Social media has become a crucial source of information for families, particularly during disasters when parents seek quick updates regarding loved ones and after a disaster for future planning. In response, Region V for Kids, a Pediatric Disaster Center of Excellence funded by the United States Administration for Strategic Preparedness and Response, formed a Communications Workgroup to disseminate disaster-related content via social media. This study evaluated whether the Region V for kids’ website user engagement with hospitals and families improved after leveraging social media for disaster content.

This retrospective study, conducted from January to August 2024, analyzed user engagement metrics from the Region V for Kids website. Metrics included landing page views, active users, average engagement time, and bounce rates. These were compared against benchmarks from significant events, such as forming a dedicated communications team, hiring a communications specialist, and posting educational resources during disasters.

After establishing the Communications Workgroup and hiring a communications specialist, user engagement improved significantly. Average engagement time increased from 5 to 26 seconds, while bounce rates decreased from 49% to 15%, indicating greater user interest. Although overall views and active user counts showed variability, there were notable increases following the Ohio Tornado Outbreaks in May 2024, demonstrating responsive engagement during critical events.

Targeted social media posts also positively impacted engagement. A May 2024 social media post on disaster preparedness for individuals with disabilities resulted in a six-fold increase in relevant webpage views. Similar trends were observed for family reunification, hazard vulnerability analysis, and pediatric medical operations coordination cell.

Social media has emerged as a vital tool for efficiently disseminating critical information, particularly during disasters. Region V for kids successfully utilized these platforms to enhance engagement and promote pediatric disaster preparedness best practices among families and hospitals.

The Symptoms and Perceptions (SaP) questionnaire is a tool developed to assess the occurrence, duration, and severity of physical and psychological symptoms in epidemiological research. The questionnaire covers up to thirty symptoms across multiple organ systems, alongside perceptions and causal beliefs. This study assesses the reliability and validity of the SaP using data from five independent population studies, representing different sample groups, exposure contexts, and timeframes. The main objective is to better understand the potential for standardized symptom assessment in disaster and environmental health studies.

Data from five epidemiological studies in the Netherlands were combined and analyzed. Each health study employed the SaP questionnaire with minor variations in item structure and content (28 to 30 symptom items): Study 1. Electromagnetic fields (N = 5,933; 2011); Study 2. Pesticides (N = 3,756; 2017); Study 3. Industrial area with multiple incidents (N = 2,394; 2020); Study 4. COVID-19 pandemic in a large province (N = 45,903; 2020); Study 5. National health monitor (N = 315,586; 2022). Various indicators of consistency and validity were assessed. Confirmatory factor analysis was performed to evaluate construct validity and dimensionality. In the analyses, a broad range of additional variables was included, such as psychological measures, health data registered in primary care, and proxies of actual and perceived exposure.

Analyses showed good internal consistency (Cronbach’s alpha > 0.80 across studies) and convergent and divergent validity, based on associations between symptom scores and data from diverse constructs. Higher levels of perceived exposure were typically accompanied by higher levels of symptom report. The factorial structure of the symptom assessment was confirmed, yielding consistent clusters of symptoms across datasets, in line with primary care classifications.

While existing literature predominantly focuses on psychological problems or disorders, a comprehensive and standardized symptom assessment approach is of importance, regardless of the nature and timeframe of an exposure case.

The Ministry of Health, Labor and Welfare in Japan has been researching “The Use of Mobile Medical Containers in Large-Scale Disaster” under the Koido Research Team, and as part of the research, is preparing draft guidelines to deploy and standardize mobile medical containers in prefectures. Amid this preparation, the Noto Peninsula Earthquake occurred on January 1, 2024, and mobile medical containers were deployed and utilized in 11 locations in the affected area. In response, the government commissioned the Mobile Medical Container Promotion Council (MMCPC) to conduct a survey and compiled “The Report on the Deployment and Operation of Mobile Medical Containers in the Noto Peninsula Earthquake in 2024” (hereafter “the Report”.)[Objective] To clarify how the lessons learned from the Noto Peninsula Earthquake should be reflected in the draft guidelines being prepared.

The study reviews the contents of the Report and discusses them with the MMCPC and other interested parties.

In the Report, the issues and recommendations from the Noto Peninsula Earthquake are described in Chapters 4 and 5. From these issues and recommendations, it became clear that the guidelines for the use of mobile medical containers should include the types of use as follows: 1)use at evacuation centers (single or multiple use), 2) supplemental functions for medical institutions (including supporter assistance, multiple use), 3)functions such as SCUs or coordination headquarters (multiple use). It was also confirmed that necessary tasks in line with the timeline, such as the occurrence of disasters, investigation, ordering, receiving orders, transportation, installation of facilities, medical care, and other related services, removal of facilities, or billing, need to be mentioned.

Further considerations need to be continued to make the guidelines more useful in the future.

This study presents two cases of late-onset Post-Traumatic Stress Disorder (PTSD) among survivors of the 2011 Great East Japan Earthquake, tsunami, and nuclear disaster. These cases were observed in Minamisoma City, Fukushima Prefecture, which experienced multiple subsequent disasters, including floods (2019), major earthquakes (2021-2022), and the COVID-19 pandemic (2020-2021). The region underwent mandatory evacuation for over a year following the nuclear disaster, significantly disrupting community structures and social support systems.

The cases were documented through clinical observations at a psychiatric practice established in 2016 in Minamisoma City, located within 20km of the Fukushima Daiichi Nuclear Power Plant. Both patients were followed longitudinally from their initial presentation through the recognition and treatment of their PTSD symptoms. Detailed clinical interviews and psychological assessments were conducted throughout the treatment period. Both patients provided written and verbal consent to present their cases in academic settings and publications.

Both cases exhibited a pattern of initial over-adaptation during the first few years post-disaster, actively participating in community recovery efforts and displaying apparent resilience. Subsequently, they developed depressive symptoms, leading to psychiatric intervention. Despite receiving treatment, their conditions fluctuated significantly. Several years of therapeutic engagement were required before patients recognized their trauma-related memories and associated symptoms. Retrospective analysis revealed that their initial over-adaptation to post-disaster community needs potentially masked underlying PTSD pathology, complicating early diagnosis and intervention.

These cases highlight the importance of recognizing delayed-onset PTSD in disaster survivors, particularly when initial over-adaptation may obscure underlying trauma. The study proposes preventive strategies and screening protocols for similar mental health issues in future disaster scenarios, emphasizing long-term monitoring.

The increasing frequency of global disasters highlights the need for timely, effective disaster education for healthcare providers. This study assesses pediatric providers’ experiences with disasters, perceptions of potential threats, and educational preferences to improve preparedness.

A survey was conducted among pediatricians affiliated with the American Academy of Pediatrics (AAP) Chapters in Washington, D.C., Maryland, and Virginia from February to April 2024. Data on personal disaster experiences, perceived threats, and preferred educational resources were collected. Descriptive statistics and odds ratios (OR) with 95% confidence intervals were used for analysis.

Of the 104 respondents, most were attending physicians (88%) working in healthcare or academic settings (73%), identifying as Millennials or Generation X (91%), with a median practice duration of 8 years. Commonly experienced disasters included winter storms, hurricanes, floods, power outages, and infectious disease outbreaks. Mass shootings and cyberattacks were perceived as the biggest threats despite limited direct experience. Preferred resources were electronic newsletters and professional associations, while during disasters, social media and real-time electronic sources were favored.

Pediatricians’ awareness of potential disaster threats exceeded their direct experiences, highlighting key areas for targeted educational interventions. The preference for digital and social media resources during disasters reflects a broader shift towards more accessible, timely education formats that are applicable across healthcare professions. While this study focused on pediatricians, the findings can be generalized to healthcare providers more broadly, emphasizing the importance of disaster education that leverages digital and social media channels to ensure clear, actionable information. This approach is crucial for public health and healthcare organizations to effectively inform healthcare providers during ongoing disaster situations.

• Event type: earthquake

• Event onset date: January 1, 2024

• Location of event: Ishikawa, Japan

• Response type: medical relief at an evacuation center

During the 2024 Noto Peninsula Earthquake, from January 3 to 24, Nippon Medical School Hospital dispatched eight medical teams in a row, with 39 medical staff (15 doctors, seven nurses, 10 paramedics, five pharmacists, and two radiographers). These teams provided 24-hour medical services at a first-aid station in a designated evacuation center with a capacity of approximately 700 evacuees. Over the three weeks, 204 patients received medical care, including 57 patients diagnosed with coronavirus disease, which posed significant challenges for infection control.

Additionally, these teams served as medical liaisons, collaborating with other support organizations to enhance sanitary conditions and reinforce health management practices. These teams implemented phase-specific interventions, such as conducting evacuation center assessments, screening the health status of individuals requiring assistance, supporting the reopening of the school used as an evacuation center, and coordinating with local healthcare systems during the chronic phase of disaster response. The number of evacuees gradually decreased, with only 92 remaining by January 24, when the first-aid station was decommissioned.

These coordinated efforts supported evacuation center operations led by the local authorities and residents. Each team played a role in preventing fatalities and improving the quality of life within the evacuation center, while adapting to the evolving needs of each phase. Ultimately, the absence of fatalities during the operational period underscored the effectiveness of these collaborative health interventions.

As healthcare advances, medical devices have become essential for diagnosis and treatment, making a reliable power supply necessary for their operation. The 2018 Hokkaido Earthquake demonstrated a surge in demand for treatments such as dialysis in disaster-based hospitals, leading to unexpected levels of emergency power usage. This highlighted the need for robust patient intake systems in both disaster-based hospitals and regional emergency hospitals. Additionally, the expansion of home healthcare has increased the need to accommodate ventilator-dependent patients during power outages, yet the rate of individualized evacuation planning remains low nationwide. To understand the current situation and develop future strategies, a survey was conducted in Okayama Prefecture to assess the preparedness of medical facilities regarding power-dependent devices and emergency response capabilities.

A survey targeting hospitals in Okayama Prefecture was conducted using Google Forms. Data were gathered on emergency power availability, power outage response protocols, and the capacity to admit patients reliant on powered medical devices.

The survey was conducted in December 2023, achieving a response rate of 59% (93 out of 157 hospitals). Findings indicated that 87% of hospitals in Okayama had power-dependent devices. The continuity of emergency power varied significantly: 9% of facilities were uncertain, 41% had sufficient power for half a day, 15% for one day, 14% for two days, and 21% for three days. However, only 47% had established power outage response manuals. Additionally, only 34% of hospitals were prepared to accommodate home-based patients, relying primarily on manufacturers for necessary support.

These results reveal gaps in disaster preparedness, especially in emergency power continuity and the ability to admit patients with power-dependent needs. Addressing these issues requires strengthening preparations in normal times by forecasting healthcare demands and balancing them with facility capabilities. Regional disaster preparedness should also be advanced through collaboration between industry, government, and academia.

Mass gatherings pose significant challenges in terms of public safety and health risks, requiring targeted and strategic risk communication and community engagement (RCCE) approaches. To effectively address these challenges, the World Health Organization (WHO) has developed an RCCE Readiness and Response Toolkit. This toolkit supports RCCE practitioners, decision-makers, and partners at all levels in planning and implementing readiness and response activities for health emergencies related to MG events. It complements existing frameworks and operational packages designed to assist event planners and stakeholders in organizing safe MG events and managing related health emergencies, and is based on global best practices.

This toolkit was developed through an iterative and consultative process that included an extensive literature review, expert consultations, pilot testing during outbreak responses, and peer reviews. It includes practical tools for risk assessment, community data collection, countering misinformation, and developing evidence-based RCCE strategies for emergency preparedness and response at mass gatherings.

The toolkit equips MG organizers, stakeholders, and RCCE practitioners with the necessary tools and frameworks to effectively communicate risks and respond to health emergencies associated with MG events. By facilitating evidence-based RCCE strategies tailored to community needs, the toolkit supports more accountable health interventions, enhancing public safety and reducing morbidity and mortality at MG events

RCCE is essential for fostering collaboration and coordination, ensuring public trust and readiness, and suggesting effective community-led solutions to bolster health emergency response management before, during, and after a mass gathering. This publication provides a step-by-step guide on developing RCCE strategies tailored to specific settings, leveraging the latest evidence and community-centered approaches to protect and save lives.

The political commitments outlined in the ASEAN Leadership Declaration on Disaster Health Management (ALD on DHM) have been translated into strategic initiatives. To support the Regional Coordination Committee on DHM (RCCDHM) in implementing the Plan of Action (PoA) for 2019–2025 and beyond, the ASEAN Institute for DHM (AIDHM) was officially launched in October 2023. The AIDHM plays a crucial role in facilitating the academic components of the PoA, encompassing research, training, and knowledge sharing, while also serving as the Secretariat for the ASEAN Academic Network on DHM (AANDHM). This report critically evaluates the organizational and operational dimensions of the AIDHM over its inaugural year (October 2023 to October 2024). Data collection involved a comprehensive review of official documents. The review results indicated that the AIDHM operates under the coordination of the ASEAN Health Cluster 2 alongside the ASEAN Senior Officials Meeting on Health Development. The AIDHM Board of Directors consists of designated representatives of the RCC-DHM of the ten ASEAN Member States, with the Dean of the Faculty of Medicine, Public Health, and Nursing at Universitas Gadjah Mada (FoM-PHN UGM) serving as the head of the AIDHM Secretariat. The AIDHM is structured into four divisions: (1) Training, (2) Research Development, (3) IT innovation, and (4) Administrative. Currently, AIDHM’s operationalization is bolstered by the Project for Strengthening ASEAN Regional Capacity on DHM (ARCH Project) and RCCDHM to meet regional PoA targets. Successful activities include the 2nd ASEAN Academic Conference on DHM in October 2023, two joint research projects focusing on emergency medical teams and safe hospitals, and the establishment of the ASEAN Journal of DHM (AJDHM). It is recommended to conduct a thorough review of the organizational structure to assess effectiveness. Furthermore, the establishment of an advisory working group for each division is essential for providing guidance and upholding standards.

Japan is widely regarded as one of the safest countries in the world. However, there are still fatal pedestrian accidents with turning traffic. The severity of the trauma tends to be high in pediatric and elderly patients. To protect these vulnerable groups, pedestrian-separated traffic lights can be an effective traffic measure. The National Police Agency has promoted the installation of the lights for more than 20 years, but it has made little progress. The rate of installation of the lights is about 4.9% in Japan. This study aims to assess the effectiveness of pedestrian-separated traffic lights.

The crossings that were installed with pedestrian-separated traffic lights between 2016 and 2020 in Tokyo were identified. The traffic accident data at those crossings from 2014 to 2022 was obtained by the Tokyo Metropolitan Police Department. The data was analyzed in each age group to evaluate the effectiveness of the pedestrian-separated traffic lights.

At the crossings where pedestrian-separated traffic lights were installed, the number of pedestrian accidents decreased by 69%. Notably, pedestrians up to 12 years old and those 65 years or older have not been involved in any traffic accidents since the installation of the pedestrian-separated traffic lights.

Installing pedestrian-separated traffic lights is an effective traffic measure to reduce pedestrian traffic accidents, especially in vulnerable groups.

The Irish government has sought to improve access to primary care by introducing free GP cards for under-6-year olds in 2015 and under-8-year-olds in 2023. This retrospective review analyzed the impact on Emergency Department (ED) attendance in Wexford General Hospital (WGH).

ED attendance data from before and after the implementation of the new policy was collated from the automated system-generated attendance reports. For under 6-year-olds, data from July 2014 to June 2015 was compared to July 2015 to June 2016. For the under 8-year-olds, data from August 2022 - July 2023 and mean annual data from August 2014 till July 2023 were compared to August 2023 - July 2024. Interpretation of the results was correlated with the national census data from 2011, 2016, and 2022.

Despite an anticipated decrease in ED attendances in this age group due to apparent improved access to primary care, there was a 33.2% increase in under 8-year-olds presenting when comparing 2022/2023 to 2023/2024 (n = 5702 to n = 7595), and a 0.72% increase in under 6-year-olds in 2014/2015 to 2015/2016 (n = 4148 to n = 4178). Mean analysis from 2014/2015 to 2022/2023 revealed an increase of 38.34% (n = 5490 to n = 7595) for the under-6 population. This is not accounted for by a growth in this population group, according to census data from 2011 to 2022.

Despite the initiative to improve access to primary care for children, an increase in the number of ED attendances in this patient group was noted. It is unclear what this apparent paradox can be attributed to, but it would be beneficial to further compare how many of these ED attendances were referred by GP’s before and after the introduction of the new policies, and to correlate this with the number of GP’s practicing in the WGH catchment area over this period.

Seismic risk reduction strategies are vital for maintaining hospital functionality during and after earthquakes, particularly in the Middle East region, which is known for its high seismic activity. Hospitals must remain operational to provide essential services during disasters. This review evaluates the effectiveness of comprehensive seismic risk reduction programs in enhancing hospital functionality after an earthquake.

A systematic literature review was conducted, targeting hospitals in earthquake-prone regions of the Middle East. Databases searched included EBSCO, Cochrane, PsycINFO, Scopus, Web of Science, PubMed, Medline, EconLit, and Google Scholar, including cross-sectional, case study, and mixed-method studies published between 2009 and 2024. Inclusion criteria focused on hospitals implementing comprehensive or partial seismic risk reduction programs. Data extraction and quality assessment were performed by three independent reviewers using standardized tools.

Five studies met the inclusion criteria. The findings revealed significant disparities in hospital preparedness and functionality. Structural and non-structural measures, such as retrofitting and staff training, should have been utilized. Hospitals with comprehensive programs demonstrated higher functionality post-earthquake. However, financial constraints, lack of technical expertise, and insufficient regulatory frameworks hindered effective implementation. Mobile hospitals were highlighted as an innovative solution to address capacity shortages during seismic events.

Despite the benefits of seismic risk reduction strategies, significant gaps remain in structural resilience and non structural support systems. Future research should focus on long-term impacts, integration of mental health services, and innovative strategies like mobile hospitals to enhance disaster preparedness and response. Collaborative efforts among stakeholders are crucial to fostering a resilient healthcare infrastructure capable of withstanding seismic threats.

Medical and disaster-related incidents associated with mass gatherings are increasingly recognized as important issues. Understanding the nature of these gatherings and implementing thorough disaster preparedness and well-planned response strategies are essential for mitigating potential impacts. Taiwan’s Mazu pilgrimage is one of the largest mass gatherings worldwide, involving rituals and processions spanning over 300 kilometers in 8 to 10 days. Few studies have examined the health impacts and influencing factors associated with such prolonged and long-distance pilgrimage movements. This study aims to assess the health impacts and associated factors of these events to inform future preparedness and response planning.

We conducted a retrospective observational study of patients visiting the emergency department during the Mazu pilgrimage from 2018 to 2024, utilizing data from the Emergency Medical Resources Management System (EMRM), Ministry of Health and Welfare. The dataset includes variables such as date of emergency visit, gender, age, primary diagnosis, mode of transportation to the emergency department, triage level, and medical interventions. The primary outcome measured was the frequency of emergency department visits.

A total of 1,637 patients visited the ED during the Mazu pilgrimages from 2018 to 2024. The mean age of all patients was 49.1 years, with 813 (49.7%) being male. Among these patients, 819 (50.0%) were transported to the ED by ambulance, and 177 (10.8%) were triaged as TTAS level I or II. Regarding patient disposition, 1,469 patients (89.7%) were discharged without admission, and 132 (8.1%) were admitted to the general ward.

For the Mazu pilgrimages in Taiwan, most patients visiting the ED presented with mild cases. Furthermore, the health impacts extended beyond EDs to the emergency medical service (EMS), which had to respond to the increased demand for ambulance transportation. Therefore, it is critical to effectively manage both prehospital EMS and emergency services in EDs to bridge potential treatment gaps.

To date, despite the COVID-19 pandemic that led to the establishment of alternate care facilities (ACFs) in many regions throughout the United States (US), limited literature exists exploring the strengths of current US federal ACF guidelines and challenges with implementing these guidelines. Intuitively, the ability to expand hospital bed surge with ACFs is cardinal to responding to certain mass-casualty incidents and public health emergencies.

A systematic review of existing literature was conducted, focusing on experiences with implementing ACFs in the US. Based on themes identified from the literature review, semi-structured interviews were conducted with ACF subject matter experts (SMEs). Transcripts from these interviews were qualitatively analyzed to identify common themes, focusing on successes, challenges, and the future direction of AFCs.

The comprehensive literature review identified 34 articles, representing 14 states and 16 ACFs. Articles addressed various topics involved in ACF implementation, describing leadership and coordination, staffing modes, satellite pharmacy onboarding, resource allocation, patient selection, challenges, and successes. 17 ACF SMEs were interviewed, representing 13 states and a variety of institutions, including community-based, academic, Red Cross, and federal partners. Key themes were identified for ACF implementation with sub-themes pertaining to successes, challenges, and the future of ACFs. Flexibility and adaptability, partnerships and collaborations, resource procurement and allocation, and leadership and stakeholder engagement were themes identified in all sub-theme areas. Key recommendations from SMEs include the development of a coherent strategic vision for each ACF, enhanced community engagement, ensuring early effective leadership, providing training and support, and enhancing coordination among outside partners.

ACFs are a viable option for addressing medical surges during healthcare crises. Preplanning through local and regional partnerships, collaboration with local healthcare systems, and flexible staffing models are key for an effective activation. The proposed experiential-based best practices complement current ACF guidelines.

Healthcare workers, particularly paramedics, face significant occupational hazards that elevate their risk of illness and injury compared to other professions. Factors such as insufficient awareness and inadequate training exacerbate these risks. The study aims to evaluate the awareness of emergency medical services (EMS) students in the Makkah region regarding various occupational hazards, including physical, biological, chemical, and mental risks. By assessing this awareness, the study needs to identify gaps in knowledge and training, ultimately contributing to improved safety protocols and educational programs in the EMS field.

This cross-sectional study assessed emergency medical services (EMS) students aged 18 to 30 at universities in the Makkah region of Saudi Arabia, excluding those over 30 and other healthcare workers. A survey with five Likert-type questions measured awareness of occupational hazards and information sources, targeting a sample size of 94 students.

Of the 96 participants, 59.4% were male, and 71.9% were aged 21-23. The majority were from King Saud bin Abdulaziz University (67.7%). The mean awareness score was 3.66, with particularly high scores in hand hygiene (4.37) and personal protective equipment (PPE) use, especially for gloves (91.5%) and masks (90.6%). Chemical hazards were the most recognized (78%), while ergonomic hazards were the least known (20.6%). Media was the primary source of information (26.7%), whereas only 18.8% cited lectures and university materials. Education was correlated with increased confidence in PPE usage; however, chi-square tests indicated no significant associations (p = 0.941).

The study concludes that while EMS students show good awareness of occupational hazards, there is a critical need for improved training and curricula. Their reliance on the media for information reveals a gap in educational resources. Enhancing training programs and revising curricula could significantly improve safety protocols and preparedness for paramedics in the Makkah region. Future research should assess the effectiveness of these educational improvements.

Nuclear power generation is increasing globally and is expected to triple by 2050. This, combined with the proliferation of nuclear materials, has highlighted the need for enhanced public health preparedness. Although an emergency event has a low probability, it could have a devastating impact on human life. Despite similar risks, emergency response communities around the globe have developed different public health approaches to nuclear and radiation preparedness. To address this challenge, a scorecard approach was piloted to identify and prioritize strategies to strengthen public health preparedness for a nuclear and radiation incident.

A pilot nuclear and radiation resilience scorecard was applied in a workshop in Montgomery, Alabama, United States, with 14 participants. There were representatives from emergency preparedness and planning (n=7), nursing, operations, program management, radiation safety, safety and security, technical hazards, and academia. Workshop participants discussed each scorecard question and then individually scored the level of resilience using a Likert scale. The questions were organized around the United Nations Office for Disaster Risk Reduction (UNDRR) Ten Essentials for Making Cities Resilient. When consensus was reached, participants developed and prioritized actions.

There were four priority actions identified. This included increasing the outreach of representatives in the nuclear and radiation industry to health facilities. Expanding planning to non-traditional areas such as primary care facilities, education systems, and transport networks. Increasing the scope of emergency warning systems to counter misinformation and creating a standardized process for educating and onboarding public health officials involved directly and indirectly in emergency management. This should include training and exercises focused on nuclear or radiation incidents.

The scorecard approach and the recommended actions provide a path forward for public health systems to function at the highest possible level when preparing for and responding to a nuclear or radiation incident.

Emergency cricothyroidotomy (EC) is a rare but critical intervention in out-of-hospital cardiac arrest (OHCA) when conventional airway management fails. Given the infrequency of EC use in OHCA, systematic knowledge on EC remains limited.

This study was a registry-based follow-up analysis performed to assess the epidemiology of EC in OHCA cases, with a focus on prevalence, success rate, indications, and survival outcomes. The study identified EC cases within the Danish Cardiac Arrest Registry from 2016 to 2022. Cases were retrieved by systematically searching prehospital medical records in the registry, using a pre-specified list of characteristic keywords derived from previously documented EC cases. Finally, the identified cases were manually validated.

Out of 36,040 OHCA cases between 2016 and 2022, the search identified 36 cases with EC, yielding a prevalence of approximately 1 in 1,000 cases of OHCA. Cases had a median age of 56 years (IQR 50-70) and were predominantly males (72%). The EC success rate was 89%, with 82% of cases involving unsuccessful intubation attempts prior to attempting EC. Key indications for EC included facial trauma (27%), aspiration-induced airway obstruction (27%), edema/swelling (9%), hypothermia-related rigidity (9%), foreign body airway obstruction (9%), and anatomical challenges due to obesity (6%). Most cases (69%) resulted in death before hospital arrival, 23% had ongoing CPR upon arrival, while 9% achieved successful resuscitation.

These findings highlight both the rarity but also the clinical feasibility of EC in prehospital settings. While EC is rarely performed, the high success rate supports its use as a viable last-resort intervention when conventional airway management fails. Additionally, the findings emphasize specific scenarios, such as facial trauma and aspiration-induced airway obstruction, as settings where EC is most likely to be necessary.

Traumatic brain injury (TBI) is a major global health burden and the leading cause of injury-related death and disability worldwide. In March 2020, the World Health Organization (WHO) declared the novel coronavirus disease 2019 (COVID-19) a global pandemic. The purpose of this study was to investigate the effects of the COVID-19 pandemic on the mortality of TBI patients transported by emergency medical services (EMS).

Adult TBI patients who were assessed and transported by EMS between January 2018 and December 2021 were analyzed. The main exposure was the COVID-19 pandemic period at the time of the event. The primary outcome was in-hospital mortality, and the secondary outcome was disability measured using the Glasgow Outcome Scale (GOS), one to three. Multivariable logistic regression analyses were conducted to calculate adjusted odds ratios (aOR) with 95% confidence intervals (95% CIs).

A total of 18,988 patients were enrolled for analysis. In-hospital mortality in the COVID-19 era group was 1,812(20.9%), and the non-COVID-19 era group was 2,040 (19.8%). Multivariable logistic regression analysis demonstrated a significantly higher probability of in-hospital mortality in the COVID era group: aOR (95% CIs) 1.11 (1.03-1.20) for the COVID era group. There is no significant difference in disability: aOR (95% CIs) 1.01(0.95-1.08) for the COVID era group.

For the TBI patients assessed and transported by EMS in South Korea, subjects transported in the COVID-19 era were more likely to have higher in-hospital mortality compared to non-COVID-19 era. It should be considered when planning and implementing EMS protocols and community healthcare strategies during pandemics.

The increasing number of ambulance calls and emergency department overcrowding have become a global issue during the past decade. The aging population and increasing morbidity play only a partial role in the increased demand. Ambulance service is often called upon, even when other, more appropriate services would be readily available. This inappropriate utilization of ambulances imposes a significant burden on the emergency health care system. This study aimed to evaluate the effectiveness of various interventions aimed at controlling ambulance dispatch volume and to facilitate the referral of patients to appropriate alternative services.

This was a prospective, observational cohort study covering all ambulance dispatches in Helsinki, Finland, in 2021- 2024. Interhospital patient transfers were excluded. The main interventions used were 1) providing guidelines and training for home care and nursing homes, 2) conducting public campaigns and increasing media coverage, 3) updating dispatching guidelines, 4) enabling case-based decision making by dispatchers, and 5) allowing dispatchers to refer callers to alternative services. The interventions were introduced between 2021 and 2023. The study plan was approved by Helsinki University Hospital.

The number of ambulance missions (and total number of units dispatched) decreased from 74,197 (86,860) in 2021 to 72,596 (84,377) in 2022 and to 72,480 (83,161) in 2023. During the first nine months of 2024, the dispatch volume was 48,344 (54,543), with a predictive model estimating a total volume of 64,507 (74,013) by the end of the year. From 2021 to the end of 2024, the estimated total reduction is expected to be 13,1% (14,8%).

The use of multiple, simultaneous interventions managed to stop rise in ambulance dispatches, leading to a reduction. This may be the first report of interventions that have managed to reverse the current trend.

Bystanders’ immediate cardiopulmonary resuscitation (CPR) significantly increases survival rates for victims of sudden cardiac arrest. However, laypeople often hesitate to intervene. In Japan, the rate of bystander CPR for witnessed out-of-hospital cardiac arrest was 59.2% in 2022. One major reason for hesitation is that laypeople do not know or cannot recall the proper steps, even when willing to assist. To address this, we created handkerchiefs depicting the steps of basic life support (BLS), including chest compressions and using an AED. This study assessed whether these illustrated handkerchiefs influence non-medical individuals’ confidence and willingness to perform BLS.

A questionnaire survey was conducted on October 20th at Nagoya City University West Medical Center, targeting non-medical attendees of the Reiwa 6th Annual Kita-ward Festival in Nagoya. The survey gathered demographic information (age, prior CPR training) and assessed participants’ hesitance and confidence to perform BLS using visual analog scales (VASs) before a hands-on BLS training session. After the session, participants rated their hesitance and confidence in performing BLS with and without the illustrated handkerchief.

Thirty-four laypeople participated in the study. The mean VAS scores for hesitance and confidence before the session were 5.1 and 3.3, respectively. Post-session, the average hesitance score significantly decreased to 2.1 with the illustrated handkerchief but remained at 5.2 without it. The average confidence score increased significantly to 7.5 with the handkerchief and 4.9 without it.

Illustrative guides showing BLS steps effectively reduced hesitance and increased confidence among laypeople in performing BLS. Portable handkerchiefs depicting BLS steps could encourage more bystanders to provide BLS to out-of-hospital cardiac arrest victims.