Attila Hertelendy

• Doctor of Philosophy
• Professor (Assistant) at Florida International University

This Perspective examines critical components of health care system response during wildfire emergencies.

Importance Rapid digitalization of health care and a dearth of digital health education for medical students and junior physicians worldwide means there is an imperative for more training in this dynamic and evolving field. Objective To develop an evidence-informed, consensus-guided, adaptable digital health competencies framework for the design a...

Objectives: While ambulance transport decisions guided by artificial intelligence (AI) could be useful, little is known of the accuracy of AI in making patient diagnoses based on the pre-hospital patient care report (PCR). The primary objective of this study was to assess the accuracy of ChatGPT (OpenAI, Inc., San Francisco, CA, USA) to predict a...

This supplemental material has been provided by the authors to give readers additional information about their work.

Objectives This study aimed to understand the current landscape of USA-based disaster medicine (DM) programs through the lens of alumni and program directors (PDs). The data obtained from this study will provide valuable information to future learners as they ponder careers in disaster medicine and allow PDs to refine curricular offerings. Methods...

Objectives This study analyzes disparities in initial health care responses in Turkey and Syria following the 2023 earthquakes. Methods Using Humanitarian Data Exchange, Crude Mortality Rates (CMR) and injury rates in both countries were calculated, and temporal trends of death tolls and injuries in the first month post- catastrophe were compared....

This Viewpoint highlights 10 categories of recommendations for preparing for current and future hurricane seasons.

Objective This study analyzes disparities in initial healthcare responses in Turkey and Syria following 2023 earthquakes. Methods Using Humanitarian Data Exchange, Crude Mortality Rates (CMR) and injury rates in both countries were calculated, and temporal trends of death tolls and injuries in the first month post- catastrophe were compared. WHO F...

Objective The release of ChatGPT in November 2022 drastically lowered the barrier to artificial intelligence with an intuitive web-based interface to a large language model. This study addressed the research problem: “Can ChatGPT adequately triage simulated disaster patients using the Simple Triage and Rapid Treatment (START) tool?” Methods Five t...

Background The release of ChatGPT (OpenAI) in November 2022 drastically reduced the barrier to using artificial intelligence by allowing a simple web-based text interface to a large language model (LLM). One use case where ChatGPT could be useful is in triaging patients at the site of a disaster using the Simple Triage and Rapid Treatment (START) p...

This study aims to identify different frontline emergency response workforce's perceived knowledge of hazards and their willingness and motivations to go to work during them. An online version of the "Fight or Flight" survey was distributed and collected from Norwegian emergency personnel during the spring of 2023. Findings reveal a gap between the...

Increased frequency, intensity, and duration of wildfires are intensifying exposure to direct and smoke-related hazards in many areas, leading to evacuation and smoke-related effects on health and health systems that can affect regions extending over thousands of kilometres. Effective preparation and response are currently hampered by inadequate tr...

Contemporary telecare systems facilitate the ability for older adults to age in place, keeping them out of residential care facilities and providing numerous quality-of-life advantages for both care receivers (CRs) and caregivers (CGs). However, despite the acceptance of digital health interventions among older adults and their CGs, telecare adopti...

Background: Disasters are becoming more frequent due to the impact of extreme weather events attributed to climate change, causing loss of lives, property, and psychological trauma. Mental health response to disasters emphasizes prevention and mitigation, and mobile health (mHealth) apps have been used for mental health promotion and treatment. How...

The Intergovernmental Panel on Climate (IPCC) Sixth Assessment report concluded that we will see an increase in frequency of extreme environmental events around the world including, hurricanes, droughts, and wildfires.1 The report further describes cascading hazards when one hazard triggers another in a series such as extreme heat triggering a coll...

In the evolving landscape of crisis leadership and emergency management, artificial intelligence (AI) emerges as a potentially transformative force with far-reaching implications. Utilizing the POP-DOC Loop, a comprehensive framework for crisis leadership analysis and decision-making, this paper delves into the diverse roles that AI is poised to pl...

Objective: Recent increases in per capita income and longevity in Central and Eastern European counties (CEECs), alongside a slow-changing soviet-era public healthcare system, has led to the emergence of private hospitals. This paper investigates the differential patient service quality perceptions for private versus public hospitals, as well as fo...

Background In recent years, the fast-paced adoption of digital health (DH) technologies has transformed health care delivery. However, this rapid evolution has also led to challenges such as uncoordinated development and information silos, impeding effective health care integration. Recognizing these challenges, nations have developed digital healt...

Introduction The mass gathering event (MGE) industry is growing globally, including in countries such as Canada. MGEs have been associated with a greater prevalence of injury and illness when compared to daily life events, despite most participants having few comorbidities. As such, adequate health, safety, and emergency medical planning is require...

Objectives The aim of this work was to determine the impact of Moral Distress (MD) in emergency physicians, nurses, and emergency medical service staff at the Rand Memorial Hospital (RMH) in the Bahamas, and the impact of Hurricane Dorian and the COVID-19 pandemic on Moral Distress. Method A cross-sectional study utilizing a 3-part survey, which c...

Objective: To assess pediatric disaster medicine (PDM) instruction in emergency medicine (EM) residency programs and to identify barriers to integrating these skills into EM training. Methods: National survey study of United States EM Residency Program Directors (PDs) and Assistant PDs during the 2021-2022 academic year. Results: Of the 186 EM...

The release of the ChatGPT prototype to the public in November 2022 drastically reduced the barrier to using artificial intelligence by allowing easy access to a large language model with only a simple web interface. One situation where ChatGPT could be useful is in triaging patients arriving to the emergency department. This study aimed to address...

BACKGROUND The release of ChatGPT (OpenAI) in November 2022 drastically reduced the barrier to using artificial intelligence by allowing a simple web-based text interface to a large language model (LLM). One use case where ChatGPT could be useful is in triaging patients at the site of a disaster using the Simple Triage and Rapid Treatment (START) p...

Objective: This study interprets data from NG situation reports (SITREPS) given to the National Guard Bureau (NGB) by each state national guard headquarters regarding their COVID-19 relief efforts from April to June 2020. This is the first published study about NG disaster relief utilizing quantitative data provided by the United States (US) milita...

One of the COVID-19 pandemic’s many strains on the United States (US) healthcare system has been its impact on the physician board certification process. Understanding this effect is critical to maintaining access to qualified medical care and upholding the benchmark of board certification. The American Board of Medical Specialties (ABMS) has shown...

Introduction:Disease surveillance is an integral part of public health. These systems monitor disease trends and detect outbreaks, whereas they should be evaluated for efficacy. The United States Centres for Disease Control and Prevention publish Guidelines for Evaluating Surveillance Systems to encourage efficient and effective use of public healt...

Background The leaders of health care organizations are grappling with rising expenses and surging demands for health services. In response, they are increasingly embracing artificial intelligence (AI) technologies to improve patient care delivery, alleviate operational burdens, and efficiently improve health care safety and quality. Objective In...

BACKGROUND The leaders of health care organizations are grappling with rising expenses and surging demands for health services. In response, they are increasingly embracing artificial intelligence (AI) technologies to improve patient care delivery, alleviate operational burdens, and efficiently improve health care safety and quality. OBJECTIVE In...

The European Union has implemented various strategies and policies to mitigate the effects of the coronavirus-19 pandemic and promote recovery. This article reviews the European Union's response and management decisions, examines the public health measures implemented to contain the virus, and explores the Union's economic recovery and support init...

Introduction Since 1902, disasters in the Northern Triangle of Central America, which consists of the countries Guatemala, Honduras, and El Salvador, have caused over one-hundred-thousand deaths, affected millions of people, and caused tens of billions of dollars in damages. Understanding the nature and frequency of these events will allow stakehol...

For the first time in history, the United States surpassed 100,000 overdose-related deaths in a 12-month period, driven by synthetic opioids such as fentanyl. Also for the first time, potential chemical weapons are readily available on the streets and the dark web. Opioids represent a rare trifecta, used for licit pain management, as an illicit dru...

BACKGROUND In recent years, the fast-paced adoption of digital health (DH) technologies has transformed health care delivery. However, this rapid evolution has also led to challenges such as uncoordinated development and information silos, impeding effective health care integration. Recognizing these challenges, nations have developed digital healt...

Introduction: Health care provision depends on reliable critical infrastructure (CI) to power equipment and to provide water for medication and sanitation. Attacks on CI limiting such functions can have a profound and prolonged influence on delivery of care. Methods: A retrospective analysis of the Global Terrorism Database (GTD) was performed o...

Objectives: To improve health and safety outcomes at mass gathering events (MGEs) for young attendees, it is essential to understand the psychosocial factors that may influence behaviour so that the implementation of support strategies before, during and after MGEs can be developed to enhance outcomes. This review identifies the psychosocial outco...

Introduction: This study aims to analyze and describe terrorism-related attacks in East Asia from 1970 to 2020. This descriptive analysis of terrorist attacks in East Asia will help first responders, emergency medical services (EMS), hospital-based medical providers, and policymakers establish a more refined hazard vulnerability assessment framewor...

Introduction: Children differ from adults, developmentally, physiologically, and psychologically. Additionally, children lack legal agency, and thus rely on adults to gain access to the healthcare system and other resources. Though children are often the face of disaster relief, the desparate needs of children can fall through the cracks during dis...

Introduction: Children are often disproportionately impacted by disasters, and yet pediatric specific considerations are not properly emphasized during disaster planning and training, resulting in the desperate needs of children falling through the cracks during disasters. Children differ from adults developmentally, physiologically, and psychologi...

Introduction: Compared to trauma-based injuries, chemical injuries can inflict widespread and persistent injuries to exposed victims. Emergency medical services (EMS) personnel are vulnerable to chemical injuries. Specialized training is required, including zone setup, personal protective equipment (PPE), decontamination, and antidote use, beyond s...

Introduction: International humanitarian aid is crucial in disasters but must be needs-driven and coordinated with requests from local authorities. We identify disaster and population factors associated with international aid appeal during disasters and hence guide preparation by international humanitarian aid providers. Method: In this retrospect...

Introduction: Chemical exposures can cause direct and indirect injuries to responding medical personnel. Therefore, hospital healthcare providers should be provided with disaster response training that includes identification of chemical hazards, establishment of the hazard zone, personal protective equipment use, decontamination, and chemical inju...

Introduction: Since 1900, disasters in the Northern Triangle of Central America—Guatemala, Honduras, and El Salvador—have caused over one-hundred-thousand deaths, affected millions of people, and caused billions of dollars of damages. As climate change causes increasingly frequent severe weather events, the catastrophic effects of disasters are lik...

Introduction: The COVID-19 pandemic created a public health crisis worldwide. Mass vaccination efforts in some cases were initiated without adequate civilian manpower due to critical medical staffing shortages. The governments of many nations deployed their military assets to fill gaps in care and to initiate projects to promote vaccinations. The C...

Introduction: The complexity of disaster management is rising because of rapidly advancing technological changes and the challenges associated with coordinating responses among multi-organizational contexts. One of the common problems with multi-organizational disaster management is the need for an interoperability language. Therefore, by maintaini...

Introduction: Multiple triage algorithms have been proposed to optimize the allocation of medical resources in mass casualty incidents. Despite attempts at standardization, first responders often assign patients to triage categories that deviate from those prescribed by these algorithms. This study seeks to understand what patient level factors cau...

Introduction: Industrial disasters can have a myriad of repercussions ranging from acute deaths, injuries, and long-term adverse health impacts on nearby populations to political fallout and environmental damage. This is a descriptive epidemiological analysis of industrial disasters occurring between 1995 and 2021 which may provide useful insight f...

Introduction: Global disasters have increased over the last century, with growing numbers of people affected. In the Middle East and North Africa, natural disasters have tripled since the 1980s. Education and training for disaster preparedness for healthcare providers can help reduce vulnerability to disasters by improving their knowledge and respo...

Introduction: Cumulative disasters have been shown to influence mental and physical health in both responders and victims, with studies showing associations in rates of depression and Post Traumatic Stress Disorder. Systemic problems that impact patient care such as limited resources, overcrowding of emergency rooms, and staffing shortages can be m...

Introduction: The COVID-19 pandemic provided a unique opportunity for the United States National Guard (NG) to assist in an infectious disease disaster. This study aims to interpret data from NG situation reports (SITREPS) given to the National Guard Bureau (NGB) by each state national guard headquarters regarding their relief efforts from April to...

Introduction: Advances in technology can drastically improve the ability of providers to care for survivors of a disaster. Research into new applications of technology in the Disaster Medicine space, and dissemination of new technological achievements are vital to saving lives. This presentation discusses several recently proven technologies in the...

Introduction: Mass gatherings have become more frequent since the beginning of the 21st century. In Canada alone, music festival and sporting event industries will each represent yearly revenues over one billion USD by 2025. Such events require adequate medical planning, as they are associated with a greater prevalence of injuries and incidents tha...

Introduction: Healthcare provision depends on reliable infrastructure to power equipment, and provide water for medication and sanitation. Attacks on infrastructure limiting such functions can have a profound and prolonged influence on the delivery of care. Method: A retrospective analysis of the Global Terrorism Database (GTD) was performed of al...

Introduction: The COVID-19 pandemic created a public health crisis worldwide. Healthcare workers also became ill at a time when hospitals were overwhelmed with patients, leaving critical staffing shortages. Mass vaccination efforts were initiated in some cases without adequate civilian manpower. The governments of many nations utilized their milita...

Introduction: Sub-Saharan Africa (SSA) has become a hotspot for global terrorism, with nearly 50% of global terror-related deaths occurring in SSA in 2021. To address growing terrorism-related health implications the field of counter-terrorism medicine (CTM) seeks to study the impacts of terrorism and implement healthcare initiatives. This study is...

BACKGROUND Disasters are becoming more frequent due to the impact of extreme weather events attributed to climate change, causing loss of lives, property and psychological trauma. Mental health response to disasters emphasizes prevention and mitigation, and mobile health (mHealth) applications have been used for mental health promotion and treatmen...

Taking care of Very Important Persons (VIPs) has always been a contentious area of medicine. Access to private healthcare in privileged classes is often linked to socioeconomic status, and the concept role of executive health medicine has emerged. The provision of care for VIP patients requires innovative approaches to assure that their status does...

Introduction International humanitarian aid during disasters should be needs-based and coordinated in response to appeals from affected governments. We identify disaster and population factors associated with international aid appeal during disasters and hence guide preparation by international humanitarian aid providers. Methods In this retrospec...

Background: The COVID-19 pandemic was an international systemic crisis which required an unprecedented response to quickly drive the digital transformation of hospitals and health care systems to support high quality health care while adhering to contagion management protocols. Objective: To identify and assess the best practices during the COVI...

Introduction Industrial disasters can have a myriad of repercussions ranging from deaths, injuries, and long-term adverse health impacts on nearby populations, to political fallout and environmental damage. This is a descriptive epidemiological analysis of industrial disasters occurring between 1995 and 2021 which may provide useful insight for hea...

On December 29, 2019, four workers from the Huanan Seafood Wholesale Market, in Wuhan, China were admitted to hospital with pneumonia. By January 7, 2020, the National Institute of Communicable Disease Control and Prevention (Chinese Center for Disease Control and Prevention) had announced that they had isolated a novel coronavirus (CoV) from patie...

The meaning of time, especially in crisis, where situations are likely to become even more complex, uncertain, and disruptive, is crucial. Incorporating previous research on organizational crises, organizational resilience, extreme context, and individual resilience, we know that leaders do play a crucial role when it comes to handle adversity in o...

Aim: This study aims to analyze and describe terrorism-related attacks in East Asia from 1970 through 2020. Background: East Asia consists of South Korea, North Korea, Singapore, Hong Kong, China, Japan, Taiwan, and Macao. According to the Global Terrorism Index (GTI) 2022, the impact of terrorism in East Asia is very low. However, the assassina...

Background: Sub-Saharan Africa (SSA) has become a hotspot for global terrorism, with nearly 50% of global terror-related deaths occurring in SSA in 2021. With a large population and complex geopolitical and social climate, terrorist activity further burdens an already strained medical system. This study provides a retrospective descriptive analysi...

The Federal Emergency Management Agency (FEMA) divides the United States (US) into ten standard regions to promote local partnerships and priorities. These divisions, while longstanding, do not adequately address known hazard risk as reflected in past federal disaster declarations. From FEMA’s inception in 1979 until 2020, the OpenFEMA dataset repo...

Introduction The United States (US) spends a staggering amount on costs secondary to natural disasters, over $2 trillion between 1980 and 2021, during which time 15,347 disaster related deaths also occurred[1]. We assess the relationship between CO2, temperature, and the number and economic costs of billion-dollar disaster events in the US during t...

Background/Introduction Moral distress is a well-described phenomenon in medical providers. It has been linked to mental health deterioration, decreased job satisfaction, and early retirement. No study has been done on the level of moral distress associated with treating patients in simultaneous disasters. Objectives 1. To learn what is known abou...

Background/Introduction One of the most severe outcomes of the Ukraine war has been the systematic destruction of communities resulting in mass migration of people to Poland. Millions of affected people have arrived in Poland as war refugees requiring medical attention from a fragile health care system overburdened by the COVID-19 pandemic. This st...

Introduction Despite the increasing risks and complexity of disasters, education for Malaysian health care providers in this domain is limited. This study aims to assess scholarly publications by Malaysian scholars on Disaster Medicine (DM)-related topics. Methodology An electronic search of five selected journals from 1991 through 2021 utilizing...

Background/Introduction Emergency Medical Services (EMS) is a critical part of Disaster Medicine (DM) and can limit morbidity and mortality with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training available to EMS physicians. The Armenian EMS sys...

Introduction Emergency Medical Services (EMS) is a critical part of Disaster Medicine and has the ability to limit morbidity and mortality in a disaster event with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training in the country. As a result, E...

In the event of a mass-casualty incident (MCI), hospital emergency departments (EDs) may be called upon to provide care to a large number of critically ill patients. As EDs plan for MCIs, determining how to best allocate staff members can play a significant role in the success or failure of a response. In academic EDs, a group that is often overloo...

Goal: Moral distress literature is firmly rooted in the nursing and clinician experience, with a paucity of literature that considers the extent to which moral distress affects clinical and administrative healthcare leaders. Moreover, the little evidence that has been collected on this phenomenon has not been systematically mapped to identify key...

Organizational sensemaking is crucial for resource planning and crisis management since facing complex strategic problems that exceed their capacity and ability, such as crises, forces organizations to engage in inter-organizational collaboration, which leads to obtaining individual and diverse perspectives to comprehend the issues and find solutio...

Extreme heat and wildfires have health implications for everyone; however, minority and low-income populations are disproportionately negatively affected due to generations of social inequities and discriminatory practices. Indigenous people in Canada are at a higher risk of many chronic respiratory diseases, as well as other non-communicable disea...

Introduction Global climate change (global warming) has been identified as the primary factor responsible for the observed increase in frequency and severity of wildfires (also known as bushfires in some countries) throughout the majority of the world’s vegetated environments. This trend is predicted to continue, causing significant adverse health...

Objectives: To evaluate the exposure to crisis leadership theory already present in Council on Education for Public Health (CEPH) accredited Master of Public Health (MPH) programs in the United States and provide a compelling case for its future inclusion. Study design: This was a narrative review. Methods: We compiled a comprehensive list of...

Summary statement: Disaster medicine (DM) training aims to recreate stressful, mass casualty scenarios faced by medical professionals in the field with high fidelity. Virtual (VR) and augmented reality (AR) are well suited to disaster training as it can provide a safe, socially distant simulation with a high degree of realism. The purpose of this...

This article highlights challenges brought forth by climate change and provides practical lessons for how healthcare system leaders can better prepare their organisations to manage more intense, frequent and costly climate emergencies. This includes consideration for how health systems must adapt to more sustainable care models, which include reduc...

Introduction: Daily emergency department surges can cause crowding in facilities that do not have adequate physical and personnel resources to meet peak demands. The mismatch between surge and surge capacity results in ED crowding, thus indicating compromised daily ED capacity. This study aimed to analyze the daily ED visits and the relevance of th...

Introduction The absence of local Emergency Medical Services (EMS) educational programs in Bahrain has given rise to an EMS workforce comprised predominantly of expatriate personnel with varying educational backgrounds that require further training before being licensed as EMS providers in Bahrain. Methods A qualitative variance analysis was perfo...

BACKGROUND The COVID-19 pandemic required an unprecedented response by hospital information technology (IT) functions to provide information technology solutions to quickly drive the digital transformation of hospitals and health care systems to support high quality health care while adhering to and supporting contagion management protocols. OBJEC...

Civilian-military collaboration in humanitarian crises has been encouraged globally; however, little is known about their diverse ethical viewpoints towards challenging and critical situations , which may cause difficulties in the partnership, and influence the outcomes of their mutual activities. The aim of this study was to identify the diversity...