No abstract

, a man armed with a gun releases sarin gas into the ventilation system of a college building. Local police, firefighters, and chemical, biological, radiological, and nuclear (CBRN) teams respond to the scene. Before the teams arrive, those who are able, flee to the hospital across the street. The emergency department already is full when contaminated patients arrive. One hour later, a car bomb explodes in the hospital parking lot. A simulated hospital in a campus gymnasium was created by the University of Toronto Emergency Medicine Residency Program, Sunnybrook and Women's College Base Hospital Land Program, Toronto Emergency Medical Services, paramedic students, nurses, physicians, administrators, and social workers. The hospital received approximately 100 patients within two hours. To prepare for the exercise, a website was built, where a literature search on CBRN terrorist events was posted, local hospital disaster plans were evaluated, and new plans were created. Discussion: Hospitals are vulnerable in terrorist events and may need protection from police and CBRN teams. Online collaboration is a useful way to learn and modify disaster plans. Active testing using simulated, mass-casualty-producing events exposes weaknesses, which can be attenuated.

Background: Drowning is one of the major health problems that is often neglected. Given that Mazandaran province is located on the banks of the Caspian Sea, and many people travel the northern provinces of Iran, and insufficient information is found on the number of rescue missions following the drowning accidents in the pre-hospital emergency domain, this study aimed to investigate the epidemiological status of the drowned cases, and design better plans for the prevention and control of these missions. Methods: In this retrospective cross-sectional study, the mission forms related to all drowned cases in the pre-hospital emergency departments of Mazandaran from March 23 to September 22, 2017 were reviewed and the data including age, sex, drowning place, outcome of the mission (dispatched and cancelled missions, outpatient treatment, death, among others), the date of the accident, and being native or non-native drowned person were extracted. The data were analyzed using SPSS (version 19) and Fischer and Chi-square tests. Results: Out of 219 drownings from March 23 to September 22, 2017 recorded by the Emergency Department of Mazandaran University of Medical Sciences, 159 cases (72.6%) were male and 60 cases (27.4) female. The mean age of the drowned individuals was 29±3 years old, and most accidents happened for 25-29 year-old ones. Drowning occurred mostly in places outside the patrolled area with 190 cases (86.7%), as well as in summer with 185 cases (84.5%) (from 23 July to 22 August) with 77 cases. The patients were sent to health centers in 43.8% of the missions. The mean age of 39 dead ones was 39±2 years old. Conclusion: Most of the drowning cases occurred outside of the patrolled area in the young and productive age group of society. Therefore, it seems necessary to establish and develop sea-protected shores, as well as provide proper education.