCIs. The electronic databases including PubMed, Cochrane Library, Scopus, Science Direct, and ProQuest were searched using predetermined keywords. Ten articles were selected and included in this review.</em></p> <p><strong><em>Results: </em></strong><em>After reviewing the articles, we identified the components of EMS preparedness in MCIs. Accordingly, 16 main components were extracted and classified into four categories, ie, individual improvement, group improvement, resources, and operations.</em></p> <p><strong><em>Conclusion: </em></strong><em>MCIs are so complicated that they require adequate prehospital preparedness. This study described the components of EMS preparedness in MCIs. The authorities in EMS will benefit from this framework in planning and responding to MCIs. </em></p> <p><em> </em></p>2023-11-20T00:00:00-05:00Copyright (c) 2023 American Journal of Disaster Medicine