Facilitators and constrainers of civilian–military collaboration: the Swedish perspectives

Khorram‐Manesh, Amir

doi:10.1007/s00068-018-1058-9

Cited by 21 publications

(66 citation statements)

References 42 publications

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“…Although there are some differences between the experts and the public's views on feasible measures, the sum of all choices defines what an immediate responder should be able to do (Table 8). These findings are in line with earlier reports, of which some claim much more involvement by the public in the medical management of victims of MCIs [1,2,18,[22][23][24][25][26][28][29][30][31][32][33][34][35][36]. In this study, the Swedish public expressed a high willingness to get engaged in the treatment of victims by stabilizing fractures, neck and lower back, implementing a cervical collar, and defending against a perpetrator, which are tasks that were not approved by the expert group or is dangerous for their lives.…”

Section: Discussionsupporting

confidence: 93%

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Immediate response to major incidents: defining an immediate responder!

Khorram‐Manesh

Plegas

Högstedt

et al. 2019

Eur J Trauma Emerg Surg

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Purpose There is a gap in time between the occurrence of a mass casualty incident (MCI) and the arrival of the first responders to the scene, which offers an opportunity for the public (immediate responders) to perform life-saving measures. The purpose of this study was to identify these measures and the public's willingness to conduct them. Method An extensive literature review was performed to identify the possible measures that can be undertaken by the public. A group of experts were asked to prioritize and rank the feasibility of performing the measures by the public. Finally, the public was asked whether they were willing to do the chosen measures before and after an appropriate education. Results Twenty different measures were identified and presented in a questionnaire as statements, which were prioritized and ranked by the expert group into four categories: what (1) should be done, (2) is good to know how, (3) is not necessary to know, and (4) should not be done. All statements were converted into understandable statements and were sent to the public. There were some differences and some agreements between the experts and the public regarding what an immediate responder should do. However, the willingness of the public to perform most of the measures was high and increased after being offered an appropriate education. Conclusion The use of immediate responders is a life-saving approach in MCIs and in situations when every minute counts and every human resource is an invaluable asset. Multiple steps, such as education, empowerment, and access, should be taken into consideration to enable bystanders to effectively help struggling survivors.

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Section: Discussionsupporting

confidence: 93%

“…An increasing number of mass casualty incidents (MCIs) in recent years has revealed some major shortcomings in the medical and non-medical aspects of its management [1][2][3][4]. Besides natural disasters and armed conflicts, terrorism and mass shootings have emerged as main causes of mass injuries, deaths, and global threats [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Immediate response to major incidents: defining an immediate responder!

Khorram‐Manesh

Plegas

Högstedt

et al. 2019

Eur J Trauma Emerg Surg

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“…Dental and veterinary professionals with a capacity to contribute either with human or material resources would not be used. 14,15,[17][18][19] Primary/ community healthcare centers with competency in preventive services, ideally located in all parts of the community, and with the ability to improve patients´ resilience and ability to cope with unexpected emergencies would not be adequately utilized.…”

Section: Failed Communication and Collaboration With Othermentioning

confidence: 99%

“…11,12,31 Discussion Surge capacity (primary and secondary) is the first step required to respond to the imbalance between needs and resources during a MID. 1,[3][4][5][6][7][8][9][11][12][13][14]17,23 FSC is a novel concept, which offers an alternative to further scale up or down the MID management process by using civilians and other available entities and facilities.…”

Section: How To Achieve Fscmentioning

confidence: 99%

Flexible surge capacity – public health, public education, and disaster management

Khorram‐Manesh

2020

Health Promot Perspect

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Background: Failed attempts to improve the delivery of healthcare to communities show distinct flaws that have a higher impact during a major incident or disaster (MID). This study evaluates the concept of surge capacity, which intends to achieve a balance between the needs and resources in affected areas by providing staff, stuff, structure, and system. Methods: A systematic literature review was performed according to the PRISMA statement and by using PubMed, Scopus, and Google Scholar, and related keywords. Results: There were limited publications about flexible surge capacity (FSC). However, the sum of data obtained indicated the need for flexibility in expanding major incidents or disasters, demanding new resources, which may neither be available on time nor reachable due to infrastructural damage. Conclusion: FSC is a novel concept based on international guidelines. It refers to the extra and adjustable human and material resources that can be mobilized by activating nonprofessional but educated staff and different but accepted facilities in a fast, smooth, and productive way. Public health and public education play an essential role in obtaining such flexibility.

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“…The Swedish defence healthcare system strongly depends on the support of civilian healthcare during increased levels of mobilisation [6]. Swedish legislation requires public healthcare institutions to maintain MCI preparedness including wartime scenarios [7,8].…”

Section: Introductionmentioning

confidence: 99%

Swedish emergency hospital surgical surge capacity to mass casualty incidents

Blimark

Örtenwall

Lönroth

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: In Sweden the surgical surge capacity for mass casualty incidents (MCI) is managed by county councils within their dedicated budget. It is unclear whether healthcare budget constraints have affected the regional MCI preparedness. This study was designed to investigate the current surgical MCI preparedness at Swedish emergency hospitals. Methods: Surveys were distributed in 2015 to department heads of intensive care units (ICU) and surgery at 54 Swedish emergency hospitals. The survey contained quantitative measures as the number of (1) surgical trauma teams in hospital and available after activating the disaster plan, (2) surgical theatres suitable for multi-trauma care, and (3) surgical ICU beds. The survey was also distributed to the Armed Forces Centre for Defence Medicine. Results: 53 hospitals responded to the survey (98%). Included were 10 university hospitals (19%), 42 county hospitals (79%), and 1 private hospital (2%). Within 8 h the surgical capacity could be increased from 105 to 399 surgical teams, while 433 surgical theatres and 480 ICU beds were made available. The surgical surge capacity differed between university hospitals and county hospitals, and regional differences were identified regarding the availability of surgical theatres and ICU beds. Conclusions: The MCI preparedness of Swedish emergency care hospitals needs further attention. To improve Swedish surgical MCI preparedness a national strategy for trauma care in disaster management is necessary.

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Facilitators and constrainers of civilian–military collaboration: the Swedish perspectives

Cited by 21 publications

References 42 publications

Immediate response to major incidents: defining an immediate responder!

Immediate response to major incidents: defining an immediate responder!

Flexible surge capacity – public health, public education, and disaster management

Swedish emergency hospital surgical surge capacity to mass casualty incidents

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