48 research outputs found
Development and evaluation of a training program to professionalize medical residents in humanitarian assistance and disaster response
No full textProfessionalization of Anesthesiologists and Critical Care Specialists in Humanitarian Action: A Nationwide Poll Among Italian Residents.
No full textBACKGROUND: Over the last decades, humanitarian crises have seen a sharp upward trend. Regrettably, physicians involved in humanitarian action have often demonstrated incomplete preparation for these compelling events which have proved to be quite different from their daily work. Responders to these crises have included an unpredictable mix of beginner-level, mid-level, and expert-level providers. The quality of care has varied considerably. The international humanitarian community, in responding to international calls for improved accountability, transparency, coordination, and a registry of professionalized international responders, has recently launched a call for further professionalization within the humanitarian assistance sector, especially among academic-affiliated education and training programs. As anesthetists have been involved traditionally in medical relief operations, and recent disasters have seen a massive engagement of young physicians, the authors conducted, as a first step, a poll among residents in Anesthesia and Critical Care Medicine in Italy to evaluate their interest in participating in competency-based humanitarian assistance education and in training incorporated early in residencies.
METHODS: The Directors of all the 39 accredited anesthesia/critical care training programs in Italy were contacted and asked to submit a questionnaire to their residents regarding the objectives of the poll study. After acceptance to participate, residents were enrolled and asked to complete a web-based poll.
RESULTS: A total of 29 (74%) of the initial training programs participated in the poll. Out of the 1,362 questionnaires mailed to residents, 924 (68%) were fully completed and returned. Only 63(6.8%) of the respondents voiced prior participation in humanitarian missions, but up to 690 (74.7%) stated they were interested in participating in future humanitarian deployments during their residency that carried over into their professional careers. Countrywide, 896 (97%) favored prior preparation for residents before participating in humanitarian missions, while the need for a specific, formal, professionalization process of the entire humanitarian aid sector was supported by 889 (96.2%).
CONCLUSIONS: In Italy, the majority of anesthesia/critical care residents, through a formal poll study, affirmed interest in participating in humanitarian assistance missions and believe that further professionalization within the humanitarian aid sector is required. These results have implications for residency training programs worldwide. Ripoll Gallardo A , Ingrassia PL , Ragazzoni L , Djalali A , Carenzo L , Burkle FM Jr , Della Corte F . Professionalization of anesthesiologists and critical care specialists in humanitarian action: a nationwide poll among Italian residents. Prehosp Disaster Med. 2015;30(1):1-6
Yemen’s Unprecedented Humanitarian Crisis: Implications for International Humanitarian Law, the Geneva Convention, and the Future of Global Health Security
No full textVirtual reality and live simulation: a comparison between two simulation tools for assessing mass casualty triage skills
No full textObjectives: This study tested the hypothesis that virtual reality simulation is equivalent to live simulation for testing naive medical students' abilities to perform mass casualty triage using the Simple Triage and Rapid Treatment (START) algorithm in a simulated disaster scenario and to detect the improvement in these skills after a teaching session.
Methods: Fifty-six students in their last year of medical school were randomized into two groups (A and B). The same scenario, a car accident, was developed identically on the two simulation methodologies: virtual reality and live simulation. On day 1, group A was exposed to the live scenario and group B was exposed to the virtual reality scenario, aiming to triage 10 victims. On day 2, all students attended a 2-h lecture on mass casualty triage, specifically the START triage method. On day 3, groups A and B were crossed over. The groups' abilities to perform mass casualty triage in terms of triage accuracy, intervention correctness, and speed in the scenarios were assessed.
Results: Triage and lifesaving treatment scores were assessed equally by virtual reality and live simulation on day 1 and on day 3. Both simulation methodologies detected an improvement in triage accuracy and treatment correctness from day 1 to day 3 (P<0.001). The time to complete each scenario and its decrease from day 1 to day 3 were detected equally in the two groups (P<0.05).
Conclusion: Virtual reality simulation proved to be a valuable tool, equivalent to live simulation, to test medical students' abilities to perform mass casualty triage and to detect improvement in such skills
An Italian version of the Ottawa Crisis Resource Management Global Rating Scale: a reliable and valid tool for assessment of simulation performance
No full textThe European Masters Degree in Disaster Medicine: a Decade of Exposure
No full textDisaster medicine education has become extremely important, following the increase in mass casualty incidents, acts of terrorism and complex humanitarian emergencies. Recent studies have reported that health care professionals do not feel sufficiently knowledgeable in this area. The European Master in Disaster Medicine (EMDM) is a II level master organized by the University of Eastern Piedmont (Novara, Italy) and the Free University of Brussels (Belgium). Up to know, the EMDM has trained more than 400 students from all over the world, providing them with the appropriate competencies to coordinate medical response during crisis situations. This article provides a general overview of the Master’s framework and reports its influence on graduates' professional career
Medium- and long-term health effects of earthquakes in high-income countries: a systematic review and meta-analysis.
No full textBACKGROUND: Accurate monitoring of population health is essential to ensure proper recovery after earthquakes. We aimed to summarize the findings and features of post-earthquake epidemiological studies conducted in high-income countries and to prompt the development of future surveillance plans. METHODS: Medline, Scopus and six sources of grey literature were systematically searched. Inclusion criteria were: observational study conducted in high-income countries with at least one comparison group of unexposed participants, and measurement of health outcomes at least 1 month after the earthquake. RESULTS: A total of 52 articles were included, assessing the effects of 13 earthquakes that occurred in eight countries. Most studies: had a time-series (33%) or cross-sectional (29%) design; included temporal comparison groups (63%); used routine data (58%); and focused on patient subgroups rather than the whole population (65%). Individuals exposed to earthquakes had: 2% higher all-cause mortality rates [95% confidence interval (CI), 1% to 3%]; 36% (95% CI, 19% to 57%) and 37% (95% CI, 29% to 46%) greater mortality rates from myocardial infarction and stroke, respectively; and 0.16 higher mean percent points of glycated haemoglobin (95% CI, 0.07% to 0.25% points). There was no evidence of earthquake effects for blood pressure, body mass index or lipid biomarkers. CONCLUSIONS: A more regular and coordinated use of large and routinely collected datasets would benefit post-earthquake epidemiological surveillance. Whenever possible, a cohort design with geographical and temporal comparison groups should be used, and both communicable and non-communicable diseases should be assessed. Post-earthquake epidemiological surveillance should also capture the impact of seismic events on the access to and use of health care services
Fresh whole blood: A feasible alternative in disasters and mass casualty incidents? a systematic review and meta-analysis
No full textAbstract Introduction While balanced blood component therapy (BCT) is pivotal in trauma patient damage control resuscitation in well-resourced settings, disasters, and mass casualty incidents (MCIs) pose significant challenges, especially in securing sufficient access to blood products. This systematic review and meta-analysis aim to explore the utilization of fresh whole blood (FWB) transfusion as a potential alternative to BCT, informing future research and clinical strategies. Methods We searched Pubmed, MEDLINE, Embase, CINAHL, the Cochrane Library and grey literature for articles identifying FWB transfusions, limited to those published in English or French. We evaluated the outcomes of post-FWB transfusion and conducted a meta-analysis comparing overall mortality in patients receiving FWB in addition to BCT during damage control resuscitation with those receiving BCT or single blood components alone. Results Of the 4830 studies identified, only 74 articles met all the eligibility criteria; the majority of them were conducted in military contexts. Mortality was lower among the FWB group compared to the BCT alone group, with a pooled OR of 0.61 (95% CI: 0.38—0.98) overall, and a pooled OR of 0.47 (95% CI: 0.25—0.87) among studies adjusting for confounders. FWB transfusion related complications rarely occurred. Conclusions While FWB shows potential as an alternative to BCT for managing severe haemorrhagic shock in disasters and MCIs, additional research is essential to validate FWB’s efficacy before considering it as a standard approach in civilian scenarios. Further studies focusing on the feasibility of implementing FWB in civilian contexts are also warranted
[Medium- and long-term health effects of the L'Aquila earthquake (Central Italy, 2009) and of other earthquakes in high-income Countries: a systematic review]
No full textto compare the methodological characteristics of the studies investigating the middle- and long-term health effects of the L'Aquila earthquake with the features of studies conducted after other earthquakes occurred in highincome Countries
