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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Disaster Medicine".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 21659

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Dr. Santiago Martínez-Isasi

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1. Faculty of Nursing, Universidade de Santiago de Compostela, 15705 Santiago Compostela, Spain
2. CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain
3. Simulation and Intensive Care Unit of Santiago (SICRUS) Research Group, Health Research Institute of Santiago, University Hospital of Santiago de Compostela CHUS, 15706 Santiago de Compostela, Spain
Interests: simulation; education; first aid; advanced and basic life support; prehospital and hospital care; emergency nursing
Special Issues, Collections and Topics in MDPI journals

Dr. Silvia Aranda-García

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Guest Editor

1. GRAFIS Research group, Institut Nacional d’Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), 08038 Barcelona, Spain
2. Health and Applied Sciences Department, Institut Nacional d’Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), 08038 Barcelona, Spain
3. CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain
Interests: basic life support; drowing; fist aid; new technologies in emergencies
Special Issues, Collections and Topics in MDPI journals

Dr. Martín Otero-Agra

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1. University School of Nursing, University of Vigo, 36001 Pontevedra, Spain
2. REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain
Interests: BLS education; simulation; first aid; ALS education
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In emergencies, the common elements are the need for immediate care and adequate treatment and response. Attention to this demand for care begins before the event occurs, with the identification of the need for an urgent response and the training and/or education of trained personnel or bystanders. The training of personnel who work in emergencies begins at the undergraduate or graduate level, specialized and consolidated in postgraduate training until the achievement of expertise in clinical practice. Simulation is one of the methodologies used that can be adapted to the level of expertise of the professional and consolidate knowledge and skills. Additionally, the training of dispatchers of emergency medical services is a fundamental tool to provide action measures to bystanders or health personnel and improve their performance in out-of-hospital emergencies. The topic of this Special Issue focuses on the training and intervention in hospital and out-of-hospital emergencies in different environments by trained professionals or bystanders.
For this Special Issue, submission of original articles and reviews are welcome.

Dr. Santiago Martínez-Isasi
Dr. Silvia Aranda-García
Dr. Martín Otero-Agra
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

simulation training
learning
health personnel
bystanders
emergency care
prehospital
emergency hospital service

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Published Papers (9 papers)

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10 pages, 2977 KiB

Open AccessArticle

Pediatric Ventilation Skills by Non-Healthcare Students: Effectiveness, Self-Perception, and Preference

by Santiago Martínez-Isasi, Cristina Jorge-Soto, Cecilia Castro-Fernández, Clara Baltar-Lorenzo, María Sobrido-Prieto, Jose Manteiga-Urbón and Roberto Barcala-Furelos

Int. J. Environ. Res. Public Health 2023, 20(4), 3026; https://doi.org/10.3390/ijerph20043026 - 9 Feb 2023

Viewed by 1491

Abstract

Since a great number of infant cardiopulmonary arrests occur outside of the hospital, it is crucial to train laypersons in cardiopulmonary resuscitation techniques, especially those professionals that will work with infants and children. The main objective of this study was to evaluate the efectiveness of ventilations performed by professional training students. The secondary objective was to analyze the preference between different ventilation and chest-compression methods. The sample consisted of 32 professional training students, 15 preschool students, and 17 physical education students. The activity was conducted separately for each group, and we provided a 10 min theoretical training about infant basic life support followed by a 45 min practical training using a Laerdal Little Anne QCPR CPR manikin. A practical test in pairs was organized to record the ventilation as performed by the participants, establishing the difference between the efficacious and the non-efficacious ones. Furthermore, we handed out a survey before and after training to evaluate their knowledge. More than 90% of the students completely agreed with the importance of learning cardiopulmonary resuscitation techniques for their professional future. More than half of the sample considered that they perform the rescue breathings with the mouth-to-mouth method better. We observed that through mouth-to-mouth-nose ventilations, the number of effective ventilations was significantly higher than the effective ventilations provided by a self-inflating bag and mask (EffectiveMtoMN 6.42 ± 4.27 vs. EffectiveMask 4.75 ± 3.63 (p = 0.007)), which was the preferred method. In terms of the compression method, hands encircling the chest was preferred by more than 85% of students. Mouth-to-mouth nose ventilation is more efficient than bag-face-mask ventilation in CPR as performed by professional training and physical activity students. This fact must be considered to provide higher-quality training sessions to professional training students. Full article

(This article belongs to the Special Issue Advancing Research on Emergency Care)

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10 pages, 848 KiB

Open AccessArticle

Evaluation of the Impact of a Tourniquet Training Program: A Cross-Sectional Study

by Valentín González-Alonso, María del Carmen Usero-Pérez, Raquel Seguido Chacón, Alicia Gómez de la Fuente, Jonathan Cortés-Martín, Raquel Rodríguez-Blanque and Juan Carlos Sánchez-García

Int. J. Environ. Res. Public Health 2023, 20(3), 2742; https://doi.org/10.3390/ijerph20032742 - 3 Feb 2023

Cited by 2 | Viewed by 2020

Abstract

Among the main preventable causes of death in the area of operations is external exsanguinating hemorrhage in the extremities, hence the importance of the tourniquet as a therapeutic tool in this type of injury and, therefore, of the training of personnel participating in international missions. The main objective of this study is to determine the impact of training in the application of this device. This is a quasi-experimental, prospective, cross-sectional study, carried out with 97 healthy volunteers, military personnel who perform their work in the Royal Guard barracks of El Pardo. The study was conducted between June 2019 and July 2021. The correct determination of the device placement site and the times of correct device placement were evaluated by determining whether there was blood flow using Doppler ultrasound measurements. Statistically significant results were obtained for application time (76.68 s to 58.06 s; p < 0.001), correct device placement (p < 0.001), and achievement of complete ischemia in the upper extremity (23.7% pretest vs. 24.7% post-test; p < 0.001). In the lower extremity, after training, longer application duration (43.33 s to 47.30 s) and lower ischemia achievement (59.8% pretest vs. 37.8% post-test) were obtained. Standardized and regulated training improves device application. More intensive training is necessary to obtain better results. Full article

(This article belongs to the Special Issue Advancing Research on Emergency Care)

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8 pages, 338 KiB

Open AccessArticle

Nursing Staff Knowledge on the Use of Intraosseous Vascular Access in Out-Of-Hospital Emergencies

by Macarena Ibarra Romero, Juan Carlos Sánchez-García, Emanuele Cavazzoli, María Isabel Tovar-Gálvez, Jonathan Cortés-Martín, Nazaret Martínez-Heredia and Raquel Rodríguez-Blanque

Int. J. Environ. Res. Public Health 2023, 20(3), 2175; https://doi.org/10.3390/ijerph20032175 - 25 Jan 2023

Viewed by 2195

Abstract

In healthcare practice, there may be critically injured patients in whom catheterisation of a peripheral venous access is not possible. In these cases, intraosseous access may be the preferred technique, using an intraosseous vascular access device (IOVA). Such devices can be used for infusion or administration of drugs in the same way as other catheterisations, which improves emergency care times, as it is a procedure that can be performed in seconds to a minute. The aim of this study was to analyse the level of knowledge of nursing staff working in emergency departments regarding the management of the intraosseous vascular access devices. To this end, a cross-sectional online study was carried out using an anonymous questionnaire administered to all professionals working in emergency and critical care units (ECCUs) in Granada district (Spain). The results show that 60% of the participants believe that with the knowledge they have, they would not be able to perform intraosseous vascular access, and 74% of the participants believe that the low use of this device is due to insufficient training. The obtained results suggest that the intraosseous access route, although it is a safe and quick way of achieving venous access in critical situations, is considered a secondary form of access because the knowledge of emergency and critical care professionals is insufficient, given the totality of the participants demanding more training in the management of intraosseous access devices. Therefore, the implementation of theoretical/practical training programmes related to intraosseous access (IO) could promote the continuous training of nurses working in ECCUs, in addition to improving the quality of care in emergency and critical care situations. Full article

(This article belongs to the Special Issue Advancing Research on Emergency Care)

20 pages, 387 KiB

Open AccessArticle

Assessment of Hospital Readiness to Respond to COVID-19 Pandemic in Jordan—A Cross Sectional Study

by Eman Zmaily Dahmash, Thaira Madi, Ahmad Shatat, Yazan Oroud, Samar Khaled Hassan, Omaima Nassar and Affiong Iyire

Int. J. Environ. Res. Public Health 2023, 20(3), 1798; https://doi.org/10.3390/ijerph20031798 - 18 Jan 2023

Cited by 1 | Viewed by 2028

Abstract

During the global COVID-19 pandemic, hospitals faced tremendous pressure to cope with the emergency preparedness situations needed to cater for the influx of patients while maintaining their essential services. This study aimed to assess the level of readiness of hospitals in Jordan to respond to the COVID-19 pandemic using the WHO hospital readiness checklist. A cross-sectional survey using the modified and validated checklist was conducted in Jordan between 15 May and 15 June 2021. The checklist entailed ten key response functions with a total of 60 activities. Data from 22 hospitals were collected through a structured survey process by two surveyors for each hospital. The overall readiness score of hospitals was 1.77 ± 0.20, with a lower overall score in the northern region (1.65 ± 0.24) than the middle (1.86 ± 0.07) or southern (1.84 ± 0.14) regions. The diagnosis response function scored highest (1.95); but despite efforts, contingency plan development was not met by most hospitals, with a total score ≤ 1.45. Provision of psychological support and occupational health support to ensure the wellbeing of staff scored below average. Outcomes from this survey exposed gaps while offering a framework for upcoming endeavors to improve hospital readiness for any potential pandemic. Full article

(This article belongs to the Special Issue Advancing Research on Emergency Care)

13 pages, 754 KiB

Open AccessArticle

Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7

by Rónán O’Caoimh, Jane McGauran, Mark R. O’Donovan, Ciara Gillman, Anne O’Hea, Mary Hayes, Kieran O’Connor, Elizabeth Moloney and Megan Alcock

Int. J. Environ. Res. Public Health 2023, 20(1), 290; https://doi.org/10.3390/ijerph20010290 - 24 Dec 2022

Cited by 10 | Viewed by 3440

Abstract

Prompt recognition of frailty in the emergency department (ED) is important to identify patients at higher risk of adverse outcomes. Despite this, few studies examine the diagnostic accuracy of screening instruments for frailty, instead focusing on predictive validity. We compared three commonly used, short frailty screens to an independent comprehensive geriatric assessment (CGA) in an urban University Hospital ED. Consecutive attendees aged ≥70 years were screened by trained raters, blind to the CGA, with the Variable Indicative of Placement risk (VIP), 3 and 4-item versions, Clinical Frailty Scale (CFS) and PRISMA-7. Accuracy was measured from the area under the ROC curve (AUROC). In total, 197 patients were included, median age 79 (±10); 46% were female. Half (49%) were confirmed as frail after CGA. All instruments differentiated frail from non-frail states, although the CFS (AUROC: 0.91) and PRISMA-7 (AUROC: 0.90) had higher accuracy compared to the VIP-4 (AUROC: 0.84) and VIP-3 (AUROC: 0.84). The CFS was significantly more accurate than the VIP-3 (p = 0.026) or VIP-4 (p = 0.047). There was no significant difference between the CFS and PRISMA-7 (p = 0.90). The CFS and PRISMA-7 were more accurate and should be considered in preference to the VIP (3 or 4-item versions) to identify frailty in EDs. Full article

(This article belongs to the Special Issue Advancing Research on Emergency Care)

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11 pages, 1380 KiB

Open AccessArticle

Gender Differences in Anxiety, Attitudes, and Fear among Nursing Undergraduates Coping with CPR Training with PPE Kit for COVID

by Clara Maestre-Miquel, Francisco Martín-Rodríguez, Carlos Durantez-Fernández, José L. Martín-Conty, Antonio Viñuela, Begoña Polonio-López, Carmen Romo-Barrientos, Juan José Criado-Álvarez, Francisca Torres-Falguera, Rosa Conty-Serrano, Cristina Jorge-Soto and Alicia Mohedano-Moriano

Int. J. Environ. Res. Public Health 2022, 19(23), 15713; https://doi.org/10.3390/ijerph192315713 - 25 Nov 2022

Viewed by 2761

Abstract

Background: The aim of this study was to examine the attitudes, fears, and anxiety level of nursing students faced with a critical clinical simulation (cardiopulmonary reanimation) with and without personal protective equipment (PPE). Methods: A pilot before–after study as conducted from 21 to 25 June 2021, with 24 students registered in the nursing degree of the Faculty of Health Sciences of the Castilla-La Mancha University (UCLM) in the city of Talavera de la Reina (Toledo, Spain). From 520 possible participants, only 24 were selected according to the exclusion and inclusion criteria. The STAI Manual for the State-Trait Anxiety Inventory, a self-evaluation questionnaire, was used to study trait STAI (basal anxiety), trait STAI before CPR, state STAI after CPR, total STAI before CPR, and total STAI after CPR as the main variables. A t-test was used to study the STAI variables according to sex and the physiological values related to the anxiety level of participants. An ANOVA statistical test was used to perform a data analysis of the STAI variables. Results: A total of 54.2% of participants (IC 95% 35.1–72.1) suffered from global anxiety before the cardiopulmonary reanimation maneuvers (CPR). The results of the STAI before CPR maneuvers showed significant differences according to gender in state anxiety (p = 0.04), with a higher level of anxiety in women (22.38 ± 7.69 vs. 15.82 ± 7.18). Conclusions: This study demonstrates different levels of anxiety in terms of gender suffered by nursing students in high-pressure environments, such as a CPR situation. Full article

(This article belongs to the Special Issue Advancing Research on Emergency Care)

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10 pages, 1743 KiB

Open AccessArticle

Development and Validation of a Novel Ultra-Compact and Cost-Effective Device for Basic Hands-On CPR Training: A Randomized, Sham-Controlled, Blinded Trial

by Joseba Rabanales-Sotos, Isabel María Guisado-Requena, Zoila Esperanza Leiton-Espinoza, Carmen María Guerrero-Agenjo, Jesús López-Torres-Hidalgo, José Luis Martín-Conty, Francisco Martín-Rodriguez, Jaime López-Tendero and Angel López-González

Int. J. Environ. Res. Public Health 2022, 19(22), 15228; https://doi.org/10.3390/ijerph192215228 - 18 Nov 2022

Cited by 4 | Viewed by 1932

Abstract

To examine the performance of a novel low-cost, ultra-compact, and attractive auditory feedback device for training laypeople in external chest compressions (ECCs), we conducted a quasi-experimental cross-sectional study from September to November 2021 at the Faculty of Nursing of Albacete, University of Castille-La Mancha, Spain. The ECC sequence was performed in the laboratory with the new device for basic hands-on CPR training. Results: One hundred college students were included in this study. The compression rate/min with the new device was 97.6, and the adequate %ECC was 52.4. According to the status of body mass index (BMI) and muscle strength of the upper limbs in the bivariate analysis, it was observed that the new device discriminated between those who performed correct ECCs according to their BMI and muscle strength and those who did not, which led to significantly influenced results in terms of the percentage of ECCs with correct depth. Conclusions: The new ultra-compact auditory feedback device “Salvando a Llanetes^®” demonstrated utility for teaching and learning ECCs in basic CPR. We can affirm that the analyzed device is an adequate, safe and economical method for teaching “CPR Hands-Only™” to the general population. Full article

(This article belongs to the Special Issue Advancing Research on Emergency Care)

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12 pages, 367 KiB

Open AccessArticle

National Survey: How Do We Approach the Patient at Risk of Clinical Deterioration outside the ICU in the Spanish Context?

by Álvaro Clemente Vivancos, Esther León Castelao, Álvaro Castellanos Ortega, Maria Bodi Saera, Federico Gordo Vidal, Maria Cruz Martin Delgado, Cristina Jorge-Soto, Felipe Fernandez Mendez, Jose Carlos Igeño Cano, Josep Trenado Alvarez, Jesus Caballero Lopez and Manuel Jose Parraga Ramirez

Int. J. Environ. Res. Public Health 2022, 19(19), 12627; https://doi.org/10.3390/ijerph191912627 - 3 Oct 2022

Cited by 1 | Viewed by 3015

Abstract

Background: Anticipating and avoiding preventable intrahospital cardiac arrest and clinical deterioration are important priorities for international healthcare systems and institutions. One of the internationally followed strategies to improve this matter is the introduction of the Rapid Response Systems (RRS). Although there is vast evidence from the international community, the evidence reported in a Spanish context is scarce. Methods: A nationwide cross-sectional research consisting of a voluntary 31-question online survey was performed. The Spanish Society of Intensive, Critical and Coronary Care Medicine (SEMICYUC) supported the research. Results: We received 62 fully completed surveys distributed within 13 of the 17 regions and two autonomous cities of Spain. Thirty-two of the participants had an established Rapid Response Team (RRT). Common frequency on measuring vital signs was at least once per shift but other frequencies were contemplated (48.4%), usually based on professional criteria (69.4%), as only 12 (19.4%) centers used Early Warning Scores (EWS) or automated alarms on abnormal parameters. In the sample, doctors, nurses (55%), and other healthcare professionals (39%) could activate the RRT via telephone, but only 11.3% of the sample enacted this at early signs of deterioration. The responders on the RRT are the Intensive Care Unit (ICU), doctors, and nurses, who are available 24/7 most of the time. Concerning the education and training of general ward staff and RRT members, this varies from basic to advanced and specific-specialized level, simulating a growing educational methodology among participants. A great number of participants have emergency resuscitation equipment (drugs, airway adjuncts, and defibrillators) in their general wards. In terms of quality improvement, only half of the sample registered RRT activity indicators. In terms of the use of communication and teamwork techniques, the most used is clinical debriefing in 29 centers. Conclusions: In terms of the concept of RRS, we found in our context that we are in the early stages of the establishment process, as it is not yet a generalized concept in most of our hospitals. The centers that have it are in still in the process of maturing the system and adapting themselves to our context. Full article

(This article belongs to the Special Issue Advancing Research on Emergency Care)

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6 pages, 303 KiB

Open AccessPerspective

Paramedics in Switzerland: A Mature Profession

by Thomas Schmutz, Youcef Guechi, Sandrine Denereaz, Florian Ozainne, Marc Nuoffer, Aris Exadaktylos and Vincent Ribordy

Int. J. Environ. Res. Public Health 2022, 19(14), 8429; https://doi.org/10.3390/ijerph19148429 - 10 Jul 2022

Cited by 3 | Viewed by 1868

Abstract

This paper describes how the profession of paramedics has evolved in Switzerland and takes the perspective of public health. Ambulance drivers play an important role in the health system, not only as a response to emergencies, but also by working in an interprofessional and interdisciplinary manner in response to other public health needs, such as home care, triage, telemedicine and interhospital transfers. This pre-hospital system is rapidly evolving and relies on the work of paramedics. Full article

(This article belongs to the Special Issue Advancing Research on Emergency Care)

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