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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 l.jpg

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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Topics

  • Background info

  • Risks

  • Emergency management

  • Emergency services

  • Education and training


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THE BALTICS


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Background info

  • Geography/Demographics/Economy

Sources: WHO, CIA


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Differences

Estonia and Latvia -

66% located on 33% of territory,

rest of the population very sparsely situated


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Natural disasters:

floods

forests’ fire

stormy winds

drought

Man-made disasters:

nuclear disasters

chemical disasters

traffic accidents

terrorism and war

infections

DISASTER RISKS


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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


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Risk of nuclear disasters

  • 1994 Tammiku, Estonia

    • Cs-137 from dump

    • 3 persons irradiated 1 person died


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Risk

Vecumnieki 1999


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Risk

Kemeri 1999


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Risk

28 September 1994

989 people on board

138 rescued


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Explosion in shopping centre “Centrs”(RIGA, 17 August ,2000)

1 cilvēks miris slimnīcā

30 cilvēki cietuši

Multitrauma, neirotrauma izolēti skeleta bojājumi apdegumi


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DISASTER MANAGEMENT LEVELS IN LITHUANIA

  • National (country) level

  • Regional (county) level

  • Local (municipality) level


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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


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DISASTER MANAGEMENT LEVELSREGIONAL LEVEL

  • Regional Authority

  • Regional Emergency Management Center

  • Regional Warning and Information Service

  • Civil Protection Services


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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


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EMERGENCY MANAGEMENT SYSTEM IN HEALTH CARE SECTOR


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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


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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


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Emergency services in Lithuania

  • Fire and Rescue Services

  • Police

  • Ambulance Services / Hospitals


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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


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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.


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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


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All three services

  • planning

  • helping with information to the relatives, public and the mass media

  • co-operation


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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


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Training


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Training

www.acls.kmu.lt


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Training


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Training

  • EmergoTrain – system, Lithuanian version


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Large scale exercises


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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


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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


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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.


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Estonian EMS - resources available

  • There are 87 EMS teams in 46 geographic locations


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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


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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


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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


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AmbulanceServicesin Latvia

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


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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


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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


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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


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Acknowledgements

  • Mārtiņš Zuteris

  • Raul Adlas

  • Ursel Kedars

  • Ago Kõrgvee


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Thank you!


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