The COVID-19 pandemic has caused significant psychological distress, especially among healthcare workers. While Psychological First Aid (PFA) and Stress First Aid (SFA) were commonly utilized in disaster settings, a few institutions had adapted them in the pandemic to provide psychological support for their healthcare workers. This systematic review aims to explore the application of PFA and SFA in addressing the psychological challenges faced by healthcare workers during the COVID-19 pandemic.

Searches were conducted in PubMed, CINAHL, and the Cochrane Library in August 2024. Studies were included if they utilized PFA or SFA as the primary intervention or employed frameworks based on either approach.

Seven studies were included in the review, with six conducted in the United States. Three studies focused on PFA-related interventions. One study reported that up to 20% of staff utilized the service. Another study highlighted a high satisfaction rate with the sessions, significant reductions in anxiety and emotional distress, and improved coping abilities. Four studies explored the implementation of PFA and SFA training for healthcare workers. Benefits of this training include increased awareness of available psychological resources, enhanced resilience, improved communication skills, greater proficiency in peer support, and better overall mental well-being.

Current literature provided encouraging evidence for the effectiveness of PFA and SFA in supporting healthcare workers during the COVID-19 pandemic. However, further research is needed to evaluate the impact of scaling up these programs and to determine their long-term effectiveness in preserving the mental health, well-being, and resilience among healthcare workers.

Because messages are broadcast on social media timelessly and efficiently, it is a critical disaster management survey tool. Taiwan’s Regional Emergency Medical Operation Center (REMOC) has responded to nationwide disaster messages in real time since 2005. To construct an early warning system to reduce the delay between the outbreak of accidents and messages received by REMOC.

Timely data, often from first responders and social media, is critical. A system was developed to collect disaster related posts from social media platforms, focusing on keywords like typhoon, flooding, and traffic accidents. Given the mix of topics, informal language, and frequent errors, text analytics and the SVM-based tool LibShortText were used to classify relevant messages. REMOC’s system identified 3,022 disaster-related messages out of 66,588 total posts. We calculated event frequency in 2019, response speed, and engagement rate (ER) to assess the responsiveness of traditional media and individual users.

Most messages collected were related to earthquakes (23%), followed by traffic accidents (17%), fires (12%), and floods (3%). Of 702 earthquake-related messages (142 episodes), social media users shared 35 messages about 18 earthquakes, while traditional media posted 667 messages about 124 earthquakes. Social media consistently posted 100% of earthquake messages faster than traditional media (“early dissemination efficacy”: 124/124). For 251 fires (367 messages), social media shared 122 messages on 82 fires, with an early dissemination efficacy of 0.57 hours. For 32 flood events (117 messages), social media posted 55 messages on 16 floods, achieving an early dissemination efficacy of 0.65 hours.

Results show that social media users responded faster than traditional media to disaster news, especially for earthquakes, fires, and floods. Earthquakes and floods had the highest response rates from social media. Integrating REMOCs and social media information systems can greatly enhance preparedness and response, particularly for earthquakes and floods.

Emergency nursing in Gaza’s war zone presents innumerable challenges when caring for female patients in a depleted health care system. Negative health outcomes specifically impact women of all ages due to a lack of access to menstrual care products, prenatal and primary care, private bathrooms, medication, essential nutrition, and clean water. The massive destruction of infrastructure and consequent internal displacement of millions have led to a rise in infectious diseases. The few remaining functional hospitals depend heavily on foreign medical delegations for supplies, which results in a lack of standardized treatment for women’s health complaints. Emergency departments must also navigate overcrowding, lack of basic supplies and specialists, and prioritization of daily mass casualty incidents from nearby explosions. These obstacles make treatment, discharge teaching, and follow-up care for women’s health difficult to implement. Despite these arduous circumstances, Gazan health care professionals find innovative solutions to improve outcomes and reduce harm while honoring the cultural and religious preferences of their female patients.

The terror attacks on October 7th, 2023, and the war that followed, have had a profound impact on the mental health of the Israeli population. The presentation will provide a comprehensive analysis of mental health outcomes following the war, incorporating data from multiple data sources.

The research focuses on the prevalence and correlates of post-traumatic stress disorder (PTSD), emotional distress, and substance use, utilizing a combination of traditional epidemiological methods, including medical records analysis and surveys with innovative data collection techniques. PTSD, anxiety, and depression, as well as quality of life, were measured in different populations and correlated with other data sources, including Google Trends™ of Spotify™ music application data regarding Israel.

31.4% of participants screened positive for PTSD approximately one month after the attacks, and significant increases in the use of tobacco, alcohol, tranquilizers, and sleep medications were reported. Younger age, female gender, and higher levels of exposure to the attacks were associated with increased PTSD and emotional distress. Google Trends identified an increase in searches related to depression, anxiety, and PTSD, and Spotify music preferences in Israel detected a decrease in songs’ valence, as defined by Spotify’s algorithm.

This study highlights the critical need for targeted mental health interventions and support mechanisms to address the widespread psychological impact of the October 7th war and to monitor its effects in various populations. These findings provide valuable insights for mental health professionals and policymakers in Israel and globally.

The Japan Disaster Relief(JDR) Medical Team was classified as an Emergency Medical Team (EMT) Type 2 in 2016 and reclassified in 2023. A working group has been set up to prepare the system for actual operations regularly, and the Type 2 outpatient care and Type 1 Fixed and Type 1 mobile are led by the Clinical Care 1 Working Group C1. The C1 is made up of members from multiple professions and is mainly focused on the functions required for outpatient care, and is not restricted to any particular profession, but is conducting a cross-sectional study.

A SWOT analysis of the C1 activity structure and studies will be conducted to identify proactive and improvement strategies.

Internal ‘strengths’ included the multidisciplinary nature of the C1 and the fact that the team members have experience in responding to disasters at home and abroad. Weaknesses included the fact that the manuals prepared were not fully utilized due to the large number of pages and the burden of reading for the team members. External factors such as limited training and drills, were cited as ‘opportunities. ‘Threats’ included improved response capabilities of other teams.

It is important to develop an ambulatory care system with members comprising multiple professions, as in C1, so that the construction of a system in each department can be examined in a cross-sectional and practical manner. On the other hand, for the JDR medical team, which has limited opportunities for dispatch, it is necessary to prepare manuals and study their operation in line with normal conditions and actual activities to ensure smooth activities at the time of dispatch.

Over the past 20 years, there has been a global increase in health and humanitarian crises, conflicts, catastrophic events, and disasters, caused by multiple risk factors and increasing vulnerabilities, which are making our planet vulnerable, hence the need to widely inform and share the culture of risk reduction on these issues, using web information and communication technologies and strategies.

Planet emergency disaster med net was created as the first Italian web site platform for national and international sharing information on Disaster Medicine, Catastrophes, Conflicts and Humanitarian Crises to increase the knowledge of professionals and those who want to approach these issues from a perspective of “disaster risk reduction” and to foster an integrated view of the current crises of the planet and possible solutions. The guiding principles will be based on the concepts of Global Health and One Health.

The goal of this project is to provide real-time information on planetary emergencies, disasters, conflicts, and humanitarian crises. The platform’s inspiring principles are based on the concept of One Health, an integrated and unifying holistic approach that aims to sustainably balance and optimize human, animal, and ecosystem health, recognizing that the health of humans, animals (both domestic and wild), and ecosystems is inextricably linked, interdependent, and interconnected. Expected results will be to promote an integrated view of current crises on the Planet and possible solutions from a health and information perspective, following a global health approach, to improve resilience and promote disaster risk reduction.

Using communication, information technology, and new technologies, including artificial intelligence, as tools to increase capacity and skills in disaster risk reduction, to improve disaster resilience, and also encouraging new ways of strong cooperation and interaction through the promotion of a transnational collaborative network in disaster medicine.

The ability to estimate healthcare utilization during mass gathering events can tremendously impact local healthcare resources and the cost of organizing such events. Various prediction models have been proposed in the literature to assist event organizers in forecasting medical service demands. This study will examine the extent and type of evidence regarding prediction modules and variables for healthcare utilization at various mass gatherings (MG) events.

The study included a search of four electronic databases (MEDLINE, EMBASE, Cochrane Library, and SCOPUS). Limits include the literature published on or after January 1, 2003. All retrieved citations looked at prediction models and variables of medical usage at all types of mass gathering events across all demographics, planned or spontaneous, that reported patient presentation rate (PPR) and/or transport to hospital rate (TTHR) at the event. All literature review articles were excluded.

This scoping review analyzed 25 studies. Thirteen studies focused on prediction models for medical usage rates in MG, and 12 studies explored predictive variables for PPR in MG.

The Arbon model (used in nine studies) was the most frequently examined. The Hartman classification model appeared in seven studies. Plan Risk Manifestations (PRIMA), a Belgian tool, was used in three studies. The Zeitz method and the South Africa Mass Gathering Model (SA-MGM) are featured in two studies.

Positively correlated variables with PPR included temperature (most cited, six times), event type (five times), heat index (four times), and crowd size (three times). Other less frequently cited variables (once each) included humidity, venue accessibility, festival format, and age class. Overall, temperature and event type were the most frequently used predictors across studies.

Healthcare utilization prediction tools vary widely. Healthcare organizations can help improve and optimize scarce resources during mass gathering events by understanding the variety and nature of these prediction tools.

Terrorist attacks on police forces are a global concern, particularly in South Asia, the Middle East, and North Africa. This study analyzes the frequency, methods, and consequences of these attacks toward police forces using the Global Terrorism Database (GTD), aiming to inform effective counter-terrorism strategies.

Data was extracted from the GTD for incidents from January 1, 1970, to December 31, 2020. The analysis included attack frequency, geographical distribution, casualties, attack methods, perpetrators, and yearly trends. Incidents meeting GTD’s terrorism criteria, excluding state terrorism, were included. Ambiguous or partially qualified events were excluded.

This study analyzed a total of 26,128 police-targeted terrorist incidents. The highest number occurred in South Asia (n = 10,417, 39.9%), followed by the Middle East and North Africa (n = 6,973, 26.7%). The most common attack methods were bombings/explosions (n = 11,172, 42.8%) and armed assaults (n = 9,033, 34.6%). Afghanistan reported the highest number of incidents (n = 5,367, 20.5%), followed by Iraq (n = 3,942, 15.1%), India (n = 2,449, 9.4%), and Pakistan (n = 1,944, 7.4%). Total Fatalities was 61,565 and Total Injuries was 72,687. The mean number of fatalities and injuries per incident were 2.43 and 2.96 respectively. Syria had the highest mean number of police casualties per incident, with 7.95 deaths and 9.36 injuries. The most frequent perpetrators were unknown assailants (n = 11,289, 43.2%) and the Taliban (n = 2,513, 9.6%). Trends show a high peak in the mid-2010s, with the highest in 2014 (n = 2,591, 9.92%).

Police forces are high-risk targets for terrorist activities, especially in unstable regions. High casualty rates in countries like Afghanistan and Iraq highlight the need for enhanced protective measures and support systems for police personnel. Effective counter-terrorism strategies must consider regional prevalence and attack methods to reduce risks and improve responses.

The United Nations’ Sustainable Development Goals (SDGs) are essential for addressing global challenges, including disaster preparedness. Narcissistic leadership, marked by self-centered decision-making and a focus on short-term gains, poses significant risks to achieving these goals. This study examines how narcissistic leadership impacts global disaster preparedness and the broader SDGs.

A systematic scoping review, complemented by action research, was conducted to explore the relationship between narcissistic leadership and disaster preparedness within the context of the SDGs. Searches were conducted across databases like PubMed and Scopus, focusing on peer-reviewed articles that discuss the effects of narcissistic leadership on environmental sustainability, infrastructure, social health factors, and global partnerships.

The review included 47 studies that highlight the detrimental effects of narcissistic leadership on disaster preparedness and SDG achievement. Narcissistic leaders were found to prioritize their personal agendas over long-term disaster resilience, leading to inadequate preparedness measures, environmental harm, and weakened international cooperation. This leadership style also exacerbates social inequalities and disrupts the implementation of effective global health strategies.

Narcissistic leadership is a significant barrier to global disaster preparedness and the successful attainment of the SDGs. Addressing this issue requires urgent global policy reforms, the promotion of collaborative and empathetic leadership, and enhanced international cooperation. Future efforts should focus on mitigating the rise of narcissistic leaders and strengthening leadership practices that support sustainable development and disaster resilience.

Linguistic communication barriers create challenges in delivering effective healthcare, particularly in emergent or disaster conditions, where miscommunication has dire consequences. Design thinking, a human-centered problem-solving technique, was utilized to identify innovative solutions to improve provider understanding of the effects of those barriers on patient care. Empathy interviews were conducted with patients, and providers evaluated contrasts in patient care between language-concordant and discordant encounters, directing the development and implementation of a preferred-language role-reversal simulation exercise.

Emergency Medicine (EM) resident physicians completed a survey evaluating experience and attitudes in caring for non-English speaking patients. In a structured simulation encounter, English-speaking EM residents placed in a patient role were treated by embedded participant physicians speaking non-English languages. Following the simulation, participants completed a post-survey and structured debrief. Responses were analyzed for differences and themes.

In 20 matched responses, residents were overall confident in their ability to diagnose and treat patients and reported lower confidence in their ability to treat non-English speaking patients. Following the simulation, overall confidence decreased, and disparity increased. Participants universally rated communication as challenging, and confidence was lower in understanding concerns and the overall quality of care. Structured debrief sessions were useful in identifying common themes, including perspectives on patient encounters and technology available.

This novel exercise was an effective tool to provide education and experience on the care of language discordant patients. Results and reflections exposed a lack of confidence in the current means available and the need for better technology and resources to help alleviate barriers when traditional avenues for communication fail. Simulation is an easily modifiable modality that may be useful to explore the impact of language and other barriers on healthcare and patient experience. This study highlights the need for further research and development to address the quality of patient care when language barriers are present.

Hemodialysis (HD), an essential treatment for patients with end-stage renal disease, is vulnerable to disasters because it is highly dependent on infrastructure such as water and electricity. During disasters, HD patients occasionally have to be transferred to other facilities where HD is available. In such cases, sharing patient information is critical for medical safety. This study aims to explore the types of information that should be shared among facilities and to investigate common and desired methods for sharing it.

A questionnaire survey was conducted among medical staff and HD patients at dialysis facilities in Miyagi Prefecture, which was greatly affected by the Great East Japan Earthquake, and subsequently developed a regional clinical information system. Between January and February 2024, questionnaires were sent to all 71 dialysis facilities in Miyagi, with responses collected either in written form or online.

A total of 383 responses from medical staff and 538 from HD patients were analyzed. Patient information is shared in hospitals using electronic and paper medical records, patient cards, dialysis records, data from dialysis machines, and regional collaboration systems. The rate of sharing this information with patients was 45%. Medical professionals prioritized HD-specific information, as well as critical details such as infectious diseases, contraindications, and allergies. Among HD patients, the most common methods for managing their information were medication notebooks, dialysis patient cards, and personal dialysis records. When transferring to other facilities, patients expressed concerns about the accuracy of HD-specific information and expected information sharing through network systems and Personal Health Records.

This study highlights existing gaps and perspectives in HD patient information sharing during disasters. It underscores the need for standardized protocols and efficient information transfer across facilities to enhance safety and continuity of care for HD patients.

Earthquakes pose a significant threat to public health, particularly among the elderly population, who are more susceptible to injury and have a higher prevalence of comorbidities. Traditional disaster triage protocols may not adequately account for the complex interplay between acute trauma and pre-existing health conditions. This study aims to refine the triage process for elderly earthquake victims by integrating comorbidities into the assessment.

We conducted a retrospective analysis of a large dataset comprising 25,006 trauma patients aged 60 and older, extracted from public databases. The dataset included information on patient demographics, pre-existing comorbidities (such as hypertension, coronary heart disease, cancer, and diabetes), post-injury vital signs, and outcomes (survival or death).

To identify the most significant predictors of mortality among these patients, we utilized the Least Absolute Shrinkage and Selection Operator (LASSO) regression technique. We applied LASSO regression with cross validation to determine the optimal penalty parameter (lambda) that minimizes the mean squared error and ensures the model’s generalizability.

Variables with non-zero coefficients in the LASSO model were deemed significant predictors of mortality. Using these predictors, we developed a nomogram—a visual, user-friendly tool—to assist healthcare professionals in making informed triage decisions in the chaotic aftermath of an earthquake.

The LASSO regression analysis revealed renal failure, coronary heart disease, and the Revised Trauma Score (RTS) as the most influential predictors of mortality in the elderly trauma patients (p < 0.05). The nomogram incorporating these factors was validated and shown to have good discriminative ability and calibration.

The integration of LASSO regression and nomogram development offers a statistically rigorous and practical approach to enhancing the accuracy and efficiency of triage decisions for elderly earthquake victims, potentially improving survival rates and resource allocation in disaster response scenarios.

Every disaster and emergency presents various and specific challenges. These can include scarcity of local resources and capacity in response, lack of safety and security even for relief workers, inefficiency due to lack of coordination and collaboration, and inequity of relief services reaching those in need.

Drawing from experiences of the Japan International Cooperation Agency (JICA), UNICEF, and the Global Fund -- and addressing diverse relief operations and response to large-scale natural disasters such as Sumatra Earthquake/Indian Ocean Tsunami and Cyclone Nargis in Myanmar; conflicts such as those in Somalia and Afghanistan; environmental disasters such as those in the Aral Sea and the forest fires in Indonesia; infectious diseases outbreak/pandemic such as Ebola Virus Disease and COVID-19 – this presentation highlights improvements seen in recent years and points to more efforts needed based on lessons learned. Improvement can be accelerated through innovation and technology, especially in information and data management, communications, and logistics. More efficient and effective global and local architecture, coordination, and collaboration mechanisms are also critical to maximizing impact in response to emergencies.

From January 2023 to March 2024, a project supported by the Japan International Cooperation Agency (JICA) aimed to establish a DMAT in Moldova. The Japan DMAT Secretariat designed a comprehensive training program and provided essential materials. Collaboration with Moldova’s National Center for Emergency Prehospital Medical Assistance (CNAMUP) and the National Agency for Public Health (ANSP) was crucial in enhancing Moldova’s disaster medical capabilities. Key activities included training sessions in Japan, site evaluations, and the implementation of a training course for future trainers in July 2024. More than 20 participants from Moldova’s key medical institutions, including the CNAMUP and the Institute of Emergency Medicine, completed the training. A significant achievement was the successful Training of Trainers course, where Moldovan professionals, who had previously received instruction in Japan, led the sessions. This marked a major step toward self-sufficiency in disaster medical response. The project not only improved the knowledge and skills of medical professionals in disaster scenarios but also laid the foundation for Moldova to develop its own disaster medical system tailored to its unique needs. The initiative highlighted the importance of fostering local expertise to create a sustainable and resilient disaster response framework. Future efforts should focus on adapting the training program to Moldova’s specific disaster risks, incorporating lessons learned from actual disaster experiences, while maintaining cooperation with Japan to ensure ongoing support and development. This project exemplifies the value of international collaboration in building strong, locally-driven disaster response systems that can save lives in critical situations.

Basic, affordable training can improve emergency systems to reduce morbidity and mortality among patients with acute emergent conditions. This study evaluates knowledge retention of Rwandan clinicians and their patient management following implementation of the World Health Organization and the International Committee of the Red Cross’s Basic Emergency Care (BEC) course. This is the first study to evaluate patient care immediately before and after participation in the BEC course.

A three-phase prospective, nonrandomized study was conducted at the University Teaching Hospital of Kigali, Rwanda, from 2022-2024, including 41 Urgent Medical Aid Service (SAMU) responders and Nurses (Phase 1), 25 general practitioners (GP, Phase 2), and 34 graduating medical students (Phase 3). Paired t-test compared mean pre- and post-test scores. GPs’ patient management for cases involving abnormal vital signs and/or hypoglycemia before and after course participation was assessed using Pearson’s Chi-squared test.

There were significant gains in knowledge pre- to post-course (mean Δ nurses = +16.3%, GP = +15.2%, medical students = 14.1%; p <0.001), with no significant difference between these groups (p = 0.70). In Phase 2, comparing pre versus post course patient management, (n = 264 pre, n = 108 post), there were non-significant increases for appropriate antibiotic use for sepsis (62.1% vs 70.3%,p = 0.26), oxygen administration for hypoxia (97.9% vs 100%, p = 0.34), and fluid delivery for shock(83.0% vs 84.1, p =0.81). There was also a non-significant decrease in glucose administration for hypoglycemia (88.2% vs 86.7%, p = 0.87).

Across medical providers, the education intervention had a significant and beneficial effect in increasing knowledge overall. There were no significant differences in recorded patient management. Future studies may be targeted towards early career clinicians with limited clinical experience to determine if a more targeted intervention matching the clinical experience of GPs would change patient management.

Universities have a unique opportunity to lead the evolution of disaster medicine by reorganizing their institutional frameworks to address the interconnected challenges of environmental sustainability and resilience. This submission uses the Johns Hopkins Institute for Planetary Health and the Planetary Health Alliance as a case study to demonstrate how reframing academic and operational structures can create new pathways for advancing disaster medicine programs.

Adopting a Planetary Health framework, the Johns Hopkins Institute for Planetary Health has aligned its research, education, and clinical initiatives to address the systemic drivers of disasters, such as climate change, biodiversity loss, and environmental degradation. By integrating environmental determinants of health with interdisciplinary collaboration, this approach has fostered innovation and expanded the scope of disaster medicine.

Key outcomes include leveraging ecological and environmental data for predictive modeling, incorporating nature based solutions into disaster preparedness, and enhancing cross-sector partnerships with public health, engineering, and policymaking stakeholders. These strategies build on the foundation of the Sendai Framework for Disaster Risk Reduction, propelling disaster medicine into a new era that emphasizes prevention, sustainability, and equity.

This report highlights how Planetary Health principles can act as a catalyst for transforming disaster medicine programs, equipping them to address cascading risks and systemic vulnerabilities in a rapidly changing world. By finding “another gear,” universities can drive disaster medicine forward, offering a replicable blueprint for institutions to align their missions with the complexities of a resilient and sustainable future.

Trauma-related deaths are rising in low- and middle-income countries (LMICs) like Nepal, where pre-hospital care systems are limited. Community health responders (CHRs) could reduce the time to post-injury care in rural settings. This pilot study evaluates the feasibility and impact of a CHR-based trauma program in rural Nepal.

A quasi-experimental study first adapted a trauma curriculum for CHRs in Achham, Nepal, using global guidelines from the World Health Organization and the American College of Surgeons, using a modified Delphi process. The final program included three components: a two-day skills training, a pictorial guidebook for reference, and a one day refresher after three months. Two municipalities in Achham were assigned to intervention or control, with only the intervention group’ CHRs receiving the training. Outcomes measured included CHRs’ knowledge and confidence assessed over six months, and patient-based pre-hospital care process indicators. Care process indicators were assessed at the hospital emergency department. Changes in knowledge over time were analyzed using repeated measures ANOVA. Bivariate analysis was performed to assess differences in pre-hospital trauma care indicators by study group.

The intervention group showed a significant increase in knowledge and confidence immediately post-course and sustained over six months. There was no significant difference in mean patient age (26.5 years versus 22.1) and trauma mechanism (p = 0.14) across the two groups. The most common mechanism was falls (n=165, 77.5%). Intervention municipalities had higher rates of pre-hospital care provision, including fracture immobilization (51.4% versus 17.1%, p < .001) and cervical collar use, compared to controls.

This study adapted and implemented a contextual trauma training program for CHRs in rural Nepal. Results show early feasibility and appropriateness in this context. The program leverages existing community networks and offers a potential approach in LMICs to bridge the existing critical gaps in rural pre-hospital trauma care that require further investigation.

A coordinated and effective response is critical in disaster scenarios, particularly when addressing pediatric patients’ unique health care needs. This abstract presents a collaborative approach between nurses and pharmacists to enhance pediatric care during disasters, emphasizing the importance of interdisciplinary teamwork in ensuring optimal outcomes for children.

Nurses play a pivotal role in the initial assessment and management of pediatric patients, providing direct care and identifying the specific needs of children affected by disasters. Their expertise in pediatric assessment allows for the timely recognition of injuries and medical conditions requiring immediate attention. Meanwhile, pediatric pharmacists bring specialized knowledge in medication management, ensuring that appropriate dosing and therapeutic options are available for young patients, especially given the physiological differences between children and adults.

This presentation will highlight key strategies for fostering collaboration between nurses and pharmacists during disaster response. We will explore effective communication techniques, shared protocols for medication administration, and joint training exercises to enhance preparedness. Case studies will illustrate successful nurse pharmacist partnerships in disaster settings, showcasing how their collaborative efforts can streamline patient care, improve medication safety, and reduce errors in drug administration.

Moreover, we will discuss the importance of establishing clear roles and responsibilities, facilitating real-time consultation, and leveraging the strengths of each discipline to create a comprehensive care plan tailored to the pediatric population. By promoting a unified approach, we aim to address the unique challenges faced by children during disasters, ultimately improving health outcomes and ensuring that their specific medical and emotional needs are met. This collaborative model not only enhances the quality of care delivered during emergencies but also sets a precedent for future interdisciplinary practices in pediatric disaster management.

Managing disasters and public health emergencies presents a complex challenge, especially in maintaining the crucial elements of surge capacity, i.e., the 4S: Staff, Stuff, Space, and System. This study focuses on using alternative care sites, focusing on hotels, during disasters and public health emergencies.

This study used a survey approach in two phases. In the first phase, the willingness to participate as an alternative care site was investigated among hotels in Bangkok, Thailand. In the second phase, the requirements for being an alternative care site were discussed with selected managers through a semi-structured interview session, including the legal implications of such utilization.

The results indicated a general willingness among participating hotels to participate as an alternative care site. However, some hotels lacked the requirements for being an alternative care site.

Based on the requirements in this paper, there is a high potential for using hotels as alternative care sites during disasters and public health emergencies. However, there is a need for further research concerning practical admission criteria and legal implications. This study recommends a Delphi study among medical and legal professionals to investigate the criteria for utilizing hotels in this capacity.

Wilderness medicine is a specialized field of training focused on providing medical care in remote and austere environments. Training providers on the unique aspects and limitations of austere/wilderness scenarios. It encompasses a wide range of skills, including trauma management, environmental emergencies, and survival techniques. Practitioners must be adept at improvising and working with limited resources, making quick decisions, and managing patients until they can reach a higher level of care. Simulation promotes higher confidence in trainees, though little studied in wilderness/austere medicine.

This study assessed the effect of outdoor simulation on emergency medicine learners using surveys surrounding aspects of austere medicine knowledge and comfort. Surveys were obtained before and after the 2-hour educational session and a 2-hour simulation. These included general wilderness medicine, temperature-related illness, mountain medicine, environmental exposures and emergencies, medical equipment planning, and patient splinting and extraction/evacuation. Surveys were conducted using a 5-point Likert scale.

Results showed significant improvement across all areas, with average gains ranging from 1.0 to 1.5 points. The most substantial increases were noted in mountain medicine (1.2, 1.5), lightning strike management (1.2, 1.6), medical gear planning (1.6, 1.6), and medications for austere environments (1.6, 1.6). Participants also reported increased familiarity with poisonous plants and fungi (1.2) and improved comfort with splinting techniques (1.4). Overall, confidence in environmental medicine, wilderness planning, medical pack creation, patient management, and patient extraction or evacuation improved by an average of 1.5 points.

The wilderness medicine training improved learners’ familiarity and comfort with various austere conditions and management. Mountain medicine, lightning strike management, medicine gear planning, and medications for austere settings were the areas that demonstrated the most improvement in familiarity and comfort in management. This training notably increased participants’ comfort and willingness to provide patient care in remote settings, underscoring the value of wilderness medicine simulation training.