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

18 July, 2020

Research in the context of coronavirus disease 2019: Considerations for critical care environments




Free full-text article

In this editorial, I discuss some key considerations of undertaking research in critical care environments in the context of COVID-19.

In summary, research during disasters and public health emergencies, such as COVID-19, should be carefully considered before it is commenced. First, for individual researchers, this means embarking on high-quality, collaborative, and meaningful research, resisting the temptation to quickly grasp low-hanging research, which has the potential to be expedited at the jeopardy of quality. Second, for organisations that facilitate research through funding support or access to potential participants, supporting research with high scientific rigour should be maintained and strategies implemented to facilitate collaborative research particularly when it becomes apparent that duplication of research efforts is imminent. Finally, journals must be agile so that they can quickly respond to the need for rapid dissemination of information while still maintaining established standards of good publishing practice.


REFERENCE:
Ranse J. (2020). Research in the context of coronavirus disease 2019: Considerations for critical care environments. Australian Critical Care. 33(4):309-310.

21 April, 2020

Australian bush fire experience



I was invited by Dr Atilla Hertelendy from Georgetown University to present to the students of the Emergency Management Program. This presentation focused on the history of bush fires in Australia, with a focus on more recent events including:
  • 2003 Canberra bush fires 
  • 2009 Black Saturday and Victorian Bushfire 
  • 2019 / 2020 Black Summer
Additionally, aspects of the healthcare professional's role, experience, and education were discussed.


Ranse J. (2020). Australian bush fire experience; online presentation [via Zoom] at the Georgetown University, Emergency Management Program, Miami, Florida, United States of America, USA, 21st April.

19 February, 2020

Psychosocial influences on patient presentations: Considerations for research and evaluation at mass-gathering events


Full-text article (PDF)


ABSTRACT

Aim: This review discusses the need for consistency in mass-gathering research and evaluation from a psychosocial perspective.

Background: Mass gatherings occur frequently throughout the world. Having an understanding of the complexities of mass gatherings is important to determine required health resources. Factors within the environmental, psychosocial, and biomedical domains influence the usage of health services at mass gatherings. A standardized approach to data collection is important to identify a consistent reporting standard for the psychosocial domain.

Method: This research used an integrative literature review design. Manuscripts were collected using keyword searches from databases and journal content pages from 2003 through 2018. Data were analyzed and categorized using the existing minimum data set as a framework.

Results: In total, 31 manuscripts met the inclusion criteria. The main variables identified were use of alcohol or drugs, crowd behavior, crowd mood, rationale, and length of stay.

Conclusion: Upon interrogating the literature, the authors have determined that the variables fall under the categories of alcohol or drugs; maladaptive and adaptive behaviors; crowd behavior, crowd culture, and crowd mood; reason for attending event (motivation); duration; and crowd demographics. In collecting psychosocial data from mass gatherings, an agreed-upon set of variables that can be used to collect de-identified psychosocial variables for the purpose of making comparisons across societies for mass-gathering events (MGEs) would be invaluable to researchers and event clinicians.



Hutton A, Ranse J, Grey K, Turris S, Lund A, Munn BM. (2020). Psychosocial influences on patient presentations: Considerations for research and evaluation at mass-gathering events. Prehospital and Disaster Medicine.

30 January, 2020

The impact of mass casualty incidents on intensive care units

Full-text article (PDF)

ABSTRACT
Objectives: Mass casualty incidents occur worldwide and have the capacity to overwhelm local healthcare facilities. There has been much research into how these events are managed in the prehospital environment and in the emergency department. However, there is a paucity in research addressing the impact that mass casualty incidents have on adult intensive care units. This review seeks to identify what literature is available that addresses the impact that mass casualty incidents have on intensive care units.

Review method used: Integrative Review Data sources: Electronic databases MEDLINE, CINAHL, PubMed and Scopus.

Review Methods: Electronic databases were searched using terms such as "Intensive Care Unit" OR "Intensive Care" OR "Critical Care" OR "ICU" AND "Mass Casualty Incidents" OR "MCI" OR "Mass Casualty Event" OR "Mass Casualty Management" OR "Disaster". Articles that were published in the preceding 10 years in English as case studies or addressing real world events were included. Editorials, theoretical papers and research involving paediatrics were excluded from the results.

Results: Seven articles met the search criteria. Results identified four key areas in ICU that were impacted by mass casualty incidents. These areas include the impact on facilities, on resources, on staff and of training on the management of mass casualty incidents.

Conclusions: This review has demonstrated a paucity in research and reporting practices on the impact that mass casualty incidents have on intensive care units. The returned articles have identified four areas that were seen as influencing management of real-world mass casualty incidents. By increasing reporting and research into factors that impact mass casualty incident management in intensive care units, policy and training can be enhanced to ensure better preparedness for future incidents.




Sellers D, Ranse J. (2020). The impact of mass casualty incidents on intensive care units. Australian Critical Care.

17 January, 2020

Impact of mass gatherings on ambulance services and emergency departments


I presented at the Qatar Health 2020 conference regarding the impact of mass gatherings on ambulance services and emergency departments. Qatar Health 2020 is a collaborative effort between Hamad Medical Corporation and the Ministry of Public Health in preparation for the FIFA World Cup 2022.

In particular, this presentation highlights:
  • the host population to event population relationship
  • frameworks for understanding the impacts of mass gatherings
  • current literature to inform practice
  • case studies relating to music festivals, and the 2018 Commonwealth Games

REFERENCES

Arbon, P., Bridgewater, F. H., & Smith, C. (2001). Mass gathering medicine: a predictive model for patient presentation and transport rates. Prehospital and Disaster Medicine, 16(3), 150-158.

Catherine Delany. Master of Emergency Nursing (Dissertation). A retrospective analysis of drug and alcohol-related patient presentations to the Gold Coast Health emergency departments during the 2018 Commonwealth Games. Supervisors: Julia Crilly, Jamie Ranse.

DeMott, J. M., Hebert, C. L., Novak, M., Mahmood, S., & Peksa, G. D. (2018). Characteristics and resource utilization of patients presenting to the ED from mass gathering events. The American Journal of Emergency Medicine, 36(6), 983-987.

Gold Coast Public Health Unit. (2019). Gold Coast 2018 Commonwealth Games Summary Report. Retrieved from: https://www.goldcoast.health.qld.gov.au/sites/default/files/GC2018%20Public%20Health%20Summary%20Report%20Final%20.pdf

Hughes, H. E., Colón-González, F. J., Fouillet, A., Elliot, A. J., Caserio-Schonemann, C., Hughes, T. C., ... & Lake, I. R. (2018). The influence of a major sporting event upon emergency department attendances; A retrospective cross-national European study. PloS one, 13(6), e0198665.

Lund A, Turris S, Bowles R, Steenkamp M, Hutton A, Ranse J, Arbon P. (2014). Mass gathering health research foundational theory: Part 1 Population models for mass gatherings. Prehospital and Disaster Medicine. 29(6):648-654.

Ranse, J., Hutton, A., Keene, T., Lenson, S., Luther, M., Bost, N., ... & Hayes, C. (2017). Health service impact from mass gatherings: a systematic literature review. Prehospital and disaster medicine, 32(1), 71-77.

Ranse, J., Lenson, S., Keene, T., Luther, M., Burke, B., Hutton, A., ... & Crilly, J. (2019). Impacts on in‐event, ambulance and emergency department services from patients presenting from a mass gathering event: A retrospective analysis. Emergency Medicine Australasia, 31(3), 423-428.

Ruest, S. M., Stephan, A. M., Masiakos, P. T., Biddinger, P. D., Camargo, C. A., & Kharasch, S. (2018). Substance use patterns and in-hospital care of adolescents and young adults attending music concerts. Addiction Science and Clinical Practice, 13(1), 1.

Shirley (Yunjing) Qiu. Bachelor of Nursing (Honours), First Class. A retrospective cohort study evaluating the impact of a mass gathering (the 2018 Commonwealth Games) on emergency department presentations with communicable diseases. Supervisors: Julia Crilly, Jamie Ranse, Peta-Anne Zimmerman

Turris S, Lund A, Hutton A, Bowles R, Ellerson E, Steenkamp M, Ranse J, Arbon P. (2014). Mass gathering health research foundational theory: Part 2 Event modelling for mass gatherings. Prehospital and Disaster Medicine. 29(6):655-663



Reference from this presentation: Ranse J. (2020). Impact of mass gatherings on ambulance services and emergency departments; invited speaker for Qatar Health 2020, Doha, Qatar, 17th January.




08 January, 2020

Using clinical based vignettes to further develop a mass-gathering triage tool




Full-text paper (PDF)

ABSTRACT
Background: Previously published triage tools for use at mass gathering events (MGE) lack real-world validation. Non-health care professionals, such as first aiders, first responders, and advanced responders often undertake a triage role at MGEs. This research aimed to determine consistency in the decision-making of a MGE triage tool.

Method: Volunteer members of St John Ambulance Australia were recruited. Surveys included participant demographics and real-world clinical vignettes. Participants determined a triage category based on the vignettes and supplied triage tool. Demographics were analysed using descriptive statistics and responses to vignettes were analysed using Fleiss Kappa [p-bar].

Results: There were 110 participants, the majority male (60%), having completed a Bachelor or higher degree (53.6%), and were non-health care professionals (70%). Of the vignettes, there was a slightly better than moderate agreement (items: 18, p-bar: 0.55). There was an excellent level of agreeance for the resuscitation category (items: 3, b-par 0.69), and moderate level of agreeance for the urgent (items: 10, b-par 0.52) and minor (items: 5, b-par 0.52) categories.

Conclusions: This research demonstrated similar findings to that of emergency department triage tool validation. Multi-country, multi-site, multi-type, real-world testing at MGEs is the next step to progress the development of this tool.



Ranse J, Cannon M, Roitman R, Morphet J. (2020) Using clinical based vignettes to further develop a mass-gathering triage tool. Australasian Journal of Emergency Care.

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