Prehospital & Disaster Medicine
Volume 29 – Issue 03 – June 2014
https://journals.cambridge.org/action/displayIssue?jid=PDM&tab=currentissue

Editorial
Is There a Scientific Basis for Disaster Health and Medicine?
Samuel J. Stratton
Excerpt
Is there a need for scientific support for disaster health and medicine? It seems that there is an accepted disaster health and medicine knowledge base that is based largely on opinions of those who have deemed themselves expert in disaster health, or based on descriptive experiences of some during disaster deployments. While opinion and experience may be methods for determining standards for health and medicine in disasters, scientific exploration is the basis for forming the knowledge base of a respected and effective domain in the various areas of health and medicine. In a sarcastic view, if opinion and singular experience were an acceptable basis for establishing knowledge, the Western civilizations would still consider the earth the center of the universe.
At present, disaster health and medical science continues to develop slowly, despite three decades of recognition by early pioneers in the disaster medicine field of the need for application of scientific principles. Certainly, attaining “pure” disaster science with randomized controlled trials to show causal effects is likely not attainable because of the need to prospectively control study variables. Because of the nature of disaster events, most variables can rarely be controlled. On the other hand, epidemiologic and qualitative methods that provide associations among variables are applicable to disaster research and provide effective working science knowledge for the field. Additionally, disaster medical research is particularly appropriate for the developing field of simulation research. Simulation research allows for development of disaster event models that can be tested against actual events as they occur and can provide for control of important variables such that disaster effects can be predicted…

Comprehensive Review
When and Why Health Care Personnel Respond to a Disaster: The State of the Science
Susan B. Connor
Abstract
Objective Emergency response relies on the assumption that essential health care services will continue to operate and be available to provide quality patient care during and after a patient surge. The observed successes and failures of health care systems during recent mass-casualty events and the concern that these assumptions are not evidence based prompted this review.
Method The aims of this systematic review were to explore the factors associated with the intention of health care personnel (HCP) to respond to uncommon events, such as a natural disaster or pandemic, determine the state of the science, and bolster evidence-based measures that have been shown to facilitate staff response.
Results Authors of the 70 studies (five mixed-methods, 49 quantitative, 16 qualitative) that met inclusion criteria reported a variety of variables that influenced the intent of HCP to respond. Current evidence suggests that four primary factors emerged as either facilitating or hindering the willingness of HCP to respond to an event: (1) the nature of the event; (2) competing obligations; (3) the work environment and climate; and (4) the relationship between knowledge and perceptions of efficacy.
Conclusions Findings of this study could influence and strengthen policy making by emergency response planners, staffing coordinators, health educators, and health system administrators.

Comprehensive Review
Enhancing the Minimum Data Set for Mass-Gathering Research and Evaluation: An Integrative Literature Review
Jamie Ransea1a2 c1, Alison Huttona2, Sheila A. Turrisa3 and Adam Lunda3
a1 Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
a2 Flinders University, Adelaide, South Australia, Australia
a3 Mass Gathering Medicine Interest Group, Department of Emergency Medicine, University of British Columbia, British Columbia, Canada
Abstract
Introduction In 2012, a minimum data set (MDS) was proposed to enable the standardized collection of biomedical data across various mass gatherings. However, the existing 2012 MDS could be enhanced to allow for its uptake and usability in the international context. The 2012 MDS is arguably Australian-centric and not substantially informed by the literature. As such, an MDS with contributions from the literature and application in the international settings is required.
Methods This research used an integrative literature review design. Manuscripts were collected using keyword searches from databases and journal content pages from 2003 through 2013. Data were analyzed and categorized using the existing 2012 MDS as a framework.
Results In total, 19 manuscripts were identified that met the inclusion criteria. Variation in the patient presentation types was described in the literature from the mass-gathering papers reviewed. Patient presentation types identified in the literature review were compared to the 2012 MDS. As a result, 16 high-level patient presentation types were identified that were not included in the 2012 MDS.
Conclusion Adding patient presentation types to the 2012 MDS ensures that the collection of biomedical data for mass-gathering health research and evaluation remains contemporary and comprehensive. This review proposes the addition of 16 high-level patient presentation categories to the 2012 MDS in the following broad areas: gastrointestinal, obstetrics and gynecology, minor illness, mental health, and patient outcomes. Additionally, a section for self-treatment has been added, which was previously not included in the 2012 MDS, but was widely reported in the literature.