This paper first explores the development and direction of disaster and emergency medicine in China and abroad from the perspective of international environment and history background, analyses four elements of disast...This paper first explores the development and direction of disaster and emergency medicine in China and abroad from the perspective of international environment and history background, analyses four elements of disaster and emergency medicine, including subject content, professionals, education practice and technical innovation, clarifies the interdependency between disaster medicine and emergency medicine, and reveals the developing rules of disaster medicine and emergency medicine. It also provides suggestions for China's development of disaster medicine and emergency medicine.展开更多
BACKGROUND： Emergency medicine was inaugurated, as an official specialty in China, only25 years ago, and its growth in clinical practice and academic development since that time have beenremarkable.METHODS： This pap...BACKGROUND： Emergency medicine was inaugurated, as an official specialty in China, only25 years ago, and its growth in clinical practice and academic development since that time have beenremarkable.METHODS： This paper is a critical and descriptive review on current situations in emergencymedicine in China, based on the literature review, personal observations, interviews with manyChinese emergency medicine doctors and experts, and personal experience in both China and USA.RESULTS： The current practice of emergency medicine in China encompasses three areas： prehospitalmedicine, emergency medicine, and critical care medicine. Most tertiary emergency departments（EDs） are structurally and functionally divided into several clinical areas, allowing the ED itself to functionas a small independent hospital. While Chinese emergency physicians receive specialty training througha number of pathways, national standards in training and certifi cation have not yet been developed. As aresult, the scope of practice for emergency physicians and the quality of clinical care vary greatly betweenindividual hospitals. Physician recruitment, diffi cult working conditions, and academic promotion remain asmajor challenges in the development of emergency medicine in China.CONCLUSION： To further strengthen the specialty advancement, more government leadershipis needed to standardize regional training curriculums, elucidate practice guidelines, provide fundingopportunities for academic development in emergency medicine, and promote the development of asystem approach to emergency care in China.展开更多
Probabilistic linguistic term sets(PLTSs)are an effective tool for expressing subjective human cognition that offer advantages in the field ofmulti-attribute decision-making(MADM).However,studies have found that PLTSs...Probabilistic linguistic term sets(PLTSs)are an effective tool for expressing subjective human cognition that offer advantages in the field ofmulti-attribute decision-making(MADM).However,studies have found that PLTSs have lost their ability to accurately capture the views of decision-makers(DMs)in certain circumstances,such as when the DM hesitates between multiple linguistic terms or the decision information is incomplete,thus affecting their role in the decision-making process.Belief function theory is a leading streamof thought in uncertainty processing that is suitable for dealing with the limitations of PLTS.Therefore,the purpose of this study is to extend PLTS to incorporate belief function theory.First,we provide the basic concepts of the extended PLTS(i.e.,belief-based PLTS)through case analyses.Second,the aggregation operator of belief-based PLTS is defined with the ordered weighted average(OWA)-based soft likelihood function,which is improved by considering the reliability of the information source.Third,to measure the magnitude of different belief-based PLTSs,the belief interval of singleton is calculated,and the comparison method of belief-based PLTS is constructed based on probabilities.On the basis of the preceding discussion,we further develop an emergency decision framework that includes several novel techniques,such as attribute weight determination and decision information aggregation.Finally,the usefulness of the framework is demonstrated through a case study,and its effectiveness is illustrated through a series of comparisons.展开更多
BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for preho...BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all.RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure.CONCLUSION: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.展开更多
BACKGROUND: We compare educational environments(i.e. physical, emotional and intellectual experiences) of emergency medicine(EM) residents training in the United States of America(USA) and Saudi Arabia(SA).METHODS: A ...BACKGROUND: We compare educational environments(i.e. physical, emotional and intellectual experiences) of emergency medicine(EM) residents training in the United States of America(USA) and Saudi Arabia(SA).METHODS: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure(PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales(autonomy, teaching, and social Support), using chi-squared, t-tests, and analysis of variance.RESULTS: A total of 219 surveys were returned for 260 residents across six programs(3 SA, 3 USA), with a response rate of 84%. Program-specific response rates varied from 79%–100%. All six residencies were qualitatively rated as "more positive than negative but room for improvement". Quantitative PHEEM scores for the USA programs were significantly higher: 118.7 compared to 109.9 for SA, P=0.001. In subscales, perceptions of social support were not different between the two countries(P=0.243); however, role autonomy(P<0.001) and teaching(P=0.005) were better in USA programs. There were no significant differences by post-graduate training year.CONCLUSION: EM residents in all three emergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.展开更多
Given that it is difficult to assess the harmfulness and make emergency response timely in the early stage when flood disasters happen in cities for that the data are complex and rapidly changing, this article constru...Given that it is difficult to assess the harmfulness and make emergency response timely in the early stage when flood disasters happen in cities for that the data are complex and rapidly changing, this article constructs a rapid assessment model, namely Simple Simos Procedure and PROMTHEE II Model (SSPPM), to assess the severity of flood disaster occurring in cities at the early stage based on a view of the rapid flood disaster assessment. On this basis, the fuzzy VIKOR method is applied to choose a scientific emergency plan. This article aims to construct a research framework model, which can provide some practice implications to reduce the losses caused by flood disaster.展开更多
To guarantee a unified response to disasters, humanitarian organizations work together via the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Although the OCHA has made great strides to imp...To guarantee a unified response to disasters, humanitarian organizations work together via the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Although the OCHA has made great strides to improve its information management and increase the availability of accurate, real-time data for disaster and humanitarian response teams, significant gaps persist. There are inefficiencies in the emergency management of data at every stage of its lifecycle: collection, processing, analysis, distribution, storage, and retrieval. Disaster risk reduction and disaster risk management are the two main tenets of the United Nations’ worldwide plan for disaster management. Information systems are crucial because of the crucial roles they play in capturing, processing, and transmitting data. The management of information is seldom discussed in published works. The goal of this study is to employ qualitative research methods to provide insight by facilitating an expanded comprehension of relevant contexts, phenomena, and individual experiences. Humanitarian workers and OCHA staffers will take part in the research. The study subjects will be chosen using a random selection procedure. Online surveys with both closed- and open-ended questions will be used to compile the data. UN OCHA offers a structure for the handling of information via which all humanitarian actors may contribute to the overall response. This research will enable the UN Office for OCHA better gather, process, analyze, disseminate, store, and retrieve data in the event of a catastrophe or humanitarian crisis.展开更多
BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS:Residency program directors at all US-based Emerge...BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS:Residency program directors at all US-based Emergency Medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.展开更多
BACKGROUND: Sleep deprivation resulting from night shifts, is a major cause of burnout among physicians. Exogenous melatonin may improve sleep quality in night-shift workers. The study aims to compare the effectivenes...BACKGROUND: Sleep deprivation resulting from night shifts, is a major cause of burnout among physicians. Exogenous melatonin may improve sleep quality in night-shift workers. The study aims to compare the effectiveness of melatonin versus placebo on sleep effi ciency in emergency medicine(EM) residents. METHODS: A randomized, double-blind, replicated crossover trial was performed on EM residents. This study consisted of 4 phases within a month with intervention periods of 2 nights and washouts of 6 days. In our study, EM residents had nine-hour shifts on 6 consecutive days, 2 mornings, 2 evenings and 2 nights and then 2 days off. At the end of shifts' cycle, 24 EM residents were given 3 mg melatonin or placebo(12 in each arm of the study) for 2 consecutive nights after the second night shift with crossover to the other arm after a six-day off drug. This crossover intervention was repeated for two more another time. Finally, we created 48 cases and comparisons in each arm. Different items related to sleep quality were assessed and compared both within the same group and between the two groups. RESULTS: In the melatonin group, daytime sleepiness(calculated by Karolinska Sleep Scale) had a signifi cant reduction after taking the second dose of drug(P=0.003) but the same result was not observed when comparing the 2 groups. Mood status(calculated by Profile of Mood States) showed no remarkable difference between the 2 groups. CONCLUSION: Melatonin might have a limited benefi t on sleep quality in EM residents working night shifts.展开更多
The outbreak of coronavirus disease 2019(COVID-19)was declared a global public health emergency on 31 January 2020.Emergency medicine procedures in Emergency Department should be optimized to cope with the current COV...The outbreak of coronavirus disease 2019(COVID-19)was declared a global public health emergency on 31 January 2020.Emergency medicine procedures in Emergency Department should be optimized to cope with the current COVID-19 pandemic by providing subspecialty services,reducing the spread of nosocomial infections,and promoting its capabilities to handle emerging diseases.Thus,the Chinese Society of Emergency Medicine and Wuhan Society of Emergency Medicine drafted this consensus together to address concerns of medical staffs who work in Emergency Department.Based on in-depth review of COVID-19 diagnosis and treatment plans,literatures,as well as management approval,this consensus proposes recommendations for improving the rationalization and efficiency of emergency processes,reducing the risk of nosocomial infections,preventing hospital viral transmission,and ensuring patient safety.展开更多
BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that inf...BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing practices.METHODS: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.RESULTS: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.CONCLUSION: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.展开更多
BACKGROUND:Macedonia has universal public health care coverage.Acute and emergency patient care is provided in different care environments based on the medical complaint and resource proximity.While emergency medicine...BACKGROUND:Macedonia has universal public health care coverage.Acute and emergency patient care is provided in different care environments based on the medical complaint and resource proximity.While emergency medicine and well organized emergency departments(EDs) are an essential component of any developed health care system,emergency medicine as a specialty is relatively non-existent in Macedonia.DATA RESOURCES:A system assessment regarding presence,availability and capacity of EDs was completed from 2013-2015,based upon assessments of 21 institutions providing emergency care and information provided by the Ministry of Health.This assessment establishes a benchmark from which to strategically identify,plan and implement the future of emergency medicine in Macedonia.RESULTS:In general,emergency departments- defined by offering acute care 24 hours per day,7 days per week- were available at all general and university hospitals.However,care resources,emergency and acute care training,and patient care capacity vary greatly within the country.There is limited uniformity in acute care approach and methodology.Hospital EDs are not organized as separate divisions run by a head medical doctor,nor are they staffed by specialists trained in emergency medicine.The diagnostic and treatment capacities are insufficient or outdated by current international emergency medicine standards and frequently require patient transfer or admission prior to initiation.CONCLUSION:Most of the surveyed hospitals are capable of providing essential diagnostic tests,but very few are able to do so at the point or time of presentation.While emergency medical services(EMS) have improved system-wide,emergent care interventions by EMS and within all hospitals remain limited.Further system-wide acute and emergency care improvements are forthcoming.展开更多
As people live longer and fewer babies are born,the elderly became the fastest and largest growing population of the world,expected to increase further from 86 million in 2005 to 394 million in 2050 worldwide.Older pa...As people live longer and fewer babies are born,the elderly became the fastest and largest growing population of the world,expected to increase further from 86 million in 2005 to 394 million in 2050 worldwide.Older patients represent a large bulk of the population arriving in emergency departments(EDs)all over the world.^([1])They use hospitals more frequently than younger patients。展开更多
The damage caused by geological and meteorological disasters was pointed out in this paper through analyzing the features and causes of geological and meteorological disasters.To strengthen emergency management of geo...The damage caused by geological and meteorological disasters was pointed out in this paper through analyzing the features and causes of geological and meteorological disasters.To strengthen emergency management of geological and meteorological disasters,it is suggested to rigorously investigate potential geological hazard points,to strengthen observation and warning system,to take group prevention and group test as a supplementary to professional observation,to build up the last line of defense to geological and meteorological disasters,to set up functional cooperation mechanism,and to publicize disaster prevention and mitigation.展开更多
BACKGROUND: Administering oxygen therapy(OT) has an essential role in preventing/managing hypoxemia in both acute and chronic conditions. It should be adjusted to achieve the normal oxygen saturation of 94%–98% in mo...BACKGROUND: Administering oxygen therapy(OT) has an essential role in preventing/managing hypoxemia in both acute and chronic conditions. It should be adjusted to achieve the normal oxygen saturation of 94%–98% in most cases. This study aims to evaluate knowledge, attitude and practice(KAP) of nurses, paramedics, emergency medical technicians(EMTs) and Emergency Medical Services(EMS) physicians working at emergency departments(ED) in Riyadh, Saudi Arabia. METHODS: In this cross-sectional study, a structured questionnaire was used to assess KAP related to OT of nurses, paramedics, EMTs and EMS physicians currently working at an ED of a tertiary care hospital. Knowledge and attitude were assessed using a Likert scale from 1–5, whereas practice was assessed as a yes/no categorical variable.RESULTS: A total of 444 emergency health-care workers(EHCWs) participated, of which 225(50.7%) were male, with the majority(77%) in the age group of 20–35 years. Over half of the sample were nurses(266; 59.9%). The mean score for knowledge about OT was 5.51±1.45, attitude was 26.31±3.17 and for practices 4.55±1.76. The main factors which were associated with poor KAP were workload and lack of local guidelines. The distribution of overall practice score was signifi cantly better among paramedics – nurses group and EMT – nurses group.CONCLUSION: This study demonstrates that there is a gap in EHCWs' KAP, particularly regarding when to provide OT to a patient. This gap can affect patients' safety. Extensive educational and training programs about OT are needed to raise awareness among health-care providers.展开更多
Fast inversion of source rupture process for significant earthquake is introduced and applied to earthquake emergency response. We retrieve and use the apparent source time functions (ASTFs) to stabilize the rupture p...Fast inversion of source rupture process for significant earthquake is introduced and applied to earthquake emergency response. We retrieve and use the apparent source time functions (ASTFs) to stabilize the rupture process inversion, aiming to get the rupture process results correctly and quickly. The applications to 22 significant earthquakes occurred between January 2009 and July 2011 show an average inversion time consumed of about four hours, suggesting a high efficiency of this method, which much improves the inversion speed of the rupture process and is helpful in earthquake disaster mitigation and relief.展开更多
Purpose::Discuss on the disaster-related nursing competency training of Chinese emergency nurses.Methods::By retrieving concerned literatures,summarize the current situation of disaster responses of Chinese emergency ...Purpose::Discuss on the disaster-related nursing competency training of Chinese emergency nurses.Methods::By retrieving concerned literatures,summarize the current situation of disaster responses of Chinese emergency nurses and the impact factors of disaster-related nursing competencies.Results::The disaster preparedness of emergency nurses in China is at a medium level and must be improved.The impact factors include the educational degree,gender,disaster relief experience,training,and mechanisms for domestic disaster relief.Conclusion::As a direct response to disaster,emergency nurses should improve the comprehensive ability of disaster nursing by systematic disaster nursing education and professional training.展开更多
基金National Key Research Program(2017YFC0806702-8)。
文摘This paper first explores the development and direction of disaster and emergency medicine in China and abroad from the perspective of international environment and history background, analyses four elements of disaster and emergency medicine, including subject content, professionals, education practice and technical innovation, clarifies the interdependency between disaster medicine and emergency medicine, and reveals the developing rules of disaster medicine and emergency medicine. It also provides suggestions for China's development of disaster medicine and emergency medicine.
文摘BACKGROUND： Emergency medicine was inaugurated, as an official specialty in China, only25 years ago, and its growth in clinical practice and academic development since that time have beenremarkable.METHODS： This paper is a critical and descriptive review on current situations in emergencymedicine in China, based on the literature review, personal observations, interviews with manyChinese emergency medicine doctors and experts, and personal experience in both China and USA.RESULTS： The current practice of emergency medicine in China encompasses three areas： prehospitalmedicine, emergency medicine, and critical care medicine. Most tertiary emergency departments（EDs） are structurally and functionally divided into several clinical areas, allowing the ED itself to functionas a small independent hospital. While Chinese emergency physicians receive specialty training througha number of pathways, national standards in training and certifi cation have not yet been developed. As aresult, the scope of practice for emergency physicians and the quality of clinical care vary greatly betweenindividual hospitals. Physician recruitment, diffi cult working conditions, and academic promotion remain asmajor challenges in the development of emergency medicine in China.CONCLUSION： To further strengthen the specialty advancement, more government leadershipis needed to standardize regional training curriculums, elucidate practice guidelines, provide fundingopportunities for academic development in emergency medicine, and promote the development of asystem approach to emergency care in China.
基金supported by National Social Science Foundation of China (Grant No.17ZDA030).
文摘Probabilistic linguistic term sets(PLTSs)are an effective tool for expressing subjective human cognition that offer advantages in the field ofmulti-attribute decision-making(MADM).However,studies have found that PLTSs have lost their ability to accurately capture the views of decision-makers(DMs)in certain circumstances,such as when the DM hesitates between multiple linguistic terms or the decision information is incomplete,thus affecting their role in the decision-making process.Belief function theory is a leading streamof thought in uncertainty processing that is suitable for dealing with the limitations of PLTS.Therefore,the purpose of this study is to extend PLTS to incorporate belief function theory.First,we provide the basic concepts of the extended PLTS(i.e.,belief-based PLTS)through case analyses.Second,the aggregation operator of belief-based PLTS is defined with the ordered weighted average(OWA)-based soft likelihood function,which is improved by considering the reliability of the information source.Third,to measure the magnitude of different belief-based PLTSs,the belief interval of singleton is calculated,and the comparison method of belief-based PLTS is constructed based on probabilities.On the basis of the preceding discussion,we further develop an emergency decision framework that includes several novel techniques,such as attribute weight determination and decision information aggregation.Finally,the usefulness of the framework is demonstrated through a case study,and its effectiveness is illustrated through a series of comparisons.
文摘BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all.RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure.CONCLUSION: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.
文摘BACKGROUND: We compare educational environments(i.e. physical, emotional and intellectual experiences) of emergency medicine(EM) residents training in the United States of America(USA) and Saudi Arabia(SA).METHODS: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure(PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales(autonomy, teaching, and social Support), using chi-squared, t-tests, and analysis of variance.RESULTS: A total of 219 surveys were returned for 260 residents across six programs(3 SA, 3 USA), with a response rate of 84%. Program-specific response rates varied from 79%–100%. All six residencies were qualitatively rated as "more positive than negative but room for improvement". Quantitative PHEEM scores for the USA programs were significantly higher: 118.7 compared to 109.9 for SA, P=0.001. In subscales, perceptions of social support were not different between the two countries(P=0.243); however, role autonomy(P<0.001) and teaching(P=0.005) were better in USA programs. There were no significant differences by post-graduate training year.CONCLUSION: EM residents in all three emergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.
文摘Given that it is difficult to assess the harmfulness and make emergency response timely in the early stage when flood disasters happen in cities for that the data are complex and rapidly changing, this article constructs a rapid assessment model, namely Simple Simos Procedure and PROMTHEE II Model (SSPPM), to assess the severity of flood disaster occurring in cities at the early stage based on a view of the rapid flood disaster assessment. On this basis, the fuzzy VIKOR method is applied to choose a scientific emergency plan. This article aims to construct a research framework model, which can provide some practice implications to reduce the losses caused by flood disaster.
文摘To guarantee a unified response to disasters, humanitarian organizations work together via the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Although the OCHA has made great strides to improve its information management and increase the availability of accurate, real-time data for disaster and humanitarian response teams, significant gaps persist. There are inefficiencies in the emergency management of data at every stage of its lifecycle: collection, processing, analysis, distribution, storage, and retrieval. Disaster risk reduction and disaster risk management are the two main tenets of the United Nations’ worldwide plan for disaster management. Information systems are crucial because of the crucial roles they play in capturing, processing, and transmitting data. The management of information is seldom discussed in published works. The goal of this study is to employ qualitative research methods to provide insight by facilitating an expanded comprehension of relevant contexts, phenomena, and individual experiences. Humanitarian workers and OCHA staffers will take part in the research. The study subjects will be chosen using a random selection procedure. Online surveys with both closed- and open-ended questions will be used to compile the data. UN OCHA offers a structure for the handling of information via which all humanitarian actors may contribute to the overall response. This research will enable the UN Office for OCHA better gather, process, analyze, disseminate, store, and retrieve data in the event of a catastrophe or humanitarian crisis.
文摘BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS:Residency program directors at all US-based Emergency Medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.
文摘BACKGROUND: Sleep deprivation resulting from night shifts, is a major cause of burnout among physicians. Exogenous melatonin may improve sleep quality in night-shift workers. The study aims to compare the effectiveness of melatonin versus placebo on sleep effi ciency in emergency medicine(EM) residents. METHODS: A randomized, double-blind, replicated crossover trial was performed on EM residents. This study consisted of 4 phases within a month with intervention periods of 2 nights and washouts of 6 days. In our study, EM residents had nine-hour shifts on 6 consecutive days, 2 mornings, 2 evenings and 2 nights and then 2 days off. At the end of shifts' cycle, 24 EM residents were given 3 mg melatonin or placebo(12 in each arm of the study) for 2 consecutive nights after the second night shift with crossover to the other arm after a six-day off drug. This crossover intervention was repeated for two more another time. Finally, we created 48 cases and comparisons in each arm. Different items related to sleep quality were assessed and compared both within the same group and between the two groups. RESULTS: In the melatonin group, daytime sleepiness(calculated by Karolinska Sleep Scale) had a signifi cant reduction after taking the second dose of drug(P=0.003) but the same result was not observed when comparing the 2 groups. Mood status(calculated by Profile of Mood States) showed no remarkable difference between the 2 groups. CONCLUSION: Melatonin might have a limited benefi t on sleep quality in EM residents working night shifts.
文摘The outbreak of coronavirus disease 2019(COVID-19)was declared a global public health emergency on 31 January 2020.Emergency medicine procedures in Emergency Department should be optimized to cope with the current COVID-19 pandemic by providing subspecialty services,reducing the spread of nosocomial infections,and promoting its capabilities to handle emerging diseases.Thus,the Chinese Society of Emergency Medicine and Wuhan Society of Emergency Medicine drafted this consensus together to address concerns of medical staffs who work in Emergency Department.Based on in-depth review of COVID-19 diagnosis and treatment plans,literatures,as well as management approval,this consensus proposes recommendations for improving the rationalization and efficiency of emergency processes,reducing the risk of nosocomial infections,preventing hospital viral transmission,and ensuring patient safety.
文摘BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing practices.METHODS: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.RESULTS: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.CONCLUSION: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.
文摘BACKGROUND:Macedonia has universal public health care coverage.Acute and emergency patient care is provided in different care environments based on the medical complaint and resource proximity.While emergency medicine and well organized emergency departments(EDs) are an essential component of any developed health care system,emergency medicine as a specialty is relatively non-existent in Macedonia.DATA RESOURCES:A system assessment regarding presence,availability and capacity of EDs was completed from 2013-2015,based upon assessments of 21 institutions providing emergency care and information provided by the Ministry of Health.This assessment establishes a benchmark from which to strategically identify,plan and implement the future of emergency medicine in Macedonia.RESULTS:In general,emergency departments- defined by offering acute care 24 hours per day,7 days per week- were available at all general and university hospitals.However,care resources,emergency and acute care training,and patient care capacity vary greatly within the country.There is limited uniformity in acute care approach and methodology.Hospital EDs are not organized as separate divisions run by a head medical doctor,nor are they staffed by specialists trained in emergency medicine.The diagnostic and treatment capacities are insufficient or outdated by current international emergency medicine standards and frequently require patient transfer or admission prior to initiation.CONCLUSION:Most of the surveyed hospitals are capable of providing essential diagnostic tests,but very few are able to do so at the point or time of presentation.While emergency medical services(EMS) have improved system-wide,emergent care interventions by EMS and within all hospitals remain limited.Further system-wide acute and emergency care improvements are forthcoming.
文摘As people live longer and fewer babies are born,the elderly became the fastest and largest growing population of the world,expected to increase further from 86 million in 2005 to 394 million in 2050 worldwide.Older patients represent a large bulk of the population arriving in emergency departments(EDs)all over the world.^([1])They use hospitals more frequently than younger patients。
基金Supported by Chongqing Soft Science Planning Program(cstc2012cx-rkxA00079)
文摘The damage caused by geological and meteorological disasters was pointed out in this paper through analyzing the features and causes of geological and meteorological disasters.To strengthen emergency management of geological and meteorological disasters,it is suggested to rigorously investigate potential geological hazard points,to strengthen observation and warning system,to take group prevention and group test as a supplementary to professional observation,to build up the last line of defense to geological and meteorological disasters,to set up functional cooperation mechanism,and to publicize disaster prevention and mitigation.
文摘BACKGROUND: Administering oxygen therapy(OT) has an essential role in preventing/managing hypoxemia in both acute and chronic conditions. It should be adjusted to achieve the normal oxygen saturation of 94%–98% in most cases. This study aims to evaluate knowledge, attitude and practice(KAP) of nurses, paramedics, emergency medical technicians(EMTs) and Emergency Medical Services(EMS) physicians working at emergency departments(ED) in Riyadh, Saudi Arabia. METHODS: In this cross-sectional study, a structured questionnaire was used to assess KAP related to OT of nurses, paramedics, EMTs and EMS physicians currently working at an ED of a tertiary care hospital. Knowledge and attitude were assessed using a Likert scale from 1–5, whereas practice was assessed as a yes/no categorical variable.RESULTS: A total of 444 emergency health-care workers(EHCWs) participated, of which 225(50.7%) were male, with the majority(77%) in the age group of 20–35 years. Over half of the sample were nurses(266; 59.9%). The mean score for knowledge about OT was 5.51±1.45, attitude was 26.31±3.17 and for practices 4.55±1.76. The main factors which were associated with poor KAP were workload and lack of local guidelines. The distribution of overall practice score was signifi cantly better among paramedics – nurses group and EMT – nurses group.CONCLUSION: This study demonstrates that there is a gap in EHCWs' KAP, particularly regarding when to provide OT to a patient. This gap can affect patients' safety. Extensive educational and training programs about OT are needed to raise awareness among health-care providers.
基金supported by the National Natural Science Foundation of China (No. 41090291)the Research Project in Earthquake Science, CEA (Nos. 201108002 and 200808068)
文摘Fast inversion of source rupture process for significant earthquake is introduced and applied to earthquake emergency response. We retrieve and use the apparent source time functions (ASTFs) to stabilize the rupture process inversion, aiming to get the rupture process results correctly and quickly. The applications to 22 significant earthquakes occurred between January 2009 and July 2011 show an average inversion time consumed of about four hours, suggesting a high efficiency of this method, which much improves the inversion speed of the rupture process and is helpful in earthquake disaster mitigation and relief.
文摘Purpose::Discuss on the disaster-related nursing competency training of Chinese emergency nurses.Methods::By retrieving concerned literatures,summarize the current situation of disaster responses of Chinese emergency nurses and the impact factors of disaster-related nursing competencies.Results::The disaster preparedness of emergency nurses in China is at a medium level and must be improved.The impact factors include the educational degree,gender,disaster relief experience,training,and mechanisms for domestic disaster relief.Conclusion::As a direct response to disaster,emergency nurses should improve the comprehensive ability of disaster nursing by systematic disaster nursing education and professional training.
