The continued professionalization of the humanitarian workforce requires sound underpinning by appropriate educational programs.The international disaster medicine and emergency health community requested the World Association for Disaster and Emergency Medicine (WADEM) develop international standards and guidelines for the education and training for disaster medicine. The Working Group of the WADEM Education Committee prepared and circulated an Issues Paper to structure input on this significant international task. Subsequently, the Working Group facilitated an Open International Meeting convened in Brussels, Belgium, 2004. The “Issues Paper” also was used as a framework to structure this International Meeting, which utilized case studies selected to represent the scope of disaster medicine, and prepared a meeting consensus on a framework for disaster health and for related educational programs.The two-day Brussels meeting attracted 51 participants from 19 countries, representing 21 disciplines.Participants reinforced the need to address the development of international standards and guidelines on education and training in this emerging discipline.Participants supported the view that the term “Disaster Health” suggested a multidisciplinary approach that is a more inclusive contemporary and appropriate term to describe this field, although there were dissenting views.The meeting formulated a consensus view in support of a framework for “Disaster Health”, which included: (1) primary disciplines; (2) support disciplines; (3) community response, resilience, and communication; and (4) socio-political context. The participants considered that this model lends itself to facilitating the development of educational programs in this field and believed that standards and guidelines initially should be developed in the “Core of Disaster Health” for undergraduates in relevant professions, for practicing professionals wishing to expand their practice in this field, and in the “Breadth of Disaster Health” for those wishing to be recognized as “Disaster Health Specialists” as academics, professionals, or policy leaders in this field at a University multidisciplinary Masters Degree level. A community-level and higher-specialist doctoral level would follow.Although the view of the participants was that the establishment of international approval/endorsement processes for education programs may have some benefits, there was less comfort in identifying which body/agency should be charged with this responsibility. The WADEM, the United Nations Office for the Coordination of Humanitarian Affairs, and the World Health Organization were identified as potential lead agents.The outcome of this international meeting is an important step toward meeting the challenge given the WADEM and will be developed further in consultation with the international disaster and emergency health community in order to improve education and training standards and professional practice.

Shift work can affect health and well-being on a variety of levels, both physiologically and psychologically, affecting aspects of work and personal life. Further research is warranted to prevent the issues of patient safety, work-related fatigue and the cumulative effects of shift work.

DVD simulations with an interprofessional education focus were developed. Paramedic students reported the simulations as being educationally, professionally and clinically relevant. The students also identified some aspects of current clinical placements that may be replaced by using DVD simulations. The cost benefit of using interprofessional DVD simulations to supplement and replace certain clinical placement rotations should be investigated further.

Introduction:International literature describing the profile of trauma patients attended by a statewide emergency medical services (EMS) system is lacking. Most literature is limited to descriptions of trauma responses for a single emergency medical service, or to patients transported to a specific Level-1 trauma hospital. There is no Victorian or Australian literature describing the type of trauma patients transported by a state emergency medical service.Purpose:The purpose of this study was to define a profile of all trauma incidents attended by statewide EMS.Methods:A retrospective cohort study of all patient care records (PCR) for trauma responses attended by Victorian Ambulance Services for 2002 was conducted. Criteria for trauma categories were defined previously, and data were extracted from the PCRs and entered into a secure data repository for descriptive analysis to determine the trauma profile. Ethics committee approval was obtained.Results:There were 53,039 trauma incidents attended by emergency ambulances during the 12-month period. Of these, 1,566 patients were in physiological distress, 11,086 had a significant pattern of injury, and a further 8,931 had an identifiable mechanism of injury. The profile includes minor trauma (n = 9,342), standing falls (n = 20,511), no patient transported (n = 3,687), and deceased patients (n = 459).Conclusions:This is a unique analysis of prehospital trauma. It provides a baseline dataset that may be utilized in future studies of prehospital trauma care. Additionally, this dataset identifies a ten-fold difference in major trauma between the prehospital and the hospital assessments.

We report on the development of a prehospital search filter. The scope of the filter is deliberately broad and many of the studies retrieved may not be relevant to the prehospital environment. However, the filter has been designed to identify reports of trials contained in The Cochrane Library with the purpose of assembling a register of prehospital trials

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Introduction A recent national review of English ambulance services, Taking Healthcare to the Patient: Transforming NHS Ambulance Services,1 published by the Department of Health, recommended that pre-hospital care research topics should be prioritised to ensure that service provision and development are evidence based wherever possible and that limited available funds are targeted to the most pressing needs. To identify gaps in research evidence related to delivery of pre-hospital care; and to rank topics in order of priority for research. Methods Research priorities were initially identified by delegates at the UK Ambulance Service Association’s annual conference, AMBEX 2006. An examination of research reviews in pre-hospital care identified other research evidence gaps. Relevant websites, databases and review bibliographies were also searched. Management, service delivery and treatment recommendations in UK policy/guidance documents published since 2000 were matched to research evidence. A list of evidence gaps was circulated in a Delphi-style three-round consultation to experts in pre-hospital care, including clinicians, managers and researchers. Round 1 confirmed/identified research gaps; Round 2 focussed on ranking topics; and Round 3 reviewed the scores and provided an option to rescore. Scores were analysed using SPSS. Results Ninety-six research issues were identified for circulation and prioritisation from 52 reviews and expert consultation and these were matched against 30 policy and guidance documents. Forty people participated in the Delphi exercise. The subject receiving highest priority for research was the development of new performance measures other than emergency ambulance response times. Other highly ranked priorities included treatment of stroke, cardiac conditions, children and people who self-harm; alternatives to Accident and Emergency (A&E) treatment; patient information sharing across care providers; access issues; decision support systems; and demand management systems for pre-hospital care. These priorities reflect three key issues: measuring activity to benefit patients; development of safe non-A&E care; and providing appropriate evidence-based clinical care in the pre-hospital environment. Implications There are many evidence gaps related to current pre-hospital policy and practice including management, clinical and service delivery issues. This Delphi consultation combines expertise of clinicians, managers and researchers to generate consensus on future research priorities in pre-hospital care. The need to develop meaningful performance measures plus alternative methods of patient management illustrates the synergistic relationship between service delivery and performance measurement. It suggests an opportunity to identify alternatives to response times as indicators of quality of pre-hospital care. The final results from this study will be useful to commissioners when developing their strategic approach to decision making about which research should be funded to facilitate continued development of quality patient care in the pre-hospital setting.

Introduction This study was undertaken as a precursor to a larger study investigating the benefits of simulation in reducing management and technique errors in the prehospital management of trauma patients. However, prior to this it was considered necessary to conduct a preliminary study to address the following: Undertake a structured evaluation of the Laerdal™ SimMan™ Patient Simulator. Determine the “functional fidelity” of the Laerdal™ SimMan™ Patient Simulator that was used in this project from the Paramedic perspective. Methods Participants taking part in the study were invited to complete an evaluation form that examined the various components of the simulator. A second evaluation form examined both the features of the simulator and their applicability to Paramedic practice. The simulator capabilities were assessed through an evaluation of the simulator features, and, with a qualitative element included, provided a descriptive analysis of simulator functional fidelity. Results Analysis identified 36 of 54 features (66%) of the simulator were rated by the respondents as at least ‘average physiological accuracy’. An analysis of applicability to practice identified 41 of 54 features (75%) were rated at least beneficial to practice by greater than 80% of respondents. In combining these results, only 5 features considered applicable to Paramedic practice demonstrated a below average level of physiological accuracy. These findings indicate that, as a general concept, the use of this particular simulator as an educational experience was held in high regard within this cohort of participants. Conclusion Previous studies in related health disciplines have identified an acceptance of a patient simulator as a learning tool by students. This study supports these findings, with Paramedic students evaluating the Laerdal™ SimMan™ Patient Simulator as having high functional fidelity, using the criteria outlined for this study. The findings from this study afford the opportunity for ongoing educational initiatives and research in the training of Paramedics utilising the Patient Simulator.