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Biddinger, Paul

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Biddinger, Paul
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    Substance use patterns and in-hospital care of adolescents and young adults attending music concerts
    (BioMed Central, 2018) Ruest, Stephanie M.; Stephan, Alexander M.; Masiakos, Peter; Biddinger, Paul; Camargo, Carlos; Kharasch, Sigmund
    Background: Few studies describe medical complaints and substance use patterns related to attending music concerts. As such, the objective of this study is to describe patient demographics, substance use and intoxication patterns, and medical interventions provided to adolescents and young adults assessed in an emergency department (ED) for complaints directly related to concert attendance. Methods: A retrospective chart review of patients 13–30 years old who were transported to the ED directly from music concerts between January 2011 and December 2015 was conducted. Descriptive statistics and logistic regression were used to analyze patient demographic, intervention, and substance use data. Results: There were 115 concerts identified, of which 48 (42%) were linked to 142 relevant ED visits; the total number of attendees at each concert is unknown. The mean age of the 142 described patients was 19.5 years (SD 3.3) with 72% < 21 and 33% < 18; 71% of patients were female and 96% of visits were substance-use related. Mean blood alcohol level was 242 mg/dL (range 104–412, SD 70). Glasgow Coma Scale (GCS) scores ranged from 3 to 15, with a mean of 14. Two patients required intubation and 61% of patients received interventions, including medications (47%), intravenous fluids (46%), specialty consultation (20%), restraints (14%), imaging (6%), and laceration repair (3%). Attendance at pop and electronic dance music concerts was associated with the widest ranges of GCS scores (8–15 and 6–14 respectively), mass casualty incident declarations, and among the highest mean blood alcohol levels (246 and 244 mg/dL, respectively). Conclusions: Substance use is the predominant reason for music concert related ED visits and patients may have serious levels of intoxication, receiving multiple medical interventions. These data demonstrate the need for additional large-scale studies to confirm trends and increase awareness of this important public health problem.
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    A Conceptual Framework to Measure Systems’ Performance during Emergency Preparedness Exercises
    (MDPI, 2014) Savoia, Elena; Agboola, Foluso; Biddinger, Paul
    Large-scale public health emergencies require a sophisticated, coordinated response involving multiple entities to protect health and minimize suffering. However, the rarity of such emergencies presents a barrier to gathering observational data about the effectiveness of the public health response before such events occur. For this reason, public health practitioners increasingly have relied on simulated emergencies, known as “exercises” as proxies to test their emergency capabilities. However, the formal evaluation of performance in these exercises, historically has been inconsistent, and there is little research to describe how data acquired from simulated emergencies actually support conclusions about the quality of the public health emergency response system. Over the past six years, we have designed and evaluated more than seventy public health emergency exercises, collaborating with public health agencies, hospitals and others to test a wide variety of systems and their capabilities. Using the data and experience that we gathered, we have developed a conceptual framework that describes the essential elements necessary to consider when applying performance measurement science to public health emergency exercises. We suggest that this framework may assist practitioners and researchers who wish to better measure performance in exercises and to improve public health emergency preparedness.
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    Use of After Action Reports (AARs) to Promote Organizational and Systems Learning in Emergency Preparedness
    (MDPI, 2012) Savoia, Elena; Agboola, Foluso; Biddinger, Paul
    Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The “lessons-learned” approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the “Lessons Learned Information Sharing (LLIS.gov)” system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strived to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed.
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    Risk-communication Capability for Public Health Emergencies Varies by Community Diversity
    (BioMed Central, 2008) Savoia, Elena; Stoto, Michael; Biddinger, Paul; Campbell Jr, Paul; Viswanath, Kasisomayajula; Koh, Howard
    Background: Public health emergencies heighten several challenges in risk-communication: providing trustworthy sources of information, reaching marginalized populations, and minimizing fear and public confusion. In emergencies, however, information may not diffuse equally among all social groups, and gaps in knowledge may increase. Such knowledge gaps vary by social structure and the size, socioeconomic status, and diversity of the population. This study explores the relationship between risk-communication capabilities, as perceived by public officials participating in emergency tabletop exercises, and community size and diversity. Findings: For each of the three communication functions tested, risk-communication capabilities are perceived to be greater in communities with fewer then 10% of the population speaking a language other than English at home, decreasing as the percentage grows to 20% (ANOVA P ≤ 0.02). With respect to community size, however, we found an N-shaped relationship between perceived risk communication capabilities and population size. Capabilities are perceived highest in the largest communities and lowest in the smallest, but lower in communities with 20,000–49,999 inhabitants compared to those with 2,500–19,999. Conclusion: The results of this study suggest the need to factor population diversity into risk communication plans and the need for improved state or regional risk-communication capabilities, especially for communities with limited local capacity.