Decision Making in a Strategic Medical Command and Control Team During the Covid-19 Pandemic: A Case Study.

Objective: To achieve resilience in the response of a major incident, it is essential to coordinate major processes and resources with the aim to manage expected and unexpected changes. The coordination is partly done through timely, adequate, and resilience-oriented decisions. Accordingly, the aim of the present paper is to describe factors that affected decision-making in a medical command and control team during the early COVID-19 pandemic.

False Alarm Effects in Early Warnings for Emergency Vehicles: Exploring Drivers' Move-Over Behavior.

Objective: This study investigated drivers' move-over behavior when receiving an Emergency Vehicle Approaching (EVA) warning. Furthermore, the possible effects of false alarms, driver experience, and modality on move-over behavior were explored.

Background: EVA warnings are one solution to encourage drivers to move over for emergency vehicles in a safe and timely manner.

Recommendations for Placement of Bleeding Control Kits in Public Spaces-A Simulation Study.

Objective: Bleeding control measures performed by members of the public can prevent trauma deaths. Equipping public spaces with bleeding control kits facilitates these actions. We modeled a mass casualty incident to investigate the effects of public bleeding control kit location strategies.

What motivates and demotivates emergency response volunteers? A survey-based factor analysis study.

Background: Organized volunteer initiatives can reduce response times and improve outcomes in emergencies such as cardiac arrests or fires. Retention of volunteers is important to maintain good coverage and capabilities. The current study explores factors underlying volunteers' motivation to continue as volunteers.

The Untrained Public's Ability to Apply the Layperson Audiovisual Assist Tourniquet vs a Combat Application Tourniquet: A Randomized Controlled Trial.

Background: Although the Stop the Bleed campaign's impact is encouraging, gaps remain. These gaps include rapid skill decay, a lack of easy-to-use tourniquets for the untrained public, and training barriers that prevent scalability. A team of academic and industry partners developed the Layperson Audiovisual Assist Tourniquet (LAVA TQ)-the first audiovisual-enabled tourniquet for public use.

Laypeople perception and interpretation of simulated life-threatening bleeding: a controlled experimental study.

Introduction: First aid performed by immediate responders can be the difference between life and death in the case of trauma with massive bleeding. To develop effective training programs to teach bleeding control to laypersons, it is important to be aware of beliefs and misconceptions people hold on bleeding and severity of bleeding situations.

Method: A controlled study was conducted in which 175 American college students viewed 78 video clips of simulated bleeding injuries.

The Effects of Stress on Tourniquet Application and CPR Performance in Layperson and Professional Civilian Populations.

Objective: The purpose of this study was to compare laypeople's and professional first responders' ability to perform tourniquet application and cardiopulmonary resuscitation (CPR) during calm and stressful circumstances.

Background: Life-threatening bleeding is a major cause of death that could be prevented by fast and appropriate first aid interventions. Therefore, laypeople are now being trained in bleeding control skills, transforming them from bystanders to immediate responders.

Mechanical Assessment of Tissue Properties During Tourniquet Application.

Introduction: Successful tourniquet application increases survival rate of exsanguinating extremity hemorrhage victims. Tactile feedback during tourniquet application training should reflect human tissue properties in order to increase success in the field. This study aims to understand the mechanical properties of a human limb during tourniquet application.

Visual estimates of blood loss by medical laypeople: Effects of blood loss volume, victim gender, and perspective.

A severe hemorrhage can result in death within minutes, before professional first responders have time to arrive. Thus, intervention by bystanders, who may lack medical training, may be necessary to save a victim's life in situations with bleeding injuries. Proper intervention requires that bystanders accurately assess the severity of the injury and respond appropriately.

Operationalising resilience for disaster medicine practitioners: capability development through training, simulation and reflection.

Resilience has in recent decades been introduced as a term describing a new perspective within the domains of disaster management and safety management. Several theoretical interpretations and definitions of the essence of resilience have been proposed, but less work has described how to operationalise resilience and implement the concept within organisations. This case study describes the implementation of a set of general resilience management guidelines for critical infrastructure within a Swedish Regional Medical Command and Control Team.

Defining a Research Agenda for Layperson Prehospital Hemorrhage Control: A Consensus Statement.

Importance: Trauma is the leading cause of death for US individuals younger than 45 years, and uncontrolled hemorrhage is a major cause of trauma mortality. The US military's medical advancements in the field of prehospital hemorrhage control have reduced battlefield mortality by 44%. However, despite support from many national health care organizations, no integrated approach to research has been made regarding implementation, epidemiology, education, and logistics of prehospital hemorrhage control by layperson immediate responders in the civilian sector.

Preliminary Investigation of Civilian Clinician Perspectives & Just-in-Time Guidance for Tourniquet Use to "Stop the Bleed".

Objective: The American College of Surgeons (ACS) encourages clinicians to provide training to laypeople on tourniquet application. It is unclear whether clinicians are confident in their abilities and equipped with adequate knowledge, skills, and resources. This study aimed to determine surgical trainee knowledge and attitudes regarding tourniquet application and compare the effectiveness of instructions.

Fixation Differences in Visual Search of Accident Scenes by Novices and Expert Emergency Responders.

Objective: We sought to investigate whether expert-novice differences in visual search behavior found in other domains also apply to accident scenes and the emergency response domain.

Background: Emergency service professionals typically arrive at accidents only after being dispatched when a civilian witness has called an emergency dispatch number. Differences in visual search behavior between the civilian witness (usually a novice in terms of emergency response) and the professional first responders (experts at emergency response) could thus result in the experts being given insufficient or erroneous information, which would lead them to arrive unprepared for the actual situation.

Short simulation exercises to improve emergency department nurses' self-efficacy for initial disaster management: Controlled before and after study.

Introduction: Head nurses at emergency departments often assume responsibility for managing the initial response to a major incident, and to create surge capacity. Training is essential to enable these nurses to perform an effective disaster response. Evaluating the effects of such training is however complicated as real skill only can be demonstrated during a real major incident.

Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload.

Background: The effects of refraining from practice for different intervals on laparoscopic suturing and mental workload was assessed with a secondary task developed by the authors. We expected the inability to practice to produce a decrease in performance on the suturing, knot tying, and secondary task and skills to rebound after a single refresher session.

Methods: In total, 22 surgical assistant and premedical students trained to Fundamentals of Laparoscopic Surgery proficiency in intracorporeal suturing and knot tying were assessed on that task using a secondary task.

Workload differences across command levels and emergency response organizations during a major joint training exercise.

Objective: This study reports on an initial test using a validated workload measurement method, the NASA Task Load Index (TLX), as an indicator of joint emergency exercise effectiveness. Prior research on emergency exercises indicates that exercises must be challenging, ie, result in high workload, to be effective. However, this is often problematic with some participants being underloaded and some overloaded.

Intracorporeal suturing: Transfer from Fundamentals of Laparoscopic Surgery to cadavers results in substantial increase in mental workload.

Introduction: A spatial secondary task developed by the authors was used to measure the mental workload of the participant when transferring suturing skills from a box simulator to more realistic surgical conditions using a fresh cadaver. We hypothesized that laparoscopic suturing on genuine bowel would be more challenging than on the Fundamentals of Laparoscopic Surgery (FLS)-simulated bowel as reflected in differences on both suturing and secondary task scores.

Methods: We trained 14 surgical assistant students to FLS proficiency in intracorporeal suturing.

Cognitive design of a digital desk for the emergency room setting.

Digital desk technology has a still mainly unexplored potential to support the everyday work of collaborating clinicians. This paper presents ER Desk - a digital desk that was designed to specifically support a team of healthcare professionals working in an emergency room setting. The underlying design requirements were elicited in a comprehensive distributed cognition study of paper-based practices in an emergency room of a middle-sized Swedish hospital.

Spatial judgments in the horizontal and vertical planes from different vantage points.

Todorović (2008 Perception 37 106-125) reported that there are systematic errors in the perception of 3-D space when viewing 2-D linear perspective drawings depending on the observer's vantage point. Because these findings were restricted to the horizontal plane, the current study was designed to determine the nature of these errors in the vertical plane. Participants viewed an image containing multiple colonnades aligned on parallel converging lines receding to a vanishing point.