| 1. |
- Berner, Andreas, et al.
(author)
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STREET: Swedish Tool for Risk/Resource Estimation at EvenTs. Part one, risk assessment – face validity and inter–rater reliability
- 2015
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In: Journal of Acute Disease. - 2221-6189. ; 4:1, s. 37-43
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Journal article (peer-reviewed)abstract
- Objective To develop a validated and generalized high reliability organizations collaborative tool in order to conduct common assessments and information sharing of potential risks during mass-gatherings. Methods The Swedish resource and risk estimation guide was used as foundation for the development of the generalized collaborative tool, by three different expert groups, and then analyzed. Analysis of inter-rater reliability was conducted through simulated cases that showed weighted and unweight κ-statistics. Results The results revealed a mean of unweight κ-value from the three cases of 0.37 and a mean accuracy of 62% of the tool. Conclusions The collaboration tool, “STREET”, showed acceptable reliability and validity to be used as a foundation for high reliability organization collaboration in a simulated environment. However, the lack of reliability in one of the cases highlights the challenges of creating measurable values from simulated cases. A study on real events can provide higher reliability but need, on the other hand, an already developed tool.
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| 2. |
- Berner, A, et al.
(author)
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STREET: Swedish tool for risk /resource estimation at events. Part two, resource assessment -face validity and inter-rater reliability.
- 2015
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In: Journal of acute disease. - 2221-6189. ; 4:2, s. 112-116
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Journal article (peer-reviewed)abstract
- Objective To develop a validated and generalized collaborative tool to be utilized by high reliability organizations in order to conduct common resource assessment before major events and mass gatherings. Methods The Swedish resource and risk estimation guide was used as foundation for the development of the generalized collaborative tool, by three different expert groups, and then analyzed. Analysis of inter-rater reliability was conducted through simulated cases that showed weighted and unweight κ-statistics. Results The results revealed a mean of unweight κ-value from the three cases of 0.44 and a mean accuracy of 61% of the tool. Conclusions A better collaboration ability and more accurate resource assessment with acceptable reliability and validity were shown in this study to be used as a foundation for resource assessment before major events/mass-gathering in a simulated environment. However, the result also indicates the challenges of creating measurable values from simulated cases. A study on real events can provide higher reliability but needs, on the other hand, an already developed tool.
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| 3. |
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| 4. |
- Carlström, Eric, 1957, et al.
(author)
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Medical Emergencies During a Half Marathon Race - The Influence of Weather
- 2019
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In: International Journal of Sports Medicine. - Stuttgart : Georg Thieme Verlag KG. - 0172-4622 .- 1439-3964. ; 40:5, s. 312-316
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Journal article (peer-reviewed)abstract
- The aim was to analyze the influence of weather conditions on medical emergencies in a half-marathon, specifically by evaluating its relation to the number of non-finishers, ambulance-required assistances, and collapses in need of ambulance as well as looking at the location of such emergencies on the race course. Seven years of data from the world's largest half marathon were used. Meteorological data were obtained from a nearby weather station, and the Physiological Equivalent Temperature (PET) index was used as a measure of general weather conditions. Of the 315,919 race starters, 104 runners out of the 140 ambulance-required assistances needed ambulance services due to collapses. Maximum air temperature and PET significantly co-variated with ambulance-required assistances, collapses, and non-finishers (R (2) =0.65-0.92; p=0.001-0.03). When air temperatures vary between 15-29 degrees C, an increase of 1 degrees C results in an increase of 2.5 (0.008/1000) ambulance-required assistances, 2.5 (0.008/1000) collapses (needing ambulance services), and 107 (0.34/1000) non-finishers. The results also indicate that when the daily maximum PET varies between 18-35 degrees C, an increase of 1 degrees C PET results in an increase of 1.8 collapses (0.006/1000) needing ambulance services and 66 non-finishers (0.21/1000).
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| 5. |
- Carlström, Eric, et al.
(author)
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The Second Opinion Dispatch- Evaluating Decisions Made by an Ambulance Dispatch Center
- 2017
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In: Global Journal of Health Science. - : Canadian Center of Science and Education. - 1916-9736 .- 1916-9744. ; 9:12, s. 107-113
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Journal article (peer-reviewed)abstract
- BACKGROUND: The efficacy and precision of dispatching right ambulance to right patient demands a proper decision-making. Wrong decisions may lead to overloading of emergency departments and shortage of ambulances. The aim of this study was to evaluate and improve the process of prehospital resource allocation conducted by a Swedish ambulance dispatch center. METHODS: A team of three experienced ambulance and dispatch nurses evaluated the decisions made by the dispatch center. The method chosen was “Action Research” divided into five actions during 76 days. In the first action, the team listened passively to the calls. The team gradually increased its involvement in the process of decision-making during the actions. RESULTS: During the actions, specific keywords indicating a need for evaluation were identified. The results showed a need to change the primary decisions in 486 cases out of 24,800 calls (2%). The most common measure after an evaluation was to change an ordinary ambulance transportation to an assessment vehicle staffed by a nurse or a physician who would select an appropriate care level (hospital vs. primary healthcare). CONCLUSION: This model not only optimized the prehospital resources but also changed the process of decision-making at the dispatch center and improved their staffs’ ability to optimize the allocation of emergency resources.
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| 8. |
- Haner, A, et al.
(author)
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The role of physician-staffed ambulances; the outcome of a pilot study.
- 2015
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In: Journal of Acute Disease. - 2221-6189. ; 4:1, s. 63-67
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Journal article (peer-reviewed)abstract
- Objective To evaluate the outcome of physician-staffed ambulances in a pilot study. Methods All physician-staffed ambulance missions conducted in Gothenburg, Sweden, in 2013 were retrospectively reviewed and evaluated for the type of missions and the need of a physician. Results Out of 1 381 physician-staffed missions, 511 were cancelled or managed by telephone. Around 239 (17%) missions required active intervention, of which only one was considered directly life-saving. Conclusions Most of the missions neither required the interventional skills of a physician, nor could they be performed at distance. However, the added medical value of physicians was found to be in other prehospital situations, such as critical decision-making, staff education and research.
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| 9. |
- Khorram-Manesh, Amir, 1958, et al.
(author)
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Civilian-military collaboration: From expectations to the reality : Civil–militär samverkan behövs för att klara masskadelägen.
- 2019
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In: Läkartidningen. - 1652-7518. ; 116
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Journal article (peer-reviewed)abstract
- The current global security threats indicate a need for a change in the Swedish defense policies including the role of civilian and military healthcare in an armed conflict. The magnitude, outcome and management of the recent terror and mass casualty incidents in Europe necessitate a closer Swedish civilian-military collaboration. However, in reality, such a collaboration might be more difficult than expected. The aim of this article is to comment on some of the critical points of such collaboration from a civilian perspective.
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| 10. |
- Khorram-Manesh, Amir, 1958, et al.
(author)
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Education in Disaster Management and Emergencies: Defining a New European Course.
- 2015
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In: Disaster medicine and public health preparedness. - : Cambridge University Press (CUP). - 1938-744X .- 1935-7893. ; 9:3, s. 245-255
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Journal article (peer-reviewed)abstract
- Unremitting natural disasters, deliberate threats, pandemics, and humanitarian suffering resulting from conflict situations necessitate swift and effective response paradigms. The European Union's (EU) increasing visibility as a disaster response enterprise suggests the need not only for financial contribution but also for instituting a coherent disaster response approach and management structure. The DITAC (Disaster Training Curriculum) project identified deficiencies in current responder training approaches and analyzed the characteristics and content required for a new, standardized European course in disaster management and emergencies.
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