Introduction: In order to prepare the healthcare system and healthcare personnel to meet the health needs of populations affected by disasters, educational programs have been developed by numerous academic institutions, hospitals, professional organizations, governments, and non-government organizations. Lacking standards for best practices as a foundation, many organizations and institutions have developed "core competencies" that they consider essential knowledge and skills for disaster healthcare personnel. Problem: The Nursing Section of the World Association for Disaster and Emergency Medicine (WADEM) considered the possibility of endorsing an existing set of competencies that could be used to prepare nurses universally to participate in disaster health activities. This study was undertaken for the purpose of reviewing published disaster health competencies to determine commonalities and universal applicability for disaster preparedness. Methods: In 2007, a review of the electronic literature databases was conducted using the major keywords: disaster response competencies; disaster preparedness competencies; emergency response competencies; disaster planning competencies; emergency planning competencies; public health emergency preparedness competencies; disaster nursing competencies; and disaster nursing education competencies. A manual search of references and selected literature from public and private sources also was conducted. Inclusion criteria included: English language; competencies listed or specifically referred to; competencies relevant to disaster, mass-casualty incident (MCI), or public health emergency; and competencies relevant to healthcare. Results: Eighty-six articles were identified; 20 articles failed to meet the initial inclusion criteria; 27 articles did not meet the additional criteria, leaving 39 articles for analysis. Twenty-eight articles described competencies targeted to a specific profession/discipline, while 10 articles described competencies targeted to a defined role or function during a disaster. Four of the articles described specific competencies according to skill level, rather than to a specific role or function. One article defined competencies according to specific roles as well as proficiency levels. Two articles categorized disaster nursing competencies according to the phases of the disaster management continuum. Fourteen articles described specified competencies as "core" competencies for various target groups, while one article described "cross-cutting" competencies applicable to all healthcare workers. Conclusions:Hundreds of competencies for disaster healthcare personnel have been developed and endorsed by governmental and professional organizations and societies. Imprecise and inconsistent terminology and structure are evident throughout the reviewed competency sets. Universal acceptance and application of these competencies are lacking and none have been validated. Further efforts must be directed to developing a framework and standardized terminology for the ...

IntroductionCardiopulmonary resuscitation (CPR) guidelines throughout the world stress the importance of high quality chest compressions soon after cardiac arrest as the most significant factor in determining survival. Little evidence exists, internationally, documenting the quality of compressions provided by healthcare providers. In this study investigators sought to determine the quality of chest compressions delivered by rescuers. It was hypothesized that greater variably in compression quality exists between rescuers than variability in individual rescuers over time.MethodsIn this observational pilot study, basic life support (BLS) providers from prehospital and in-hospital settings were invited to participate in the investigation. Ten minutes of continuous chest compressions were recorded on the Resusci Anne and the Laerdal PC Skillreporting System. An adequate compression was defined as a compression with depth > 38mm, full chest recoil, and correct hand position. The Quality Compression Index (QCI) was developed to factor rate into the characteristics of an adequate compression. QCI is a scaled performance index calculated every 30 seconds.ResultsProviders came from a variety of clinical backgrounds, aged 35.5 ± 11.0 years. Of the 103 total participants, 94 (91.3%) completed 10 minutes of compressions. The most significant degradation in the quality of compressions occurred within the first two minutes. There was greater variability between different rescuers than the variability over time. Mean Square Error (MSE) due to subjects was comparatively greater than the MSE due to time (63.2 vs. 7.68). Performance of CPR, male sex, < 45 years of age, and prehospital background, correlated with higher quality. Time since last BLS certification and the number of times a rescuer completed a BLS class did not correlate with the quality.ConclusionsGreater variability in the quality of compressions exists between different rescuers than a rescuer over time. Some participants were not able to deliver ideal compressions from the start, when the effects of fatigue were minimal.

Prehospital and Disaster MedicineVol.

As a highly centralized and quick-responding armed group, the armed forces play an important role in disaster rescue. Most national law has authorized the armed forces to participate in disaster rescue. The armed forces are an important, constantly prepared power for disaster rescue (including medical rescue). The missions of the armed forces medical unit in disaster rescue include providing health services for the soldiers who attend to the rescue mission and to the residents of the disaster areas.In order to fulfill the disaster rescue mission, the armed forces must be prepared in advance and be kept in a highly alert state. They should construct emergency medical service units, prepare different kinds of disaster rescue plans, and train medical personnel in the use of rescue equipment and the skills needed. In disaster rescues, the armed forces should respond quickly and arrive at the disaster site as early as possible. The command and organizing system of disaster rescue should be a combined organization of military force, police, and civilian.

in support of the United Nations Development Programme (UNDP)sponsored project entitled Poverty Alleviation and Humanitarian Assistance in the Tumen River Area, which is adjacent to North Korea. Before launching the program, a survey and field assessment were done that identified a large knowledge and skill gap between city hospitals and rural clinics, and a lack of disaster preparedness, even after the outbreak of severe acute respiratory syndrome (SARS). The program was divided into three phases fostering full participation from January 2003 to January 2005. Each phase followed four steps: (1) needs assessment/planning; (2) curriculum development/customizing; (3) implementing; and (4) evaluation. The first phase consisted of a 10-day workshop to train 30 trainers from eight countries in the Yanbian area as key partners. In the second phase, 300 doctors and nurses from eight counties participated in a five-day workshop consisting of lecturing, arranging, and evaluation by the participants from the first phase. Between the first and second phases, the researchers and local lecturers published a Chinese textbook on Emergency and Disaster Preparedness, which was the first in China. The third phase was a two-day workshop for approximately 900 rural doctors who dealt with emergency cases. Since the educational background of rural doctors varies from elementary school to bachelor's degrees, another five-day train-thetrainers session was conducted for 32 rural doctors prior to the main sessions, with the curriculum and language customized to meet their educational levels. Remarkably, the participants of each session expressed >90% satisfaction of the training and materials, and showed a significant improvement between pre-test and post-test scores. Participants were involved positively during Morning Recap (recapitulation) time and role-play. Throughout the training program, strong cooperation and participation was seen between Yanbian governmental officials and participants. In conclusion, small control and large autonomy motivates a strong partnership and sustainability in emergency care.