Since the adoption of the Hyogo Framework, much work has been done to mitigate the effects of disasters as adequate preparation will enable Registered emergency nurses (ENs) to mitigate the negative consequences of disasters.

To assess the knowledge, attitude, and practices of ENs in the northern division of Fiji (ND) toward disaster preparedness and management.

A quantitative, cross-sectional study design using a self-administered questionnaire queried 61 ENs working in Emergency Departments (ED) in divisional, sub-divisional hospitals and health centers in the ND.

A low proportion (23%) of these ENs have attended disaster preparedness training from the time they started working with the employer demonstrating they are not prepared to mitigate the effects of disaster on the affected population in the ND. Though they have adequate knowledge and a positive attitude in engaging themselves towards disaster management, only 43% of these ENs were knowledgeable about appropriate policies and procedures. This study found that 72.1% have never read or seen their health disaster management policy.

Given the number of disasters experienced in Fiji every year, there is an urgent need for a comprehensive disaster management policy and training for ENs across the ND.

DARPA’s In the Moment (ITM) program seeks to develop algorithmic decision makers for battlefield triage that are aligned with key decision-making attributes of trusted humans. ITM also seeks to develop a quantitative alignment score (based on the decision-making attributes) as a method for establishing appropriate trust in algorithmic decision-making systems. ITM is interested in a specific notion of trust, specifically the willingness of a human to delegate difficult decision-making to an algorithmic system. While the AI community often identifies technical performance characteristics (e.g., error rate) as trust factors for autonomous systems, ITM focuses on human attributes and characteristics (e.g., risk tolerance, rule following, or other personality characteristics; subject matter expertise; and human values to name a few) that could be encoded into algorithmic systems. This presentation will provide an overview of ITM program, including the quantitative alignment framework that will produce an alignment score between the human trustor and algorithmic trustee, as well as the evaluation planned to assess the contribution of alignment to the willingness to delegate.

Define how difficult decisions are understood in the context of the In the Moment program.

Describe the role of trust and decision-maker alignment for the In the Moment program.

Discuss the elements of the In the Moment evaluation, including the role of human delegation of difficult decisions.

In this interactive session which combines instruction with live-streaming, participants will learn about the use of ChatGPT in disaster medicine.

Create an OpenAI account, write an effective prompt, and manage a conversation with ChatGPT.

List errors common to ChatGPT and understand why they occur.

Review how ChatGPT can interface with internet connected devices and other apps.

Discuss the ethical, legal, and social implications of generative AI.

The NIGHTINGALE PROJECT aims at transforming the landscape of Mass Casualty Incident (MCI) response by seamlessly incorporating cutting-edge technologies. At its core, this initiative leverages advanced solutions, including wearable wristbands and unmanned aerial vehicles (drones), to enhance the operational efficiency and effectiveness of MCI response teams. These technologies are designed to provide real-time data collection, communication, and coordination capabilities, offering invaluable support for first responders in chaotic and resource-constrained MCI scenarios. The successful integration of such innovative technologies within the complex operational context of MCI handling poses a series of challenges that hold the potential to reshape the existing paradigms. Therefore, NIGHTINGALE users have performed a thorough analysis of the widely operated protocols and discussed common denominators of MCI prehospital response in light of these new technological solutions, with the objective of translating recommendations into practice.

Gain a comprehensive understanding of the cutting-edge technologies (such as wearables and drones) that can potentially be integrated in prehospital MCI response.

Learn how these technologies operate and their potential benefit in enhancing MCI response.

Understand challenges and implications of technology integration into the complex operational context of MCI handling.

Despite the increasing risk of disasters and health crises worldwide, we are failing to equip the new generation of health care workers with basic education and training in disaster medicine and global public health. Unfortunately, the teaching of disaster medicine is underrepresented in several countries worldwide.

Understand the role of education and training as integral components of disaster preparedness.

Recognize the fundamentals of adult learning and competency-based education and training.

Discover the general principles of education and training in disaster medicine.

Explore the state of the art of simulation-based training in disaster medicine.

Artificial Intelligence (AI) covers a broad range of technologies that offer great potential and raise concerns, including ethical concerns. Some of these apply to any new technology. Potential benefits provide ethical justifications for AI, but what about potential risks and harms? How do we assess unknown harms, especially ‘dual use’ dilemmas where beneficial AI could be hijacked for harmful uses? Other ethical issues relate to the data used in AI. Machine learning offers the potential to process massive amounts of data that can be put to good use in disaster risk reduction, planning and guiding disaster responses. However, the quality of the output depends on the quality of the data input. What ethical responsibilities apply to monitoring data quality? How will privacy and confidentiality be protected for such data, especially if used for disasters in conflict or insecure settings? What if the data is influenced by inequities, or the output is used for stigmatization or discrimination? This presentation will examine these and other ethical issues with AI and disasters.

To identify ethical issues with AI and disasters.

To provide ethical analysis of concerns about AI and disasters.

To propose ethically responsible ways of using AI for disasters.

Since 2006, the Maricopa County Department of Public Health (MCDPH) has conducted routine surveillance of heat-associated deaths in the county. During that time, the number of deaths each year has been on the rise with 2022 numbers showing a 25% increase over 2021. Risk factors such as homelessness and alcohol and drug use have been shown to increase the risk of heat-associated death. During the summer of 2023, record-breaking heat in the metro-Phoenix area was widely reported. The MCDPH heat-associated death surveillance data was widely reported and used by policy makers to address extreme heat as a regional disaster. In this presentation participants will learn how heat-associated death surveillance has evolved over time to inform public health leaders and policy makers to the risk factors associated with poor outcomes from extreme heat. Participants will also understand how the data is shared at the local, national and international levels to inform extreme heat response activities.

Participants will learn how heat-associated death surveillance has evolved over time to inform public health leaders and policy makers of the risk factors associated with poor outcomes from extreme heat.

Participants will also understand how the data is shared at the local, national and international levels to inform extreme heat response activities.

Telehealth, or the use of digital health technology to support clinical care, education, and health administration over a distance, has increased dramatically in the 21st century. The frequency and severity of disasters that cause damage, disruption, loss of life, and health service deterioration have also increased over the same period. Advances in telecommunication networks and mobile technology have made telehealth systems more accessible and affordable, and rising acceptance has engaged hesitant users. Yet, telehealth remains underutilized particularly for cross-jurisdictional disaster response in the United States. In this presentation, we will discuss progress in the development and implementation of new regional disaster telehealth systems funded by the U.S. Administration for Strategic Preparedness and Response. We will review administrative and legal barriers to implementation in the context of real-world examples to understand how they impact domestic disaster response capabilities. We will also discuss innovative new global partnerships that have successfully leveraged digital tools to provide access to health resources for international humanitarian disaster response. Finally, we will consider next steps in the path to fully actualizing the potential for telehealth to transform disaster response.

Discuss current federally funded efforts to develop and implement regional telehealth systems designed to support cross-jurisdictional disaster medical response in the United States.

Examine administrative and legal barriers to adoption and implementation that can impact timely mobilization, deployment, and use of disaster telehealth services.

Review examples of successful and failed implementation to guide future research, development, and implementation efforts for system developers, sponsors, and governmental and non-governmental disaster response entities.

Rapid deforestation, urbanization, and biodiversity loss over the last century has changed landscapes and disorientated the climate. This has magnified temperature, wind speed, air quality, and other meteorological variables. For example, the urban heat island effect has resulted in city areas being hotter than nearby rural areas and expanding physical landscapes combined with shifting precipitation patterns has increased flood risks in new locations. The result has been unexpected disruption to healthcare, supply chains, and changes in vector, water, and foodborne disease patterns. To find solutions to this challenge, a transdisciplinary approach is needed to assess and anticipate the impact of floods and other emerging risks on public health systems. The United Nations Public Health System Resilience Scorecard (Scorecard) could provide the process needed for this to occur. This is a reliable, scalable, and versatile tool that has been applied and tested in multiple communities and countries. Attendees to this session will learn about the Scorecard methodology and how it can be applied in different settings, used to build consensus, and employed to inform future resilience actions. Ultimately, providing a framework for maximizing the resilience of public health systems during a time of rapidly shifting environmental, social, and fiscal climates.

Identify the impact floods and other disasters can have on public health systems in non-traditional at-risk areas.

Explore the United Nations Public Health System Resilience Scorecard (Scorecard) and its alignment with the 2030 United Nations agenda.

Understand why a transdisciplinary approach is needed to assess the impact of floods and other emerging risks on public health systems.

Demonstrate how the Scorecard can be applied in multiple communities and countries to identify, rank, and prioritize resilience actions for public health systems.

Point-of-care ultrasound is a proven life-saving diagnostic tool that can be easily utilized in remote and austere settings with ever-improving portability. The utility of point-of-care ultrasound in prehospital care as a feasible and valuable tool to assist in prioritizing patients for damage control resuscitation and transport from the field will be highlighted with a focus on resource-limited environments and conflict settings. The session will conclude with a discussion around the successes, challenges, and lessons-learned after the implementation of a point-of-care ultrasound for trauma training program that was deployed to Ukraine in the fall of 2022.

Understand the role that point-of-care ultrasound can play in prehospital patient management.

Identify the benefits and pitfalls of point-of-care ultrasound utilization in the prehospital and resource-scarce environment.

Outline successful strategies and identify potential challenges for implementing a point-of-care ultrasound for trauma training program in complex environments.

The Military Unique Curriculum at the Uniformed Services University consists of three high-fidelity simulations to prepare students for future conflicts in austere operational environments. One of these simulations, Operation Bushmaster is a five-day high-fidelity military medical field practicum (MFP) held for fourth-year military medical students and nursing students. During this simulation, students deploy to Fort Indiantown Gap, PA, where they enter the notional country of “Torbia.” Assembled in platoons, the students care for simulated critical condition patients (portrayed by first year medical students) within a stressful combat environment. In addition, while participating in Operation Bushmaster, students fill various roles relevant to their future deployments, including surgeon, platoon leader, assistant platoon leader, preventative medicine technician, ambulance team leader, and behavioral health technician while caring for simulated disease and non-battle injury patients, combat stress casualties, and combat trauma casualties in a variety of scenarios. The simulation concludes with a mass casualty event where students care for over thirty patients during a one-hour time frame. This presentation will explore the educational impact of Operation Bushmaster on student learning and readiness to deploy by describing several educational research studies conducted at Operation Bushmaster. Best practices for developing training simulations like Operation Bushmaster will be described and discussed.

Participants will identify the critical elements of high-fidelity simulations at the Uniformed Services University.

Participants will describe the impact of Operation Bushmaster on military medical trainee learning.

Participants will discuss the value of using high-fidel\ity simulation for disaster training and readiness.

Climate change has impacts that contribute to increased disasters and chronic stressors. Subsequently we are faced with the great resignation of employees in the first responder and healthcare workforces.

These industries are crucial to community recovery and there is an urgent need to understand risk and protective factors toward burnout and mental health.

We hypothesize that disaster experiences and community disruptions contribute to burnout and mental health problems among the healthcare and emergency personnel workforces. Mixed methodology was used to identify services that would support retention.

As symptoms of burnout increased, mental health problems also increased. Increased burnout was associated with increased work hours per week, more hours than usual, and more traditional first responder roles. Social isolation and other trauma, such as disaster, were associated with mental health problems. Protective factors included wellbeing, connectedness, and self-care.

Findings support the need for services aimed at reducing negative mental health and loneliness while improving coping skills. This presentation explores the utility of artificial intelligence, such as wearable technology, to screen, triage, and provide mental health services. By leveraging technologies, we offer a plan for addressing burnout, increased retention and the future of disaster mental health.

The COVID-19 pandemic created a public health crisis worldwide. Healthcare workers became sick at a time when hospitals were overwhelmed with patients, leaving critical staffing shortages. International governments instructed their military assets to fill gaps in care and to initiate projects to promote public health efforts. The COVID-19 pandemic created a unique international military response to a biologic disaster.

This literature review highlights the non-conflict assets allocated, abilities utilized, projects completed, overall effectiveness, and lessons learned by the military community worldwide to support their local populace. This collated information is then compared using three interoperability frameworks to assess government responses. This data is then extrapolated to give recommendations for future civil-military actions occurring after climate change related disruption of healthcare delivery systems.

Medline (PubMed), SCOPUS, and CINAHL were searched for English language articles from 2020 with terms focused on the military, COVID-19, and collaboration. After data collection, the Joint Emergency Services Interoperability Program, Operational Interoperability Maturity Model, and Homeland Security Interoperability Continuum frameworks were utilized to evaluate collaboration and coordination between governments and military in response to the disaster.

Data collection has been completed. Analysis and conclusion planned for completion by November 2023.

Modern warfare has challenged the way in which far-forward medical assistance is provided in such settings. Since the existing approach and tools are insufficient for the changing landscape and humanitarian assistance, steps need to be taken to support an appropriate response. Of particular importance is the revision of a curriculum that fits the civilian medical system and facilitates its adaptation to the context and available resources.

Present the correlation between the asymmetry in warfare, the implementation of an integrated trauma system and its application in the management of civilian casualties.

Understand how lessons from the implementation of trauma care close to the frontlines contribute to generate a model for the provision of trauma care in asymmetric conflict.

The confluence of extreme weather conditions and crowded forests are contributing to larger and more severe forest fires. The progressive migration of the US population into the wildland-urban-interface is placing more people in the path of wildfire, while the emissions from wildland fire are reversing historical improvements in national air quality and placing the health of people remote from the wildfire at risk. The presentation will describe the historical pattern of wildfire in the U.S., factors contributing to a significant increase recently, and projections for wildfire behavior into the future. The human health effects of wildfire will be addressed within the context of mental health issues emerging among survivors of wildfire, and health effects to exposure to emissions of firefighters, and populations at a distance. Clinical and public health recommendations for individuals and communities to protect themselves from smoke exposure will be presented.

Describe the factors that are increasing the size and severity of wildfire.

Describe actions individuals and communities can take to reduce exposure to wildfire smoke.

Describe key unanswered questions requiring new research to inform policy and decision-making by professionals charged with managing forests and environmental quality, prescribed fire, public health and healthcare.