Prehospital time affects survival in trauma patients. Mass casualty incidents (MCIs) are overwhelming events where medical care exceeds available resources. This study aimed at evaluating the prehospital time during MCIs and investigating the effect of triage.

A retrospective analysis was performed using Florida’s Event Medical Services Tracking and Reporting System database. All patients involved in MCIs during 2018 were accessed, and prehospital time intervals were evaluated and compared to that of non-MCIs. The effect of MCI triage and field triage (Field Triage Criteria) on prehospital time was evaluated.

In 2018, it was estimated that 2236 unique MCIs occurred in Florida, with a crude incidence of 10.1-10.9/100000 people. 2180 EMS units arrived at the hospital for patient disposition with a median alarm-to-hospital time of 43.74 minutes, significantly longer than non-MCIs (39.15 min; P < 0.001). MCI triage and field triage were both associated with shorter alarm-to-hospital time (39.37 min and 37.55 min, respectively).

MCIs resulted in longer prehospital time intervals than non-MCIs. This finding suggests that additional efforts are needed to reduce the prehospital time for MCI patients. MCI triage and field triage were both associated with shorter alarm-to-hospital times. Widespread use may improve prehospital MCI care.

In the wake of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, rapid identification of pediatric mental health risk is extremely important. The Western Regional Alliance for Pediatric Emergency Management held an integrated, interdisciplinary national tabletop exercise to familiarize mental health and non-mental health professionals with Psychological Simple Triage and Rapid Treatment (PsySTART), an evidence-based triage and incident management system used to evaluate new mental health risk impacts following exposure to traumatic events, such as coronavirus disease (COVID-19).

Participants Participants were exposed to 3 practice cases that reflected a combination of “all hazards” scenarios and were asked to triage each case using PsySTART. Participants were asked to interpret results at both an individual site and aggregate county and/or state level.

The exercise had a total of 115 participants with a total of 156 discrete triage encounters. A user-defined operating picture was created with graphs of aggregate mental health risk data, generating cross-regional, real-time situational awareness. After the exercise, a vast majority of the participants reported confidence in their ability to use PsySTART in their practices.

Participants are now better equipped with tools to perform mental health triage for early intervention during COVID-19 and other disasters and understand risk on a population level.

Our objective was to compare care-seeking patterns in Mosul, Iraq, in 2018, 1 y after Islamic State of Iraq and Syria (ISIS) control, with findings from neighborhoods that had been sampled in 2017

For this multi-stage randomized cluster household survey, we created one cluster in each of 20 neighborhoods randomly selected from the 40 neighborhoods in the 2016/17 survey; 12 in east Mosul, 8 in west Mosul. In each, 30 households were interviewed beginning at a randomly selected start house. Questions were derived from the 2016/2017 post-ISIS survey.

We interviewed the head of household or senior female in 600 households containing 3375 persons. One year after ISIS, some household demographic shifts had occurred. Diarrhea in children during the past 2 wk decreased from 50.1% to 7.5% (P < 0.001); however, cough/difficulty breathing increased from 15.5% to 33.6% (P < 0.01). Among adults, care-seeking for noncommunicable diseases increased from 22.3% to 43.5% (P < 0.001). Emotional and psychological complaints common in the previous survey were now nearly absent. Pregnancy complications diminished from 65.2% to 15.4% (P < 0.001).

Communicable diseases predominated among children and noncommunicable diseases among adults. Access to health care substantially improved, although barriers remained. Satisfaction with services was mixed, with dissatisfaction expressed about testing, medicine access, and costs, but the work of health providers was rated highly.

On July 3, 2021, a landslide occurred in part of Atami City, Shizuoka, Japan.

The government of Shizuoka Prefecture requested the dispatch of Shizuoka Disaster Medical Assistance Teams (S-DMATs).

On day 2, the evacuees were evacuated into 2 hotels (A and B). Hotel A accommodated over 570 independent and dependent evacuees. Hotel B accommodated 44 dependent aged individuals, who lived in the same long-term health-care facility, together with their 11 caregivers. The evacuees in hotel B returned to the previous facility on day 10 without any specific medical problems. The evacuees in hotel A were managed in the guest rooms as family units. Individuals requiring care in guest rooms in hotel A became isolated because they could not call for help or walk. Furthermore, hotel guest rooms were not barrier-free. The S-DMATs supported the evacuees.

Independent evacuees received the maximum benefits from the use of a hotel as a shelter. In contrast, it was difficult for dependent evacuees to benefit from the hotel as it is as a shelter when living alone in the hotel. Dependent evacuees required appropriate support to eat, walk, use the toilet, and keep themselves clean when using a hotel as a shelter.

This study aims at exploring the dynamics of health-care provision during recent unplanned public mass gatherings in Beirut, and how the health-care system adapts to mass movements in protests.

A qualitative study was conducted using semi-structured interviews with 12 health-care providers who volunteered at medical tents set during protests in Beirut, Lebanon. Responses were transcribed and coded.

Three themes were noted: preparedness and logistics, encountered cases, and participants’ proposed recommendations. In terms of preparedness and logistics, participants lacked knowledge of field medicine protocols and an organizational structure. They faced difficulties in securing equipment and advertising their services. Most encountered cases were physical injuries rather than mental health problems. The participants proposed both short-term recommendations, including advice on how to boost care provided, and long-term recommendations on structuring the health-care system to be better prepared.

On-site health-care provision during unplanned mass gatherings is a vital need. We recommend forming a task force of health-care workers from various fields led by the Ministry of Public Health in every respective country to plan protocols, train personnel, and secure resources beforehand.

Influenza vaccination remains the most effective primary prevention strategy for seasonal influenza. This research explores the percentage of emergency medical services (EMS) clinicians who received the seasonal flu vaccine in a given year, along with their reasons for vaccine acceptance and potential barriers.

A survey was distributed to all EMS clinicians in Virginia during the 2018-2019 influenza season. The primary outcome was vaccination status. Secondary outcomes were attitudes and perceptions toward influenza vaccination, along with patient care behaviors when treating an influenza patient.

Ultimately, 2796 EMS clinicians throughout Virginia completed the survey sufficiently for analysis. Participants were mean 43.5 y old, 60.7% male, and included the full range of certifications. Overall, 79.4% of surveyed EMS clinicians received a seasonal flu vaccine, 74% had previously had the flu, and 18% subjectively reported previous side effects from the flu vaccine. Overall, 54% of respondents believed their agency has influenza or respiratory specific plans or procedures.

In a large, state-wide survey of EMS clinicians, overall influenza vaccination coverage was 79.4%. Understanding the underlying beliefs of EMS clinicians remains a critical priority for protecting these frontline clinicians. Agencies should consider practical policies, such as on-duty vaccination, to increase uptake.

This study aims to report the clinical features of a cohort of patients with suspected coronavirus disease (COVID-19) from Tobruk, Libya, and reflect upon the diagnosis challenge in low-resource settings.

A descriptive report of the first 100 patients with suspected COVID-19 who have visited the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19 screening clinic at the National Centre for Disease Control in Tobruk, Libya.

The most common presenting symptoms were fever (90%), cough (89%), dyspnea (85%), sore throat (79%), fatigue (78%), headache (64%), loss of smell (52%), loss of taste (53%), loss of appetite (43%), nausea and vomiting (26%), diarrhea (22%), and rhinorrhea (16%); 51% of the patients had lymphocytopenia, whereas 13% had thrombocytopenia. Bilateral infiltrates were the most common radiologic finding on chest X-ray (76%), and COVID-19 IgM and/or IgG antibodies were detected in 80% of the patients, whereas only 37% of the patients were tested positive by the reverse transcriptase polymerase chain reaction (RT-PCR).

The disease continued its spread across the region. Fever, cough, and dyspnea were the main symptoms; 21% of the patients did not have any chest X-ray abnormalities. Initial negative results for either antibody testing or RT-PCR-testing for COVID-19 do not rule out the infection.

The lockdown for the COVID-19 pandemic affects lifestyle patterns globally and impacts children and adolescents. This study aims to assess the effect of the lockdown on body weight, eating habits, and physical activity of Jordanian youth (children and adolescents).

A cross-sectional study was conducted on a sample of 477 Jordanian children and adolescents aged 6-17 y. The study tool was a structured validated questionnaire. It comprised 4 parts, including a general description of the study purpose, sociodemographic and anthropometric data, physical activity data, and food intake pattern. Questions were reported before and during lockdown. Changes in outcomes over the 2 study time points were evaluated.

After the lockdown period, the mean body weight and body mass index for age Z-scores (BAZ) showed a significant increase (P < 0.001) compared with before the lockdown period. More than 50% of the subjects reported that they spent more than 3 h in front of the screen during the lockdown. The percent of subjects who watched TV for more than 3h was increased. Moreover, physical inactivity was increased significantly during the lockdown. All food groups consumption was significantly increased during the lockdown compared to before the lockdown.

COVID-19 lockdown period was characterized by an increase in the use of screen-based devices, lower physical activity, uncontrolled food intake, and weight gain.

The 2019 coronavirus disease (COVID-19) is a global pandemic with no therapy, and pharmacists being a part of the health care system have a vital role in the management of COVID-19. The purpose of this study is to assess the knowledge, attitude, and practices of community pharmacists (CPs) regarding COVID-19.

An online survey was conducted among 393 CPs in 2 provinces of Pakistan during the lockdown period. A validated questionnaire (Cronbach’s alpha, 0.745) was used for data collection. All statistical analyses were analyzed by using SPSS, version 21 (IBM Corp, Armonk, NY).

Among 393 participants, 71.5% (n = 281) had good knowledge, 44% (n = 175) had a positive attitude, and 57.3% (n = 225) had good practices regarding COVID-19. Social media (45.29%, n = 178) were reported as the main source to seek information of COVID-19. Good knowledge, age ≥ 26 years, and a PhD degree level were the substantial determinants (P = < 0.05) of a good attitude. Similarly, a CP with experience of > 5 years, a PhD degree, good knowledge, and a good attitude has higher odds of having good practices as compared with reference categories (P = < 0.05).

In short, a majority of the CPs had good knowledge but had a poor attitude and practice toward the management of COVID-19. Standard-structured educational and counseling programs for CPs regarding COVID-19 are needed for effective management.

Weather extremes are increasing with climate change and associated with higher morbidity and mortality. Promotion of social connections is an emerging area of research and practice for risk reduction during weather extremes. This study examines the practice of checking on neighbors during extreme summer heat and extreme winter weather. Objectives are to (1) describe the extent of neighbor checking during these extremes, and (2) examine factors associated with neighbor checking.

We analyze survey data (n = 442) from a primarily low- and moderate- income study sample in a Southeastern U.S. city, using descriptive statistics and logistic regression.

About 17.6% of participants checked on neighbors during extreme summer heat, and 25.2% did so during extreme winter weather. Being middle or older aged and having more adverse physical health impacts were positively associated with neighbor checking, for both extremes. For winter only, having less education was positively associated with neighbor checking.

Community-based partnerships for reducing risk during weather extremes may consider people who are older or have experienced their own adverse health impacts as initial target groups for promoting neighbor checking. Future research should also examine the motivations for, details about, and impacts of neighbor checking in greater depth.

Hospitals are expected to operate at a high-performance level even under exceptional conditions of peak demand and resource disruptions. This understanding is not mature yet, and there are wide areas of possible improvement. In particular, the fast mobilization and reconfiguration of resources frequently result into the severe disruption of elective activities, worsening the quality of care. More resilient resource allocation strategies, ie, which adapt to the dynamics of the prevailing circumstance, are needed to maximize the effectiveness of health-care delivery. In this study, a simulation approach was adopted to assess and compare different hospital’s adaptive resource allocation strategies in responding to a mass casualty incident (MCI).

A specific set of performance metrics was developed to take into consideration multiple objectives and priorities and holistically assess the effectiveness of health-care delivery when coping with an MCI event. Discrete event simulation (DES) and system dynamics (SD) were used to model the key hospital processes and the MCI plan.

In the daytime scenario, during the recovery phase of the emergency, a gradual disengagement of resources from the emergency department (ED) to restart ordinary activities in operating rooms and wards, returned the best performance. In the night scenario, the absorption capacity of the ED was evaluated by identifying the current bottleneck and assessment of the benefit of different resource mobilization strategies.

The present study offers a robust approach, effective strategies, and new insights to design more resilient plans to cope with MCIs. Future research is needed to widen the scope of the analysis and take into consideration additional resilience capacities, such as operational coordination mechanisms, among multiple hospitals in the same geographic area.