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Oral Presentations-WADEM Congress on Disaster and Emergency Medicine 2019 Abstracts of Oral Presentations-WADEM Congress on Disaster and Emergency Medicine 2019 AGED CARE AND DISABILITY Dallas Mega Shelter Onsite Medical Operations 2. FEMA. 2010. https://www.fema.gov/media-library-data/ Supporting Evacuee Functional Independence and Family 20130726-1831-25045-7316/fnss_guidance.pdf. Unit Integrity During Response to Hurricane Harvey Prehosp. Disaster Med. 2019;34(Suppl. 1):s1 Prof. Raymond E. Swienton, Dr. Kelly R. Klein, doi:10.1017/S1049023X19000220 Dr. E. Liang Liu, Dr. Lindsay A. Flax, Prof. Raymond L. Fowler University of Texas Southwestern, Dallas, United States Development of an Evacuation Exercise for Residential Introduction: In the United States, over 50% of people have at Aged Care Facilities Using the Emergo Train System (ETS) least one chronic medical condition, access, or functional limi- Mr. Karl Cronan, Ms. Linda Winn tation. In 2017 during Hurricane Harvey, the establishment of a NSW Ambulance, Eveleigh, Australia comprehensive multidisciplinary onsite medical clinic provided health and medical services to over 3,800 evacuees at the Dallas Introduction: Events such as the Sydney Quakers Hill Nursing Mega Shelter, providing large-scale general population sheltering Home fire highlighted the great need for robust evacuation support to all evacuees and prioritizing family unit integrity by plans for Residential Aged Care Facilities (RACFs). However, meeting physical, sensory, and cognitive limitations, and chronic plans alone are not sufficient and routine exercises are necessary medical conditions. The effectiveness of the Dallas Mega Shelter to test the capability of a facility’s emergency plan. Current onsite medical operations supporting this aim is reviewed. methods of exercising facility evacuations, such as live drills, are Aim: To utilize onsite health and medical resources to meet limited and only test isolated elements of the evacuation proc- access and functional needs of evacuees seeking general ess, which fall drastically short of being able to simulate the real- population mass sheltering in Dallas, Texas during Hurricane time resources and procedures required to perform a large scale Harvey. evacuation of a RACF. Methods: Observational. Aim: To develop an exercise tool that assists Residential Aged Results: Over 3,800 evacuees were evaluated for functional Care Facilities (RACF) to evaluate their evacuation procedures needs support services (FNSS) resulting in over 2,500 evacuee patient encounters during 21 continuous days of onsite health using quantifiable data, based on real-time and providing min- and medical clinic operations.1 A comprehensive array of ser- imal disruption to existing residents. vices were available at no cost to the evacuees and were in accor- Methods: Utilizing the existing ETS framework, an aged care dance with the Federal Emergency Management Association resident patient bank was developed by NSW Health Emergency (FEMA) published Guidance on Planning for Integration of Management Unit, including: • Functional Needs Support Service in General Population A bank of 200 residents from data sourced from the Australian 2 Institute of Health and Welfare. Shelters. The goal to maintain nearly all evacuees choosing to • stay in the Mega Shelter was achieved. The challenges, limita- Layout for the resident gubers and Summary Care Plans. • Resources and equipment routinely used in RACF’s. tions, and risks identified are reviewed. • Real-world testing of the prototype in exercises across NSW, Discussion: FNSS guidelines require all persons, regardless Australia of limitations, when evacuated from home be provided all ser- • Mortality and morbidity data to measure outcomes. vices necessary to allow them to remain in general population • 2 Validation of the exercise tool nationally and internationally. sheltering. This prioritization of personal choice, functional Results: A bank of residents was developed to test evacuation independence, and family integrity for those with compre- systems and processes, in a scalable, realistic simulation based hensive FNSS requirements presented notable challenges, on patient outcomes. This will result in improved planning including public health and safety risks impacting the wellbeing and process, empowerment of RACFs, better patient outcomes, of others. Meeting these expectations must be balanced with and increased resilience and preparedness. maintaining shelter integrity. Discussion: A significant investment of data, time, and effort References has gone into producing this resident bank for use in RACF 1. Liu, EL, Morshedi B, Miller BL, et al. Dallas mega shelter evacuation exercises across NSW Australia. A presentation medical operations response to Hurricane Harvey. DMPHP delivered at the ETS World Congress in the Netherlands 2017 Dec;6:1–4. (2018), by NSW Health Emergency Management Unit, May 2019 Prehospital and Disaster Medicine s2 Aged Care and Disability showcased the relevance and suitability of this tool across 1995-2017. The gathered information included the reason the world. for evacuation, injuries, deaths, and locations within the Prehosp. Disaster Med. 2019;34(Suppl. 1):s1–s2 United States. doi:10.1017/S1049023X19000232 Results: From 1995 to 2017, there was a total of 51 evacuations and 141 deaths in nursing homes. 27 (53%) evacuations were due to external events which resulted in a combined 121 (86%) Mortality in Nursing Home Evacuations in the United deaths, and 24 (47%) evacuations were due to internal events States from 1995-2017 which resulted in a combined 20 (14%) deaths. Hurricanes were Dr. Sharon Mace1, Mr. Daniel Caicedo2, responsible for the majority of deaths during evacuations, fol- Miss. Aishwarya Sharma2 lowed by fires and floods. The number of evacuations and 1. Cleveland Clinic Lerner College of Medicine at Case Western deaths increased the greatest between 2005 to 2008. Reserve University, Cleveland, United States Discussion: External events have the greatest impact on loss of 2. Ohio University Heritage College of Osteopathic Medicine, life. Internal disasters are about equal in the number of inci- Warrensville Heights, United States dents, however, external events have a much greater mortality rate. Exact numbers on injuries, morbidity, and mortality are Introduction: There are an estimated 15,600 nursing homes difficult to ascertain, but it appears to be related to natural with a total of 1.4 million residents in the United States. The disasters. In view of the increasing likelihood of natural disas- number of residents will continue to increase due to the aging ters related to global warming, a drastic improvement of population, and the associated morbidities will make it difficult standard evacuation procedures of long-term nursing homes to evacuate them safely. is critical to decreasing mortality of nursing home residents. Aim: This study is the first of its kind to provide an analysis of There also needs to be a nationally standardized method the number of nursing home deaths caused by external and of reporting evacuations in order to better analyze data on internal events following evacuations. nursing homes. Methods: Information from the databasesLexisNexisand Prehosp. Disaster Med. 2019;34(Suppl. 1):s2 PubMed were compiled and limited to news articles from doi:10.1017/S1049023X19000244 Prehospital and Disaster Medicine Vol. 34, Supplement 1 Abstracts of Oral Presentations-WADEM Congress on Disaster and Emergency Medicine 2019 AUSTERE SURGERY Surgical Procedures Performed by Emergency Medical 1. University of Sydney, Sydney, Australia Teams in Sudden-Onset Disasters: A Systematic Review 2. Médecins sans Frontières- Operational Centre Brussels, Brussels, Dr. Charles Coventry1, Prof. Andrew Holland1,2, Belgium Dr. Ashish Vaska3, Prof. Rebecca Ivers4, Dr. David Read5 3. National Critical Care and Trauma Response Centre 1. University of Sydney, Sydney, Australia 4. University of NSW 2. Children’s Hospital at Westmead, Sydney, Australia 3. University Hospital Geelong, Geelong, Australia Introduction: Emergency medical teams (EMTs) have helped 4. University of NSW, Sydney, Australia to provide surgical care in many recent sudden onset disasters 5. National Critical Care and Trauma Response Centre, Darwin, (SODs), especially in low- and middle-income countries Australia (LMICs). General surgical training in Australia has undergone considerable change in recent years, and it is not known whether Aim: To describe the types of surgical procedures performed the new generation of general surgeons is equipped with the by emergency medical teams (EMTs) with general surgical broad surgical skills needed to operate as part of EMTs. capability in the aftermath of sudden-onset disasters (SODs) Aim: To analyze the differences between the procedures per- in low- and middle-income countries (LMICs). formed by contemporary Australian general surgeons during Methods: A search of electronic databases (PubMed, training and the procedures performed by EMTs responding MEDLINE, and EMBASE) was carried out to identify articles to SODs in low- and middle-income countries (LMICs). published between 1990 and 2018 that describe the type of sur- Methods: General surgical trainee logbooks between February gical procedures performed by EMTs in the impact and post- 2008 and January 2017 were obtained from General Surgeons impact phases a SOD. Further relevant articles were obtained Australia. Operating theatre logs from EMTs working during by hand-searching reference lists. the 2010 earthquake in Haiti, 2014
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