310 results match your criteria EMS and Terrorism


Disasters on campus: A cross-sectional survey of college EMS systems' preparedness to respond to mass casualty incidents.

Am J Disaster Med 2022 Fall;14(4):271-295

Chief of Disaster and Operational Medicine Section, Department of Emergency Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC.

Objective: The objective of this study was to assess the training and readiness levels of Collegiate Emergency Medical Service (EMS) providers to respond to mass casualty incidents (MCIs).

Methods: An anonymous cross-sectional survey of Collegiate EMS providers was performed.

Participants: Participants were US-based EMS providers affiliated with the National Collegiate Emergency Medical Services Foundation. Read More

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Advances in prehospital hemorrhagic shock management since Paris' terrorist attacks in 2015: A before-and-after retrospective study.

Am J Disaster Med 2022 Fall;14(4):247-252

Paris Fire Brigade Emergency Medicine Department, Paris, France.

Background: In France, in 2015, prehospital emergency doctors were faced with civilian casualties in hemorrhagic shock resulting from terrorist attacks with automatic rifle fire and explosive weapons. The present study aimed to evaluate the impact of these attacks on the advanced life support (ALS) team's practices and equipment and on physician training in the prehospital management of traumatic hemorrhagic shock.

Methods: This before-and-after multicenter study evaluated professional practices based on a questionnaire sent to emergency department heads and medical practitioners in 370 ALS teams in metropolitan France. Read More

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Terrorist Attacks in the Middle East: A Counter-Terrorism Medicine Analysis.

Prehosp Disaster Med 2022 Mar 3:1-5. Epub 2022 Mar 3.

Director, BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Associate Professor, Harvard Medical School, Cambridge, MassachusettsUSA.

Background: The Middle East and North Africa (MENA) region has been, like many parts of the world, a hotbed for terrorist activities. Terrorist attacks can affect both demand for and provision of health care services and often places a unique burden on first responders, hospitals, and health systems. This study aims to provide an epidemiological description of all terrorism-related attacks in the Middle East sustained from 1970-2019. Read More

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Terrorist Attacks Against Emergency Medical Services: Secondary Attacks are an Emerging Risk.

Prehosp Disaster Med 2022 Feb 2:1-7. Epub 2022 Feb 2.

Department of Political Science, Leiden University, Leiden, The Netherlands.

Introduction: Terrorists increasingly aim at so-called soft targets, such as hospitals. However, little is known about terrorist attacks against Emergency Medical Services (EMS).

Objective: This study aims to review all documented terrorist attacks against EMS that occurred world-wide from 1970-2019 using the Global Terrorism Database (GTD). Read More

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February 2022

Lessons Learned in a Large-Scale Mass Casualty Simulation.

J Nurs Educ 2022 Jan 1;61(1):50-52. Epub 2022 Jan 1.

Background: Traditional Nursing Programs are required to provide student instruction regarding disaster care. The Brigham Young University College of Nursing, in conjunction with campus emergency medical services (EMS), holds two large-scale mass casualty simulations each year. Nursing students work alongside EMS to provide initial care to the victims. Read More

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January 2022

A Conceptual Framework for Non-Military Investigators to Understand the Joint Roles of Medical Care in the Setting of Future Large Scale Combat Operations.

Prehosp Emerg Care 2022 Jan 25:1-8. Epub 2022 Jan 25.

Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.

As the wars in Iraq and Afghanistan end, the US military has begun to transition to the multi-domain operations concept with preparation for large scale combat operations against a near-peer adversary. In large scale combat operations, the deployed trauma system will likely see challenges not experienced during the Global War on Terrorism. The development of science and technology will be critical to close existing capability gaps and optimize casualty survival. Read More

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January 2022

Comparison of Unmanned Aerial Vehicle Technology versus Standard Practice of Scene Assessment by Paramedic Students of a Mass-Gathering Event.

Prehosp Disaster Med 2021 Dec 27;36(6):756-761. Epub 2021 Oct 27.

Chair, Department of Emergency Medicine, Universitair Ziekenhuis Brussel; Research Group in Emergency and Disaster Medicine, Vrije Universiteit Brussel, Jette, Belgium.

Introduction: The proliferation of unmanned aerial vehicle (UAV) technology has the potential to change the situational awareness of medical incident commanders' (ICs') scene assessment of mass gatherings. Mass gatherings occur frequently and the potential for injury at these events is considered higher than the general population. These events have generated mass-casualty incidents (MCIs) in the past. Read More

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December 2021

The Great Belt train accident: the emergency medical services response.

Scand J Trauma Resusc Emerg Med 2021 Sep 23;29(1):140. Epub 2021 Sep 23.

Department of Research and Development, Norwegian Air Ambulance Foundation, Postboks 414 Sentrum, Oslo, Norway.

Background: Major incidents (MI) are rare occurrences in Scandinavia. Literature depicting Scandinavian MI management is scarce and case reports and research is called for. In 2019, a trailer falling off a freight train struck a passing high-speed train on the Great Belt Bridge in Denmark, killing eight people instantly and injuring fifteen people. Read More

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September 2021

Medical Coordination Rescue Members' and Ambulance Nurses' Perspectives on a New Model for Mass Casualty and Disaster Management and a Novel Terror Attack Mitigation Approach in the Netherlands: A Qualitative Study.

Prehosp Disaster Med 2021 Oct 17;36(5):519-525. Epub 2021 Aug 17.

Senior Researcher, Scientific Coordinator, Academic Network of Applied Public Health and Emergency Medicine (ANAPHEM), Radboud University Medical Center, Nijmegen, the Netherlands.

Introduction: Mass-casualty incidents (MCIs), specifically incidents with chemical, biological, radiological, and nuclear agents (CBRN) or terrorist attacks, challenge medical coordination, rescue, availability, and adequate provision of prehospital and hospital-based emergency care. In the Netherlands, a new model for Mass Casualty and Disaster Management (MCDM) along with a Terror Attack Mitigation Approach (TAMA) was introduced in 2016.

Study Objective: The objective of this study was to provide insight in the first experiences of health policy advisors and managers with a medical rescue coordinator and ambulance nursing background regarding the new MCDM and TAMA in order to identify strengths and pitfalls in emergency preparedness and to provide recommendations for improvement. Read More

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October 2021

Dynamic Communication Quantification Model for Measuring Information Management During Mass-Casualty Incident Simulations.

Hum Factors 2022 02 18;64(1):228-249. Epub 2021 Jul 18.

26732 Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Objective: To develop a new model to quantify information management dynamically and to identify factors that lead to information gaps.

Background: Information management is a core task for emergency medical service (EMS) team leaders during the prehospital phase of a mass-casualty incident (MCI). Lessons learned from past MCIs indicate that poor information management can lead to increased mortality. Read More

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February 2022

Terrorism-Related Chemical, Biological, Radiation, and Nuclear Attacks: A Historical Global Comparison Influencing the Emergence of Counter-Terrorism Medicine.

Prehosp Disaster Med 2021 Aug 30;36(4):399-402. Epub 2021 Jun 30.

Director, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Associate Professor, Harvard Medical School, Boston, MassachusettsUSA.

Background: Terrorist attacks are growing in complexity, increasing concerns around the use of chemical, biological, radiation, and nuclear (CBRN) agents. This has led to increasing interest in Counter-Terrorism Medicine (CTM) as a Disaster Medicine (DM) sub-specialty. This study aims to provide the epidemiology of CBRN use in terrorism, to detail specific agents used, and to develop training programs for responders. Read More

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Position Statement: Mass Gathering Medical Care.

Prehosp Emerg Care 2021 Jul-Aug;25(4):593-595. Epub 2021 Apr 30.

The National Association of Emergency Medicine Services (EMS) Physicians (NAEMSP) recognizes the continued growth and complexity of mass gathering events and the integral role of the medical director in their planning and management. There is a growing body of literature that provides additional insight into patient presentations as well as preparation, staffing, and planning for these events. The clinical practice of EMS medicine encompasses the provision of care in a variety of out-of-hospital environments, including those defined as mass gathering events. Read More

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Surge Capacity Crisis and Mitigation Plan in Trauma Setting Based on Real-Time National Trauma Registry Data.

Disaster Med Public Health Prep 2022 Apr 17;16(2):689-697. Epub 2021 Mar 17.

Department of Surgery, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar.

Background: The objective of this study was to assess the current breaking point of crisis surge capacity of trauma services in Qatar and to develop a mitigation plan.

Methods: The study utilized real-time data from the National Trauma Registry. Data was explored cumulatively by weeks, months and a year's interval and all trauma admissions within this time frame were considered as 1 'Disaster Incident. Read More

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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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Evaluation of Interaction Between Emergency Medical System and Hospital Network During a Train Derailment in Milano.

Disaster Med Public Health Prep 2022 Apr 15;16(2):829-834. Epub 2021 Feb 15.

Azienda Regionale Emergenza Urgenza Lombardia, Milan, Italy.

On January 25, 2018 a 5-car train derailed in Pioltello, 10 kilometers North-East of Milano City. A standardized post-hoc form was distributed to the hospitals involved in the management of the victims and allowed for an evaluation of the response to the incident.The management of the incident by EMS (Emergency Medical System) was effective in terms of organization of the scene and distribution of the patients, although the time for the first severe patient to reach the closest appropriate hospital was very long (2 hours). Read More

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Norwegian Emergency Medicine Systems' Training and Equipment for Penetrating Injuries: A National Survey-Based Study.

Disaster Med Public Health Prep 2022 Apr 9;16(2):659-662. Epub 2021 Feb 9.

Anaesthesia and Critical Care Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsoe, Norway.

Objective: Recent terror attacks led the Norwegian government to develop a procedure for emergency and law enforcement services cooperation during Active Violent Incidents (AVI, abbreviated PLIVO in Norwegian). To address further national initiatives to improve preparedness for mass casualty events and penetrating injuries among emergency medical services (EMS) in Norway, training and equipment status were mapped.

Methods: All EMS regions in Norway were invited to participate in an electronic nation-wide survey about practical medical training in PLIVO scenario training and specific training in hemorrhage control and penetrating injuries. 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

Taxing working memory to modulate mental imagery of the 9/11 terrorist attacks following media exposure during childhood: a pilot study in young adult UK residents.

Anxiety Stress Coping 2021 07 8;34(4):423-436. Epub 2021 Jan 8.

Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, UK.

Background And Objectives: Media trauma in civilians is linked to intrusive imagery-based memory symptoms. We investigated whether mental imagery of the 9/11 terrorist attacks following media exposure is dampened by taxing working memory (WM).

Methods: Forty-five young adult UK residents, who were exposed to the 9/11 terrorist attacks as children via the media, identified a personally-relevant mental image of the attacks. Read More

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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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The Role of Emergency Medical Services in Earthquake Response: Integrating the ABC Approach of Israel's Magen David Adom.

Disaster Med Public Health Prep 2021 12 6;15(6):770-776. Epub 2020 Jul 6.

Department of Emergency Medicine, Shaare Zedek Medical Center, Israel.

Throughout history, earthquakes have caused devastation and loss of life. Emergency medical services (EMS) plays a vital role in the response to any mass-casualty incident or disaster. Magen David Adom, Israel's premier EMS organization, has a unique strategy known as the ABC approach to earthquake response. Read More

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December 2021

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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