293 results match your criteria EMS and Terrorism


An innovative emergency transportation scenario for mass casualty incident management: Lessons learnt from the Formosa Fun Color Dust explosion.

Medicine (Baltimore) 2021 Mar;100(11):e24482

Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, 135, Nan-Hsiao Street, Changhua 500, Taiwan, ROC.

Abstract: The purpose of this research is to analyze and introduce a new emergency medical service (EMS) transportation scenario, Emergency Medical Regulation Center (EMRC), which is a temporary premise for treating moderate and minor casualties, in the 2015 Formosa Fun Color Dust Party explosion in Taiwan. In this mass casualty incident (MCI), although all emergency medical responses and care can be considered as a golden model in such an MCI, some EMS plans and strategies should be estimated impartially to understand the truth of the successful outcome.Factors like on-scene triage, apparent prehospital time (appPHT), inhospital time (IHT), and diversion rate were evaluated for the appropriateness of the EMS transportation plan in such cases. Read More

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The next nine minutes: Lessons learned from the large-scale active shooter training prior to the STEM school shooting.

Am J Disaster Med 2020 Fall;15(4):241-249

Captain South Metro Fire Rescue, Centennial, Colorado.

Objective: As the incidence of active shooters increase, local emergency response has also changed. South Metro Fire Rescue coordinated a series of hyper-realistic active shooter simulation drills involving multiple agencies.

Methods: "The Next Nine Minutes" was one of the largest active shooter drills performed to date with 904 personnel that were trained in 18 mass casualty active shooter drills. Read More

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January 2021

The effectiveness of a formal curriculum in teaching mass casualty management.

J Emerg Manag 2020 Sep/Oct;18(5):411-424

Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania.

Objective: To improve knowledge, skills, and confidence in mass casualty management through design and im-plementation of a formal educational curriculum.

Design: Observational study using a mixed-methods formal educational training curriculum.

Setting: Rural Emergency Medical Services (EMS) system in Pennsylvania. Read More

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November 2020

Mortality among Fire Department of the City of New York Rescue and Recovery Workers Exposed to the World Trade Center Disaster, 2001-2017.

Int J Environ Res Public Health 2020 08 28;17(17). Epub 2020 Aug 28.

Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201, USA.

The World Trade Center (WTC) attacks on 9/11/2001 have consistently been associated with elevated rates of physical and mental health morbidities, while evidence about mortality has been limited. We examined mortality between 9/12/2001 and 12/31/2017 among 15,431 WTC-exposed Fire Department of the City of New York (FDNY) firefighters and emergency medical service providers (EMS), specifically assessing associations between intensity of WTC-exposure and mortality risk. Standardized mortality ratios (SMR) and 95% confidence intervals (CI) compared FDNY cohort mortality with the US general population using life table analysis. Read More

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Two teams, one mission: A study using EMS units in hospital triage during active-shooter and other mass-casualty events.

Am J Disaster Med 2020 Winter;15(1):33-41

Professor, Center for Homeland Defense and Security, Naval Postgraduate School, Monterey, California.

Background: Recent mass-casualty events have exposed errors with common assumptions about response proc-esses, notably triage and transport of patients. Response planners generally assume that the majority of patients from a mass-casualty event will have received some level of field triage and transport from the scene to the hospital will have been coordinated through on-scene incident command. When this is not the case, emergency response at the hospital is hampered as staff must be pulled to handle the influx of untriaged patients. Read More

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How to Stop the Bleed: First Care Provider Model for Developing Public Trauma Response Beyond Basic Hemorrhage Control.

West J Emerg Med 2020 Feb 25;21(2):365-373. Epub 2020 Feb 25.

Washington University in St. Louis, Department of Surgery, St. Louis, Missouri.

Introduction: Since 2013, the First Care Provider (FCP) model has successfully educated the non-medical population on how to recognize life-threatening injuries and perform interventions recommended by the Committee for Tactical Emergency Casualty Care (C-TECC) and the Hartford Consensus in the disaster setting. Recent programs, such as the federal "Stop The Bleed" campaign, have placed the emphasis of public training on hemorrhage control. However, recent attacks demonstrate that access to wounded, recognition of injury, and rapid evacuation are equally as important as hemorrhage control in minimizing mortality. Read More

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February 2020

Pediatric Readiness in Emergency Medical Services Systems.

Pediatrics 2020 01 19;145(1). Epub 2019 Dec 19.

Division of Pediatric Surgery, University of Louisville and Norton Children's Hospital, Louisville, Kentucky.

Ill and injured children have unique needs that can be magnified when the child's ailment is serious or life-threatening. This is especially true in the out-of-hospital environment. Providing high-quality out-of-hospital care to children requires an emergency medical services (EMS) system infrastructure designed to support the care of pediatric patients. Read More

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January 2020

Assessing the pre-hospital care preparedness to face mass casualty incident in Saudi Arabia in 2017-2018.

Saudi Med J 2019 Oct;40(10):1032-1039

Disaster Management, Saudi Red Crescent Authority, Riyadh, Kingdom of Saudi Arabia. E-mail.

Objectives: To assess the mass casualty incident (MCI) preparedness of pre-hospital care providers in Saudi Arabia and to identify and highlight their strengths and weaknesses when responding to MCIs.  Methods: This cross-sectional descriptive quantitative analysis was conducted between January 2017 and 2018 and included all Saudi Red Crescent Authority (SRCA) general administration branches in 13 regions in Saudi Arabia. The modified version of the emergency medical specialists (EMS) incident response and readiness assessment (EIRRA) tool was used in this study. Read More

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October 2019

Triage Performance of School Personnel Using the SALT System.

Prehosp Disaster Med 2019 Aug;34(4):401-406

2.Summa Health System,Akron,OhioUSA.

Introduction: The aim of this study was to determine if school personnel can understand and apply the Sort, Assess, Life-saving interventions, Treat/Transport (SALT) triage methods after a brief training. The investigators predicted that subjects can learn to triage with accuracy similar to that of medically trained personnel, and that subjects can pass an objective-structured clinical exam (OSCE) evaluating hemorrhage control.

Methods: School personnel were eligible to participate in this prospective observational study. Read More

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Triage in Complex, Coordinated Terrorist Attacks.

Prehosp Disaster Med 2019 Aug;34(4):442-448

Monash University Community Emergency Health and Paramedics,Melbourne, Victoria,Australia.

Introduction: Terror attacks have increased in frequency, and tactics utilized have evolved. This creates significant challenges for first responders providing life-saving medical care in their immediate aftermath. The use of coordinated and multi-site attack modalities exacerbates these challenges. Read More

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The Emergency Medical System (EMS) response to Iraqi pilgrims' bus crash in Iran: a case report.

BMC Emerg Med 2019 07 16;19(1):38. Epub 2019 Jul 16.

Safety Promotion and Injury Prevention Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: In Iran, Road Traffic Injuries (RTIs) with mass casualties occur repeatedly. Since Road Traffic Accidents (RTAs) occur far from health facilities, EMSs play an important role in reducing the disability and mortality resulting from RTIs. Thus, the study aimed to report Iraqi pilgrims' bus which rolled over in the Malayer town. Read More

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Comparing the Accuracy of Mass Casualty Triage Systems When Used in an Adult Population.

Prehosp Emerg Care 2020 Jul-Aug;24(4):515-524. Epub 2019 Jul 31.

To use a previously published criterion standard to compare the accuracy of 4 different mass casualty triage systems (Sort, Assess, Lifesaving Interventions, Treatment/Transport [SALT], Simple Triage and Rapid Treatment [START], Triage Sieve, and CareFlight) when used in an emergency department-based adult population. We performed a prospective, observational study of a convenience sample of adults aged 18years or older presenting to a single tertiary care hospital emergency department. A co-investigator with prior emergency medical services (EMS) experience observed each subject's initial triage in the emergency department and recorded all data points necessary to assign a triage category using each of the 4 mass casualty triage systems being studied. Read More

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The Joint Counterterrorism Awareness Workshop Series (JCTAWS): Integrating disciplines for enhanced capabilities during a complex coordinated attack.

J Emerg Manag 2019 May/Jun;17(3):210-212

Professor and Chair, Department of Emergency Medicine, Chief Clinical Officer, Western Region Greenville Health System, University of South Carolina School of Medicine Greenville, Greenville, South Carolina.

Evolving threats, such as Complex Coordinated Terrorist Attacks (CCTAs) and other High-Threat Active Violence Incidents, require a comprehensive "Whole of Community" approach to enhance readiness within the emergency management mission. Engaging all community stakeholders, inclusive of the private sector, public safety organizations, and the health and healthcare communities, is essential for risk reduction by preventing and limiting consequences from such critical incidents. The Joint Counterterrorism Awareness Workshop Series (JCTAWS) is a unique interdisciplinary table-top exercise sponsored by the Department of Homeland Security/Federal Emergency Management Agency, Federal Bureau of Investigation, and National Counterterrorism Center, and is designed to test plans and capabilities surrounding a CCTA. Read More

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Feasibility of Telesimulation and Google Glass for Mass Casualty Triage Education and Training.

West J Emerg Med 2019 May 26;20(3):512-519. Epub 2019 Apr 26.

University of California, Irvine School of Medicine, Department of Emergency Medicine, Irvine, California.

Introduction: Our goal was to evaluate the feasibility and effectiveness of using telesimulation to deliver an emergency medical services (EMS) course on mass casualty incident (MCI) training to healthcare providers overseas.

Methods: We conducted a feasibility study to establish the process for successful delivery of educational content to learners overseas via telesimulation over a five-month period. Participants were registrants in an EMS course on MCI triage broadcast from University of California, Irvine Medical Simulation Center. Read More

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Post-9/11 Peripheral Neuropathy Symptoms among World Trade Center-Exposed Firefighters and Emergency Medical Service Workers.

Int J Environ Res Public Health 2019 05 16;16(10). Epub 2019 May 16.

Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201, USA.

Peripheral neuropathy can result from numerous conditions including metabolic disorders, inflammatory disease, or exposure to environmental or biological toxins. We analyzed questionnaire data from 9239 Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed firefighters and emergency medical service workers (EMS) to evaluate the association between work at the WTC site and subsequent peripheral neuropathy symptoms using the validated Diabetic Neuropathy Symptom (DNS) score. We grouped the population into an "Indicated" group with conditions known to be associated with paresthesia ( = 2059) and a "Non-Indicated" group without conditions known to be associated ( = 7180). Read More

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Impact of Stressful Events on Motivations, Self-Efficacy, and Development of Post-Traumatic Symptoms among Youth Volunteers in Emergency Medical Services.

Int J Environ Res Public Health 2019 05 8;16(9). Epub 2019 May 8.

The Department of Emergency Management & Disaster Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel.

During the last decades, Israeli emergency medical services (EMS) personnel has been exposed to different potentially traumatic events, including mass terror attacks. The aims of the present study were to identify how potentially traumatic events affect young volunteers in their motivation to volunteer and their perceived self-efficacy while being at risk of developing post-traumatic symptoms. The final sample included 236 Magen David Adom (MDA, the "Israeli Red Cross") youth volunteers. Read More

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Paramedic and Emergency Medical Technician Reflections on the Ongoing Impact of the 9/11 Terrorist Attacks.

Prehosp Disaster Med 2019 Feb;34(1):56-61

3Harvard Humanitarian Initiative,Harvard University and Harvard T.C. Chan School of Public Health,Cambridge,MassachusettsUSA.

IntroductionIn the years following the September 11, 2001 terrorist attacks in New York City (New York USA), otherwise known as 9/11, first responders began experiencing a range of health and psychosocial impacts. Publications documenting these largely focus on firefighters. This research explores paramedic and emergency medical technician (EMT) reflections on the long-term impact of responding to the 9/11 terrorist attacks. Read More

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February 2019

Victory I Consensus Document: Proposal for the Implementation of the Hartford Doctrine in the Spanish Context.

J Spec Oper Med Winter 2018;18(4):27-29

Several international recommendations advise adapting military healthcare response models to intentional mass casualty incidents (IMCIs) in civil environments. The IMCI experience and associated published research from the United States, where these situations are frequent and properly analyzed more often, are, unfortunately, not directly applicable to the Spanish model of emergency medical services (EMS), where each autonomous region has its own competencies and protocols. However, there is a series of common elements that served as a reference for the development of an effective, evidence- based, IMCI consensus response plan called Victoria I. Read More

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Persistent self-reported ear and hearing problems among World Trade Center-exposed firefighters and emergency medical service workers, 2001-2017-A longitudinal cohort analysis.

Am J Ind Med 2019 01 6;62(1):43-49. Epub 2018 Dec 6.

Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York.

Background: The goal of this study was to estimate the impact of exposure to the World Trade Center (WTC) site on annual and persistent rates of otalgia and hearing impairment among Fire Department of the City of New York (FDNY) Firefighters and Emergency Medical Service Workers (EMS).

Methods: Responders completed routine physical health questionnaires at monitoring visits. We used logistic and marginal logistic regression models to explore the association between otalgia and hearing impairment and WTC arrival time. Read More

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January 2019

Assessment of the disaster medical response system through an investigation of a 43-vehicle mass collision on Jung-ang expressway.

Accid Anal Prev 2019 Feb 20;123:60-68. Epub 2018 Nov 20.

Wonju College of Medicine, Yonsei University, Department of Emergency Medicine, Republic of Korea. Electronic address:

Purpose: It was considered the challenges of the actual response and the potential for improvement, including the activities of the disaster response system, national emergency medical center, and the regional base hospital for the treatment of multiple traffic accident victims. The purpose of this study was to analyze the accident management system through real investigating the multiple collision over 10 vehicles with mass casualty events as a disaster situation.

Methods: This study was retrospective study to analyze the disaster event with multiple collision traffic accident on the expressway in Korea. Read More

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February 2019

Risk factors for post-9/11 chronic rhinosinusitis in Fire Department of the City of New York workers.

Occup Environ Med 2018 12 18;75(12):884-889. Epub 2018 Oct 18.

Pulmonary, Critical Care and Sleep Medicine Division, Departments of Medicine and Environmental Medicine, New York University School of Medicine, New York City, New York, USA.

Objectives: Chronic rhinosinusitis (CRS) has high socioeconomic burden but underexplored risk factors. The collapse of the World Trade Center (WTC) towers on 11 September 2001 (9/11) caused dust and smoke exposure, leading to paranasal sinus inflammation and CRS. We aim to determine which job tasks are risk factors for CRS in WTC-exposed Fire Department of the City of New York (FDNY) firefighters and emergency medical services (EMS) workers. Read More

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December 2018

Wisdom of the Crowd in Saving Lives: The Life Guardians App.

Prehosp Disaster Med 2018 Oct 17;33(5):550-552. Epub 2018 Sep 17.

3Department of Emergency Medicine,Shaare Zedek Medical Center,Jerusalem.

Multi-casualty incidents (MCIs) continue to occur throughout the world, whether they be mass shootings or natural disasters. Prehospital emergency services have done a professional job at stabilizing and transporting the victims to local hospitals. When there are multiple casualties, there may not be enough professional responders to care for the injured. Read More

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October 2018

Comparing the Accuracy of Mass Casualty Triage Systems in a Pediatric Population.

Prehosp Emerg Care 2019 May-Jun;23(3):304-308. Epub 2018 Oct 17.

Introduction: It was previously difficult to compare the accuracy of different mass casualty triage systems to one another. This pilot study is one of the first attempts to operationalize an expert panel's criterion standard definitions of triage categories in a pediatric population in order to compare accuracy between different systems.

Objective: To compare the accuracy of 4 different mass casualty triage systems (SALT, JumpSTART, Triage Sieve, and CareFlight) when used for children. Read More

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Botulism Outbreak in a Regional Community Hospital: Lessons Learned in Transfer and Transport Considerations.

Prehosp Emerg Care 2019 Jan-Feb;23(1):49-57. Epub 2018 Sep 10.

Botulism is a potentially lethal disease caused by a toxin released by Clostridium botulinum. Outbreaks of botulism from food sources can lead to a Mass Casualty Incident (MCI) involving sometimes hundreds of individuals. We report on a recent outbreak of botulism treated at a regional community hospital with a focus on emergency medical services (EMS) response and transport considerations. Read More

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Correlation Between Paramedic Disaster Triage Accuracy in Screen-Based Simulations and Immersive Simulations.

Prehosp Emerg Care 2019 Jan-Feb;23(1):83-89. Epub 2018 Aug 21.

Disaster triage is an infrequent, high-stakes skill set used by emergency medical services (EMS) personnel. Screen-based simulation (SBS) provides easy access to asynchronous disaster triage education. However, it is unclear if the performance during a SBS correlates with immersive simulation performance. Read More

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Intuitive versus Algorithmic Triage.

Prehosp Disaster Med 2018 Aug;33(4):355-361

3Department of Emergency Medicine,University of Massachusetts Medical School,Worcester,MassachusettsUSA.

IntroductionThe most commonly used methods for triage in mass-casualty incidents (MCIs) rely upon providers to take exact counts of vital signs or other patient parameters. The acuity and volume of patients which can be present during an MCI makes this a time-consuming and potentially costly process.HypothesisThis study evaluates and compares the speed of the commonly used Simple Triage and Rapid Treatment (START) triage method with that of an "intuitive triage" method which relies instead upon the abilities of an experienced first responder to determine the triage category of each victim based upon their overall first-impression assessment. Read More

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GPS Devices in a Simulated Mass Casualty Event.

Prehosp Emerg Care 2019 Mar-Apr;23(2):290-295. Epub 2018 Aug 17.

Objective: The aim of this study was to assess the staff perception of a global positioning system (GPS) as a patient tracking tool at an emergency department (ED) receiving patients from a simulated mass casualty event.

Methods: During a regional airport disaster drill a plane crash with 46 pediatric patients was simulated. Personnel from airport fire, municipal fire, law enforcement, emergency medical services, and emergency medicine departments were present. Read More

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