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SCIENTIFIC NETWORKING AND THE GLOBAL HEALTH SUPERCOURSE FOR THE PREVENTION OF THREAT FROM MAN MADE AND NATURAL DISASTERS August 8-11 2005, Kaunas, Lithuania. Emergency preparedness in the Baltics. Dinas Vaitkaitis Kaunas University of Medicine Lithuanian Society for Emergency Medicine.

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emergency preparedness in the baltics

SCIENTIFIC NETWORKING AND THE GLOBAL HEALTH SUPERCOURSE FOR THE PREVENTION OF THREAT FROM MAN MADE AND NATURAL DISASTERS

August 8-11 2005, Kaunas, Lithuania

Emergency preparedness in the Baltics

Dinas Vaitkaitis

Kaunas University of Medicine

Lithuanian Society for Emergency Medicine

topics
Topics
  • Background info
  • Risks
  • Emergency management
  • Emergency services
  • Education and training
background info
Background info
  • Geography/Demographics/Economy

Sources: WHO, CIA

differences
Differences

Estonia and Latvia -

66% located on 33% of territory,

rest of the population very sparsely situated

disaster risks
Natural disasters:

floods

forests’ fire

stormy winds

drought

Man-made disasters:

nuclear disasters

chemical disasters

traffic accidents

terrorism and war

infections

DISASTER RISKS
ignalina npp
IGNALINA NPP
  • Two RBMK-1500 reactors since 1983 and 1987 – one of them is still working
  • 1,5 Billion kWh/month
  • Personnel: 3900 (April, 2003)
    • day shift : 2500
    • night shift:230
    • security service: 530
    • shelter for: 800
risk of nuclear disasters
Risk of nuclear disasters
  • 1994 Tammiku, Estonia
    • Cs-137 from dump
    • 3 persons irradiated 1 person died
slide9
Risk

Vecumnieki 1999

slide10
Risk

Kemeri 1999

slide11
Risk

28 September 1994

989 people on board

138 rescued

explosion in shopping centre centrs riga 17 august 2000
Explosion in shopping centre “Centrs”(RIGA, 17 August ,2000)

1 cilvēks miris slimnīcā

30 cilvēki cietuši

Multitrauma, neirotrauma izolēti skeleta bojājumi apdegumi

disaster management levels in lithuania
DISASTER MANAGEMENT LEVELS IN LITHUANIA
  • National (country) level
  • Regional (county) level
  • Local (municipality) level
disaster management levels national level
DISASTER MANAGEMENT LEVELSNATIONAL LEVEL
  • Government of the Republic of Lithuania
  • Emergency Management Commission
  • Emergency Management Center
  • Civil Protection Department
  • Ministries
  • Emergency Management Centers
  • Fire Department
  • Health Emergency Situation Center
  • Maritime Search and Rescue Center
  • Air Search and Rescue Centre
  • Other Governmental Institutions
disaster management levels regional level
DISASTER MANAGEMENT LEVELSREGIONAL LEVEL
  • Regional Authority
  • Regional Emergency Management Center
  • Regional Warning and Information Service
  • Civil Protection Services
disaster management levels municipality level
DISASTER MANAGEMENT LEVELSMUNICIPALITY LEVEL
  • Local Authority
  • Local Emergency Management Center
  • Fire and rescue Departments
  • Local Warning and Information Service
  • Business and Industry
  • Civil Protection Services
health care organization levels in case of disaster state level
HEALTH CARE ORGANIZATION LEVELS IN CASE OF DISASTER:STATE LEVEL
  • MINISTRY OF HEALTH
  • DISASTER MANAGEMENT CENTER OF THE MOH
  • HEALTH EMERGENCY SITUATIONS CENTER TO THE MOH
  • Kaunas Medical University Clinics
  • Vilnius University Hospital ,,Santariskiu Clinics”
  • Vilnius University Emergency Hospital
  • Lithuanian Oncology Center
  • VU Children Hospital
  • VU Zalgirio Clinics (stomatol. surgery)
  • VU Psichiatry Hospital
  • Other special. hospitals
  • Radiation Protection Center
  • Centre of Communicable Diseases Prevention and Control
  • Public Health Services
  • Institute of Hygiene
health care organization levels in case of disaster county and municipality levels
COUNTY LEVEL

County hospitals (60)

Public Health Centers (11)

MUNICIPALITY LEVEL

Municipality hospitals (50)

Branches of Public Health Centers (39)

HEALTH CARE ORGANIZATION LEVELS IN CASE OF DISASTER:COUNTY AND MUNICIPALITY LEVELS
emergency services in lithuania
Emergency services in Lithuania
  • Fire and Rescue Services
  • Police
  • Ambulance Services / Hospitals
the fire and rescue services
The Fire and Rescue Services
  • rescue work
  • protection of persons and property
  • first aid at the accident site
  • transportation of injured from the accident site to assembly area
the police
The police
  • Coordination of work of all three emergency services at the accident site
  • Protection of persons and property
  • Traffic control
  • Registration of the victims and bystanders.
health services
Health services
  • Assessing injured and setting care priorities
  • Life saving first aid measures near the accident site and while transporting victims to hospitals
  • Medical transport
  • Allocation of injured to different hospitals

63 Ambulance stations/services

265 teams –day time, 210 – night time

all three services
All three services
  • planning
  • helping with information to the relatives, public and the mass media
  • co-operation
other services in the relief operations
Other services in the relief operations
  • See search and rescue
    • Under guidance of Captain of Klaipeda See-Port
    • Rescue ship “Šakiai”
  • Air search and rescue
    • 7 helicopters of the Airforce
    • Center of Aeronautics and Air Search
  • Emergency Management Centers under guidance of Crisis Management Center
training
Training

www.acls.kmu.lt

t raining29
Training
  • EmergoTrain – system, Lithuanian version
education research and training
Education, research and training
  • University studies of medicine at two universities (+1 public health)
  • Health faculties at five colleges
  • Postgraduate training
  • Exercises
  • Emergency medicine – research programme at Kaunas University of Medicine
organisation of pre hospital emergency medical care in estonia
Organisation of Pre-hospital Emergency Medical Care in Estonia
  • Provided entirely by Emergency Medical Services with minimal involvement of GPs in rural areas
  • There is no governmental body regulating the EMS activities nor is there any functioning legal framework governing the area
slide33
Union of Estonian Emergency Medical Services is a nonprofit organisation for EMS professionals (physicians, nurses and EMTs), devoted to quality of emergency medical care by providing training and guidance to its members, consulting the government in questions vital for the development of EMS etc.
estonian ems resources available
Estonian EMS - resources available
  • There are 87 EMS teams in 46 geographic locations
the qualification of ems teams in estonia
The qualification of EMS teams in Estonia
  • 6 reanimobiles with anaesthesiologist on board (based in Tallinn and Tartu)
  • 40 physician manned ambulances (generalists with training in EM)
  • 41 teams lead by a specialist nurse

All EMS teams consist of 3 members: a doctor or a specialised nurse, a nurse and a driver trained as EMT

education and training
Education and Training
  • Undergraduate medical education
    • Physicians - Tartu University
    • Nurses - 3 schools (Tallinn, Tartu, Kohtla-Järve)
  • Specialisation
    • EM physicians in residency progam at Tartu University Hospital
    • Nurses at Tallinn EMS
    • EMTs at Tallinn and Tartu EMS, Centre of Disaster Medicine of Tallinn Mustamäe Hospital
medical disaster preparedness organisation in latvia
Medical disaster preparedness organisation in Latvia
  • State level - Ministry of Health
    • Centre of Emergency and Disaster medicine
      • Operative reserves
  • District level - responsibility for preparedness
  • Local level
    • Ambulance Service
    • Hospitals
  • DM planning – for each level
slide38

AmbulanceServicesin Latvia

52 Ambulance stations in 70 localization points 173 teams –day time, 143 – night time

slide39

EMS – “ stay and play” concept

  • EMS teams in Latvia:
    • IT teams – MD + MD assistant + driver (53day time/36 night time)
    • EM teams – MD assistant + driver (123/110)
    • Legislation demand – 2 medical educated persons on each team
slide40

EMS – today

  • Lack of co-ordination;
  • “Border problems”
  • Management and dispatch problems (many dispatch “centres”);
  • Different levels of accessibility of EMH
    • Cities 15 minutes
    • Country side 25-90 min.
  • Lack of unitary communication system
  • Personnel problems
  • Different EM numbers
slide41

Catchment area LV-EE Valmiera- Pärnu

Catchment area LV-LT

Jelgava- Siauliai

International co-operation(“Disasters do not know borders”)

Neighbouring countries: cross - border co-operation

acknowledgements
Acknowledgements
  • Mārtiņš Zuteris
  • Raul Adlas
  • Ursel Kedars
  • Ago Kõrgvee
ad