Implementation of a medical command and control team in Switzerland

In case of a major incident or disaster, the advance medical rescue command needs to manage several essential tasks simultaneously. These include the rapid deployment of ambulance, police, fire and evacuation services, and their coordinated activity, as well as triage and emergency medical care on site. The structure of such a medical rescue command is crucial for the successful outcome of medical evacuation at major incidents. However, little data has been published on the nature and structure of the command itself. This study presents a flexible approach to command structure, with two command heads: one emergency physician and one experienced paramedic. This approach is especially suitable for Switzerland, whose federal system allows for different structures in each canton. This article examines the development of these structures and their efficiency, adaptability and limitations with respect to major incident response in the French‐speaking part of the country.     

Suicide bombings: process of care of mass casualties in the developing world

In recent times Pakistan's biggest city, Karachi, has witnessed numerous terrorist attacks. The city does not have an emergency response system and only one of the three public sector hospitals has a trauma centre. We describe the pattern of injuries and management of two terror-related mass casualty incidents involving suicide bombers in a developing nation with limited resources. The first incident occurred in May 2002 with 36 casualties, of whom 13 (36%) died immediately and 11 (30.5%) died at the primary receiving hospitals. The second incident was targeted against the local population in May 2004. The blast resulted in 104 casualties, of which 14 (13.46%) died at the site. All patients had their initial assessment and treatment based on Advanced Trauma and Life Support principles and documented on a trauma form.     

城市水源地突发性水污染事故思考

在介绍水源地突发性水污染事故的概念、类型和包括突发性、不确定性、多样性、扩散性、危害性和艰巨性等基本特点的基础上,从水源地应急监测系统、资料匮乏、后续处置、结构单一和协调机制等方面分析了水源地的安全性,构建了包括应急处理系统、法律法规体系、预警系统、动态监测、联动机制和应急预案等方面的水源地突发性水污染应急对策系统。     

小城镇突发公共事件应急决策系统的研究

近年来,突发公共事件的应急研究是研究热点,但对小城镇却缺少应有的关注和重视.本文剖析了当前小城镇突发公共事件应急管理存在的弊端,简要介绍了小城镇突发公共事件应急决策系统的设计与实现,包括应急预案、历史灾情库和法律法规库三大功能.着重论述了小城镇突发公共事件应急流程和预案的框架要素,并分析了应急决策系统与小城镇应急管理体制的融合机制问题.     

Networking emergency teams in Jerusalem

With the recent upsurge in terrorism, more and more attention is being directed at examining the effectiveness and efficiency of emergency teams. These teams tend to focus on their areas of expertise without necessarily communicating, cooperating or coordinating their operations. Research suggests that improved interpersonal communication and coordination enhances the overall work of each emergency team, and that their combined effort is far in excess of the sum of their individual endeavours. This paper outlines attempts made in Jerusalem to improve the performance of emergency teams and to help the helpers by holding training workshops, setting up a forum of co‐workers and encouraging dialogue among various emergency teams in the city. A planned intervention programme was designed to enable informal networking between team leaders. The programme had an impact on team workers and resulted in a more coordinated and effective service delivery during emergencies.     

基于Visual Basic.NET的油气事故应急资源需求预测支持决策系统

针对油气事故后应急资源需求预测困难的问题,在对油气事故特性及应急资源需求类型分析的基础上,构建了基于案例推理(CBR)的油气事故应急资源需求预测模型,并使用Visual Basic.NET及SQL Server数据库开发了油气事故应急资源需求预测支持决策系统。将该系统应用于实际油气事故案例进行验证,结果表明系统中应急资源需求预测模型科学可靠,系统对油气事故应急资源需求预测结果与其实际用量基本吻合。该系统可为油气事故后快速有效开展应急救援活动提供相应的理论依据。     

粉土用作路堤填料的试验研究

通过对安徽地区粉土的室内改良试验,从试验的角度对不同的掺灰剂(水泥、石灰)及不同配合比改良后粉土的性质进行分析。研究改良后粉土CBR(承载比)值及无侧限抗压强度与龄期及配合比的关系,并根据室内试验的结果,提供经济合理的方案;通过对改良后粉土CBR值和无侧限抗压强度的比较,认为两者对于判断材料强度具有相关性,由试验结果拟合得到两者的关系。     

Comparison of the expectations of residents and rescue providers of community emergency medical response after mudslide disasters

The integration of community resources is critical for emergency response. A thorough understanding of a community's requirements in advance is essential. This study examines communities that suffered mudslide disasters, and discusses expectations of the emergency medical response provided to the community from the perspectives of residents and rescue groups. The questionnaire used in the study was designed to adopt the Likert Scale for quantification purposes. Its content was divided into six categories based on emergency response. Both residents and rescue providers acknowledged that finance and reimbursement were the highest priority. Public information was regarded as the least important by both groups. Significant differences existed between the groups on patient care activities and supportive activities (P = 0.02 and 0.03, respectively), which were more appreciated by residents. We conclude that residents had higher expectations of evacuation, temporary relocation, lodging, food, and sanitary management than the rescue groups.     

Public perceptions and attitudes to biological risks: Saudi Arabia and regional perspectives

Saudi Arabia has experienced frequent occurrences of biological disasters due to a wide range of generator factors, including natural disasters and epidemics. A national survey (n=1,164) was conducted across 13 regions of Saudi Arabia to examine public perceptions to the risk of a biological disaster. The primary results reveal: (a) a degree of knowledge about biological threats such as SARS and H5N1 flu, despite the lack of individual experience with disasters; (b) age, gender, education and faith are positively related to the perception of biological risk; and (c) a number of important community resilience factors exist, including faith, education and willingness. This study concludes that the development of adapted resilience strategies in disaster management can be achieved through public education and training involving cooperation with official organisations and religious authorities in the country to increase public awareness, knowledge and skills in mitigating biological threats.     

Earthquake drills and simulations in community-based training and preparedness programmes

The San Francisco, California, bay area is subject to continuous seismic risk. One particular response has been the development of community-based training programmes designed to teach residents basic emergency response skills. Citizens are taught emergency medical techniques, search and rescue, fire suppression and other fundamental response skills. Current estimates in the Bay Area place the number of programmes at more than 100. Many programmes now include an annual community drill to reinforce the training and to evaluate the programme. The study described here is based on an evaluation of an effort initiated by BayNET (Bay Area Neighborhood Emergency Training), a voluntary association of communities with community-based disaster preparedness programmes. In April 1996, BayNET asked all of its members to hold a community earthquake drill. After the drill, a mail survey was conducted of all programme managers. The survey examined the structure and administration of the programmes, training efforts and other related components. This paper describes the typology of drill formats that communities used, the role of the simulation in the city's preparedness efforts, the qualitative costs and benefits, as well as an assessment of the drill based on survey respondents.     

Compliance with recommended protective actions during an H7N9 emergency: a risk perception perspective

This study investigates the factors determining an individual's response to official recommended protective measures, based on the Health Belief Model and the Protective Action Decision Model, to understand the adoption of protective behaviour during an H7N9 (Avian Influenza A) emergency. A public survey involving 1,375 respondents was conducted in Anhui Province, China, during the 2013 H7N9 outbreak to test the research model and hypotheses. The results indicate that protective, stakeholder, and risk perceptions influence positively an individual's willingness to take recommended actions. Protective and stakeholder perceptions also have a positive bearing on lay people's risk perceptions. A stakeholder perception is a vital determinant of a protective perception. More importantly, the effects of protective and stakeholder perceptions on behavioural responses to recommendations are mediated in part by risk perception. These findings can help public health officials to develop messages to encourage members of the population to protect themselves effectively during an influenza crisis.     

How near is near? The distance perceptions of residents of a nuclear emergency planning zone

This paper reports the results of a study conducted within the emergency planning zone (EPZ) of the Nine Mile Point (NMP) nuclear complex located in Oswego County, New York. An EPZ is the area in the vicinity of a nuclear power plant for which detailed plans are implemented for the management of emergencies and for the communication of the risks of nuclear energy production. EPZs are subdivided into emergency response planning areas (ERPAs) according to distance from the plant. This study aimed at discovering how residents of the NMP EPZ perceived distance to the nuclear plant. Distance was conceptualized in five different and complementary ways: estimated straight line distance, estimated driving distance, actual straight distance, actual driving distance and perceived distance. The results indicate that people living at a very short distance from the nuclear plant perceive and estimate distance differently than people living farther away. These results have policy implications and suggest alternative and potentially more efficient ways to redesign ERPAs. Fundamental geographic variables and concepts such as distance, location, proximity and their associated human perceptions are important human dimensions of risk analysis. These results should be of interest to nuclear emergency planners and are probably applicable to many other hazard planning activities.     

Preparedness for anthrax attack: the effect of knowledge on the willingness to treat patients

Little is known about the factors that may impact on the willingness of physicians and nurses to treat patients during a bioterrorism attack. This survey was conducted among 76 randomly selected nurses and physicians in the emergency rooms of three public hospitals in order to analyse the relationship between knowledge, profession and the willingness to treat anthrax. The study finds that the willingness of physicians and nurses to come to work is 50% greater among the group with the highest knowledge about anthrax (P < 0.0001). Within that group, the willingness to treat patients suspected of being infected with anthrax was 37% greater (P < 0.0001) and the willingness to treat patients diagnosed with anthrax was 28% greater (P = 0.004) than in the other groups. These results imply that enhancement of knowledge among health care workers may improve their willingness to come to work and treat patients infected with anthrax during a bioterrorism attack.     

Implementing cash for work programmes in post-tsunami Aceh: experiences and lessons learned

Cash for work (CFW) programmes are utilised in various disaster and emergency contexts and were a prominent component of the tsunami response in Aceh province, Indonesia. This paper describes Mercy Corps' CFW programme, discusses CFW implementation experiences and provides key recommendations for similar programmes in future emergencies. For the majority of CFW participants and their households, CFW was the only source of household income and 93 per cent of household incomes were attributable to it. The CFW programme empowered displaced populations to return to their communities; 91 per cent of participants indicated that CFW facilitated their return. Other reported psychosocial benefits included providing productive activities and giving communities an opportunity to work together. Mercy Corps' experience in Aceh demonstrates that cash disbursements can be safely delivered in a widespread manner in emergencies, and that when implemented on a short-term basis, can have positive impacts at the individual and community level.     

干湿和冻融循环对压实黄土路用性能影响的试验研究

为研究气候环境对黄土路用性能的影响作用,通过室内CBR试验测定土样在干湿循环和冻融循环条件下的CBR值,分析不同循环条件下的P-L曲线、循环次数与CBR值的关系以及含水率与CBR值的演变规律,试验结果表明:(1)在P-L关系曲线中,循环次数一定时,贯入量随着单位压力的增加而增加;相同单位压力下,循环次数越多,试件强度越低,贯入量越大。(2)在5次干湿循环过程中,CBR值均随着循环次数的增加而降低,干湿循环作用下的CBR值与循环次数呈负线性相关,第2次干湿循环为转折点,CBR值减小值逐步增加,反复干湿循环作用下,基质吸力和孔隙结构特征是相互影响的。(3)冻融循环过程中,冻融循环作用下的CBR值与循环次数成二次方负相关,且有趋于稳定值的趋势。(4)在反复循环过程中,分析得到的变化规律为模拟黄土路基在气候环境影响下的长期演变规律研究以及实际工况提供一定的参考依据。     

Organisational challenges in the United Kingdom's post‐disaster ‘crisis support’ work

Local authorities in the United Kingdom are required to ‘lead’ multi‐agency humanitarian responses to major disasters. Concerns mounted in the late twentieth century that responses to people bereaved in the immediate aftermath of such events at best failed to meet their needs and at worst compounded their distress. Subsequent reviews and reforms reframed some victim needs as ‘rights’ and established legal, administrative, and practice frameworks to improve matters. Local authority ‘crisis support’, provided in partnership with other actors, lies at the heart of the UK's contemporary emergency response to the bereaved. Drawing on primary research on the development and the deployment of crisis support in a local authority, and while acknowledging both incident‐ and context‐related difficulties, this paper considers the significance of challenges with their origins in organisational factors. Recent developments within and between responders may exacerbate them. This paper argues, therefore, that further research into such developments is necessary.     

Immediate behavioural responses to earthquakes in Christchurch,New Zealand,and Hitachi,Japan

This study examines people's immediate responses to earthquakes in Christchurch, New Zealand, and Hitachi, Japan. Data collected from 257 respondents in Christchurch and 332 respondents in Hitachi revealed notable similarities between the two cities in people's emotional reactions, risk perceptions, and immediate protective actions during the events. Respondents' physical, household, and social contexts were quite similar, but Hitachi residents reported somewhat higher levels of emotional reaction and risk perception than did Christchurch residents. Contrary to the recommendations of emergency officials, the most frequent response of residents in both cities was to freeze. Christchurch residents were more likely than Hitachi residents to drop to the ground and take cover, whereas Hitachi residents were more likely than Christchurch residents to evacuate immediately the building in which they were situated. There were relatively small correlations between immediate behavioural responses and demographic characteristics, earthquake experience, and physical, social, or household context.     

我国Natech事件分布规律及涉水Natech事件致因分析

为弥补我国自然—技术事件(Natech事件)案例研究空白,基于多种数据挖掘方法对近20 a公开报道的自然灾害诱发的技术事故案例进行收集整理,建立了Natech事件数据库.对该类事件时空分布、行业分布进行交叉分析后发现:Natech事件季节特征明显,暴雨和大风是主要肇因,建筑业和交通运输业脆弱性较强.在引入不利气象情景对...     

Patterns of preference and practice: bridging actors in wildfire response networks in the American Northwest

The roles of bridging actors in emergency response networks can be important to disaster response outcomes. This paper is based on an evaluation of wildfire preparedness and response networks in 21 large‐scale wildfire events in the wildland—urban interface near national forests in the American Northwest. The study investigated how key individuals in responder networks anticipated seeking out specific people in perceived bridging roles prior to the occurrence of wildfires, and then captured who in fact assumed these roles during actual large‐scale events. It examines two plausible, but contradictory, bodies of theory—similarity and dissimilarity—that suggest who people might seek out as bridgers and who they would really go to during a disaster. Roughly one‐half of all pre‐fire nominations were consistent with similarity. Yet, while similarity is a reliable indicator of how people expect to organise, it does not hold up for how they organise during the real incident.