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People with hearing disabilities (PwHDs) face many challenges in their everyday lives, as their environments were not designed to accommodate their needs. They may have a communication disability as well as a hearing disability. To cope, PwHDs rely on the assistance of others, their communities, technology, and personal resources. In emergency situations challenges become greater and resources scarcer.
Method:
This study was conducted from November 2018 through July 2020. A mixed-methods approach consisting of in-depth interviews and online quantitative surveys with PwHDs in Israel was used. The qualitative part enquired about the resources they used to cope during emergencies and the obstacles they faced. Grounded theory was used for the analysis of the findings. The quantitative part focused on their perceptions of self-efficacy, methods of communication, and accessibility of services in emergency situations. The participants were deaf or hard of hearing individuals, and those who used hearing aids and/or had a cochlear implant, as well as individuals who chose not to use them. The study excluded people over 60, because we focused on those who didn’t suffer from hearing loss caused by age. The survey was accessible in Israeli sign language using Qualtrics survey platform. The statistical analysis was conducted using SPSS ver.23.
Results:
PwHDs’ resources for coping with emergencies were identified and classified under four categories.
1. Characteristics of the PwHD: type, methods of communication (sign language, read lips, speech) and accessibility of services.
2. Personal resources: Independent communication and self-efficacy.
3. Time of event: Daytime or nighttime.
4. Characteristics of the emergency: Personal vs. collective.
Conclusion:
The study identified the resources PwHDs used to cope with emergencies. Results can help develop standards of accessibility for places providing services during both day and night that will allow PwHDs to communicate independently.
People with hearing disabilities (PwHDs) often do not receive the warnings sent out to the general community during emergencies. Our goal was to identify the obstacles preventing PwHDs from accessing vital information in routine circumstances and during general emergencies.
Method:
This study was conducted from November 2018 through July 2020. We used a mixed-methods approach. The qualitative portion consisted of a standardized, open-ended interview with 19 PwHDs from various socio-economic backgrounds, religions, areas of residence and levels of hearing disability about coping with emergency situations in Israel. Grounded theory was used for analysis of the findings. The quantitative portion consisted of a cross-sectional survey of 288 PwHDs focused on perceptions of their self-efficacy in dealing with emergencies, methods of communication and accessibility of services. Using the Qualtrics survey platform with Israel sign language videoclips that included subtitles in straightforward Hebrew increased the participation. The statistical analysis was conducted using SPSS ver.23.
Results:
Most respondents explained that their responses differed depending on whether the emergency is collective or personal.
1. Collective emergencies: Events such as earthquakes or wars that affect everyone. Most solutions provided to the general population are not accessible to or suitable for PwHDs.
2. Private emergencies: PwHDs often encounter personal emergencies such as difficulty asking for help on the street, the inability to contact call centers or the difficulty in obtaining accessible information from organizations.
Conclusion:
The distinction between types of emergencies requires the development of different resources for dealing with routine issues and public emergencies. The latter affect PwHDs less than private emergencies. Standards of accessibility must be established for places providing services both during the day and at night, such as emergency rooms, telephone service centers, clinics, etc. These standards are the basis that which will allow for PWHDs to communicate independently.
To review and analyze the cumulative two-year, Israeli experience with medical care for children victims of terrorism during the prehospital and hospital phases.
Methods:
Data were collected from the: (1) Magen David Adom National Emergency Medical System Registry (prehospital phase); (2) medical records from the authors’ institutions (pediatric triage); and (3) Israel Tr auma Registry (injury characteristics and utilization of in-hospital resources). Statistical analyses were performed as appropriate.
Introduction:
During the recent wave of violence in Israel and the surrounding region, hundreds of children have been exposed to and injured by terrorist attacks. There is a paucity of data on the epidemiology and management of terror-related trauma in the pediatric population and its effects on the healthcare system. This study focuses on four aspects of terrorism-related injuries: (1) tending to victims in the prehospital phase; (2) triage, with a description of a modified, pediatric triage algorithm; (3) characteristics of trauma-related injuries in children; and (4) utilization of in-hospital resources.
Results:
During the study period, 41 mass-casualty events (MCEs) were managed by Magen David Adom. Each event involved on average, 32 regular and nine mobile intensive care unit ambulances with 93 medics, 19 paramedics, and four physicians. Evacuation time was 5–10 minutes in urban areas and 15–20 minutes in rural areas. In most cases, victims were evacuated to multiple facilities. To improve efficiency and speed, the Magen David Adom introduced the use of well-trained “first-responders” and volunteer, off-duty professionals, in addition to “scoop and run” on-the-scene management. Because of differences in physiology and response between children and adults, a pediatric triage algorithm was developed using four categories instead of the usual three. Analysis of the injuries sustained by the 160 children hospitalized after these events indicates that most were caused by blasts and penetration by foreign objects. Sixty-five percent of the children had multiple injuries, and the proportion of critical to fatal injuries was high (18%). Compared to children with non-terrorism-related injuries, the terrorism-related group had a higher rate of surgical interventions, longer hospital stays, and greater needs for rehabilitation services.
Conclusion:
Terrorism-related injuries in children are severe and increase the demand for acute care. The modifications in the management of pedi-atric casualties from terrorism in Israel may contribute to the level of preparedness of medical and paramedical personnel to cope with future events. Further studies of other aspects of traumatic injuries, such as its short- and long-term psychological consequences, will provide a more comprehensive picture of the damage inflicted on children by acts of terrorism.
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