Major Incident Experience and Preparedness in a Developing Country

2013 ◽  
Vol 7 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Hesam Seyedin ◽  
Rouhollah Zaboli ◽  
Hamid Ravaghi

AbstractBackgroundResearch shows that having previous experience of major incidents has a positive impact on awareness and preparedness of organizations. We investigated the effects of major incident experience on preparedness of health organizations on future disasters in Iran.MethodsA qualitative study using a semistructured interview technique was conducted with 65 public health and therapeutic affairs managers. Analysis of the data was performed used the framework analysis technique, which was supported by qualitative research software.ResultsThe study found that prior experience of major incidents results in better performance, coordination, and cooperation in response to future events. There was a positive effect on policy making and resource distribution and an increase in (1) preparedness activities, (2) raising population awareness, and (3) improving knowledge. However, the preparedness actions were predominantly individual-dependent.ConclusionsOur findings showed that to increase system efficiency and effectiveness within health organizations, an appropriate major incident management system is needed. The new system can use lessons learned from previous major incidents to better equip health organizations to cope with similar events in the future. (Disaster Med Public Health Preparedness. 2013;7:313-318)

2018 ◽  
Vol 27 (5) ◽  
pp. 523-533
Author(s):  
Adrienne Lefevre ◽  
Madison Walter-Garcia ◽  
Kimberly Hanson ◽  
Julia Smith-Easley

Purpose In the incident command system (ICS) structure, response documentation is formally found within the planning section. However, longer term emergency responses have demonstrated the need for a flexible and innovative role that encompasses a variety of activities, including response documentation, communications science, real-time evaluation of major themes, and information management. The paper aims to discuss this issue. Design/methodology/approach This need can be universally met through the functional role of “Historian,” a term specific to ICS, or in the case of public health response, incident management system (IMS). It should be noted that the Historian role discussed is not related to the academic study of history, but to archiving key successes and challenges during a response. Ideally the Historian should be activated at the start of an emergency response and remain active to capture the overall picture of the response, including internal information, such as lessons learned, response activities, and decision-making processes. Findings The Historian compiles details of response activities that inform leadership, donors and external communications products while alleviating pressures on the planning section. The primary, minimum output of an IMS Historian is a response timeline, which notes major internal and external events during a response with emphasis on major themes, lessons learned, and creating a user-friendly interface to display this information (see the list “Abbreviated Example of Hurricane Matthew Response Timeline” in the text). Originality/value In a world with competing priorities and ongoing emergencies, the Historian’s role of archiving details of response efforts can help the international public health community to share lessons learned and contribute to lower morbidity and mortality among those affected by emergencies.


2018 ◽  
Vol 33 (6) ◽  
pp. 587-595 ◽  
Author(s):  
Nidaa A. Bajow ◽  
Wajdan I. AlAssaf ◽  
Ameera A. Cluntun

AbstractIntroductionUnacceptable practices of health care providers during disasters have been observed because they work outside the scope of their daily practices and have inadequate training. A greater need for the involvement of health professionals in disaster management has been noted in Saudi Arabia. This study evaluates the efficacy of a training course in prehospital major incident management for health care providers in Saudi Arabia.MethodsAn interactive course for general principles in prehospital major incident management was developed with domains and core competencies. The course was designed according to the local context and was based on international standards. It was piloted over four days at the Officers Club of the Ministry of Interior (Riyadh, Saudi Arabia) and was sponsored by Mohammed Bin Naif Medical Center, King Fahd Security College in Riyadh, Saudi Arabia. The participants (n=29) were from different disciplines from main government health facilities in Riyadh. They completed a pre-test and a post-test.ResultsThe overall score was 55.1% on the pre-test and 68.4% on the post-test (Wilcoxon test for paired samples, P <.05). Three out of the four domains had significant difference between pre- and post-test results, as well as the overall total knowledge.Conclusion:Conducting inter-disciplinary and competency-based disaster medicine courses for health care providers can augment appropriate disaster preparedness for major incidents in Saudi Arabia.BajowNA,AlAssafWI,CluntunAA.Course in prehospital major incidents management for health care providers in Saudi Arabia.Prehosp Disaster Med.2018;33(6):587–595.


Author(s):  
Ian Greaves ◽  
Paul Hunt

Chapter 1 covers information on what a major incident is, definitions and classifications including chemical, biological, radiological and nuclear (CBRN), special arrangements, historical and recent major incidents, mass fatalities, the Civil Contingencies Act 2004, nomenclature, and the Joint Emergency Services Inter-operability Programme (JESIP). The phases and objectives of a response to a major incident are described. This chapter also outlines the generic structured approach including command and control, safety (including zones and cordons), communication, assessment, triage and categorization systems, casualty treatment, roles and responsibilities, and casualty transportation.


2009 ◽  
Vol 4 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Seyed Hesam Seyedin, PhD ◽  
Mohammad Reza Aflatoonian, MPH ◽  
James Ryan, OStJ, MCh, FRCS, DMCC, FFAEM

Background: On December 26, 2003, an earthquake occurred in the city of Bam in Iran which completely destroyed the city. National and international responses to the calamity were quick and considerable and nongovernmental organizations (NGOs) from all over the world conducted extensive emergency assistance, fulfilling a crucial role during the emergency.The present study discusses some difficulties and problems which originated from the activities of international NGOs during their response to the Bam earthquake.Methods: A qualitative study using semistructured interview technique was conducted with nineteen public health and therapeutic affairs managers who were directly responsible for response and recovery in Bam. Analysis of the data was carried out by the framework analysis technique and supported by qualitative research software, the Atlas.ti.Results: The study found that although international NGOs did their best to help people in the region, they also had some adverse impacts on the community in the disaster affected areas. The problems originated from lack of knowledge of cultural issues, inefficient timing for the delivery of funds and services, uneven goods delivery, and poor communication with local people and authorities.Conclusions: The study’s findings could have implications for the international aid organizations including the United Nations (UN). Some activities such as roles and responsibilities of the NGOs; networking; and coordination and education of the NGOs could serve as the cornerstone for improvement of their efforts during disasters.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P A Cook ◽  
C Ure ◽  
S C Hargreaves ◽  
E Burns ◽  
M Coffey ◽  
...  

Abstract Background Communities in Charge of Alcohol (CICA) is an Asset Based Community Development (ABCD) place-based approach to reducing alcohol harm. Local volunteers, from areas with multiple indicators of deprivation, train to become accredited 'Alcohol Health Champions' (AHCs). AHCs, supported by a local co-ordinator, provide brief opportunistic advice at an individual level and mobilise action on alcohol availability through influencing licensing decisions at a community level. CICA is the first programme we are aware of globally that has attempted to build local AHC capacity. Here we explore lessons learned from four case study areas (of the original ten) that persisted with the intervention for more than 12 months. Methods A case study approach to investigate the context, acceptability, facilitators and barriers to maintaining CICA. Descriptive analysis of ongoing recruitment of champions, numbers of training events and activity of champions (as reported by area coordinators). Framework analysis of interviews with AHCs and stakeholders. Results CICA has increased public health capacity by training 123 AHCs in its first year. The four areas that continued with CICA have trained a further 34. The different approaches in the four areas include: embedding champions in wider health champion/volunteering projects; innovative use of new technology (portable fibroscan); expansion into different geographical areas. AHCs and coordinators report significant social value from participation in CICA. Conclusions The likelihood of embedding CICA into a local area's activities appeared to be dependent on the energy and enthusiasm of the local area's co-ordinator, and may be dependent on that individual remaining in post. ABCD programmes may be more likely to be sustainable if capacity building is supported. CICA might be more sustainable if it was embedded in a wider programme of ABCD, since health issues are interrelated and AHCs often wish to broaden their portfolio. Key messages A volunteer alcohol health champions programme increased public health capacity in areas of social deprivation by utilising the assets (skills) of local people. Embedding a community alcohol health champions programme in a wider programme of asset based community development is more sustainable and allows champions to broaden their volunteering portfolio.


2020 ◽  
Vol 10 (3) ◽  
pp. 175-179 ◽  
Author(s):  
Amir Khorram-Manesh

Background: Failed attempts to improve the delivery of healthcare to communities show distinct flaws that have a higher impact during a major incident or disaster (MID). This study evaluates the concept of surge capacity, which intends to achieve a balance between the needs and resources in affected areas by providing staff, stuff, structure, and system. Methods: A systematic literature review was performed according to the PRISMA statement and by using PubMed, Scopus, and Google Scholar, and related keywords. Results: There were limited publications about flexible surge capacity (FSC). However, the sum of data obtained indicated the need for flexibility in expanding major incidents or disasters, demanding new resources, which may neither be available on time nor reachable due to infrastructural damage. Conclusion: FSC is a novel concept based on international guidelines. It refers to the extra and adjustable human and material resources that can be mobilized by activating nonprofessional but educated staff and different but accepted facilities in a fast, smooth, and productive way. Public health and public education play an essential role in obtaining such flexibility.


2013 ◽  
Vol 28 (2) ◽  
pp. 170-173 ◽  
Author(s):  
Benjamin W. Wachira ◽  
Wayne Smith

AbstractKenya's major incidents profile is dominated by droughts, floods, fires, terrorism, poisoning, collapsed buildings, accidents in the transport sector and disease/epidemics. With no integrated emergency services and a lack of resources, many incidents in Kenya escalate to such an extent that they become major incidents. Lack of specific training of emergency services personnel to respond to major incidents, poor coordination of major incident management activities, and a lack of standard operational procedures and emergency operation plans have all been shown to expose victims to increased morbidity and mortality.This report provides a review of some of the major incidents in Kenya for the period 2000-2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.WachiraB, SmithW. Major incidents in Kenya: the case for emergency services development and training. Prehosp Disaster Med. 2013;28(2):1-4.


BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048792
Author(s):  
Karin Hugelius ◽  
Samuel Edelbring ◽  
Karin Blomberg

ObjectiveTo explore the relationship between preparations and real-life experiences among prehospital major incident commanders.DesignAn explorative, qualitative design was used.SettingPrehospital major incidents in Sweden. Data were collected between December 2019 and August 2020.ParticipantsPrehospital major incident commanders (n=15) with real-life experiences from major events, such as fires, bus accidents, a bridge collapse and terrorist attacks, were included. All but one had participated in 2-day training focusing on the prehospital management of major incidents. In addition, about half of the participants had participated in simulation exercises, academic courses and other training in the management of major incidents.MethodsData from two-session individual interviews were analysed using inductive thematic analysis.ResultsThe conformity between real-life major incidents and preparations was good regarding prehospital major incident commanders’ knowledge of the operational procedures applied in major incidents. However, the preparations did not allow for the complexities and endurance strategies required in real-life incidents. Personal preparations, such as mental preparedness or stress management, were not sufficiently covered in the preparations. To some extent, professional experience (such as training) could compensate for the lack of formal preparations.ConclusionsThis study identified perceived gaps between preparations and real-life experiences of being a prehospital major incident commander. To minimise the gaps between demands and expectations on perceived control and to better prepare individuals for being prehospital major incident commanders, the training and other preparations should reflect complexities of real-life incidents. Preparations should develop both technical skills required, such as principles and methodology used, and personal preparedness. Personal preparations should include improving one’s mental preparedness, self-knowledge and professional self-confidence required to successfully act as a prehospital incident commander. Since little is known about what pedagogical methods that should be used to enhance this, further research is needed.


2012 ◽  
Vol 27 (4) ◽  
pp. 351-358 ◽  
Author(s):  
Kevin Mackway-Jones ◽  
Simon Carley

AbstractObjectiveTo collate the opinions of experts and to reach consensus about the research priorities in the management of major incidents.DesignA three-round e-Delphi study was conducted using an international panel of experts drawn from active researchers and active educators in major incident management. General areas for consideration were derived from the literature analysis undertaken as part of the overall project.ResultsExperts generated 221 statements in 11 topic areas in the first round. Fifty-one of these statements reached consensus in Round 2. A further 23 statements reached consensus in Round 3, leaving 147 statements that did not reach consensus.ConclusionsAn international expert panel reached consensus on 74 topics of research priority in major incidents management. The strongest themes within these topics were education and training, planning, and communication.Mackway-Jones K, Carley S. An international expert Delphi study to determine research needs in major incident management. Prehosp Disaster Med. 2012;27(4):1-8.


2017 ◽  
Vol 12 (3) ◽  
pp. 373-378
Author(s):  
Mathieu Pasquier ◽  
Fabrice Dami ◽  
Pierre-Nicolas Carron ◽  
Bertrand Yersin ◽  
Rodrigue Pignel ◽  
...  

ABSTRACTCarbon monoxide (CO) can cause mass intoxication, but no standard triage algorithm specifically addresses CO poisoning. The roles of some recent diagnostic tools in triage as well as treatment with hyperbaric oxygen are controversial. We describe a mass casualty case of CO poisoning involving 77 patients, with a focus on the triage and treatment options decided on-site. The reasons for choosing these options are reviewed, and the pitfalls that occurred and the lessons learned from this major incident are described. We discuss the potential to improve the management of such an event and strategies to accomplish this, including simplifying triage and administering oxygen to all exposed persons for 6 h. (Disaster Med Public Health Preparedness. 2018; 12: 373–378)


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