Powered equipment for patient handling was designed to alleviate Emergency Medical Service (EMS) clinician injuries while lifting patients. This project evaluated the organizational rationale for purchasing powered equipment and the outcomes from equipment use.

This project analyzed secondary data obtained via an insurance Safety Intervention Grant (SIG) program in Ohio USA. These data were primarily in reports from EMS organizations. Investigators applied a mixed-methods approach, analyzing quantitative data from 297 grants and qualitative data from a sample of 64 grants. Analysts abstracted data related to: work-related injuries or risk of musculoskeletal-disorders (MSD), employee feedback regarding acceptance or rejection, and impact on quality, productivity, staffing, and cost.

A total of $16.67 million (2018 adjusted USD) was spent from 2005 through 2018 for powered cots, powered loading systems, powered stair chairs, and non-patient handling equipment (eg, chest compression system, powered roller). Organizations purchased equipment to accommodate staff demographics (height, age, sex) and patient characteristics (weight, impairments). Grantees were fire departments (n = 254) and public (n = 19) and private (n = 24) EMS organizations consisting of career (45%), volunteer (20%), and a combination of career and volunteer (35%) staff. Powered equipment reduced reported musculoskeletal injuries, and organizations reported it improved EMS clinicians’ safety. Organization feedback was mostly positive, and no organization indicated outright rejection of the purchased equipment. Analyst-identified design advantages for powered cots included increased patient weight capacity and hydraulic features, but the greater weight of the powered cot was a disadvantage. The locking mechanism to hold the cot during transportation was reported as an advantage, but it was a disadvantage for older cots without a compatibility conversion kit. Around one-half of organizations described a positive impact on quality of care and patient safety resulting from the new equipment.

Overall, organizations reported improved EMS clinicians’ safety but noted that not all safety concerns were addressed by the new equipment.

Understanding the disaster profile of WHO-regions is crucial for anticipating future needs for mobilizing emergency medical teams and enhancing healthcare surge during disasters.

This study provides an overview of disaster profile and associated health needs globally and regionally.

Secondary data were retrieved from multiple open data sources. 50-year disaster trends were assessed. Global and regional disaster patterns, cumulative crude and standardized incidence and health impact for the last 16 years were calculated, and regional disparities were compared.

Climate-related disasters have significantly increased globally, especially floods and storms. They, along with droughts, lead to the highest humanitarian needs and displacement, increasing healthcare demands. Conflicts, notably in the Eastern-Mediterranean region, have also increased, causing substantial health impacts.

Epidemics caused the highest morbidity and earthquakes caused the highest mortality, especially in fragile and conflict-affected states (FCAS), where disaster frequencies per population are significantly higher than in non-FCAS. Storms and extreme temperatures also contribute significantly to disaster-mortality, especially in Southeast-Asia and Europe.

Africa experienced the highest number of disasters, while the Western-Pacific bore the highest crude health impact. However, Southeast-Asia, Eastern-Mediterranean, and African regions - where access to healthcare is limited- showed a higher disaster incidence rate and health impact per 100,000 population. Within regions, disparities are prominent, with some FCAS exhibiting exceptionally high disaster rates and impacts, exceeding regional and global averages.

Investment in regional and national emergency medical teams and equivalent rapid response capacities, adapting tailored strategies to regional disaster profiles, is urgently needed, especially for FCAS in Southeast-Asia, Eastern-Mediterranean, Africa regions.

Many Emergency Medical Services (EMS) agencies modified their protocols during the height of the COVID-19 pandemic, particularly those involving procedures that lead to an increased risk of airborne exposure, such as intubation. In 2020, local Advanced Life Support (ALS) providers’ first-line airway management device was the supraglottic airway (SGA), and tracheal intubations (TIs) were rarely performed.

This study’s aim was to investigate the potential clinical effect of this pandemic-related protocol change on first-pass TI success rates and on overall initial advanced airway placement success.

This study was a retrospective prehospital chart review for all ALS encounters from a single urban EMS agency that resulted in the out-of-hospital placement of at least one advanced airway per encounter from January 1, 2019 through June 30, 2021 (n = 452). Descriptive statistics and chi square tests were used to evaluate data. Statistical significance was defined at P < .05.

Significantly fewer TIs were attempted in 2020 (n = 16) compared to 2019 (n = 80; P < .001), and first-pass TI success rates significantly decreased in 2021 (n = 22; 61.1%) compared to 2019 (n = 63; 78.8%; P = .047). Also, SGA placement constituted 91.2% of all initial airway management attempts in 2020 (n = 165), more than both 2019 (n = 114; 58.8%; P < .001) and 2021 (n = 87; 70.7%; P < .001). Overall first-attempt advanced airway placement success, encompassing both supraglottic and TI, increased from 2019 (n = 169; 87.1%) to 2020 (n = 170; 93.9%; P = .025). Conversely, overall first attempt advanced airway placement success decreased from 2020 to 2021 (n = 104; 84.6%; P = .0072).

Lack of exposure to TI during the COVID-19 pandemic likely contributed to this local agency’s decreased first-pass TI success in 2021. Moving forward, agencies should utilize simulation labs and other continuing education efforts to help maintain prehospital providers’ proficiency in performing this critical procedure, particularly when protocol changes temporarily hinder or prohibit field-based psychomotor skill development.

Patients with thoracic trauma require rapid decision making and early intervention, especially during natural disasters when the influx of patients complicates hospitalization decisions. Identifying the characteristics of these patients can improve triage protocols, optimize resource allocation, and enhance outcomes in future disaster scenarios.

The aim of this study was to determine the characteristics of hospitalized patients after the February 2023 earthquakes in Türkiye and to contribute to Disaster Medicine.

This retrospective, cross-sectional study was conducted in a university hospital’s emergency department (ED) located in the earthquake area. All patients over 18 years old with earthquake-related thoracic trauma were included. Demographic information, mechanisms of injury, associated injuries, laboratory results, and treatments were recorded. Patients were divided into two groups: discharged and hospitalized.

The study included 179 patients, with a median age of 45 years. Overall, 80.4% were trapped under debris, and 43.8% were rescued on the first day. Hospitalization rates were higher in patients trapped under debris and those rescued after the first day. Blunt thoracic trauma was observed in 95.5% of patients. One hundred and three patients (57.5%) underwent Extended Focused Assessment with Sonography in Trauma (E-FAST) in the ED, 152 patients (84.9%) underwent x-ray, and 129 patients (72.1%) underwent computed tomography (CT). Imaging studies revealed rib fractures in 49.7% and lung parenchymal injuries in 48.6% of patients. Patients with lung parenchymal injury had higher hospitalizations rates. Hospitalized patients had higher levels of white blood cells (WBCs), potassium, blood urea nitrogen (BUN), creatinine, creatinine kinase (CK), creatine kinase-myocardial band (CKMB), and troponin I.

This study highlights the prevalence of blunt thoracic trauma and the importance of imaging in the assessment of thoracic injuries following earthquakes. While few patients needed surgery, many required hospitalizations and had abnormal laboratory results, emphasizing the need for careful monitoring for complications like muscle damage and infection.

The Ethiopian Emergency Medical Team (EMT) Strategic Plan (2024-2029) is critical to strengthen the nation’s capacity to respond to health emergencies. It provides a structured approach to developing a comprehensive, standardized, and resilient national EMT system that meets international standards.

To establish a robust framework for developing, maintaining, and enhancing a nationally coordinated EMT system. The plan aims to ensure that Ethiopia is well-prepared to respond to health emergencies timely, efficiently, and effectively at national, continental, and global levels.

The strategic plan was developed through a collaborative process involving experts from various disciplines. A thorough situational analysis was conducted, assessing the strengths, weaknesses, opportunities, and threats of the current EMT system. This analysis was aligned with the institutional mission, vision, and values, as well as national and international humanitarian and health standards, regulations, and frameworks.

The strategic plan outlines six key initiatives to operationalize the EMT framework. These include establishing governance and leadership structures, enhancing stakeholder collaboration, implementing digital information and knowledge management systems, continuous capacity building for EMT members, strengthening operations and logistics support (OSL) systems, and ensuring standardization through the establishment of subnational EMTs. These initiatives are supported by actionable steps with a monitoring and evaluation mechanism to ensure effective implementation.

The EMT Strategic Plan for Ethiopia is a critical document setting foundation for a responsive and resilient EMT. By integrating governance, collaboration, technology, training, logistics, and quality assurance, Ethiopia aims to create a world-class EMT system dedicated to saving lives and alleviating suffering during public health emergencies.

Non-traumatic back pain commonly leads people to seek health care from paramedics via triple-zero (emergency phone number in Australia), yet the management approaches by providers of ambulance services remain unclear.

This study aims to investigate paramedic management of non-traumatic back pain in New South Wales (NSW), Australia, including the call characteristics, provisional diagnoses, and the clinical care being delivered by paramedics.

This study is a retrospective analysis of NSW Ambulance computer-aided dispatch and electronic medical records from January 1, 2017 through December 31, 2022. Adults who sought ambulance service with a chief complaint of back pain, were triaged as non-traumatic back pain, and subsequently received treatment by paramedics were included. Multivariable logistic regression models were used to explore factors associated with primary outcomes; ambulance transport, opioid use, and use of medication combinations were reported as odds ratios (ORs).

There were 73,128 calls to NSW Ambulance with a chief complaint of back pain that were triaged as non-traumatic back pain. Of these, 54,444 (74.4%) were diagnosed with spinal pain, of which 52,825 (97.1%) were categorized by the paramedic as back or neck pain, 1,573 (2.9%) as lumbar radicular pain, and 46 (0.1%) as serious spinal pathology. Eight out of ten patients with spinal pain were transported to emergency departments. The medicine most administered by a paramedic was an opioid (37.4% of patients with spinal pain). Older patients (OR = 1.36; 95% CI, 1.30 to 1.44) were more likely to be transported to an emergency department. Patients with moderate (OR = 4.39; 95% CI, 4.00 to 4.84) and severe pain (OR = 18.90; 95% CI, 17.18 to 20.79) were more likely to be administered an opioid.

Paramedic management of non-traumatic back pain in NSW typically results in the administration of an opioid and transport to an emergency department.

The episodic nature of crises necessitates the right-siting of resources. By leveraging the capabilities of the private sector, the MOH can remain focused on its core functions without being encumbered by logistics management and manpower concerns.

In under 18 months, The Ministry of Health (MOH) of Singapore advanced the Singapore Emergency Medical Team (SGEMT) classification by adopting a whole-of-government and private sector collaborative approach.

In-depth appreciation of WHO EMT requirements and recognition of MOH own limitations, MOH tapped into the expertise of medical practitioners and incorporated insights from the Singapore Armed Forces and Singapore Civil Defence Force, who brought valuable experience from past humanitarian missions.

MOH made the strategic decision to outsource non-core functions such as warehousing, equipment maintenance, and ready-pool of technicians that can be rapidly mobilized. These functions were outsourced to a stringently selected service provider.

To complement these efforts, the MOH engaged in learning from regional partners, participating in study trips, and regional exercises. This ensured a comprehensive understanding of best practices from the EMT global community. Additionally, the MOH participated in regional disaster response framework, which includes the ASEAN EMT SOP.

The MOH’s foresight in partnering with the Ministry of Foreign Affairs has fortified the SGEMT’s global operational capabilities, ensuring support from Singapore’s diplomatic network worldwide when required.

This strategic alliance underscores Singapore’s dedication to global health security and exemplifies a proactive approach to emergency preparedness and response, demonstrating the nation’s readiness to tackle crises effectively.

This strategic alliance underscores Singapore’s dedication to global health security and exemplifies a proactive approach to emergency preparedness and response, demonstrating the nation’s readiness to tackle crises effectively.

Anaphylactic reactions can lead to life-threatening situations. Therefore, a rapid diagnosis and therapy are indicated. Various guidelines recommend immediate treatment with intramuscular adrenaline in severe anaphylaxis. Based on study data from different countries, it has been shown that therapy of anaphylaxis is often not carried out according to existing guidelines.

The aim of the study was an analysis of the emergency treatment and outcome of anaphylaxis in children and adults according to its severity. Focus was placed on the recommended first-line therapy with adrenaline in cases of severe reactions. Further demographic data, triggers, symptoms, and hospitalization rates of anaphylaxis were analyzed.

Data from Emergency Medical Services from Dresden/Germany in cases of anaphylaxis from the start of 2012 through the end of 2016 were retrospectively analyzed. The data of the air rescue were not considered. The severity of the anaphylaxis, the therapy, the further monitoring, and the outcome were analyzed.

A total of 1,131 adults and 223 children with anaphylactic reactions (Grade I-IV) were analyzed. Overall, 591 adults and 102 children showed a severe anaphylaxis. The most common trigger for severe anaphylactic reactions was food in children (61%) and medication in adults (33%). Seven percent of adults and eight percent of children with Grade II or higher anaphylactic reactions received adrenaline. There is a significant correlation between adrenaline therapy and improved condition/outcome in adults and children. Sixty-six percent of adults and 83% of children with severe anaphylaxis were hospitalized. Twenty-one percent of the adults and 13% of the children did not receive further medical observation despite a severe reaction.

The guideline-compliant first-line therapy with adrenaline was not carried out in the majority of the cases analyzed. However, the study shows that treatment with adrenaline for anaphylaxis leads to a significant improvement in the patients’ condition.

Research was conducted to identify needs for policy and legislation changes aimed at creating enabling environment for the implementation of the Emergency Medical Teams (EMT) Regional Action Plan 2024-2030 (RAP) to be facilitated by the WHO Regional European EMT Capability Hub (REECH).

• Establishing commonalities and differences in EMT-related policy and legislation in countries representing different subregions of the WHO/Europe.

• Informing the RAP policy and legislation framework development.

An analysis of the legal and normative frameworks governing EMTs in the selected countries – Spain, the UK, Georgia, Kyrgyzstan. The study involves reviewing legislative documents, policy frameworks, and operational guidelines that regulate EMTs’ integration into national health systems and emergency response coordination mechanisms.

Common characteristics of national legislation and policy frameworks include clear legal mandates, integration with national health systems, and alignment with national health policies. Differences identified: EMT governance and subordination (e.g., health sector in Georgia and UK, civil protection domain in Spain and Kyrgyzstan); patterns of international collaboration (e.g., stronger engagement with EUCPM for Spain, WHO guidance and support for Kyrgyzstan and Georgia).

The WHO European region’s diversity informs different approaches to policies and legislation aimed at supporting RAP. Enablers include clear EMT mandates and their integration with national health systems and international mechanisms. However, routes to these enablers vary due to differences in policies, health system design, and legislation adoption procedures. Future research will include more countries and a detailed list of research questions to identify patterns in legislation and policy enablers for achievement of the Global EMT goals.

This study aimed to design and validate a measurement tool in Turkish to assess the challenges perceived by individuals involved in the disaster response process, such as volunteers, health care personnel, firefighters, and members of nongovernmental organizations (NGOs).

This methodological study was conducted from November 2023 through March 2024. The scale development process comprised item development, expert reviews, and language control, followed by the creation of a draft survey, pilot testing, application of the final scale, and statistical analyses. All stages, including validity and reliability analyses, were conducted in Turkish. While reliability analysis used Cronbach’s alpha, item-total correlations, intraclass correlation coefficients, test-retest reliability, Tukey’s additivity, and Hotelling’s T-squared tests, validity analysis included Exploratory and Confirmatory Factor Analyses (EFA/CFA). Software such as AMOS 22.0 and SPSS 22.0 were used to perform statistical analysis.

Findings indicated six dimensions with 23 items, with factor loadings ranging from 0.478 to 0.881. The CFA demonstrated acceptable fit indices. Test-retest analysis showed a robust positive correlation (r = 0.962) between the measurements. The scale’s total Cronbach’s alpha coefficient was 0.913. Sub-dimension reliability scores were calculated as follows: 0.865 for environmental and health, 0.802 for communication and information, 0.738 for organizational, 0.728 for logistical, 0.725 for individual, and 0.809 for other factors.

This study showed that the Perceived Challenges in Disaster Response Scale (PCDRS), developed and validated in Turkish, is a reliable and valid measurement tool. It offers a foundation for understanding the challenges faced by disaster response teams and for formulating improvement strategies.

Mass-casualty incidents (MCIs) are overwhelming events which generate a surge in casualties, exceeding local capacity and stressing emergency services. Significant mortality, morbidity, and economic impact is often caused. They attract responses from both local and international governmental and non-governmental medical responders. To improve professional standards and accountability, there has been much recent focus on record-keeping by teams in these contexts. This paper seeks to further understand what data are gathered and shared as a result of MCIs to outline current practice and help move towards improved minimum standards of documentation.

A structured database search and abstract screening process was conducted utilizing PRISMA guidelines for scoping reviews. Data were then collected from all papers identified. To ensure all relevant data were gathered, authors of each included study were contacted to clarify their approach to data collection for their work.

From 154 included manuscripts, 64 data categories were found and recorded, capturing MCIs over a period of 32 years located in 42 countries from all World Health Organization (WHO) global regions. Retrospective and contemporaneous data collection was equally prevalent. In-hospital or research team data collection was most common. The ten most common data categories collected were: number of injuries (94.8%), number of deaths (89.6%), injury type (81.2%), cause of injury (79.9%), age (63.0%), sex (63.0%), treatment (62.3%), severity of injury (61.7%), outcome of injury (59.1%), and investigations/treatments given (55.8%). Of the contactable authors, only 29 responded. Sixteen reported reviewing notes retrospectively or using follow-up patient interviews.

There was significant variety in what data were collected, who collected it, and how it was done. The most common data categories were descriptive pieces of information or related to demographics. Only one-half of papers discussed treatments given. Information on both prehospital care and longer-term rehabilitation was much less prevalent.

Terrorism and shooting related MCIs were the largest by paper number. Predominantly made up of more recent MCIs in higher income countries, these findings potentially reflect more organized health care systems.

Overall, data collection in MCIs is challenging and heavily reliant on retrospective analysis. Current practice lacks standardization. If professionalism and accountability for health care delivery in MCIs is to be improved, so must the methods of data collection and minimum standards of documentation.

Mountain Rescue Services (MRS) are a vital link in the chain of survival when it comes to emergencies at high altitudes. Cognitive impairment in hypobaric hypoxic conditions is known, and previous studies have shown suboptimal performance of MRS members after a steep ascent. These impairments may be linked to regional cerebral oxygenation (rSO2). Therefore, this study aimed to investigate whether there are dynamics in rSO2 between “baseline” and “working” altitudes after climbing up to a potential patient.

In this alpine proof-of-concept field study, experienced mountaineers of the Austrian MRS had to perform an active rapid ascent of 1,200 meters on foot to 3,454 meters above sea level. Near-infrared spectroscopy (NIRS) was used to measure rSO2 before and after the climb. Continuous data were compared among subgroups using Mann-Whitney-U tests, and categorical data were compared with χ2-square tests. Statistical significance was defined by two-tailed P values of <.05.

Twenty MRS members were assessed. Their rSO2 values at baseline altitude were significantly higher than at working altitude (70 [SD = 1]% versus 60 [SD = 1]%; absolute difference 10 [95% CI, 6-15]; P <.001). When assessing the single dynamics of each mountain rescuer, there was a wide variability in delta rSO2, ranging from a minimum of 0% to a maximum of 32% (mean 10 [SD = 8]%).

Overall, low rSO2 values were found in mountain rescuers at high altitudes, and there were considerable interpersonal differences of changes in cerebral oxygenation after an ascent. Using rSO2 to assess performance-readiness in mountain rescuers and individual proneness to potential cognitive dysfunction or acute mountain sickness (AMS) could be further research goals.

Persons with disabilities (PWD) in developing countries are particularly affected by climate change-related disasters.

To explore the health impacts of climate change-related natural disasters on persons with pre-existing physical and mental disabilities in developing countries.

The Joanna Briggs Institute evidence synthesis guideline was applied and results were reported following PRISMA guidelines. PubMed, PsycINFO, Scopus, and Embase databases were searched using terms related to ‘persons with disabilities,’ ‘climate change,’ and “developing countries.” The database search retrieved 406 articles, forty-two articles were eligible for full-text review and 14 met the inclusion criterion which were reviewed and thematic analysis was performed.

The 14 articles included 5 studies generalized across multiple countries and nine profiled specific developing countries. Five key themes were identified: impact on PWD physical health and mental health, resilience, and coping strategies of PWD in disasters, PWD involvement in inclusive disaster planning, and climate-change related natural disasters on PWDs in developing countries as a human rights issue.

Additional research is needed to better understand the negative health impacts of climate change-related natural disasters on persons with pre-existing physical and mental disabilities in developing countries. Contributing social and economic factors as well as facilitative coping and resilience strategies of the affected population in this context also require further study. Addressing these research gaps can inform development of effective, disability-inclusive disaster management practices which contribute to more equitable climate-change related health and rights-based outcomes for PWDs in developing countries. Resulting trauma can concomitantly result in increased acute demand for physical rehabilitation therapy services.

The aim of this study was to systematically review evidence that supports best practice post-crash response emergency care.

The research questions to achieve the study objective were developed using the Patient, Intervention, Control, Outcome standard following which a systematic literature review (SLR) of research related to prehospital post-road-crash was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

A total of 89 papers were included in the analysis, presented according to the PRISMA guidelines.

This research explored and identified key insights related to emergency care post-road-crash response. The findings showed that interservice coordination and shared understanding of roles was recommended. Application of traditional practice of the “Golden Hour” has been explored and contested as a standard for all care. Notwithstanding this, timeliness of provision of care remains important to certain patient groups suffering certain injury types and is supported as part of a trauma system approach for patient care.

Extreme heat waves are a growing global health concern, with their frequency and intensity escalating due to climate change. Understanding past trends in heat wave impacts is crucial for informing effective mitigation and adaptation strategies.

This study aims to analyze the historical impact of extreme heat waves on global mortality and morbidity, identifying geographical and temporal trends to inform public health interventions.

We conducted a retrospective analysis using data from the Emergency Events Database. This comprehensive database provided records of heat wave events and associated mortality and morbidity data spanning recent decades. Statistical analysis was performed to identify trends and patterns in heat wave occurrences and their health impacts.

Our analysis reveals a concerning increase in both the frequency and severity of extreme heat waves globally. This trend corresponds with a significant rise in heat-related mortality and morbidity, particularly in regions with limited adaptive capacity and among vulnerable populations such as the elderly and those with pre-existing health conditions.

The findings underscore the urgent need for proactive measures to mitigate the health risks posed by extreme heat. These include strengthening healthcare infrastructure to manage heat-related illnesses, developing effective early warning systems, and implementing community-based interventions to reduce heat exposure. This research provides a critical historical perspective on the growing threat of extreme heat, emphasizing the importance of global cooperation and immediate action to protect populations from this escalating public health challenge.

Mass-gathering events (MGEs) such as sporting competitions and music festivals that take place in stadiums and arenas pose challenges to health care delivery that can differ from other types of MGEs. This scoping review aimed to describe factors that influence patient presentations to in-event health services, ambulance services, and emergency departments (EDs) from stadium and arena MGEs.

This scoping review followed the Preferred Reporting Items of Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR) checklist and blended both Arksey and O’Malley methodology and the Joanna Briggs Institute’s (JBI’s) approach. Four databases (CINAHL, Embase, PubMed, and Scopus) were searched using keywords and terms about “mass gatherings,” “stadium” or “arena,” and “in-event health services.” In this review, the population pertains to the spectators who seek in-event health services, the concept was MGEs, and the context was stadiums and/or arenas.

Twenty-two articles were included in the review, most of which focused on sporting events (n = 18; 81.8%) and music concerts (n = 3; 13.6%). The reported patient presentation rate (PPR) ranged between one and 24 per 10,000 spectators; the median PPR was 3.8 per 10,000. The transfer to hospital rate (TTHR) varied from zero to four per 10,000 spectators, and the median TTHR was 0.35 per 10,000. Key factors reported for PPR and TTHR include event, venue, and health support characteristics.

There is a complexity of health care delivery amid MGEs, stressing the need for uniform measurement and continued research to enhance predictive accuracy and advance health care services in these contexts. This review extends the current MGE domains (biomedical, psychosocial, and environmental) to encompass specific stadium/arena event characteristics that may have an impact on PPR and TTHR.