Emergency Management

The EURAM annual conference is approaching fast. The general programme is now out: www.euram2010.org.
I hope you will attend the Public Management track; 37 papers have been double-blind reviewed and selected among 100! The programme is attached.
We have also organized a plenary symposium “If public governance means everything, is it possible that it means nothing? Exploring boundaries and manifestations of a blurred concept” with the participation of Stephen Osborne (University of Edinburgh & President of the IRSPM), Myrna Mandell (California State University), Reto Steiner (University of Bern & EURAM Public Management SIG), Les Metcalfe (Durham University Business School), Christoph Reichard (University of Potsdam).

Decision-making is a cognitive process stemming from the analysis of available courses of action related to a given problem. Rationally, potential courses of action are derived from deliberate analysis of available data related to a problem and its potential outcomes. Decisions are generally characterized as normative, descriptive or naturalistic. Normative decisions are based on evidence, logic and analysis; descriptive decisions are based on intuition and experience. Naturalistic decisions are formed as a hybrid of normative and descriptive processes.

For decision-makers the revolution in information technology and the amount and scope of the data they provide has become overwhelming, leading to cognitive overload, confusion and an inability to function effectively. Decision Support Systems (DSS) facilitate data analysis and selection of a viable course of action rapidly and effectively. However, like the human decision- makers they serve, DSS capabilities may also suffer from cognitive overload, inaccuracy, and complexity, especially in time-sensitive environments.

This study explores DSS employment for time-sensitive decision processes using Digitally Aided Close Air Support (DACAS) as a model. The study explores decision theory, models, DSS development and time-sensitive environments. Using DACAS as a model the paper reveals the obstacles and opportunities associated with the employment of DSS for time- sensitive processes. Finally, the study makes recommendations for improved employment of DSS in time-sensitive environments.

Format: 170 x 240 mm ; 608 pages
ISBN: 9782294739897

Sous la direction de Catherine Muller et Jérôme Chevillotte

La formation des infirmiers anesthésistes diplômés d'État (IADE) est centrée sur les techniques d'anesthésie-réanimation-urgences et vise à l'acquisition des connaissances théoriques et cliniques nécessaires à la pratique infirmière au cours des anesthésies générales ou locorégionales.

Riche et complet,cet ouvrage est axé sur le référentiel des deux années de formation et couvre, de manière théorique et pratique, l'ensemble du programme.

Le contenu, composé de 200 fiches illustrées de schémas et dessins, est émaillé de conseils et d'études de cas analysées pour l'IADE diplômé ou en cours d'études.
Présentées de façon claire et synthétique, ces 200 fiches sont regroupées en 6 grands chapitres :
Sciences humaines, sociales et droit ;
Sciences cliniques, biologiques et médicales ;
Fondamentaux en anesthésie-réanimation-urgences ;
Exercices particuliers en anesthésie-réanimation-urgences ;
Outils en anglais ;
Situations cliniques.

Véritable vade-mecum unique pour un usage quotidien théorique et pratique en anesthésie réanimation et urgences, ce Guide de l'infirmier anesthésiste est conforme au nouveau programme de formation et aux dernières recommandations professionnelles et ainsi autant destiné aux étudiants infirmiers anesthésistes qu'aux professionnels diplômés soucieux de parfaire leurs connaissances.

El presente artículo busca mostrar a grandes rasgos los principales requerimientos técnicos para escuelas y centros de entrenamiento a tenerse en cuenta en la construcción y administración de los mismos. Teniendo en cuenta los siguientes referentes internacionales:

• NFPA 1402 “Guía para la construcción y puesta en Servicio de Escuelas Contra Incendio”.

• NFPA 1403 “Estándar para Entrenamiento con actividades prácticas de llama viva”.

Introdução: A Medicina de Emergência, embora ainda não considerada como tal no Brasil, é uma especialidade médica que objetiva o processo de atendimento ágil e eficaz em situações de agravo agudo à saúde das pessoas, pressupondo
hierarquização de estrutura. Está extremamente relacionada com outras áreas de atuação e deve garantir o fluxo de atendimento, tanto no aspecto estrutural (pré, intra e pós-hospitalar) como no aspecto inter-disciplinar. Fluxo é definido como acrescentar valor aos processos e serviços, aumentando os benefícios, diminuindo gastos ou pela combinação dessas duas estratégias, no atendimento de pacientes ao longo dos serviços e filas de espera que compreendem o moderno sistema de saúde. Métodos como planejamento de sistemas, gerenciamento da variabilidade, desenvolvimento de liderança e gerenciamento da demanda-capacidade são utilizados para compor estratégias de gerenciamento. São exemplo de estratégias de gerenciamento de fluxo já implantadas no Brasil a classificação de risco, a regulação médica, o atendimento pré-hospitalar e as unidades especializadas intrahospitalares.
No entanto, a compreensão desses conceitos é relativamente nova e devem ser estabelecidas metas de pesquisa para melhoria do processo.
Objetivos: 1)Caracterizar a importância do fluxo em sistemas de emergência; 2)Caracterizar métodos e estratégias de gerenciamento de fluxo em situações concretas de atendimento em emergência; 3)Caracterizar problemas e efeitos colaterais que a ausência de fluxo pode ocasionar aos serviços de emergência; 4)Propor um construto teórico para avaliar métodos e estratégias de fluxo em emergências em saúde na realidade brasileira.
Metodologia: Foram revistos cinco estudos de situações concretas de gerenciamento de fluxo em emergências, descrevendo-se exemplos de problemas a serem resolvidos no contexto de entrada, estadia e saída do sistema de emergências em saúde. A partir desses casos, construiu-se um mapa conceitual para nortear as iniciativas de pesquisa.
Resultados: Foram identificados problemas que exigem o equacionamento do fluxo em emergências, compreendendo a comunicação entre unidades do sistema, comunicação entre equipes de saúde, interação entre unidades intra-hospitalares,
planejamento de capacidade, preparo para situações de catástrofe, efeitos decorrentes de sistemas saturados (flutuação da relação demanda-capacidade; efeito Roemer; efeito de Porta-Giratória) e princípios éticos. Esse problemas obtidos por revisão de literatura foram contextualizados em casos concretos da realidade brasileira que auxiliaram na elaboração de um novo construto teórico para direcionar
as iniciativas de pesquisa na área, adaptando-as às  necessidades culturais e sociais brasileiras.
Conclusões: Problemas relacionados a inexistência ou lentificação do fluxo em sistemas de emergência são identificáveis em casos concretos da realidade brasileira e devem ser equacionados através de pesquisa na áreas que leve em consideração peculiaridades culturais e sociais.

Honolulu is susceptible to coastal flooding hazards. Like other coastal cities, Honolulu&s long-term economic viability and sustainability depends on how well it can adapt to changes in the natural and built environment. While there is a disagreement over the magnitude and extent of localized impacts associated with climate change, it is widely accepted that by 2100 there will be at least a meter in sea level rise (SLR) and an increase in extreme weather events. Increased exposure and vulnerabilities associated with urbanization and location of human activities in coastal areas warrants serious consideration by planners and policy makers. This article has three objectives. First, flooding due to the combined effects of SLR and episodic hydro-meteorological and geophysical events in Honolulu are investigated and the risks to the community are quantified. Second, the risks and vulnerabilities of critical infrastructure and the surface transportation system are described. Third, using ...

Bangladesh is likely to be one of the most vulnerable countries in the world to climate change due to geographical location and geo-morphological conditions. Bangladesh experiences extremely disastrous situations like a cyclone, flood, saline water intrusion, water logging, heavy rainfall, river erosion, storm surge, etc. that occur frequently in the coastal part of Bangladesh. This results in a huge loss of lives, damages properties and degrades the integrity of the environmental components. This study was conducted on 2 villages (Chotta Chalna and Shivnagar) of Dacope Upazila of Khulna district with the purpose of assessing existing climate change adaptation scenarios and techniques for mitigating climate change-related risks. Necessary data were collected from various sources namely direct household survey, focus group discussion, and key informants interview and from various journals, related thesis papers. About 46% of the respondents cited cyclone is the most terrific type haz...

Presentation in 2020 SEGD Wayfinding + Placemaking. In response to the global crises currently underway, designers from Africa, Asia, Europe, and South America address what they are seeing in their home states, and what they are doing to help people feel safe, comfortable, confident, and welcome in public places. Discussions in best practices in signage, environments, digital platforms, icon making, and communication bring new paradigms and behaviors.

A common practice uses funny and cute internet memes to describe natural hazards, such as hurricanes, to the general public. Emergency managers create an industry lacking credibility and seriousness when they use unrealistic and comedic scenarios to describe disasters. If people believe that hurricanes are cute and funny, they will not understand their risk and therefore will not prepare adequately.

Frequency, Causes, Severity and Outcome of burn victims admitted in the tertiary care hospital of Peshawar in the year 2013

Principal Author: Salman Qureshi*
Co Authors: Mahboob Khan*, Hadi Raza*, Najmush Shakireen*, Amir Zaman*, Bakhtawar Qureshi* *

* Peshawar Medical College
** Khyber Medical University, Peshawar

Background: Every year, significant amount of patients suffer from burns injuries resulting both in morbidity and mortality. Burn injuries are of especial important due the fact that these injuries affect people of both genders and of all ages, thus not confined to any specific age group or gender. In medicine, burn care is among one of the few disciplines which is regarded both medically and surgically a challenging task.  The current study was undertaken to find the frequency of burn victims admitted in Lady Reading Hospital, Peshawar and to identify various causes responsible for the burn injuries and to assess the severity of burn injuries reported and finally to evaluate the ultimate outcome of burn victims at the time of discharge.

Methodology: A retrospective study was carried out at Burn & Plastic Surgery Unit of Lady Reading Hospital, Peshawar. The data was collected from the record register and patients files. The sample size was 49. Simple random sampling technique was used. The ethical consideration was taken in account and confidentiality of subjects was secured. The data was analyzed in SPSS Version 19. The entire study duration was about 5 months.

Results: Total 1103 patients were admitted in the year 2013 with burn injuries out of which the record of 49 patients were taken under consideration for data analysis (n=49, M: 26 & F:23). The mean age calculated was 27.63 years while the standard deviation was 17.34 years.  33 patients had not received any first aid before coming to the hospital. Flame injuries were the commonest followed by electrical and chemical burns. The percentage of Total Body Surface Area (TBSA) burn ranged from 2% to 61%. Inhalational injury was present in 3 patients. The mean length of hospital stay calculated was 8.98 days. 5 patients were having previous history of burn. 22.4% patients were sufferer of chronic diseases at the time of admission. In normal patients, the mean length of hospital stay was 7.53 days. Majority of the patients were having facial burns followed by burns involving legs and arms. History of violence was positive in 6 patients. 23 patients were having first degree burns, 12 were having second degree burns while the remaining 12 patients were having third degree burns. 32 patients were completely healthy at the time of discharge, 5 patients got disabled, 6 patients died while rest of the 6 were referred to other hospital.

Conclusion: Flame injuries were commonest while Hot liquid burns and steam burns were least common. Facial burns were most common followed by burns involving upper and lower limbs. Majority of the patients were having first degree burns. Majority of the patients were completely healthy at the time of discharge however morbidity as well as mortality was also reported in few cases.

Keywords: Burn victims, Total Body Surface Area. Disability adjusted life years, Length of Hospital Stay

Todays’ world is constantly evolving towards improving humanenvironment interaction and thus achieving a better quality of life in the digital age. Apart of this, the proper understanding and perspectives for progressive development of this idea is discoverable in multiple current and future problem areas. The paper outlines a methodological approach for modelling, simulation and assessment from the complex discrete systems perspective. The presented idea is illustrated from both theoretical and practical prospects, noting numerous successful results. Some possible improvements of the proposed approach are finally discussed.

Les infirmières représentent la profession de santé la plus exercée en France. Les 110 000 infirmières libérales constituent un maillage dense et cohérent. Leur mode d'exercice et leur niveau de formation en font un élément essentiel pour la réingénierie de la chaîne des secours en situation de crise. Polyvalentes, organisées, douées d'une discipline confraternelle imposée par une inscription forte dans un parcours de soins aux multiples intervenants, les infirmières libérales sont capables de faire face rapidement à l'onde de choc d'une situation exceptionnelle impliquant de nombreuses victimes.

This study will examine various forms of literature to provide insight into the accessibility of Emergency Management (EM) resources to First Nations on-reserve communities and attempt to make comparisons to non Indigenous communities and their resource accessibility.  To do so, it will examine Canada's various policies and frameworks for Emergency Management, and the international documents and agreements on which they are based. These frameworks shape the way in which collaboration, and communication is addressed by Federal, Provincial and Territorial EM planning and outlines the direction in which EM in Canada is headed. Indigenous peoples face a particular set of vulnerabilities from inter-generational traumas resulting from historic colonial practices that create unique obstacles to effective emergency management. These vulnerabilities are amplified by the reserve system and cultural difficulties toward beneficial municipal and provincial partnerships. By looking at existing EM practices through the principles of High Reliability Organizations, while bearing a sensitivity to the appropriateness to First Nations on-reserve communities we can develop a comprehensive and adaptable framework to Indigenous determinants of vulnerability and uncover assets within Indigenous communities that can improve the Canadian practices of EM in general.

The tsunami of December 26, 2004, can be described as one of the worst disasters medical systems have ever had to face. This paper will describe the geophysical properties of tsunamis and their disastrous impact on human beings and infrastructure. Finally, we will present three different modes of response to the tsunami that were present in different provinces in Thailand. These three modes represent different strategies of disaster management, and analyzing each will help to begin understanding how best to respond to the next large-scale natural disaster.

This research focuses on disaster education and the Indonesian government's reports on the implementation of the Hyogo Framework for Action (HFA) 2005-2015. This research also underlies the Sendai Framework for Disaster Risk Reduction (SFDRR) 2015-2030, which calls for a more profound paradigm shift through the educational field than does the HFA. The SFDRR positions 'understanding risk' as priority number one, which implies the role of education in disaster risk reduction (DRR) programs. As the international framework for DRR changes, it is necessary for Indonesia to evaluate its existing programs and make improvements to the DRR strategy in the education sector that applies to each region. This study focuses on the stakeholders who are expected to have the capacity to establish the DRR program as a long-term strategy for DRR in the education sector. The school community needs to know how to correctly respond to disasters to limit injuries and potentially fatal effects....

In the context of growing vulnerability to climatic hazards in Asia, the Republic of Korea's (RoK) National Emergency Management Agency (NEMA) hosted the Fourth Bi-annual Ministerial Conference on Disaster Risk Reduction in October 2010. The resulting Roadmap and Action Plan for the period to 2015 detailed a strategy for dealing with known and unknown naturerelated risks in the countries of Asia and the Pacific. As part of the RoK's commitment to delivering this vision for a safer Asia, Korea's National Disaster Management Institute, a division of NEMA, has begun hosting international education and training programmes for governmental officials and civilians from other Asian countries. This article reports on a recent visit to the NDMI campus in Cheonan with details of the comprehensive training and education facilities offered by the centre and the wide variety of programmes, targeting both natural hazards and civil defence, which have been developed to cater for both g...

Uncertain times require prompt reflexes to survive and this study is a collaborative reflex to better understand uncertainty and navigate through it. The Coronavirus (Covid-19) pandemic hit hard and interrupted many dimensions of our lives, particularly education. As a response to interruption of education due to the Covid-19 pandemic, this study is a collaborative reaction that narrates the overall view, reflections from the K12 and higher educational landscape, lessons learned and suggestions from a total of 31 countries across the world with a representation of 62.7% of the whole world population. In addition to the value of each case by country, the synthesis of this research suggests that the current practices can be defined as emergency remote education and this practice is different from planned practices such as distance education, online learning or other derivations. Above all, this study points out how social injustice, inequity and the digital divide have been exacerbate...

Introduction: Flood disaster is a natural disaster that has unexpectedly occurred again. Community cooperation in terms of managing flood and focusing on families’ needs has become more systematic. It is important for a household to be prepared in any disaster. One of the preparations that should be done is the stockpiling of emergency supplies or flood supply kits during evacuation. This study aimed to develop a specific disaster kit for households for evacuation during a flood disaster based on cultural context. Methods: Data were collected from 75 key informants from every level of households that really have a great experience during the flood disaster that helping family packing for a living needs before evacuation. The development of the disaster kit based on cultural needs and all their views, needs, experiences, challenges, frustration and happiness was obtained from the interview sessions. Results: There are five themes that emerged from this research related to developing ...

– Avulsion of permanent teeth is the most serious of all dental injuries. The prognosis depends on the measures taken at the place of accident or the time immediately after the avulsion. Replantation is the treatment of choice, but cannot always be carried out ...

In this thesis I take up the challenge to see whether designers would benefit from using science fiction in order to extend their resources when generating novel interaction design concepts for emergency situations. I discuss the relationship between the nature of fiction and design, and trademarks for emergency situations. I choose four scenes from different media types to analyse, further ideate and evaluate in order to derive final concepts, which I submitted to user testing. I argue that designers may well take science fiction into consideration when generating novel interaction design concepts in a successful way.

Within the auspices of today's society, the subjects of civil rights and diversity go hand in hand - it seems that there cannot be one without the other.  This is true within organizations such as FEMA.  With there being such a multifariousness of employees within the different governmental agencies, the need for legislation, guidelines, reviews and revisions to protect the basic human rights of all individuals has become a major point of concern.

Most risk management activity in the healthcare sector is retrospective, based on learning from experience. This is feasible where the risks are routine, but emergency operations plans (EOP) guide the response to events that are both high risk and rare. Under these circumstances, it is important to get the response right the first time, but learning from experience is usually not an option. This case study presents the rationale for taking a proactive approach to improving healthcare organizations' EOP. It demonstrates how the Prospective Hazard Analysis (PHA) Toolkit can drive organizational learning and argues that this toolkit may lead to more efficient improvement than drills and exercises.

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Wiley's copyright policies do not allow me to post the published version of the paper, but they do allow me to send out individual copies. So if you don't have access to the Journal of Healthcare Risk Management and would like a copy of this article, please email me at:
alan [dot] j [dot] card [at] gmail [dot] com

The medical management of acute coronary syndrome (ACS) follows the recommendations of international medical societies. The call to the emergency services by the patient triggers a race against the clock in pre-hospital care. It is essential to reduce the duration of the inadequate perfusion of the heart in order to limit its consequences. An effective reperfusion strategy must be planned in advance taking into account the logistical constraints. It is crucial that the general public is educated to recognise the signs of ACS and to call the emergency services immediately (such as (15,112, 991).
La prise en charge médicale du syndrome coronarien aigu (SCA) est cadrée par les recommandations des sociétés savantes internationales. L’appel au centre 15 par le patient déclenche une course contre la montre en préhospitalier. Il faut réduire le délai de mauvaise perfusion du cœur et en limiter les conséquences. Une stratégie de reperfusion efficace doit être anticipée avec des contraintes logistiques. L’éducation des populations est primordiale dans la reconnaissance des signes de SCA, avec un appel précoce au centre 15, 112 ou 911.