Doctoral thesis

Australian civilian hospital nurses’ lived experience of an out-of-hospital environment following a disaster

Mass Gathering Health / Mass Gathering Medicine

Various publications and presentations relating to Mass Gathering and Major Event health

Disaster Health

Various publications and presentations relating to disaster health

26 September, 2014

Canberra's hospitals ability to cope in a disaster

I was interviewed by Mark Parton on 1206AM Canberra 2CC regarding the ability of Canberra's health system to cope if a disaster or mass casualty incident was to occur in the region.

The interview was initiated on the background of a number of reports in The Canberra Times relating to the overcapacity of Canberra's hospitals, and in particular the Emergency Departments:
My interview highlighted that the health system in Canberra had coped in the past with major incidents. Additionally, I discussed the educational preparedness of nurses and the ability of the health systems to adapt based on previous events. For example, the establishment of influenza assessment clinics as adjunct to the emergency departments in communicable diseases such as H1N109 Influenza.

My interview is below:







19 September, 2014

Patient presentations to onsite health providers, ambulance paramedics and hospital emergency departments from a mass gathering: a case study





ABSTRACT:
Background:
A number of challenges exist in providing adequate health care at a mass gathering. Health providers aim to maximise their efficiency in responding to health emergencies within the mass gathering environment, whilst minimising potential impact of surge presentations to the health service in the surrounding community or region. The mass gathering literature commonly reports on the onsite care from single events, and does not consider the effect on prehospital or hospital services.

Aim:
This research aims to enhance our understanding of the health service requirements of an outdoor music festival.

Methods:
Design: Retrospective review of patient report forms from onsite health services at outdoor music festival.
Setting: One outdoor music festival in 2012 in the Australian Capital Territory with approximately 20,000 participants. The festival had one first aid post and a health team staffed by doctors, nurses and paramedics.
Data collection: Data was obtained and linked between onsite care providers (St John Ambulance Australia), prehospital (ACT Ambulance Service) and hospitals (Canberra Hospital and Calvary Health Care ACT). A pre-existing and used minimum data set1 was used to code patient characteristics from this event.
Data analysis: Descriptive statistics such as frequency distributions and means of central tendency. 

Results:
This is a summary of some of the key findings.

  • Onsite first aid care: The most frequent illness was headaches (n=94), injury was superficial lacerations (n=13), environmental was substance and/or alcohol intoxication (n=12).
  • Onsite health professional care: The most frequent illness was headaches (n=3), injury was fractures (n=2), environmental was substance and/or alcohol intoxication (n=12).
  • Ambulance transport: The most frequent injury was fractures (n=2), environmental was substance and/or alcohol intoxication (n=4). One patient required prehospital endotracheal intubation, Three patients required airway adjuncts, Six patients received intravenous medications from paramedics including opioids.
  • Hospital services: One patient required an open reduction and internal fixation in the operating theatre. One patient required intubation and ventilator support in the Intensive Care Unit.


Discussion:
This is the first research to describe patient presentations to onsite care providers, prehospital services and hospitals from a mass gathering. This research provides insight into the health service usage from one event. Presentation to the onsite health professionals resulted in a longer length of stay in the onsite medical facility. Onsite health professionals may have diverted 15 patients who would have otherwise been seen by local ambulance and hospital services. Multi-site research should be undertaken to explore the health service usage from a variety of mass gatherings.



Ranse J, Lenson S, Keene T, Luther M, Burke B, Hutton A. (2014). Patient presentations to onsite health providers, ambulance paramedics and hospital emergency departments from a mass gathering: a case study; poster presented at the Paramedics Australasia International Conference 2014, Gold Coast, Australia, 18-20 September.

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