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1.
Nursing (Säo Paulo) ; 24(278): 5948-5957, jul.-2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1343204

ABSTRACT

Objetivo: Caracterizar a atuação do enfermeiro de bordo, com ênfase no atendimento à múltiplas vítimas. Metodologia: Estudo exploratório e qualitativo. Os dados foram obtidos por meio de questionários semiestruturados, aplicados nosenfermeiros debordo em Belo Horizonte/MG. Utilizada a técnica metodológica de Bola de Neve (Snowball Sampling) e analisesob o conteúdo de Laurence Bardin. Resultado: Dos enfermeiros atuantes no resgate aéreo, que aceitaram participar, a maioria são do sexo masculino, possuem a renda familiar média de nove salários mínimos, mais de um vínculo empregatício, experiência média de seis anos. A partir da análise dos dados, as categorias elencadas foram: Atendimento Sistematizado e Capacitação Aeromédica. Conclusão: É preciso reconhecer o papel do enfermeiro no atendimento as vítimas no resgate aeromédico. Vale ressaltar a importância da capacitação para alcançar a excelência, no ambiente hostil confinado.(AU)


Objective: To characterize the role of the nurse on board, with an emphasis on attending to multiple wounds. Methodology: Exploratory and qualitative study. Data were obtained through semi-structured, scientific questionnaires on board nurses in Belo Horizonte / MG. The Snowball methodological technique was used and analyzed under the content of Laurence Bardin. Result: Of the nurses working in the air rescue, who agreed to participate: the majority are male, have an average family income of nine relative, more than one job, average experience of six years. From the analysis of the data, according to the categories listed were: Systematized Service and Aeromedical Training. Conclusion: It is necessary to recognize the role of the nurse in the care aswounds in the aeromedical rescue. It is worth emphasizing the importance of training to achieve excellence in a confined hostile environment.(AU)


Objetivo: Caracterizar a atuação do enfermeiro de bordo, com ênfase no atendimento à múltiplas vítimas. Metodologia: Estudo exploratório e qualitativo. Os dados foram obtidos por meio de questionários semiestruturados, aplicados nosenfermeiros debordo em Belo Horizonte/MG. Utilizada a técnica metodológica de Bola de Neve (Snowball Sampling) e analisesob o conteúdo de Laurence Bardin. Resultado: Dos enfermeiros atuantes no resgate aéreo, que aceitaram participar, a maioria são do sexo masculino, possuem a renda familiar média de nove salários mínimos, mais de um vínculo empregatício, experiência média de seis anos. A partir da análise dos dados, as categorias elencadas foram: Atendimento Sistematizado e Capacitação Aeromédica. Conclusão: É preciso reconhecer o papel do enfermeiro no atendimento as vítimas no resgate aeromédico. Vale ressaltar a importância da capacitação para alcançar a excelência, no ambiente hostil confinado.(AU)


Subject(s)
Humans , Air Ambulances/standards , Mass Casualty Incidents , Nurses , Surveys and Questionnaires , Rescue Work , Emergency Medical Services
2.
Rev. cuba. salud pública ; 46(4): e2270, oct.-dic. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156631

ABSTRACT

Introducción: En el Policlínico Docente Julián Grimau, del municipio Arroyo Naranjo, el amoníaco constituye riesgo de emergencia química que puede afectar parte de la población que atiende. De ahí, que sea necesario para la respuesta médica ante estas situaciones, tener en cuenta las especificidades de la institución y su carácter sistémico. Objetivo: Proponer un sistema de respuesta médica ante emergencia química por amoníaco en el Policlínico Docente Julián Grimau. Métodos: Se realizó una investigación en sistemas y servicios de salud, entre septiembre de 2017 y diciembre de 2018, en el Policlínico Docente Julián Grimau. Se realizó un análisis documental relacionado con las acciones médicas en las emergencias químicas, en la atención primaria de salud. Se utilizaron, además, los métodos: sistémico estructural-funcional para el diseño del sistema, y el informante clave para su concreción. Resultados: Se plantearon premisas teórico prácticas y se diseñó el sistema de respuesta del policlínico, en su fase de alarma, que asumió dos subsistemas: el de urgencia, conformado por los componentes: recepción, tratamiento especial, clasificación y tratamiento de urgencia; y, el de aseguramiento, constituido por los componentes humano, material y diagnóstico. Conclusiones: La estructura sistémica organizacional de la respuesta médica ante emergencias químicas por amoníaco en el Policlínico Julián Grimau se sustenta en premisas teórico-prácticas propias que determinan la estructura holística institucional para establecer el proceso desde un enfoque sistémico-estructural-funcional. De ahí que el sistema propuesto, para la fase de alarma sea flexible, objetivo, participativo, oportuno, adecuado y selectivo(AU)


Introduction: At Julián Grimau Teaching Polyclinic in Arroyo Naranjo municipality, ammonia is a risk of chemical emergency that can affect part of the population that it serves to. Hence, it is necessary for the medical response to these situations to take into account the specificities of the institution and its systemic character. Objective: Propose a medical response system for chemical emergency by ammonia in Julián Grimau Teaching Polyclinic. Methods: A research was carried out on health systems and services, from September 2017 to December 2018, in Julián Grimau Teaching Polyclinic. A documentary analysis related to medical actions in chemical emergencies was conducted in primary health care's level. In addition, the following methods were used: structural-functional systemic for the design of the system, and the key informant for its concretion. Result: Practical- theoretical premises were stated and the polyclinic's response system was designed, in its alarm phase, which assumed two subsystems: the emergency one, formed by the components: reception, special treatment, classification and emergency treatment; and, the assurance one, consisting of human, material and diagnostic components. Conclusions: The organizational systemic structure of the medical response to chemical emergencies by ammonia in the Julián Grimau Polyclinic is based on its own theoretical-practical premises that determine the institutional holistic structure to establish the process from a systemic-structural-functional approach. Hence, the proposed system for the alarm phase is flexible, objective, participatory, timely, adequate and selective(AU)


Subject(s)
Humans , Male , Female , Poisoning/epidemiology , Emergency Medical Services/methods , Mass Casualty Incidents
3.
Rev. baiana enferm ; 34: e34648, 2020. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1115325

ABSTRACT

Objetivo descrever a aplicabilidade de uma simulação realística de incidentes com múltiplas vítimas no processo de ensino-aprendizagem na enfermagem. Método estudo descritivo, com abordagem quantitativa que envolveu uma simulação realística. Participaram da simulação 250 pessoas, sendo incluídos no estudo 30 acadêmicos de enfermagem. Para a coleta de dados, aplicou-se um questionário para analisar a experiência acadêmica com simulação e paciente simulado. Resultados a maioria (80%) dos alunos não vivenciou experiência anterior com simulação e 53,3% concordaram que houve integração entre medicina e enfermagem durante a simulação. Para 66,7% dos graduandos foi possível colocar seu conhecimento em prática, havendo contribuição para melhora do raciocínio clínico e sobre as condutas realizadas. Conclusão a utilização da simulação realística na graduação de enfermagem é uma estratégia metodológica que contribui para o aprendizado e possibilita aos acadêmicos vivenciarem situações do seu futuro ambiente profissional.


Objetivo describir la aplicabilidad de una simulación realista de incidentes con múltiples víctimas en el proceso de enseñanza-aprendizaje en enfermería. Método estudio descriptivo con abordaje cuantitativo, utilizándose una simulación realista. Participaron 250 personas en la simulación, siendo incluidos en el estudio, 30 estudiantes de enfermería. Para la recolección de datos, se aplicó un cuestionario para analizar la experiencia académica con la simulación y el paciente simulado. Resultados la mayoría (80%) de los estudiantes tenía experiencia anterior con la simulación y el 53,3% estuvo de acuerdo en que hay integración entre medicina y enfermería durante la simulación. Para el 66,7% de los estudiantes, fue posible poner sus conocimientos en práctica, contribuyendo a la mejora del razonamiento clínico y comportamientos. Conclusión el uso de la simulación realista en la graduación en enfermería es una estrategia metodológica que contribuye al aprendizaje y permite a los estudiantes experimentar situaciones de su futuro entorno profesional.


Objective to describe the applicability of a realistic simulation of incidents involving multiple victims in the nursing teaching-learning process. Method descriptive study with quantitative approach involving a realistic simulation. The participants were 250 persons, including 30 nursing students. For data collection, a questionnaire was applied to analyze the academic experience with simulation and simulated patient. Results most (80%) students had previous experience with simulation and 53.3% agreed that there is integration between medicine and nursing during the simulation. For 66.7% of the students, it allowed putting their knowledge into practice, contributing to improvement of clinical reasoning and behaviors. Conclusion the use of realistic simulation in undergraduate nursing is a methodological strategy that contributes to the learning and allows students experience situations of their future professional environment.


Subject(s)
Humans , Emergency Nursing , Mass Casualty Incidents , Simulation Training , Students, Nursing , Education, Nursing
4.
Rev. latinoam. enferm. (Online) ; 28: e3251, 2020. tab
Article in English | LILACS, BDENF | ID: biblio-1101733

ABSTRACT

Objective: to construct and validate a tool for the evaluation of responders in tactical casualty care simulations. Method: three rubrics for the application of a tourniquet, an emergency bandage and haemostatic agents recommended by the Hartford Consensus were developed and validated. Validity and reliability were studied. Validation was performed by 4 experts in the field and 36 nursing participants who were selected through convenience sampling. Three rubrics with 8 items were evaluated (except for the application of an emergency bandage, for which 7 items were evaluated). Each simulation was evaluated by 3 experts. Results: an excellent score was obtained for the correlation index for the 3 simulations and 2 levels that were evaluated (competent and expert). The mean score for the application of a tourniquet was 0.897, the mean score for the application of an emergency bandage was 0.982, and the mean score for the application of topical haemostats was 0.805. Conclusion: this instrument for the evaluation of nurses in tactical casualty care simulations is considered useful, valid and reliable for training in a prehospital setting for both professionals who lack experience in tactical casualty care and those who are considered to be experts.


Objetivo: construir e validar um instrumento de avaliação da prática, por meio da simulação, nos cuidados de saúde estratégicos. Método: três instrumentos para práticas de avaliação de aplicação do torniquete, bandagem de emergência e agente hemostático recomendados pelo Consenso de Hartford foram desenvolvidos e validados. A validade e a confiabilidade foram estudadas. A validação foi realizada por quatro especialistas da área e trinta e seis enfermeiros participantes selecionados por amostragem por conveniência. Três instrumentos de avaliação com 8 itens foram avaliados (com exceção da bandagem de emergência, que tinha 7 itens para avaliar). Cada prática foi avaliada por três especialistas. Resultados: uma pontuação excelente foi obtida no cálculo do índice de correlação para as três práticas e nos dois níveis avaliados (competente e especialista). A pontuação média para a aplicação do torniquete foi de 0,897, para o curativo de emergência foi de 0,982 e para a aplicação de agentes hemostáticos tópicos foi de 0,805. Conclusão: este instrumento de avaliação da prática por meio de simulação nos cuidados de saúde estratégicos é considerado útil, válido e confiável para o treinamento no contexto pré-hospitalar tanto dos profissionais que não possuem experiência nos cuidados estratégicos quanto nos considerados peritos.


Objetivo: construir y validar un instrumento de evaluación de la práctica, mediante simulación, en la atención sanitaria táctica. Método: se construyeron y validaron tres rúbricas de las prácticas de aplicación del torniquete, vendaje de emergencia y agente hemostático recomendadas por el Consenso Hartford. Se estudió la validez y fiabilidad. La validación se realizó por cuatro expertos en la materia y treinta y seis participantes enfermeros que fueron la muestra de conveniencia. Se evaluaron tres rúbricas con 8 ítems (excepto para el vendaje de emergencia que fueron 7 ítems a evaluar). Cada práctica fue evaluada por tres expertos. Resultados: se ha obtenido una excelente puntuación en el cálculo del índice de correlación para las tres prácticas y en los dos niveles evaluados (competente y experto). La puntuación media para la rúbrica de aplicación del torniquete fue de 0.897, la del vendaje de emergencia 0.982 y para la aplicación de hemostáticos tópicos 0.805. Conclusión: este instrumento de evaluación de la práctica mediante simulación en la atención sanitaria se considera útil, válido y fiable para la formación en el entorno prehospitalario tanto de profesionales que carecen de experiencia en atención táctica como de aquellos considerados como expertos.


Subject(s)
Humans , Male , Female , Adult , Tourniquets , Reproducibility of Results , Emergency Medical Services/standards , Emergency Treatment/standards , Mass Casualty Incidents , Hemorrhage
5.
Nursing (Säo Paulo) ; 22(252): 2887-2890, maio.2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-998989

ABSTRACT

Trata-se de um estudo exploratório descritivo de abordagem quantitativa, realizado na cidade de Sobral/CE com profissionais de um serviço pré-hospitalar, objetivando descrever o conhecimento sobre métodos de triagem em incidentes com múltiplas vítimas. Teve como amostra (n=30) de participantes entre médicos, enfermeiros e técnicos de enfermagem. Como método de coleta de dados, foi desenvolvido um formulário on-line por meio de uma plataforma digital para condensar e analisar os dados. Identificou-se por meio deste estudo uma percepção limitada expressa pelos profissionais quanto a vivência e o nível de conhecimento acerca dos métodos de triagem em incidentes com múltiplas vítimas. Apenas 50% dos casos apresentados em um teste simulado elaborado para o estudo tiveram resolubilidade aceitável. Diante dos achados sugere-se o fomento de um programa especifico de treinamento na ótica da educação permanente, assim como, a construção de atividades intersetoriais para a projeção de um plano de resposta frente a evento evolvendo múltiplas vítimas.(AU)


This is na exploratory descriptive study with a quantitative approach, carried out in the city of Sobral / CE with professionals from a prehospital service, aiming to describe the know ledge about methods of screening in multiple victim incidents. A sample of participants (n = 30) was among physicians, nurses and nursing technicians. As a methodof data collection, an online form was developed through a digital platform to condense and analyze the data. We identified through this study a limited perception expressed by the professionals regarding the experience and thel evelof know ledge about the methods of triage in incidentes with multiple victims. Only 50% of the cases presented in a simulated test prepared for the study had acceptable resolubility. In view of the findings, it is suggested the development of a specific training program in the perspective of permanente education, as well as the construction of intersectoral activities to project a response planto an eventinvolving multiple victims.(AU)


Se trata de um estúdio exploratório descriptivo de abordaje cuantitativo, realizado em la ciudad de Sobral / CE com profesionales de um servicio prehospitalario, conel objetivo de describir el conocimiento sobre métodos de clasificaciónen incidentes com múltiples víctimas. Se tuvo como muestra (n = 30) de participantes entre médicos, enfermeros y técnicos de enfermería. Como método de recolección de datos, se há desarrollado un formulário en línea a través de una plataforma digital para condensar y analizarlos datos. Se identificó por medio de este estudio una percepción limitada expresada por los professional es encuanto a la vivencia y el nivel de conocimiento acerca de los métodos de clasificación en incidentes com múltiples víctimas. Sóloel 50% de los casos presentados en una prueba simulada elaborada para el estúdio tuvieron una resolución aceptable. Ante los hallazgos se sugere el fomento de un programa específico de entrenamiento em la óptica de la educación permanente, así como la construcción de atividades intersectoriales para la proyección de unplan de respuesta frente al evento evolucionando múltiples víctimas.(AU)


Subject(s)
Humans , Mass Casualty Management , Triage , Emergency Medical Services , Ambulatory Care , Mass Casualty Incidents
6.
Article in Korean | WPRIM | ID: wpr-766588

ABSTRACT

The fatality rate of a disaster is associated with the impact of the disaster and the case fatality rate. The severity of the disaster can be reduced by an efficient disaster management system, and the capacity of the trained disaster response system can lower the case mortality rate. The severity of a disaster is determined by the interaction of risk factors and vulnerabilities in a particular area, and the case-fatality rate is determined by a correlation between the capacity of the disaster response team and the survivability of the victims. The disaster management system and the disaster response system are complementary and interconnected, and the efficiency of cooperation and linkage can be improved by developing well organized digitalization. Efforts to increase the survival rate of victims through digitalization has been a continued process and new alternatives are being developed in accordance with the advances in information and communication technology to manage disaster risk factors and to improve disaster response capabilities. However, in case of mass casualty incidents, it is still difficult to reduce the case mortality rate by securing the survival time limit of the victims. Often, sharing the disaster scene information and communicating with the victim is not feasible. A lack of ability to provide real time escape route to exit or safe zone proves fatal. The communication revolution of the next generation wireless wide area network called 5G can overcome the disruption of communication network during the disaster incidents. It can enable real time tracking of the position of victim and linking the victims with its rescuers. Hence, it is possible to increase the survival rate of victims during mass casualty incidents by associating information and communication technologies with appropriate disaster management and response strategies, real-time information exchange and education and training of rescuers and citizens.


Subject(s)
Disasters , Education , Emergencies , Mass Casualty Incidents , Mortality , Risk Factors , Survival Rate , United Nations
7.
Pensando fam ; 22(2): 105-120, jul.-dez. 2018.
Article in Portuguese | LILACS | ID: biblio-1002744

ABSTRACT

O resultado do trabalho de luto da perda de um filho depende muito de como a família está encarando essa perda e de qual o ciclo de vida pelo qual o sistema familiar está passando. A presente pesquisa aborda alguns aspectos teóricos importantes relacionados às observações feitas em dois dias de acompanhamento das atividades da Associação dos Familiares de Vítimas e Sobreviventes da Tragédia de Santa Maria (AVTSM), no município de Santa Maria, estado do Rio Grande do Sul, nos dias 11 e 12 de abril de 2017, bem como procede à análise de conteúdo de seis entrevistas realizadas com mães e pai de vítimas. O trabalho realizado pela AVTSM é de fundamental importância aos pais e às mães que participam, pois, além de proporcionar atividades psicossociais para os membros e fortalece o vínculo coletivo entre eles. Além disso, tais atividades têm caráter terapêutico e incentivam os envolvidos a melhorar e a resgatar a vontade de viver e de se adaptar à realidade cruel que é viver sem seus filhos.(AU)


The outcome from the elaboration of mourning of the loss of a son largely depends on how the family is facing this loss and what life cycle the family system is going through. The present research addresses some important theoretical aspects related to observations made in two days of monitoring from the activities of the Association of Families of Victims and Survivors of the Santa Maria's Tragedy (AVTSM), in the city of Santa Maria, in the Rio Grande do Sul State, on 11 and 12 of April in 2017. Together with the analysis of the content of six interviews made with parents of the victims. The work made by AVTSM is of fundamental importance to mothers and fathers that participate in it, because it not only proportionate psychosocial activities to the members, it also strengthens the collective bond between them. Moreover, these activities have a therapeutic character and encourages the involved to get better and recover the will to live and adapt to the cruel reality that is living without their children.(AU)


Subject(s)
Humans , Bereavement , Family Therapy/methods , Man-Made Disasters , Epidemiology, Descriptive , Data Collection/instrumentation , Survivors/psychology , Mass Casualty Incidents/psychology
8.
Article in Korean | WPRIM | ID: wpr-714042

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the characteristics of the emergency medical services (EMS) response and clinical information on mass casualty chemical incidents in Korea. METHODS: This retrospective observational study analyzed the integrated data of the EMS rescue records and EMS-treated severe trauma registry from January 2012 to December 2013. Two databases were integrated using the unique accident identification number. Chemical incidents were defined by an in-depth review of the EMS rescue records according to a previous study. Mass casualty incidents were defined as more than 6 injured individuals. The rescue, EMS, and hospital variables of mass casualty chemical incidents were analyzed. RESULTS: A total of 8 mass casualty chemical incidents and 73 patients were included. The mean responded rescue vehicles and EMS vehicles were 2.4 and 3.5, respectively. The 4 incidents were an oil spill due to traffic accidents and most patients suffered minor trauma. A carbon monoxide leak caused the largest number of patients (23 people). The explosion caused by flammable polyethylene leaks showed the highest severity. In that explosion, the mortality rate was 40% and 8 patients had a disability at discharge. CONCLUSION: This study evaluated the characteristics of the EMS response and clinical information on mass casualty chemical incidents in Korea.


Subject(s)
Accidents, Traffic , Carbon Monoxide , Chemical Hazard Release , Emergency Medical Services , Explosions , Humans , Korea , Mass Casualty Incidents , Mortality , Observational Study , Petroleum Pollution , Polyethylene , Retrospective Studies
9.
Cad. Saúde Pública (Online) ; 33(5): e00010616, 2017. tab
Article in English | LILACS | ID: biblio-839710

ABSTRACT

Planning for mass gatherings involves health system preparedness based on an understanding of natural and technological hazards identified through prior risk assessment. We present the expected hazards reported by health administrators of the host cities for the 2014 FIFA World Cup in Brazil and discuss the hazards considering minimal available public hospital beds in the 12 cities at the time of the event. Four different groups of respondents were interviewed: pharmaceutical service administrators and overall health administrators at both the municipal and hospital levels. The hospital bed occupancy rate was calculated, based on the Brazilian Health Informatics Department (DATASUS). The number of surplus beds was calculated using parameters from the literature regarding surge and mass casualty needs and number of unoccupied beds. In all groups, physical injuries ranked first, followed by emerging and endemic diseases. Baseline occupancy rates were high (95%CI: 0.93-2.19) in all 12 cities. Total shortage, considering all the cities, ranged from -47,670 (for surges) to -60,569 beds (for mass casualties). The study can contribute to discussions on mass-gathering preparedness.


O planejamento de megaeventos envolve a preparação do sistema de saúde, com base na compreensão dos perigos naturais e tecnológicos, através da avaliação antecipada dos riscos. Os autores apresentam os riscos esperados relatados pelos gestores da saúde das cidades-sede durante a Copa do Mundo FIFA de 2014 no Brasil e discutem os riscos com base na disponibilidade mínima de leitos hospitalares públicos nas 12 cidades na época do evento. Quatro grupos foram entrevistados: gestores de serviços farmacêuticos e gestores gerais da saúde, ambos nos níveis municipal e hospitalar. Foi calculada a taxa de ocupação dos leitos hospitalares com base em dados do Departamento de Informática do Sistema Único de Saúde (DATASUS). O excedente de leitos foi calculado, utilizando parâmetros da literatura sobre picos de demanda (surges) e acidentes com múltiplas vítimas e o número de leitos desocupados. Em todos os grupos, as causas externas ocuparam o primeiro lugar, seguido pelas doenças emergentes e endêmicas. Todas as 12 cidades já apresentavam taxas de ocupação altas (IC95%: 0,93-2,19). O déficit total de leitos, considerando todas as cidades, variava de -47.670 (para picos de demanda) até -60.569 leitos (para acidentes com múltiplas vítimas). O estudo pode subsidiar as discussões sobre o preparo para megaeventos.


Planificar eventos para masas de gente implica la preparación del sistema de salud, basada en una comprensión de los riesgos naturales y tecnológicos, que hayan sido identificados previamente tras una evaluación de riesgos. Presentamos los riesgos esperados que fueron informados por los gestores de salud en las ciudades brasileñas anfitrionas de la Copa Mundial de la FIFA, y los discutimos, considerando el número mínimo disponible de camas en hospitales públicos en 12 ciudades, durante el evento deportivo. Hubo cuatro grupos diferentes de entrevistados: gestores del servicio farmacéutico y, en general, distintos gestores de salud en ambos niveles: municipal y hospitalario. La ratio de ocupación de camas se calculó basándose en el Sistema de Información del Sistema Único de Salud (DATASUS). El número de camas sobrantes fue calculado usando parámetros de la literatura, concernientes a las necesidades surgidas, número de víctimas y número de camas desocupadas. En todos los grupos, las lesiones físicas se encontraban en primera posición, seguidas de las enfermedades emergentes y endémicas. Las ratios base de referencia de ocupación fueron altas (IC95%: 0,93-2,19) en las12 ciudades. La escasez total, considerando todas las ciudades, oscila desde -47.670 (para incrementos) a -60.569 camas (para víctimas en masa). El estudio puede contribuir a discusiones sobre la preparación de eventos para muchedumbres.


Subject(s)
Humans , Soccer , Hospital Bed Capacity/statistics & numerical data , Anniversaries and Special Events , Patient Admission , Urban Population , Brazil , Interviews as Topic , Cities , Disaster Planning , Emergency Service, Hospital , Mass Casualty Incidents
10.
Article in Korean | WPRIM | ID: wpr-222532

ABSTRACT

PURPOSE: To investigate and document a disaster medical response during the collapse of the Gyeongju Mauna Ocean Resort gymnasium, which occurred on February 17, 2014. METHODS: The official records of each institution were verified to select the study population. All the medical records and emergency medical service records were reviewed by an emergency physician. Personal or telephonic interviews were conducted without a separate questionnaire if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent. RESULTS: One hundred fifty-five accident victims, who were treated at 12 hospitals mostly for minor wounds, were included in this study. The collapse killed 10 people. Although the news of the collapse was disseminated in 4 minutes, it took at lease 69 minutes for a dispatch of 4 disaster medical assistance teams to take action; 4.5% of patients were treated on-site, 56.7% were transferred to 2 nearest hospitals, and 42.6% were transferred to hospitals with poor preparation to handle disaster victims. CONCLUSION: In the collapse of the Gyeongju Mauna Ocean Resort gymnasium, the initial triage and distribution of patients were inefficient, with delayed arrival of medical assistance teams. These problems had also been noted in prior mass casualty incidents. Government agencies are implementing improvements, and this study could aid the implementation process.


Subject(s)
Disaster Victims , Disasters , Emergencies , Emergency Medical Services , Government Agencies , Health Resorts , Humans , Mass Casualty Incidents , Medical Assistance , Medical Records , Social Networking , Triage , Wounds and Injuries
11.
Psicol. ciênc. prof ; 36(4): 932-945, out.-dez. 2016.
Article in Portuguese | LILACS | ID: biblio-829371

ABSTRACT

Resumo Eventos críticos (EC) são eventos que dão início a uma cadeia de incidentes, resultando em uma situação de desastre, a menos que um sistema de segurança interfira para evitá-lo ou minimizá-lo. Este artigo apresenta um relato de experiência durante um EC em que psicólogas elaboraram a estratégia de gestão da atenção psicossocial e saúde mental decorrente do incêndio na boate Kiss, ocorrido em 2013, na cidade de Santa Maria (RS). O objetivo deste relato de experiência é apresentar e analisar a estratégia elaborada de apoio psicossocial e de saúde mental. Fazendo uso de métodos qualitativos, iniciamos a discussão descrevendo a rede pública de Atenção Psicossocial do município na época em que ocorreu o incêndio. Na sequência, delineia-se uma análise descritiva das medidas tomadas nas primeiras 24 horas após esse evento e, finalmente, apresentam-se as estratégias elaboradas para os meses subsequentes. Para esse relato foram utilizados dados e referências do Sistema Único de Saúde e do Sistema Nacional de Proteção e Defesa Civil, contemplando o panorama nacional no momento da intervenção. Dentre os resultados destacam-se a imprescindibilidade do trabalho articulado no nível loco-regional e o delineamento da avaliação sistemática envolvendo os três entes federados. Atividades e ações elaboradas como resposta foram estruturadas de forma condizente com as necessidades psicossociais do público-alvo, bem como com as diretrizes e políticas (inter) nacionais, enfocando a criação de uma estratégia articulada e sustentável em um curto e médio prazo e visando o bem-estar psicossocial dos afetados....(AU)


Abstract Critical incidents (CI) are events that trigger a series of other incidents resulting in a disaster situation, unless a security system takes place in order to avoid or minimize it. This article presents an experience reported by a group of psychologists responsible for a specific CI: the fire occurred at Kiss nightclub in Santa Maria/RS in 2013, that resulted in the death of 242 people and left many others injured. The objective of this text is to describe and analyze the psychosocial support and mental health strategy elaborated during that event. First, the article shows how Santa Maria´s public mental health network was set at the time of the event. Then, it lists and analyzes the measures adopted in the first 24 hours after the CI. Finally, it discusses the strategy created for the following weeks and months. Data from the Brazilian Unified Health System (SUS) and the National System of Protection and Civil Defense were also used, in order to assist the intervention analysis. The activities proposed at the time not only appeared to be in agreement with the minimum psychosocial needs of the target population, but also aligned with national and international guidelines, that value articulated and sustainable, short and midterm strategies, capable of contributing with the well-being of the citizens....(AU)


Resumen Los incidentes críticos (IC) son eventos que estimulan una cadena de otros incidentes que resultan en una situación de desastre, a menos que un sistema de seguridad se ponga en marcha con el fin de evitar o reducir al mínimo el desastre. Este artículo tiene como objetivo presentar un relato de una experiencia de un grupo de psicólogas que trabajó en una situación de incidente crítico (IC)- el incendio en la discoteca Kiss en Santa María, RS en 2013. El objetivo del texto es presentar la estrategia de apoyo psicosocial y de salud mental elaborado durante ese evento. Con el fin de hacer eso, presentamos, en primer lugar, la red de salud mental pública que existía en Santa María en el momento en que ocurrió el incendio. En segundo lugar, mostramos las medidas adoptadas en las primeras 24 horas después del IC. Finalmente, se discute la estrategia elaborada para las siguientes semanas y meses. Los datos del sistema de salud pública y el Sistema Nacional de Protección y Defensa Civil también se utilizaron para ayudar a analizar la intervención. Los resultados destacan el carácter indispensable de la labor conjunta del nivel local y regional y el diseño de una evaluación sistemática entre los tres entes federales. Las actividades propuestas en el momento estaban en línea con las necesidades psicosociales de la población objetivo y con las directrices nacionales e internacionales, centrándose en la creación de una estrategia articulada y sostenible en el corto y mediano plazo para contribuir con el bienestar de los ciudadanos....(AU)


Subject(s)
Humans , Male , Female , Civil Defense , Fires , Man-Made Disasters , Mass Casualty Incidents , Mental Health , Public Health , Safety , Mental Health Services
13.
Article in English | WPRIM | ID: wpr-644673

ABSTRACT

OBJECTIVE: To investigate and document the disaster medical response during the Gyeongju Mauna Ocean Resort gymnasium collapse on February 17, 2014. METHODS: Official records of each institution were verified to select the study population. All the medical records and emergency medical service run sheets were reviewed by an emergency physician. Personal or telephonic interviews were conducted, without a separate questionnaire, if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent. RESULTS: One hundred fifty-five accident victims treated at 12 hospitals, mostly for minor wounds, were included in this study. The collapse killed 10 people. Although the news of collapse was disseminated in 4 minutes, dispatch of 4 disaster medical assistance teams took at least 69 minutes to take the decision of dispatch. Four point five percent were treated at the accident site, 56.7% were transferred to 2 hospitals that were nearest to the collapse site, and 42.6% were transferred to hospitals that were poorly prepared to handle disaster victims. CONCLUSION: In the Gyeongju Mauna Ocean Resort gymnasium collapse, the initial triage and distribution of patients was inefficient and medical assistance arrived late. These problems had also been noted in prior mass casualty incidents.


Subject(s)
Disaster Victims , Disasters , Emergencies , Emergency Medical Services , Health Resorts , Humans , Mass Casualty Incidents , Medical Assistance , Medical Records , Social Networking , Triage , Wounds and Injuries
14.
Cad. Saúde Pública (Online) ; 32(7): e00087116, 2016. tab, graf
Article in English | LILACS | ID: biblio-952292

ABSTRACT

Abstract: Recently, Brazil has hosted mass events with recognized international relevance. The 2014 FIFA World Cup was held in 12 Brazilian state capitals and health sector preparedness drew on the history of other World Cups and Brazil's own experience with the 2013 FIFA Confederations Cup. The current article aims to analyze the treatment capacity of hospital facilities in georeferenced areas for sports events in the 2016 Olympic Games in the city of Rio de Janeiro, based on a model built drawing on references from the literature. Source of data were Brazilian health databases and the Rio 2016 website. Sports venues for the Olympic Games and surrounding hospitals in a 10km radius were located by geoprocessing and designated a "health area" referring to the probable inflow of persons to be treated in case of hospital referral. Six different factors were used to calculate needs for surge and one was used to calculate needs in case of disasters (20/1,000). Hospital treatment capacity is defined by the coincidence of beds and life support equipment, namely the number of cardiac monitors (electrocardiographs) and ventilators in each hospital unit. Maracanã followed by the Olympic Stadium (Engenhão) and the Sambódromo would have the highest single demand for hospitalizations (1,572, 1,200 and 600, respectively). Hospital treatment capacity proved capable of accommodating surges, but insufficient in cases of mass casualties. In mass events most treatments involve easy clinical management, it is expected that the current capacity will not have negative consequences for participants.


Resumo: Recentemente, o Brasil sediou eventos de massa com relevância internacional reconhecida. A Copa do Mundo FIFA de 2014 foi realizada em 12 capitais estaduais e a preparação do setor da saúde contou com a história de outras Copas do Mundo e com a própria experiência do Brasil com a Copa das Confederações FIFA de 2013. O presente artigo objetivou analisar a capacidade de tratamento de instalações hospitalares em áreas georeferenciadas para eventos esportivos, nos Jogos Olímpicos de 2016, na cidade do Rio de Janeiro, com base em um modelo construído a partir da literatura. Os dados foram coletados nas bases de dados de saúde do Brasil e da página de Internet da Rio 2016. As instalações esportivas para os Jogos Olímpicos e os hospitais circundantes em um raio de 10km foram localizados por geoprocessamento; foi designada uma "área de saúde", referindo-se ao afluxo provável de pessoas a serem tratadas em caso de necessidade hospitalar. Seis fatores foram utilizados para calcular necessidades para surtos e um fator de cálculo foi usado para as desastres (20/1.000). Capacidade de tratamento hospitalar é definida pela coincidência de leitos e equipamentos de suporte de vida, ou seja, o número de monitores cardíacos (eletrocardiógrafos) e respiradores em cada unidade hospitalar. O Maracanã, seguido do Estádio Olímpico (Engenhão) e o Sambódromo, teria a maior demanda para internações (1.572, 1.200 e 600, respectivamente). A capacidade de tratamento hospitalar mostrou-se capaz de acomodar surtos, mas insuficiente em casos de vítimas em massa. Em eventos de massa, a maioria dos tratamentos envolve uma fácil gestão clínica. Espera-se que a capacidade atual não terá consequências negativas para os participantes.


Resumen: Recientemente, Brasil fue sede de eventos de masa con relevancia internacional reconocida. La Copa Mundial de la FIFA 2014 se llevó a cabo en 12 capitales de los estados y la preparación del sector de la salud tenía la historia de otras copas mundiales y con la experiencia de Brasil en la Copa Confederaciones de la FIFA 2013. Este artículo tiene como objetivo analizar la capacidad de tratamiento de las instalaciones hospitalarias en zonas georreferenciados para los eventos deportivos, en los Juegos Olímpicos de 2016, en la ciudad de Río de Janeiro, basado en un modelo construido a partir de la literatura. Los datos fueron recogidos en las bases de datos de salud en Brasil y en el sitio web del Río 2016. Las instalaciones deportivas para los Juegos Olímpicos y los hospitales circundantes dentro de un radio de 10km fueron localizados por el geoprocesamiento; un "área de la salud" fue designado, en referencia a la posible afluencia de personas que van a tratarse en el caso de una emergencia hospitalaria. Seis factores se utilizaron para calcular las necesidades a los brotes y un factor de cálculo se utilizó para los desastres (20/1.000). Capacidad de tratamiento hospitalario se define por la coincidencia de camas y equipos de soporte vital, o el número de monitores cardíacos (electrocardiógrafos) y respiradores en cada hospital. El Maracanã, seguido por el Estadio Olímpico (Engenhão) y el Sambódromo, tendría la mayor demanda de hospitalizaciones (1.572, 1.200 y 600, respectivamente). La capacidad de tratamiento hospitalario ha demostrado ser capaz de adaptarse a los brotes, pero insuficiente en casos de víctimas en masa. En los eventos masivos, la mayoría de los tratamientos implican un manejo clínico fácil. Se espera que la capacidad actual no tendrá consecuencias negativas para los participantes.


Subject(s)
Humans , Sports , Disaster Planning/organization & administration , Emergency Service, Hospital/organization & administration , Anniversaries and Special Events , Brazil , Mass Casualty Incidents , Geographic Mapping
15.
Article in English | WPRIM | ID: wpr-85714

ABSTRACT

To effectively mitigate and reduce the burden of mass casualty incidents (MCIs), preparedness measures should be based on MCIs' epidemiological characteristics. This study aimed to describe the epidemiological characteristics and outcomes of emergency medical services (EMS)-assessed MCIs from multiple areas according to cause. Therefore, we extracted the records of all MCIs that involved > or = 6 patients from an EMS database. All patients involved in EMS-assessed MCIs from six areas were eligible for this study, and their prehospital and hospital records were reviewed for a 1-year period. The EMS-assessed MCIs were categorized as being caused by fire accidents (FAs), road traffic accidents (RTAs), chemical and biological agents (CBs), and other mechanical causes (MECHs). A total of 362 EMS-assessed MCIs were identified, with a crude incidence rate of 0.6-5.0/100,000 population. Among these MCIs, 322 were caused by RTAs. The MCIs involved 2,578 patients, and 54.3% of these patients were women. We observed that the most common mechanism of injury varied according to MCI cause, and that a higher number of patients per incident was associated with a longer prehospital time. The highest hospital admission rate was observed for CBs (16 patients, 55.2%), and most patients in RTAs and MECHs experienced non-severe injuries. The total number of deaths was 32 (1.2%). An EMS-assessed MCI database was established using the EMS database and medical records review. Our findings indicate that RTA MCIs create a burden on EMS and emergency department resources, although CB MCIs create a burden on hospitals' resources.


Subject(s)
Accidents, Traffic/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Biohazard Release/statistics & numerical data , Chemical Hazard Release/statistics & numerical data , Child , Child, Preschool , Cross-Sectional Studies , Databases, Factual , Emergency Medical Services , Female , Hospitals , Humans , Infant , Infant, Newborn , Male , Mass Casualty Incidents/statistics & numerical data , Middle Aged , Retrospective Studies , Young Adult
16.
Article in Korean | WPRIM | ID: wpr-115326

ABSTRACT

PURPOSE: The purpose of this study was to report medical care activities of Disaster Medical Assistance Team (DMAT) and medical facilities that responded to the Goyang Bus Terminal fire on May 26, 2014, and to draw improvement of the current disaster medical response system. METHODS: We retrospectively reviewed emergency medical service (EMS) run sheet and medical records of patients who visited the emergency department the day of the fire. We also interviewed the officials involved in disaster response. RESULTS: A total of 73 patients participated in this study. Among them, 9 were classified as Emergency, 60 as Non-Emergency, and 4 as Death on arrival (DOA). Fifty one patients visited the nearest hospital, and 17 patients were transported by EMS. DMAT arrived at the scene in 58 minutes, however there was little medical activity. CONCLUSION: Initial Triage and distribution of patients was rather inadequate and DMAT arrived late. For the future, we recommend constant training of the paramedics and leaders of 119, and to mend DMAT requesting and response system.


Subject(s)
Allied Health Personnel , Disasters , Emergencies , Emergency Medical Services , Emergency Service, Hospital , Fires , Humans , Mass Casualty Incidents , Medical Assistance , Medical Records , Retrospective Studies , Triage
17.
Chinese Journal of Traumatology ; (6): 314-319, 2015.
Article in English | WPRIM | ID: wpr-316792

ABSTRACT

<p><b>OBJECTIVE</b>The 8.12 Tianjin Port Explosion in 2015 caused heavy casualties. Pingjin Hospital, an affiliated college hospital in Tianjin, China participated in the rescue activities. This study aims to analyze the emergency medical response to this event and share experience with trauma physicians to optimize the use of medical resource and reduce mortality of critical patients.</p><p><b>METHODS</b>As a trauma centre at the accident city, our hospital treated 298 patients. We retrospectively analyzed the data of emergency medical response, including injury triage, injury type, ICU patient flow, and medical resource use.</p><p><b>RESULTS</b>There were totally 165 deaths, 8 missing, and 797 non-fatal injuries in this explosion. Our hospital treated 298 casualties in two surges of medical demand. The first one appeared at 1 h after explosion when 147 wounded were received and the second one at 4 h when 31 seriously injured patients were received, among whom 29 were transferred from Tianjin Emergency Center which was responsible for the scene injury triage. After reexamination and triage, only 11 cases were defined as critical ill patients. The over-triage rate reached as high as 62.07%. Seventeen patients underwent surgery and 17 patients were admitted to the intensive care unit.</p><p><b>CONCLUSIONS</b>The present pre-hospital system is incomplete and may induce two surges of medical demand. The first one has a much larger number of casualties than predicted but the injury level is mild; while the second one has less wounded but almost all of them are critical patients. The over-triage rate is high. The hospital emergency response can be improved by an effective re-triage and implementation of a hospital-wide damage control.</p>


Subject(s)
Blast Injuries , Mortality , Therapeutics , China , Explosions , Female , Health Services Needs and Demand , Hospitals, University , Humans , Injury Severity Score , Male , Mass Casualty Incidents , Retrospective Studies , Surge Capacity , Trauma Centers , Triage
18.
Chinese Journal of Traumatology ; (6): 323-325, 2015.
Article in English | WPRIM | ID: wpr-316790

ABSTRACT

Tianjin Medical University General Hospital treated 233 wounded in 8.12 Tinjin Port explosion. Here we would like to analyze the treatment process for the wounded, and share the experiences of orga- nization and management for emergency rescue operation.


Subject(s)
Blast Injuries , Therapeutics , China , Emergency Medical Services , Explosions , Hospitals, University , Humans , Mass Casualty Incidents , Triage
19.
Chinese Medical Journal ; (24): 2664-2671, 2015.
Article in English | WPRIM | ID: wpr-315276

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China.</p><p><b>DATA SOURCES</b>Chinese literature was searched by Chinese Academic Journal Network Publishing Database (founded in June 2014). The English literature was searched by PubMed (MEDLINE) (1950 to June 2014). We also searched Official Websites of Chinese Central Government's (http://www.gov.cn/), National Health and Family Planning Commission of China (http://www.nhfpc.gov.cn/), and China Earthquake Information (http://www.csi.ac.cn/).</p><p><b>STUDY SELECTION</b>We included studies associated with mass casualty events related to China, the PT applied in China, guidelines and standards, and application and development of the carding PT method in China.</p><p><b>RESULTS</b>From 3976 potentially relevant articles, 22 met the inclusion criteria, 20 Chinese, and 2 English. These articles included 13 case reports, 3 retrospective analyses of MCI, two methods introductions, three national or sectoral criteria, and one simulated field testing and validation. There were a total of 19 kinds of MCI PT methods that have been reported in China from 1950 to 2014. In addition, there were 15 kinds of PT methods reported in the literature from the instance of the application.</p><p><b>CONCLUSIONS</b>The national and sectoral current triage criteria are developed mainly for earthquake relief. Classification is not clear. Vague criteria (especially between moderate and severe injuries) operability are not practical. There are no triage methods and research for children and special populations. There is no data and evidence supported triage method. We should revise our existing classification and criteria so it is clearer and easier to be grasped in order to build a real, practical, and efficient PT method.</p>


Subject(s)
China , Emergency Medical Services , Humans , Mass Casualty Incidents , Triage , Methods
20.
Hanyang Medical Reviews ; : 131-135, 2015.
Article in Korean | WPRIM | ID: wpr-186446

ABSTRACT

Disasters are unpredictable and unavoidable. The definition of disaster is a serious disruption of the functioning of society, causing widespread human, material, or environmental losses that exceed the ability of affected society to cope using only its own resources. Disaster medicine is a discipline resulting from combination of emergency medicine and disaster management. The field of disaster medicine involves the study of subject matter from multiple medical disciplines, and disaster medicine presents unique ethical situations not seen in other areas of medicine. Disaster can be classified into two categories, natural disaster and manmade disaster, each type of disaster has its own characteristics. Disaster management has a cycle of 4 activities, preparedness, response, recovery, and prevention/mitigation. Disaster medicine specialists have a role in each part of this cycle. To achieve effective disaster response, the National Disaster Life Support Foundation suggests the DISASTER Paradigm(TM), which consists of detection, incident command, safety and security, assess hazards, support, triage and treatment, evacuation, and recovery.


Subject(s)
Disaster Medicine , Disaster Planning , Disasters , Emergencies , Emergency Medicine , Humans , Mass Casualty Incidents , Specialization , Triage
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