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Sample records for accident and emergency medicine

  1. Administration of medicines by emergency nurse practitioners according to protocols in an accident and emergency department.

    Marshall, J.; Edwards, C.; Lambert, M.

    1997-01-01

    OBJECTIVE: To present the legal and professional issues related to nurse administration of drugs according to protocols, and describe the implementation and initial audit findings of such a scheme. SETTING: Accident and emergency (A&E) department of a district general hospital. METHODS: Analysis of legal and professional opinion. Protocols acceptable to the medical, nursing, and pharmacy professions were developed across a wide range of drugs appropriate for administration by accident and eme...

  2. Accident and emergency management

    There is an increasing potential for severe accidents as the industrial development tends towards large, centralised production units. In several industries this has led to the formation of large organisations which are prepared for accidents fighting and for emergency management. The functioning of these organisations critically depends upon efficient decision making and exchange of information. This project is aimed at securing and possibly improving the functionality and efficiency of the accident and emergency management by verifying, demonstrating, and validating the possible use of advanced information technology in the organisations mentioned above. With the nuclear industry in focus the project consists of five main activities: 1) The study and detailed analysis of accident and emergency scenarios based on records from incidents and rills in nuclear installations. 2) Development of a conceptual understanding of accident and emergency management with emphasis on distributed decision making, information flow, and control structure sthat are involved. 3) Development of a general experimental methodology for evaluating the effects of different kinds of decision aids and forms of organisation for emergency management systems with distributed decision making. 4) Development and test of a prototype system for a limited part of an accident and emergency organisation to demonstrate the potential use of computer and communication systems, data-base and knowledge base technology, and applications of expert systems and methods used in artificial intelligence. 5) Production of guidelines for the introduction of advanced information technology in the organisations based on evaluation and validation of the prototype system. (author)

  3. Emergency planning and preparedness for accidents involving radioactive materials used in medicine, industry, research and teaching

    This Safety Series book should be considered as a technical guide aimed at the users of radioactive materials and the appropriate local and national authorities. It does not represent a single solution to the problems involved but rather draws the outlines of the plans and procedures that have to be developed in order to mitigate the consequences of an accident, should one occur. The preparation of local and national plans should follow the technical recommendations provided in this publication, with due consideration given to local factors which might vary from country to country (e.g. governmental systems, local legislation, quantities of radioactive materials involved). Several types of accidents are described, together with their possible radiological consequences. The basic principles of the protective measures that should be applied are discussed, and the principles of emergency planning and the measures needed to maintain preparedness for an operational response to an accident are outlined

  4. Accident knowledge and emergency management

    The report contains an overall frame for transformation of knowledge and experience from risk analysis to emergency education. An accident model has been developed to describe the emergency situation. A key concept of this model is uncontrolled flow of energy (UFOE), essential elements are the state, location and movement of the energy (and mass). A UFOE can be considered as the driving force of an accident, e.g., an explosion, a fire, a release of heavy gases. As long as the energy is confined, i.e. the location and movement of the energy are under control, the situation is safe, but loss of confinement will create a hazardous situation that may develop into an accident. A domain model has been developed for representing accident and emergency scenarios occurring in society. The domain model uses three main categories: status, context and objectives. A domain is a group of activities with allied goals and elements and ten specific domains have been investigated: process plant, storage, nuclear power plant, energy distribution, marine transport of goods, marine transport of people, aviation, transport by road, transport by rail and natural disasters. Totally 25 accident cases were consulted and information was extracted for filling into the schematic representations with two to four cases pr. specific domain. (au) 41 tabs., 8 ills.; 79 refs

  5. Accident knowledge and emergency management

    Rasmussen, B.; Groenberg, C.D.

    1997-03-01

    The report contains an overall frame for transformation of knowledge and experience from risk analysis to emergency education. An accident model has been developed to describe the emergency situation. A key concept of this model is uncontrolled flow of energy (UFOE), essential elements are the state, location and movement of the energy (and mass). A UFOE can be considered as the driving force of an accident, e.g., an explosion, a fire, a release of heavy gases. As long as the energy is confined, i.e. the location and movement of the energy are under control, the situation is safe, but loss of confinement will create a hazardous situation that may develop into an accident. A domain model has been developed for representing accident and emergency scenarios occurring in society. The domain model uses three main categories: status, context and objectives. A domain is a group of activities with allied goals and elements and ten specific domains have been investigated: process plant, storage, nuclear power plant, energy distribution, marine transport of goods, marine transport of people, aviation, transport by road, transport by rail and natural disasters. Totally 25 accident cases were consulted and information was extracted for filling into the schematic representations with two to four cases pr. specific domain. (au) 41 tabs., 8 ills.; 79 refs.

  6. Socioeconomic deprivation and accident and emergency attendances

    Scantlebury, Rachel; Rowlands, Gillian; Durbaba, Stevo;

    2015-01-01

    BACKGROUND: Demand for England's accident and emergency (A&E) services is increasing and is particularly concentrated in areas of high deprivation. The extent to which primary care services, relative to population characteristics, can impact on A&E is not fully understood. AIM: To conduct...

  7. Medical Journalism and Emergency Medicine

    Saeed Safari

    2015-07-01

    Full Text Available Nowadays, many researches in the field of medicine are conducting all around the world and medical journalism is a way to share the results. In fact, dissemination of the related manuscripts can prevent the repetitive research or may even lead to conducting a better survey. Therefore high quality medical journals are considered as up-to-date resources for further investigations. Medical journals are propagating their papers in various media including television programs, newspapers, internet websites and different social media. So they can influence the government policy makers, health-care professionals and even public. Moreover, most researchers hear about medical discoveries for the first time through medical journals and their related social media. So as well a high quality journal can help to improve medical science, a journal of poor quality can be damaging and distorting. Indeed, popular journals have the power of inventing a “communication storm” to draw attention to a certain topic. Thus they have to respect the accepted international principles to prevent spreading inaccurate and misleading data. This paper aims to review the previous and current situation of medical journalism by focus on field of emergency medicine.

  8. Bioethics and Emergency Medicine: problems and perspectives

    Maurizio Mori

    2005-10-01

    Full Text Available Before examining the specific problems of emergency medicine, the article identifies the cardinal points for orientation in bioethics, in the conviction that the knowledge of the basic aspects of the subject allow the reader to make more conscious and suitable choices. The questions of moral relativism and the consequences of the biomedical revolution are addressed in detail in order to support the argument for a new ethical base for healthcare in general and for emergency medicine.

  9. The nuclear accident emergency and preparation activities of Zhejiang Province emergency committee for nuclear power station accident

    The offsite accident emergency preparation for coordinating operation of Qinshan Nuclear Power Station by Zhijiang province people government since 1989 has carried out. The emergency and preparation consist of the following activities: 1. Setting up the organization; 2. Drawing the offsite emergency plan and establishing the emergency system; 3. Enforcing the nuclear accident offsite emergency exercise before operation of the nuclear power station; 4. Holding the nuclear accident emergency staff training course and conducting safety education for the public around the nuclear power station

  10. Medical Journalism and Emergency Medicine

    Saeed Safari; Alireza Baratloo; Mahmoud Yousefifard

    2015-01-01

    Nowadays, many researches in the field of medicine are conducting all around the world and medical journalism is a way to share the results. In fact, dissemination of the related manuscripts can prevent the repetitive research or may even lead to conducting a better survey. Therefore high quality medical journals are considered as up-to-date resources for further investigations. Medical journals are propagating their papers in various media including television programs, newspapers, internet ...

  11. Emergency medicine terminology in the United Kingdom—time to follow the trend?

    C. Reid; Chan, L

    2001-01-01

    Objective—To determine the frequency of use of the terms "accident and emergency" and "emergency medicine" and their derivatives in original articles in the Journal of Accident and Emergency Medicine.

  12. Radiological accidents balance in medicine

    This work deals with the radiological accidents in medicine. In medicine, the radiation accidents on medical personnel and patients can be the result of over dosage and bad focusing of radiotherapy sealed sources. Sometimes, the accidents, if they are unknown during a time enough for the source to be spread and to expose a lot of persons (in the case of source dismantling for instance) can take considerable dimensions. Others accidents can come from bad handling of linear accelerators and from radionuclide kinetics in some therapies. Some examples of accidents are given. (O.L.). 11 refs

  13. Pain in young children attending an accident and emergency department

    McCarthy, C.; Hewitt, S; Choonara, I.

    2000-01-01

    Objectives—To assess pain in young children presenting to an accident and emergency (A&E) department. To evaluate the use of the toddler-preschooler postoperative pain scale (TPPPS) and the use of analgesia in these children.

  14. Unusual presentation of tuberculosis to the accident and emergency department.

    Jones, K E; McLauchlan, C A

    1995-01-01

    A patient with localized, reactive tendinitis secondary to tuberculosis presented to the accident and emergency (A&E) department. Tendinitis is a relatively common complaint, and it is important to consider uncommon systemic causes, including tuberculosis.

  15. Diphtheria presenting in the accident and emergency department.

    Walters, R F

    1987-01-01

    A case of diphtheria encountered in the accident and emergency department is described. In addition, 38 cases of diphtheria have been analysed, and demonstrate that, although now rare in this country, the disease still exists and its clinical features remain unchanged. It presents almost as often in the accident and emergency department as it does to the general practitioner and remains overwhelmingly a disease of children. Diphtheria is still a notifiable disease. The diagnosis must be made ...

  16. Emergency thoracotomy for thoracic trauma in the accident and emergency department: indications and outcome

    Jahangiri, Marjan; Youhana, Aprim; Hyde, Jonathan; Lewis, Terence; Griffin, Steven; Wood, Alan; Magee, Patrick

    1996-01-01

    To assess the efficacy of emergency thoracotomy performed for thoracic trauma in the accident and emergency department, a retrospective analysis of patients who underwent this procedure and were brought to hospital by the Helicopter Emergency Medical Service was carried out. Between 1991 and 1994, 16 patients had emergency thoracotomy performed in the accident department. Twelve patients had sustained blunt trauma and four patients had sustained penetrating injuries. Three patients first asse...

  17. Accident and emergency nursing – clinical audit

    Kitching, Holly

    2010-01-01

    Abstract The aim of this audit is to measure current practice in minor head injury management in an emergency department against the recommendations stated in the National Institute for Clinical Excellence (NICE) (2007) guidelines for Head injury: Triage, assessment, investigation and early management of head injury in infants, children and adults. Objectives Is to determine the impact on workload in the emergency department in-relation to the implementation of the NICE head injur...

  18. Reconstruction of the Chernobyl emergency and accident management

    Full text of publication follows: on April 26, 1986 the most serious civil technological accident in the history of mankind occurred of the Chernobyl Nuclear Power Plant (ChNPP) in the former Soviet Union. As a direct result of the accident, the reactor was severely destroyed and large quantities of radionuclides were released. Some 800000 persons, also called 'liquidators' - including plant operators, fire-fighters, scientists, technicians, construction workers, emergency managers, volunteers, as well as medical and military personnel - were part of emergency measurements and accident management efforts. Activities included measures to prevent the escalation of the accident, mitigation actions, help for victims as well as activities in order to provide a basic infrastructure for this unprecedented and overwhelming task. The overall goal of the 'Project Chernobyl' of the Institute of Risk Research of the University of Vienna was to preserve for mankind the experience and knowledge of the experts among the 'liquidators' before it is lost forever. One method used to reconstruct the emergency measures of Chernobyl was the direct cooperation with liquidators. Simple questionnaires were distributed among liquidators and a database of leading accident managers, engineers, medical experts etc. was established. During an initial struggle with a number of difficulties, the response was sparse. However, after an official permit had been issued, the questionnaires delivered a wealth of data. Furthermore a documentary archive was established, which provided additional information. The multidimensional problem in connection with the severe accident of Chernobyl, the clarification of the causes of the accident, as well as failures and successes and lessons to be learned from the Chernobyl emergency measures and accident management are discussed. (authors)

  19. Oral and maxillofacial surgery in accident and emergency departments.

    Wood, G D; Leeming, K A

    1995-01-01

    Patients with oral and facial injuries presenting as emergencies to the accident and emergency (A&E) unit at Arrowe Park Hospital have been used to compare the treatment method of direct referral to oral and maxillofacial surgery with that of the routine A&E procedure. A quicker and more effective treatment was administered by direct referral of patients to oral and maxillofacial surgery and an argument for such specialist staff to be based in A&E departments is advanced.

  20. Human factors and safety in emergency medicine

    Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

    1994-01-01

    A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.

  1. Medical isotopes and emerging nuclear medicine technologies

    This presentation discusses medical isotopes and the emerging nuclear medicine technologies as well as the impact of Chalk River reactor shutdown on patient management and diseases. It outlines the chain of supply of isotopes across the globe and isotope shortage impact. It recommends the following mitigating strategies: modifications of scanning techniques, adjustment of patient scheduling, optimization of Tc-99m generator use, patient prioritization, alternate procedures and PET scanning.

  2. Emergency planning and preparedness for a nuclear accident

    Based on current regulations, FEMA approves each site-specific plan of state and local governments for each power reactor site after 1) formal review offsite preparedness, 2) holding a public meeting at which the preparedness status has been reviewed, and 3) a satisfactory joint exercise has been conducted with both utility and local participation. Annually, each state, within any position of the 10-mile emergency planning zone, must conduct a joint exercise with the utility to demonstrate its preparedness for a nuclear accident. While it is unlikely that these extreme measures will be needed as a result of an accident at a nuclear power station, the fact that these plans have been well thought out and implemented have already proven their benefit to society. The preparedness for a nuclear accident can be of great advantage in other types of emergencies. For example, on December 11, 1982, a non-nuclear chemical storage tank exploded at a Union Carbide plant in Louisiana shortly after midnight. More than 20,000 people were evacuated from their homes. They were evacuated under the emergency response plan formulated for use in the event of a nuclear accident at the nearby Waterford Nuclear plants. Clearly, this illustrates how a plan conceived for one purpose is appropriate to handle other types of accidents that occur in a modern industrial society

  3. PWR auxiliary systems, safety and emergency systems, accident analysis, operation

    The author presents a description of PWR auxiliary systems like volume control, boric acid control, coolant purification, -degassing, -storage and -treatment system and waste processing systems. Residual heat removal systems, emergency systems and containment designs are discussed. As an accident analysis the author gives a survey over malfunctions and disturbances in the field of reactor operations. (TK)

  4. Measuring patients' experiences in the Accident and Emergency department

    Bos, N.

    2013-01-01

    Two questionnaires were used to measure patients’ experiences in the Accident and Emergency department (A&E). First, the English A&E department questionnaire used in the English National Survey Programme, and after translation in Dutch used in the Netherlands. The second questionnaire concerned the

  5. Hepatitis B vaccination in United Kingdom accident and emergency departments.

    Heyworth, J

    1988-01-01

    Hepatitis B vaccination is not widespread amongst staff in accident and emergency departments in the United Kingdom. The results of a survey of departments training senior registrars reveal that unfounded fears concerning the safety of the vaccine are responsible for the low uptake. The need for vaccination, cost, medicolegal aspects and future developments are discussed.

  6. An update on emergency care and emergency medicine in Russia.

    Rodigin, Anthony

    2015-12-01

    Russia's national healthcare system is undergoing significant changes. Those changes which affect healthcare financing are particularly vital. As has often been the case in other nations, the emergency care field is at the forefront of such reforms. The ongoing challenges constitute the environment in which the hospital-based specialty of emergency medicine needs to develop as part of a larger system. Emergency care has to evolve in order to match true needs of the population existing today. New federal regulations recently adopted have recognized emergency departments as the new in-hospital component of emergency care, providing the long-needed legal foundation upon which the new specialty can advance. General knowledge of Western-style emergency departments in terms of their basic setup and function has been widespread among Russia's medical professionals for some time. Several emergency departments are functioning in select regions as pilots. Preliminary data stemming from their operation have supported a positive effect on efficiency of hospital bed utilization and on appropriate use of specialists and specialized hospital departments. In the pre-hospital domain, there has been a reduction of specialized ambulance types and of the number of physicians staffing all ambulances in favor of midlevel providers. Still, a debate continues at all levels of the medical hierarchy regarding the correct future path for emergency care in Russia with regard to adaptation and sustainability of any foreign models in the context of the country's unique national features. PMID:26608599

  7. Process criticality accident likelihoods, magnitudes and emergency planning. A focus on solution accidents

    This paper presents analyses and applications of data from reactor and critical experiment research on the dynamics of nuclear excursions in solution media. Available criticality accident information is also discussed and shown to provide strong evidence of the overwhelming likelihood of accidents in liquid media over other forms and to support the measured data. These analyses are shown to provide valuable insights into key parameters important to understanding solution excursion dynamics in general and in evaluating practical upper bounds on criticality accident magnitudes. This understanding and these upper bounds are directly applicable to the evaluation of the consequences of postulated criticality accidents. These bounds are also essential in order to comply with national and international consensus standards and regulatory requirements for emergency planning. (author)

  8. ANS-8.23: Criticality accident emergency planning and response

    A study group has been formed under the auspices of ANS-8 to examine the need for a standard on nuclear criticality accident emergency planning and response. This standard would be ANS-8.23. ANSI/ANS-8.19-1984, Administrative Practices for Nuclear Criticality Safety, provides some guidance on the subject in Section 10 titled -- Planned Response to Nuclear Criticality Accidents. However, the study group has formed a consensus that Section 10 is inadequate in that technical guidance in addition to administrative guidance is needed. The group believes that a new standard which specifically addresses emergency planning and response to a perceived criticality accident is needed. Plans for underway to request the study group be designated a writing group to create a draft of such a new standard. The proposed standard will divide responsibility between management and technical staff. Generally, management will be charged with providing the necessary elements of emergency planning such as a criticality detection and alarm system, training, safe evacuation routes and assembly areas, a system for timely accountability of personnel, and an effective emergency response organization. The technical staff, on the other hand, will be made responsible for establishing specific items such as safe and clearly posted evacuation evacuation routes and dose criteria for personnel assembly areas. The key to the question of responsibilities is that management must provide the resources for the technical staff to establish the elements of an emergency response effort

  9. Human factors and safety in emergency medicine.

    Schaefer, H G; Helmreich, R L; Scheidegger, D

    1994-12-01

    A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale. PMID:7740192

  10. Recruitment and Retention of Patients into Emergency Medicine Clinical Trials

    Cofield, Stacey; Conwit, Robin; Barsan, William; Quinn, James

    2010-01-01

    The emergency medicine and pre-hospital environments are unlike any other clinical environments and require special consideration to allow the successful implementation of clinical trials. This article reviews the specific issues involved in Emergency Medicine Clinical Trials (EMCT), and provides strategies from emergency medicine and non-emergency medicine trials to maximize recruitment and retention. While the evidence supporting some of these strategies is deficient, addressing recruitment and retention issues with specific strategies will help researchers deal with these issues in their funding applications and in turn develop the necessary infrastructure to participate in emergency medicine clinical trials. PMID:21040112

  11. Experience and lessons learned from emergency disposal of Fukushima nuclear power station accident

    After Fukushima nuclear accident, we visited the related medical aid agencies for nuclear accidents and conducted investigations in disaster-affected areas in Japan. This article summarizes the problems with emergency disposal of Fukushima nuclear accident while disclosing problems should be solved during the emergency force construction for nuclear accidents. (authors)

  12. Use of an accident and emergency department by hospital staff.

    Mann, C J

    1996-01-01

    OBJECTIVE: To assess the number of attendances by hospital staff at an accident and emergency (A&E) department, and reasons for their attendance. METHODS: A&E attendances by hospital staff were studied for a 12 month period. Comparison was made with attendances by non-hospital staff in full or part time employment. Differences between the observed and expected numbers of attendances were analysed using chi 2 analysis. RESULTS: 560 staff attendances were recorded out of 78,103 total attendance...

  13. An update on emergency care and emergency medicine in Russia

    Rodigin, Anthony

    2015-01-01

    Russia’s national healthcare system is undergoing significant changes. Those changes which affect healthcare financing are particularly vital. As has often been the case in other nations, the emergency care field is at the forefront of such reforms. The ongoing challenges constitute the environment in which the hospital-based specialty of emergency medicine needs to develop as part of a larger system. Emergency care has to evolve in order to match true needs of the population existing today. ...

  14. Emerging infectious diseases and travel medicine.

    Ostroff, S M; Kozarsky, P

    1998-03-01

    International movement of individuals, populations, and products is one of the major factors associated with the emergence and reemergence of infectious diseases as the pace of global travel and commerce increases rapidly. Travel can be associated with disease emergence because (1) the disease arises in an area of heavy tourism, (2) tourists may be at heightened risk because of their activities, or (3) because they can act as vectors to transport the agent to new areas. Examples of recently recognized diseases with relationship to travel include HIV, Legionnaire's disease, cyclosporiasis, Vibrio cholerae O139 Bengal, hantavirus, and variant Creutzfeldt-Jacob disease. Reemerging diseases include dengue fever, malaria, cholera, schistosomiasis, leptospirosis, and viral hemorrhagic fevers. In addition, tuberculosis, drug-resistant shigellosis, and cholera have been major concerns in refugee and migrant populations. Because of the unique role of travel in emerging infections, efforts are underway to address this factor by agencies such as the CDC, WHO, the International Society of Travel Medicine, and the travel industry. PMID:9494841

  15. Accident Emergency Response And Routing Software (AERARS using Genetic Algorithm

    Naveen Ramachandran,

    2011-07-01

    Full Text Available AERARS is a response and routing software for accident emergency requirement. A method has been proposed in this project for using a genetic algorithm to find the shortest route between a source and adestination. It make use of genetic algorithms ability to search the opt solution from the population helping to solve spatially addressed problem. The numbers of accident spots are plotted in ArcGISenvironment and ten major accident spots are identified. The software package is designed with closest facility estimation and shortest route generation along with other basic software facilities in Visual Basic environment. Genetic algorithm provided a great optimality to the solutions. The closest facility tool helps to estimate the nearest hospital, ambulance, police station and fire station. The shortest route estimation tool generates shortest path between a locations to the hospital or ambulance spot. The various risk zonesare assessed and more safety measures can be taken to reduce the frequency of accident. The software efficiency can be further increased by incorporating GPS and satellite technology.

  16. Process criticality accident likelihoods, consequences, and emergency planning

    Evaluation of criticality accident risks in the processing of significant quantities of fissile materials is both complex and subjective, largely due to the lack of accident statistics. Thus, complying with standards such as ISO 7753 which mandates that the need for an alarm system be evaluated, is also subjective. A review of guidance found in the literature on potential accident magnitudes is presented for different material forms and arrangements. Reasoned arguments are also presented concerning accident prevention and accident likelihoods for these material forms and arrangements. 13 refs., 1 fig., 1 tab

  17. Accidents in nuclear power engineering. Emergency-engineering service and its purposes

    The review of severe accidents in the world practice of NPP operation is given. The problems met when eliminating the Chernobyl' NPP accident effects are discussed. The main purposes of the emergency-engineering service in nuclear power engineering are considered. These are: possible accident forecasting and preparation of the equipment for its effect elimination; prevention of accidents and abnormal situations at nuclear power objects; accident effect liquidation, NPP unit decommissioning. Some directions which development takes the priority, are formulated. 21 refs

  18. Nuclear accident/radiological emergency assistance plan. NAREAP - edition 2000. Emergency preparedness and response

    The purpose of the Nuclear Accident/Radiological Emergency Assistance Plan (NAREAP) is to describe the framework for systematic, integrated, co-ordinated, and effective preparedness and response for a nuclear accident or radiological emergency involving facilities or practices that may give rise to a threat to health, the environment or property. The purpose of the NAREAP is: to define the emergency response objectives of the Agency's staff in a nuclear accident or a radiological emergency; to assign responsibilities for performing the tasks and authorities for making the decisions that comprise the Agency staff's response to a nuclear accident or radiological emergency; to guide the Agency managers who must ensure that all necessary tasks are given the necessary support in discharging the Agency staff responsibilities and fulfilling its obligations in response to an emergency; to ensure that the development and maintenance of detailed and coherent response procedures are well founded; to act as a point of reference for individual Agency staff members on their responsibilities (as an individual or a team member) throughout a response; to identify interrelationships with other international intergovernmental Organizations; and to serve as a training aid to maintain readiness of personnel. The NAREAP refers to the arrangements of the International Atomic Energy Agency and of the United Nations Security and Safety Section at the Vienna International Centre (UNSSS-VIC) that may be necessary for the IAEA to respond to a nuclear accident or radiological emergency, as defined in the Early Notification and Assistance Conventions. It covers response arrangements for any situation that may have actual, potential or perceived radiological consequences and that could require a response from the IAEA, as well as the arrangements for developing, maintaining and exercising preparedness. The implementing procedures themselves are not included in the NAREAP, but they are required

  19. Transport accident emergency response plan

    To comply with the IAEA recommendations for the implementation of an Emergency Response Plan as described in Safety Series 87, Transnucleaire, a company deeply involved in the road and rail transports of the fuel cycle, masters means of Emergency Response in the event of a transport accident. This paper aims at analyzing the solutions adopted for the implementation of an Emergency Response Plan and the development of a technical support and adapted means for the recovery of heavy packagings. (authors)

  20. Patterns of presentation of abused children to the accident and emergency department.

    Olney, D B

    1988-01-01

    A search of accident and emergency department records showed that 61% of 85 children registered as being physically or sexually abused by the Department of Community Paediatrics at St James's University Hospital, Leeds, England, were found to have visited the accident and emergency department an average of 2.9 times before the diagnosis was made. Fifty-two per cent of the attendances were because of problems other than injuries. Staff of accident and emergency departments should be aware that...

  1. What do we really know about infants who attend Accident and Emergency departments?

    Heys, M; Kwong, H-M; Reed, J.; Blair, M

    2014-01-01

    Aims: Accident and Emergency attendances continue to rise. Infants are disproportionately represented. This study examines the clinical reasons infants attend UK Accident and Emergency departments. Methods: A retrospective review of 6,667 infants aged less than one year attending Accident and Emergency at two district general hospitals in London from 1st April 2009 to 30th March 2010. All infants had been assigned to a diagnostic category by the medical coding department according to Natio...

  2. Emergency medicine in space.

    Stewart, Lowan H; Trunkey, Donald; Rebagliati, G Steve

    2007-01-01

    Recent events, including the development of space tourism and commercial spaceflight, have increased the need for specialists in space medicine. With increased duration of missions and distance from Earth, medical and surgical events will become inevitable. Ground-based medical support will no longer be adequate when return to Earth is not an option. Pending the inclusion of sub-specialists, clinical skills and medical expertise will be required that go beyond those of current physician-astronauts, yet are well within the scope of Emergency Medicine. Emergency physicians have the necessary broad knowledge base as well as proficiency in basic surgical skills and management of the critically ill and injured. Space medicine shares many attributes with extreme conditions and environments that many emergency physicians already specialize in. This article is an introduction to space medicine, and a review of current issues in the emergent management of medical and surgical disease during spaceflight. PMID:17239732

  3. Emergency department radiation accident protocol.

    Leonard, R B; Ricks, R C

    1980-09-01

    Every emergency department faces the potential problem of handling one or more victims of a radiation accident. While emergency departments near nuclear power plants or isotope production laboratories probably have a detailed protocol for such emergencies, a similar protocol is needed for the emergency department that may have to handle an isolated event, such as a vehicular accident that spills radioactive material and contaminates passengers or bystanders. This communication attempts to answer that need, presenting a step-by-step protocol for decontamination of a radiation victim, the rationale on which each step is based, a list of needed supplies, and a short summary of decorporation procedures that should be started in the emergency department. PMID:7425419

  4. Intracardiac therapy following emergency thoracotomy in the accident and emergency department: an experimental model.

    Moulton, C; Pennycook, A; Crawford, R

    1992-01-01

    For a select group of patients with penetrating chest trauma, immediate thoracotomy in the accident and emergency department offers the only chance of survival. Foley catheters have been used to achieve haemostasis in cardiac wounds but are not widely used for intracardiac fluid and drug administration during resuscitation. In an anatomical model designed to assess this procedure an average flow rate of 275 ml min-1 was achieved. The equipment required is readily available and easily assembled.

  5. Scoping accident(s) for emergency planning

    At the request of the Conference of State Radiation Control Program Director's (CRCPD), in November 1976 the U.S. Nuclear Regulatory Commission formed a joint Task Force with representatives of the U.S. Environmental Protection Agency to answer a number of questions posed by the States regarding emergency planning. This Task Force held monthly meetings through November 1977. In December 1977 a draft report was prepared for limited distribution for review and comment by selected State and local organizations. The NRC/EPA Task Force deliberations centered on the CRCPD request for '... a determination of the most severe accident basis for which radiological emergency response plans should be developed by offsite agencies...' in the vicinity of nuclear power plants. Federal Interagency guidance to the States in this regard has been that the scoping accident should be the most serious conservatively analyzed accident considered for siting purposes, as exemplified in the Commission's Regulations at 10 CFR Part 100 and the NRC staffs Regulatory Guides 1.3 and 1.4, and as presented in license applicant's Safety Analysis Reports and the USNRC Staffs Safety Evaluation Reports. The draft report of the Task Force amplifies on this recommendation: to present a clearer picture of its import and introduces the concept of protective action zones (PAZs) within which detailed emergency plans should be developed; one zone for the plume exposure pathway and a second, larger zone for contamination pathways. The time dependence of potential releases and atmospheric transport, and important radionuclide groups of possible import are also discussed in the draft Task Force report. A status report regarding this effort, as of June 1978, will be presented. (author)

  6. General practice: a secondment from emergency medicine--so what!

    Nicol, M. F.; McLauchlan, C A

    1998-01-01

    The Joint Committee for Higher Medical Training has issued a core curriculum for training in accident and emergency medicine. This article highlights some of the knowledge, skills, and attitudes one may usefully gain from a period of 6-12 months in general practice and how this can be integrated and adapted to a career in emergency medicine.

  7. Emergency medicine in Ecuador.

    Webb, H R; Sagarin, M J

    2001-09-01

    Emergency medical care in Ecuador is limited by geographic, economic, political, and infrastructural barriers. Afflictions of the developing world (eg, tropical infections and natural disasters) combine with ailments of the developed world (eg, trauma and cardiovascular disease) to mandate improved emergency medical systems. The nation has recently initiated FASBASE, a program dedicated to the enhancement of both prehospital and emergency department (ED) services. Furthermore, a dedicated residency program in Emergency and Disaster Medicine recently graduated its first class. Although more programs and funding are necessary to sustain the effort, Ecuador has begun to develop a modern emergency medical system. PMID:11555804

  8. Emergency Medicine Resident Rotations Abroad: Current Status and Next Steps

    Stephen C. Morris, MD, MPH; Erika D. Schroeder, MD, MPH

    2016-01-01

    Introduction: International rotations for residents are increasingly popular, but there is a dearth of evidence to demonstrate that these rotations are safe and that residents have appropriate training and support to conduct them. Methods: A survey was sent to all U.S. emergency medicine (EM) residencies  with publicly available e-mail addresses. The survey documents and examines the training and support that emergency medicine residents are offered for international rot...

  9. Preventing radiological accidents and emergencies by legislative and regulatory means

    The Goiania radiation accident triggered a reassessment of radiation safety systems. From a legal point of view, the course of events indicates that there were deficiencies either in the existing legal framework or in the implementation of that framework. Proposals to avoid similar accidents in the future are discussed, stressing the need for a sound legal regime and a close co-operation between state authorities and users of radioactive sources. In particular, the importance is underscored of the human factor in achieving a high level of radiation safety. (author)

  10. Planning and Preparing for Emergency Response to Transport Accidents Involving Radioactive Material. Safety Guide

    This Safety Guide provides guidance on various aspects of emergency planning and preparedness for dealing effectively and safely with transport accidents involving radioactive material, including the assignment of responsibilities. It reflects the requirements specified in Safety Standards Series No. TS-R-1, Regulations for the Safe Transport of Radioactive Material, and those of Safety Series No. 115, International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources. Contents: 1. Introduction; 2. Framework for planning and preparing for response to accidents in the transport of radioactive material; 3. Responsibilities for planning and preparing for response to accidents in the transport of radioactive material; 4. Planning for response to accidents in the transport of radioactive material; 5. Preparing for response to accidents in the transport of radioactive material; Appendix I: Features of the transport regulations influencing emergency response to transport accidents; Appendix II: Preliminary emergency response reference matrix; Appendix III: Guide to suitable instrumentation; Appendix IV: Overview of emergency management for a transport accident involving radioactive material; Appendix V: Examples of response to transport accidents; Appendix VI: Example equipment kit for a radiation protection team; Annex I: Example of guidance on emergency response to carriers; Annex II: Emergency response guide.

  11. Carbon monoxide poisoning: correlation of neurological findings between accident and emergency departments and a hyperbaric unit

    Lynch, R.; Laden, G; Grout, P

    2001-01-01

    Objectives—To investigate and quantify the differences in neurological examination findings in patients acutely poisoned with carbon monoxide, between initial assessment at accident and emergency (A&E) departments and subsequently at a hyperbaric unit.

  12. A radioactive waste transportation package monitoring system for normal transport and accident emergency response conditions

    This paper addresses spent fuel and high level waste transportation history and prospects, discusses accident histories of radioactive material transport, discusses emergency responder needs and provides a general description of the Transportation Intelligent Monitoring System (TRANSIMS) design. The key objectives of the monitoring system are twofold: (1) to facilitate effective emergency response to accidents involving a radioactive waste transportation package, while minimizing risk to the public and emergency first-response personnel, and (2) to allow remote monitoring of transportation vehicle and payload conditions to enable research into radioactive material transportation for normal and accident conditions. (J.P.N.)

  13. Emergency care of the elderly in the short-stay ward of the accident and emergency department.

    Harrop, S.N.; Morgan, W J

    1985-01-01

    Review of a consecutive series of the elderly patients who presented unheralded to the Accident and Emergency Department of the Royal Gwent Hospital showed that a relative minority (11%) were difficult to manage because they had no obvious acute medical condition or injury which qualified them for admission by the firms to whom they were first referred. The difficulty was compounded by the shortage of geriatric beds. Judicious use of short-stay ward beds in the accident and emergency departme...

  14. Emergency drinking water treatment during source water pollution accidents in China: origin analysis, framework and technologies.

    Zhang, Xiao-Jian; Chen, Chao; Lin, Peng-Fei; Hou, Ai-Xin; Niu, Zhang-Bin; Wang, Jun

    2011-01-01

    China has suffered frequent source water contamination accidents in the past decade, which has resulted in severe consequences to the water supply of millions of residents. The origins of typical cases of contamination are discussed in this paper as well as the emergency response to these accidents. In general, excessive pursuit of rapid industrialization and the unreasonable location of factories are responsible for the increasing frequency of accidental pollution events. Moreover, insufficient attention to environmental protection and rudimentary emergency response capability has exacerbated the consequences of such accidents. These environmental accidents triggered or accelerated the promulgation of stricter environmental protection policy and the shift from economic development mode to a more sustainable direction, which should be regarded as the turning point of environmental protection in China. To guarantee water security, China is trying to establish a rapid and effective emergency response framework, build up the capability of early accident detection, and develop efficient technologies to remove contaminants from water. PMID:21133359

  15. Emergency medicine in Nepal: present practice and direction for future.

    Pandey, Nishant Raj

    2016-12-01

    Emergency medicine is one of the youngest recognized specialties in Nepal, and its growth in clinical practice and academic development has been challenging. In this paper, we reviewed the current state of emergency medicine in Nepal based on review of the literature, personal observations and experience, and interviews with many Nepali and foreign emergency physicians. Most hospitals in Nepal have adopted a multi-specialist approach, where emergency room physicians are primarily general practitioners/family physicians or house officers. As physicians are receiving their training via various pathways, national standards in training and certification have not been developed. As a result, the scope of practice for emergency physicians and the quality of care vary greatly among hospitals. Difficult working conditions, physician recruitment, compensation, and academic enrichment remain major challenges in the development of emergency medicine. For the sustainable development of this specialty, more international guidance and local leadership is needed to standardize the training curriculum, to provide adequate funding opportunities for academic development and to promote the overall development of the emergency care system. PMID:27416937

  16. Survey of the use of rapid sequence induction in the accident and emergency department

    Walker, A.; Brenchley, J

    2000-01-01

    Objectives—To determine the current position regarding the use of rapid sequence induction (RSI) by accident and emergency (A&E) medical staff and the attitudes of consultants in A&E and anaesthetics towards this.

  17. Biological tissue adhesive for multiple use in the accident and emergency department

    Gerrard, C.; S. Moore; Ryan, B

    2000-01-01

    Objective—To assess the strength of the glue and microbial contamination over 28 days from opening a vial of tissue adhesive in the accident and emergency setting, and to quantify cost savings of repeated use of the vials.

  18. Head injuries in accident and emergency departments. How different are children from adults?

    Brookes, M; MacMillan, R.; Cully, S; E. Anderson; S. Murray; Mendelow, A D; Jennett, B

    1990-01-01

    STUDY OBJECTIVE--The aim of the study was to examine the differences between child and adult patients attending accident and emergency departments after recent head injuries. DESIGN AND SETTING--A retrospective survey based on existing case records from 23 Scottish accident and emergency departments for 1985 was compared with prospective data from one hospital over 9 months in 1984. PATIENTS--3838 children under 15 and 4775 adults attended hospital with head injuries during the period analyse...

  19. Referral to the accident and emergency department following the use of community alarms

    Youssef, G.; Underhill, T; Tovey, C

    2000-01-01

    Objectives—To assess the degree of appropriate referral to the accident and emergency (A&E) department following the use of a community alarm where a mobile warden works in conjunction with the community alarm control centre.

  20. Integrating four-dimensional geographical information and mobile techniques into radiological accident emergency response training

    When radiological accidents occur, radioactive material may spread into the atmosphere, causing large-scale and long-term contamination. To diminish the effects of such accidents, researchers from many countries have investigated training programs in emergency response to radiological accidents, especially in the wake of several serious radiological accidents. Although many training programs have been proposed, this study identifies two problems: the lack of effective data representation and the lack of complete training records. Therefore, by considering various requirements for relief and evacuation work at radiological accident sites, it integrates four-dimensional geographical information and mobile techniques to construct a training platform for radiological accident emergency response. During training, groups of participants learn to respond to simulated radiological accident scenarios. Moreover, participants can use the training platform to review and discuss training details. Judging by the results, the training platform has not only increased the effectiveness of training programs, but also complied with standard operating procedures for radiological accident emergency response in Taiwan. In conclusion, this study could serve as a useful reference for similar studies and applications. (author)

  1. Review of emergency thoracotomy for chest injuries in patients attending a UK Accident and Emergency department.

    Bleetman, A; Kasem, H; Crawford, R

    1996-03-01

    Over a two and a half year period, 25 patients presenting to the Glasgow Royal Infirmary underwent emergency thoracotomy for suspected severe chest injuries. Eighteen (72 per cent) were performed in the Accident and Emergency (A&E) department and seven (28 per cent) in a fully equipped operating theatre after resuscitation. There were 23 men and 2 women. Twenty-three (92 per cent) had been stabbed, one (4 per cent) had been shot and one (4 per cent) had sustained a blunt injury in a road traffic accident. Eight (32 per cent) patients survived. All survivors had been stabbed and seven were well enough to undergo thoracotomy in theatre. Only one (5.6 per cent) of the patients operated upon in the A&E department survived to discharge, although three (16.8 per cent) survived the initial procedure. Three of four patients survived, in whom the diagnosis of cardiac tamponade was initially missed. Thirteen (76.5 per cent) of the 17 who did not survive had no vital signs on admission. Outcomes may be improved if appropriately trained hospital staff are immediately available and prehospital delays are minimized so that patients arrive sooner with signs of life still present. Ambulance paramedic interventions have little to offer these patients and may worsen the prognosis if they result in delayed transport to hospital. The emphasis placed on diagnosis and treatment of cardiac tamponade in Advanced Trauma Life Support programmes is appropriate and all staff involved in these cases should undergo this type of training. PMID:8730388

  2. Community emergency response to nuclear power plant accidents: A selected and partially annotated bibliography

    The role of responding to emergencies at nuclear power plants is often considered the responsibility of the personnel onsite. This is true for most, if not all, of the incidents that may happen during the course of the plant's operating lifetime. There is however, the possibility of a major accident occurring at anytime. Major nuclear accidents at Chernobyl and Three Mile Island have taught their respective countries and communities a significant lesson in local emergency preparedness and response. Through these accidents, the rest of the world can also learn a great deal about planning, preparing and responding to the emergencies unique to nuclear power. This bibliography contains books, journal articles, conference papers and government reports on emergency response to nuclear power plant accidents. It does not contain citations for ''onsite'' response or planning, nor does it cover the areas of radiation releases from transportation accidents. The compiler has attempted to bring together a sampling of the world's collective written experience on dealing with nuclear reactor accidents on the sate, local and community levels. Since the accidents at Three Mile Island and Chernobyl, that written experience has grown enormously

  3. Community emergency response to nuclear power plant accidents: A selected and partially annotated bibliography

    Youngen, G.

    1988-10-01

    The role of responding to emergencies at nuclear power plants is often considered the responsibility of the personnel onsite. This is true for most, if not all, of the incidents that may happen during the course of the plant`s operating lifetime. There is however, the possibility of a major accident occurring at anytime. Major nuclear accidents at Chernobyl and Three Mile Island have taught their respective countries and communities a significant lesson in local emergency preparedness and response. Through these accidents, the rest of the world can also learn a great deal about planning, preparing and responding to the emergencies unique to nuclear power. This bibliography contains books, journal articles, conference papers and government reports on emergency response to nuclear power plant accidents. It does not contain citations for ``onsite`` response or planning, nor does it cover the areas of radiation releases from transportation accidents. The compiler has attempted to bring together a sampling of the world`s collective written experience on dealing with nuclear reactor accidents on the sate, local and community levels. Since the accidents at Three Mile Island and Chernobyl, that written experience has grown enormously.

  4. ANS [American Nuclear Society] topical meeting on radiological accidents: Perspectives and emergency planning: Proceedings

    The increasing use of radioactive materials and the increasing public concern about possible accidents involving these materials has led to greater emphasis on preparing for such emergencies. The ANS Topical Meeting on Radiological Accidents - Perspectives and Emergency Planning provided a review of experiences with radiological accidents. The meeting covered some of the most important aspects of radiological accidents. Papers were presented which dealt with radiological accident experience. Technical response to accidents is of primary interest to many in the nuclear community; most of the papers submitted fell into this area. So many of these papers dealt with the use of computers in response that a session on that topic was arranged. A very significant impact of most radiological accidents is the cost, especially the cost of cleanup. There were papers on what is known about costs and associated current topics, such as modification and extension of the Price-Anderson Act. At least as important as the technical response to accidents is how society attempts to deal with them. A session on institutional issues was included to discuss how governments and other organizations respond to and deal with accidents. Medical effects of accidents are of great concern to the public. Invited papers to review the effects of high doses of radiation as well as very low doses were included in that session. Although the nuclear industry has an excellent safety record, this fact often does not agree with the public perception of the industry. The final session explored the public response to and perception of radiological emergencies and accidents. This subject will ultimately determine the future use of radioactive materials in this country

  5. Review and assessment of package requirements (yellowcake) and emergency response to transportation accidents

    As a consequence of an accident involving a truck shipment of yellowcake, a joint NRC--DOT study was undertaken to review and assess the regulations and practices related to package integrity and to emergency response to transportation accidents involving low specific activity radioactive materials. Recommendations are made regarding the responsibilities of state and local agencies, carriers, and shippers, and the DOT and NRC regulations

  6. Bibliography for nuclear criticality accident experience, alarm systems, and emergency management

    The characteristics, detection, and emergency management of nuclear criticality accidents outside reactors has been an important component of criticality safety for as long as the need for this specialized safety discipline has been recognized. The general interest and importance of such topics receives special emphasis because of the potentially lethal, albeit highly localized, effects of criticality accidents and because of heightened public and regulatory concerns for any undesirable event in nuclear and radiological fields. This bibliography lists references which are potentially applicable to or interesting for criticality alarm, detection, and warning systems; criticality accident emergency management; and their associated programs. The lists are annotated to assist bibliography users in identifying applicable: industry and regulatory guidance and requirements, with historical development information and comments; criticality accident characteristics, consequences, experiences, and responses; hazard-, risk-, or safety-analysis criteria; CAS design and qualification criteria; CAS calibration, maintenance, repair, and testing criteria; experiences of CAS designers and maintainers; criticality accident emergency management (planning, preparedness, response, and recovery) requirements and guidance; criticality accident emergency management experience, plans, and techniques; methods and tools for analysis; and additional bibliographies

  7. Bibliography for nuclear criticality accident experience, alarm systems, and emergency management

    Putman, V.L.

    1995-09-01

    The characteristics, detection, and emergency management of nuclear criticality accidents outside reactors has been an important component of criticality safety for as long as the need for this specialized safety discipline has been recognized. The general interest and importance of such topics receives special emphasis because of the potentially lethal, albeit highly localized, effects of criticality accidents and because of heightened public and regulatory concerns for any undesirable event in nuclear and radiological fields. This bibliography lists references which are potentially applicable to or interesting for criticality alarm, detection, and warning systems; criticality accident emergency management; and their associated programs. The lists are annotated to assist bibliography users in identifying applicable: industry and regulatory guidance and requirements, with historical development information and comments; criticality accident characteristics, consequences, experiences, and responses; hazard-, risk-, or safety-analysis criteria; CAS design and qualification criteria; CAS calibration, maintenance, repair, and testing criteria; experiences of CAS designers and maintainers; criticality accident emergency management (planning, preparedness, response, and recovery) requirements and guidance; criticality accident emergency management experience, plans, and techniques; methods and tools for analysis; and additional bibliographies.

  8. Emergency preparedness and measures to prevent severe accidents in the Republic of Korea

    The paper reviews the national programme for prevention and mitigation of severe nuclear plant accidents and emergency preparedness in case of nuclear accidents in the Republic of Korea. The programme has implemented most post-Three Mile Island measures for safety improvements and set up a national system of emergency response to handle any nuclear related accident. The programme has also thoroughly examined safety related equipment and operating procedures of operating reactors in the Republic of Korea. As a result of the safety enhancing activities, Korea Electric Power Corporation (KEPCO) is establishing an emergency response facility, a post-accident sampling system and full scope probablistic risk analysis work. After the Chernobyl accident, the Government of the Republic of Korea went through a safety check-up of the operating plants once again and KEPCO installed a retraining programme for reactor operators and an upgraded safety check-up procedure and schedule. Improvements were made on a number of safety systems including an emergency core cooling system, a fire monitoring system and a quality assurance programme for fire prevention. In addition, the national programme has been setting up an international co-operative system in order to respond quickly to any unexpected accident through rapid mobilization of international experts, equipment and materials. (author). 1 fig., 1 tab

  9. Technology and work within emergency medicine

    Kristensen, Margit

    From medical research it has been recognized that physicians doing medical work in the pre-hospital area can make a difference for the acutely ill people, meaning higher survival (Høyer, Schønemann). In the light of this it has during the last years - in the biggest cities in Denmark - been...... human life on the most basic, physical level - and they are mobile and carry out nomadic work (using the definitions of mobility and nomadicity, as described in Bogdan (2006). However spaces and places in which they work, the degree of mobility and nomadicity, they ‘practice', and the artefacts and...

  10. Effect of guidelines on management of head injury on record keeping and decision making in accident and emergency departments.

    Thomson, R.; Gray, J; Madhok, R; Mordue, A.; Mendelow, A D

    1994-01-01

    OBJECTIVE--To compare record keeping and decision making in accident and emergency departments before and after distribution of guidelines on head injury management as indices of implementation. DESIGN--Before (1987) and after (1990) study of accident and emergency medical records. SETTING--Two accident and emergency departments in England. PATIENTS--1144 adult patients with head injury in department 1 (533 in 1987, 613 in 1990) and 734 in department 2 (370, 364 respectively). MAIN MEASURES--...

  11. Relation of out of hours activity by general practice and accident and emergency services with deprivation in Nottingham: longitudinal survey.

    Carlisle, R; Groom, L. M.; Avery, A J; Boot, D; Earwicker, S.

    1998-01-01

    OBJECTIVES: To investigate the relation between out of hours activity of general practice and accident and emergency services with deprivation and distance from accident and emergency department. DESIGN: Six month longitudinal study. SETTING: Six general practices and the sole accident and emergency department in Nottingham. SUBJECTS: 4745 out of hours contacts generated by 45,182 patients from 23 electoral wards registered with six practices. MAIN OUTCOME MEASURES: Rates of out of hours cont...

  12. Help guides for post-accident consequence management: farm activities and exiting the emergency phase

    After having recalled the main actions foreseen in the PPIs (plans particuliers d'intervention, intervention specific plans) in case of radionuclide release in the environment after a nuclear accident, i.e. sheltering and ingestion of steady iodine, and also indicated the different phases of consequence management (preparation, emergency and post-accident phases), this report describes and comments the contents of two guides published by the IRSN (the French Radioprotection and Nuclear Safety Institute) and dealing with the management of post-accident consequences. The first one is a guide to aid to decision-making for the management of the agricultural sector in case of nuclear accident, and the second one is a guide for the preparation of the end of the emergency phase in which actions to be performed during the first week after the end of accidental releases are described

  13. Emergency Medicine Resident Rotations Abroad: Current Status and Next Steps

    Stephen C. Morris, MD, MPH

    2016-01-01

    Full Text Available Introduction: International rotations for residents are increasingly popular, but there is a dearth of evidence to demonstrate that these rotations are safe and that residents have appropriate training and support to conduct them. Methods: A survey was sent to all U.S. emergency medicine (EM residencies with publicly available e-mail addresses. The survey documents and examines the training and support that emergency medicine residents are offered for international rotations and the frequency of adverse safety events. Results: 72.5% of program director responded that their residents are participating in rotations abroad. However, only 15.4% of programs reported offering training specific to working abroad. The results point to an increased need for specific training and insurance coverage. Conclusion: Oversight of international rotations should be improved to guarantee safety and education benefit.

  14. ETH-CHEMRISK: A pilot decision support system for industrial accidents emergency planning and preparedness

    ETH-CHEMRISK is designed in accordance with the principles and methods of emergency planning and preparedness as applied to the case of industrial (chemical) accidents. The outline of this decision support system design follows from both the features that nuclear and chemical accident consequence analysis share, and those that make the two different from each other. It uses and integrates concepts such as: data base, geographical information system, risk assessment, graphic driven software environment

  15. Identification and evaluation of competencies of health professionals in the hospital emergency management of the radiation accident victim

    A preliminary list of ten competency and forty-six sub-competency statements derived from literature and consultation with experts and based on the general areas of clinical performance defined by the National Board of Medical Examiners were the concern of Phase I of this study. Forty-eight experts in nuclear medicine, radiology, radiotherapy, health physics, medical physics, radiation biology, public and occupational health, surgery, and emergency medicine and nursing considered this preliminary list of competencies and sub-competencies to determine which were essential for health professionals who may be caring for radiation accident victims in hospital emergency departments. Eight competencies and thirty-three sub-competencies were rated as Essential competencies. Competencies dealing with establishing priorities in patient care and initiating treatment, assessment, contamination control, and decontamination were highly rated. In the second part of this study, the Essential competencies were utilized in the development of an original evaluation instrument designed to identify deficiencies and continuing education needs during radiation accident drills or exercises. The instrument was designed for use in sixteen possible patient care situations in which the radiation accident victims have varying medical and radiological conditions. Development of the evaluation instrument was described

  16. Diagnostic ultrasound use in physiotherapy, emergency medicine, and anaesthesiology

    McKiernan, Sharmaine [School of Health Sciences, University of Newcastle, Callagham, NSW 2308 (Australia)], E-mail: sharmaine.mckiernan@newcastle.edu.au; Chiarelli, Pauline; Warren-Forward, Helen [School of Health Sciences, University of Newcastle, Callagham, NSW 2308 (Australia)

    2010-05-15

    Background: Diagnostic ultrasound is traditionally and extensively used within the radiology department. However in recent years its use has expanded outside this traditional area into health professions such as physiotherapy, emergency medicine and anaesthesiology. Purpose: The radiology community needs to be aware of the expansion of use of diagnostic ultrasound. This article starts this exploration in the health professions mentioned, however it is acknowledged that diagnostic ultrasound use goes beyond what is covered in this article. As diagnostic ultrasound is a user dependant modality and the outcome of an examination is largely influenced by the skill and experience of the operator, the radiology community should take a guiding role in its use, training and protocol development for health professionals. Method: This article explores the literature on the use of diagnostic ultrasound within physiotherapy, emergency medicine and anaesthesiology. Literature was searched for on the databases Medline, Cinahl and Embase. Results: Diagnostic ultrasound is being used in health professions such as physiotherapy, where it is being used to provide biofeedback to patients on contraction of abdominal and pelvic floor muscles; emergency medicine, for the investigation of free fluid within the abdomen of a trauma patient and anaesthesiology, for the placement of catheters and nerve blocks. Conclusion: As members of the radiology community are considered experts in the field, they need to take the lead to guide and mentor the other health professionals who are now using the modality. To be able to achieve this they must have an understanding of what these professions are using the modality for.

  17. Diagnostic ultrasound use in physiotherapy, emergency medicine, and anaesthesiology

    Background: Diagnostic ultrasound is traditionally and extensively used within the radiology department. However in recent years its use has expanded outside this traditional area into health professions such as physiotherapy, emergency medicine and anaesthesiology. Purpose: The radiology community needs to be aware of the expansion of use of diagnostic ultrasound. This article starts this exploration in the health professions mentioned, however it is acknowledged that diagnostic ultrasound use goes beyond what is covered in this article. As diagnostic ultrasound is a user dependant modality and the outcome of an examination is largely influenced by the skill and experience of the operator, the radiology community should take a guiding role in its use, training and protocol development for health professionals. Method: This article explores the literature on the use of diagnostic ultrasound within physiotherapy, emergency medicine and anaesthesiology. Literature was searched for on the databases Medline, Cinahl and Embase. Results: Diagnostic ultrasound is being used in health professions such as physiotherapy, where it is being used to provide biofeedback to patients on contraction of abdominal and pelvic floor muscles; emergency medicine, for the investigation of free fluid within the abdomen of a trauma patient and anaesthesiology, for the placement of catheters and nerve blocks. Conclusion: As members of the radiology community are considered experts in the field, they need to take the lead to guide and mentor the other health professionals who are now using the modality. To be able to achieve this they must have an understanding of what these professions are using the modality for.

  18. Emergency Response to Radioactive Material Transport Accidents

    Although transport regulations issued by IAEA is providing a high degree of safety during transport opertions,transport accidents involving packages containing radioactive material have occurred and will occur at any time. Whenever a transport accident involving radioactive material accurs, and many will pose no radiation safety problems, emergency respnose actioms are meeded to ensure that radiation safety is maintained. In case of transport accident that result in a significant relesae of radioactive material , loss of shielding or loss of criticality control , that consequences should be controlled or mitigated by proper emergency response actions safety guide, Emergency Response Plamming and Prepardness for transport accidents involving radioactive material, was published by IAEA. This guide reflected all requirememts of IAEA, regulations for safe transport of radioactive material this guide provide guidance to the publicauthorites and other interested organziation who are responsible for establishing such emergency arrangements

  19. Emergency medicine in Dubai, UAE.

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice. PMID:20157462

  20. Emergency medicine in Dubai, UAE

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  1. Chemical and nuclear emergencies: Interchanging lessons learned from planning and accident experience

    Because the goal of emergency preparedness for both chemical and nuclear hazards is to reduce human exposure to hazardous materials, this paper examines the interchange of lessons learned from emergency planning and accident experience in both industries. While the concerns are slightly different, sufficient similarity is found for each to draw implications from the others experience. Principally the chemical industry can learn from the dominant planning experience associated with nuclear power plants, while the nuclear industry can chiefly learn from the chemical industry's accident experience. 23 refs

  2. Disaster medicine. Present status of medicine for emergent radiation exposure

    Global and Japanese medical networks organized for the accidental emergent exposure are outlined, actual measures at Japanese accidents are summarized, and their present tasks/problems are discussed. ICRP issues comments concerning radiation protection based on scientific findings verified by UNSCEAR, where there are such international organizations for the emergent network as WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) and IAEA Response Assistance Network (RANET). Two Japanese facilities (National Institute of Radiological Sciences: NIRS, and Nagasaki University) are in REMPAN and 3 (NIRS, Japan Atomic Energy Agency and Hiroshima Univ.), in RANET. The Radiation Emergency Medicine Network Council (REMNC, founded in NIRS, 1997) plays the central role in Japanese networks, consisting from medical facilities in prefectures having the nuclear facility and in their neighboring areas. Those facilities are responsible for the primary, secondary and tertiary medicare of the emergent exposure: id est (i.e.), respectively; in/near the nuclear facility, in its infirmary and in the emergency evacuation site; for hospitalization; and for hospitalization with expertized treatment. At Tokai JCO criticality accident in Ibaraki prefecture (1999), 3 workers exposed to the high dose of neutron flux were rapidly carried into the tertiary facility NIRS according to the treatment planning by REMNC. At Fukushima Daiichi Nuclear Power Plant Accident in 2011, the tertiary NIRS, Hiroshima Univ., and secondary Fukushima Medical Univ. in REMNC mainly intervened various kinds of medicare as early as at the first stage. Hospitals in Tochigi prefecture neighboring to Fukushima had to face the emergency derived from the radioactive plume. Present tasks/problems posed by these accidents are two: reconsideration of disaster measures for the network like REMNC to spread defined areas and facilities in wider regions and smaller hospitals; and importance of 3 risk

  3. Populations protection and territories management in nuclear emergency and post-accident situation

    This document gathers the slides of the available presentations given during these conference days. Twenty seven presentations out of 29 are assembled in the document and deal with: 1 - radiological and dosimetric consequences in nuclear accident situation: impact on the safety approach and protection stakes (E. Cogez); 2 - organisation of public authorities in case of emergency and in post-event situation (in case of nuclear accident or radiological terror attack in France and abroad), (O. Kayser); 3 - ORSEC plan and 'nuclear' particular intervention plan (PPI), (C. Guenon); 4 - thyroid protection by stable iodine ingestion: European perspective (J.R. Jourdain); 5 - preventive distribution of stable iodine: presentation of the 2009/2010 public information campaign (E. Bouchot); 6 - 2009/2010 iodine campaign: presentation and status (O. Godino); 7 - populations protection in emergency and post-accident situation in Switzerland (C. Murith); 8 - CIPR's recommendations on the management of emergency and post-accident situations (J. Lochard); 9 - nuclear exercises in France - status and perspectives (B. Verhaeghe); 10 - the accidental rejection of uranium at the Socatri plant: lessons learnt from crisis management (D. Champion); 11 - IRE's radiological accident of August 22, 2008 (C. Vandecasteele); 12 - presentation of the CEA's crisis national organisation: coordination centre in case of crisis, technical teams, intervention means (X. Pectorin); 13 - coordination and realisation of environmental radioactivity measurement programs, exploitation and presentation of results: status of IRSN's actions and perspectives (P. Dubiau); 14 - M2IRAGE - measurements management in the framework of geographically-assisted radiological interventions in the environment (O. Gerphagnon and H. Roche); 15 - post-accident management of a nuclear accident - the CODIRPA works (I. Mehl-Auget); 16 - nuclear post-accident: new challenges of crisis expertise (D. Champion); 17 - aid guidebooks

  4. Consistency in accident analyses in DOE safety, environmental, and emergency planning documents

    A consistency review of accident analyses in US Department of Energy (DOE) safety, environmental, and emergency planning documents is presented. The range of and key differences in driving assumptions used in accident definition and frequency assessment, radiological source term generation, and atmospheric transport and fate modeling across recent environmental impact statements (EISs) and emergency planning documents and the effects of these differences on results are summarized. Considerable variation in both the assumptions and the underlying level of conservatism is shown to exist. Recommendations are made for source term generation and assumed meteorological conditions to reduce inconsistencies without being overly prescriptive. Recommendations also are made to improve consistency in assessing the frequencies of various generic accident sequences traditionally analyzed in EIS and emergency planning documents. All recommendations are shown to be consistent with currently applicable DOE guidance

  5. Guidelines for attendance and registration for radiological emergencies of nuclear accidents

    Today in Brazil the use of nuclear energy is becoming an usual practice in various activities. Thus, must be a matter of great weight, directions for attendance and registration for radiological emergencies or nuclear accidents. This work shows the planning elaborated by the Comissao Nacional de Energia Nuclear (Brazilian CNEN) for nuclear plants, aiming avoid the injurious effects from the ionizing radiation exposure, radionuclides release or the direct or indirect exposure of ionizing radiation, that proceeding from a radiological emergencies or a nuclear accidents. (J.A.M.M.)

  6. Management of a radiological emergency. Experience feedback and post-accident management

    In France, the organization of crisis situations and the management of radiological emergency situations are regularly tested through simulation exercises for a continuous improvement. Past severe accidents represent experience feedback resources of prime importance which have led to deep changes in crisis organizations. However, the management of the post-accident phase is still the object of considerations and reflections between the public authorities and the intervening parties. This document presents, first, the nuclear crisis exercises organized in France, then, the experience feedback of past accidents and exercises, and finally, the main aspects to consider for the post-accident management of such events: 1 - Crisis exercises: objectives, types (local, national and international exercises), principles and progress, limits; 2 - Experience feedback: real crises (major accidents, other recent accidental situations or incidents), crisis exercises (experience feedback organization, improvements); 3 - post-accident management: environmental contamination and people exposure, management of contaminated territories, management of populations (additional protection, living conditions, medical-psychological follow up), indemnification, organization during the post-accident phase; 4 - conclusion and perspectives. (J.S.)

  7. Emergency response planning and preparedness for transport accidents involving radioactive material

    The purpose of this Guide is to provide assistance to public authorities and others (including consignors and carriers of radioactive materials) who are responsible for ensuring safety in establishing and developing emergency response arrangements for responding effectively to transport accidents involving radioactive materials. This Guide is concerned mainly with the preparation of emergency response plans. It provides information which will assist those countries whose involvement with radioactive materials is just beginning and those which have already developed their industries involving radioactive materials and attendant emergency plans, but may need to review and improve these plans. The need for emergency response plans and the ways in which they are implemented vary from country to country. In each country, the responsible authorities must decide how best to apply this Guide, taking into account the actual shipments and associated hazards. In this Guide the emergency response planning and response philosophy are outlined, including identification of emergency response organizations and emergency services that would be required during a transport accident. General consequences which could prevail during an accident are described taking into account the IAEA Regulations for the Safe Transport of Radioactive Material. 43 refs, figs and tabs

  8. Emergency reception of accidents and incidents in working with ionizing radiation

    This manual is intended to be a general manual for the responsible expert regarding radiation hygienics in order to assist him in establishing an organization for combat of accidents and incidents. First attention is paid considerations underlying emergency measures and aid, subsequently the demands and desirabilities in the practical organization are discussed. (author). 3 figs

  9. Development and application of random walk model of atmospheric diffusion in emergency response of nuclear accidents

    Plume concentration prediction is one of the main contents of radioactive consequence assessment for early emergency to nuclear accidents. This paper describes random characteristics of atmospheric diffusion itself, introduces random walk model of atmospheric diffusion (Random Walk), and compare with Lagrangian puff model (RIMPUFF) in the nuclear emergency decision support system (RODOS) developed by European Community for verification. The results show the concentrations calculated by the two models are quite close except that plume area calculated by Random Walk is a little smaller than that by RIMPUFF. The random walk model for atmospheric diffusion can simulate the atmospheric diffusion in case of nuclear accidents and provide more actual information for early emergency and consequence assessment as one atmospheric diffusion module of the nuclear emergency decision support system. (authors)

  10. The Sheffield experiment: the effects of centralising accident and emergency services in a large urban setting

    Simpson, A; Wardrope, J.; Burke, D

    2001-01-01

    Objectives—To assess the effects of centralisation of accident and emergency (A&E) services in a large urban setting. The end points were the quality of patient care judged by time to see a doctor or nurse practitioner, time to admission and the cost of the A&E service as a whole.

  11. Experience of domestic violence by women attending an inner city accident and emergency department

    Sethi, D; Watts, S.; Zwi, A.; Watson, J; McCarthy, C.

    2004-01-01

    Objectives: To identify the prevalence of domestic violence (DV) (defined as physical abuse perpetrated by intimate partners) in women attending an inner city accident and emergency department and to elicit women's response about being asked routinely about domestic violence in this setting.

  12. Dermatobia hominis in the accident and emergency department: "I've got you under my skin".

    MacNamara, A; Durham, S

    1997-05-01

    An unusual form of larval infestation from South America is presented which, in view of increasing tourism to South america's tropical areas, may present to any accident and emergency department. Infestation with Dermatobia hominis is reviewed in terms of clinical recognition and life cycle. Techniques of removal are described. PMID:9193989

  13. The assistance and recording of radiological emergencies and nuclear accidents of Brazilian National Nuclear Energy Commission

    The Brazilian National Nuclear Energy Commission with the aim of obtain the prompt notification and of assisting in potential or real radiological emergency situations and nuclear accidents, has organized an integrated system, in prevention regimen, working 24 hours a day. All notifications related to events that could result in an emergency situation, coming from any part of the national territory, are immediately sent to the system. This system was implemented in July 1990 and has received 107 notifications of which 10% were classified as potential emergency situations. The system organization is described. (B.C.A.). 08 refs, 04 figs

  14. Quality in paediatric emergency medicine: Measurement and reporting.

    Borland, Meredith L; Shepherd, Mike

    2016-02-01

    There is a clear demand for quality in the delivery of health care around the world; paediatric emergency medicine is no exception to this movement. It has been identified that gaps exist in the quality of acute care provided to children. Regulatory bodies in Australia and New Zealand are moving to mandate the implementation of quality targets and measures. Within the paediatric emergency department (ED), there is a lack of research into paediatric specific indicators. The existing literature regarding paediatric acute care quality measures has been recently summarised, and expert consensus has now been reported. It is clear that there is much work to be performed to generalise this work to ED. We review suggestions from the current literature relating to feasible indicators within the paediatric acute care setting. We propose options to develop a quality 'scorecard' that could be used to assist Australian and New Zealand EDs with quality measurement and benchmarking for their paediatric patients. PMID:27062615

  15. The Fukushima Daiichi Accident. Technical Volume 3/5. Emergency Preparedness and Response

    This volume describes the key events and response actions from the onset of the accident at the Fukushima Daiichi nuclear power plant (NPP), operated by the Tokyo Electric Power Company (TEPCO), on 11 March 2011. It also describes the national emergency preparedness and response (EPR) system in place in Japan and the international EPR framework prior to the accident. It is divided into five sections. Section 3.1 describes the initial actions taken by Japan in response to the accident, involving: identification of the accident, notification of off-site authorities and activation of the response; mitigatory actions taken on-site; and initial off-site response. Section 3.2 describes the protective measures taken for personnel in response to the natural disaster, protection of emergency workers, medical management of emergency workers and the voluntary involvement of members of the public in the emergency response. Section 3.3 describes the protective actions and other response actions taken by Japan to protect the public. It addresses urgent and early protective actions; the use of a dose projection model, the System for Prediction of Environmental Emergency Dose Information (SPEEDI), as a basis for decisions on protective actions during the accident; environmental monitoring; provision of information to the public and international community; and issues related to international trade and waste management. Section 3.4 describes the transition from the emergency phase to the recovery phase. It also addresses the national analysis of the accident and the emergency response. Section 3.5 describes the response by the IAEA, other international organizations within the Inter- Agency Committee on Radiological and Nuclear Emergencies (IACRNE), the actions of IAEA Member States with regard to protective actions recommended to their nationals in Japan and the provision of international assistance. A summary, observations and lessons conclude each section. There are three

  16. National emergency plan for nuclear accidents

    The national emergency plan for nuclear accidents is a plan of action designed to provide a response to accidents involving the release or potential release of radioactive substances into the environment, which could give rise to radiation exposure to the public. The plan outlines the measures which are in place to assess and mitigate the effects of nuclear accidents which might pose a radiological hazard in ireland. It shows how accident management will operate, how technical information and monitoring data will be collected, how public information will be provided and what measures may be taken for the protection of the public in the short and long term. The plan can be integrated with the Department of Defence arrangements for wartime emergencies

  17. Management of Fever in Postpneumococcal Vaccine Era: Comparison of Management Practices by Pediatric Emergency Medicine and General Emergency Medicine Physicians

    Goldman, David L.; Avner, Jeffrey R.

    2014-01-01

    Background. The primary objective of this study was to compare management practices of general emergency physicians (GEMPs) and pediatric emergency medicine physicians (PEMPs) for well-appearing young febrile children. Methods. We retrospectively reviewed the charts of well-appearing febrile children aged 3–36 months who presented to a large urban children's hospital (PED), staffed by PEMPs, or a large urban general emergency department (GED), staffed by GEMPs. Demographics, immunization status, laboratory tests ordered, antibiotic usage, and final diagnoses were collected. Results. 224 cases from the PED and 237 cases from the GED were reviewed. Children seen by PEMPs had significantly less CXRs (23 (10.3%) versus 51 (21.5%), P = 0.001) and more rapid viral testing done (102 (45%) versus 40 (17%), P GEMPs and highlight the need for standardization of care. PMID:24982807

  18. Radiological accidents balance in medicine; Bilan des accidents radiologiques en medecine

    Nenot, J.C.

    1995-12-31

    This work deals with the radiological accidents in medicine. In medicine, the radiation accidents on medical personnel and patients can be the result of over dosage and bad focusing of radiotherapy sealed sources. Sometimes, the accidents, if they are unknown during a time enough for the source to be spread and to expose a lot of persons (in the case of source dismantling for instance) can take considerable dimensions. Others accidents can come from bad handling of linear accelerators and from radionuclide kinetics in some therapies. Some examples of accidents are given. (O.L.). 11 refs.

  19. Emergency medicine residents’ attitudes and opinions of in-training exam preparation

    Eastin, Travis

    2013-01-01

    Travis R Eastin, Aaron W BernardDepartment of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, USAPurpose: Emergency Medicine (EM) residents take the American Board of Emergency Medicine (ABEM) in-training exam, and performance on this exam has been shown to correlate to performance on the ABEM qualifying exam. Though many residencies have in-training exam preparation activities, there is little data on the effectiveness of these efforts. This study aimed to el...

  20. Emergency medicine residents' attitudes and opinions of in-training exam preparation

    Eastin TR; Bernard AW

    2013-01-01

    Travis R Eastin, Aaron W BernardDepartment of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, USAPurpose: Emergency Medicine (EM) residents take the American Board of Emergency Medicine (ABEM) in-training exam, and performance on this exam has been shown to correlate to performance on the ABEM qualifying exam. Though many residencies have in-training exam preparation activities, there is little data on the effectiveness of these efforts. This study aimed to el...

  1. Severe accident modeling and offsite dose consequence evaluations for nuclear power plant emergency planning

    We have investigated the roles of Firewater Addition System and Passive Flooder in ABWR severe accidents, such as LOCA and SBO. The results are apparent that Firewater System is vital in the highly unlikely situation where all AC are lost. Also in this paper, we present EPZDose, an effective and faster-than-real time code for offsite dose consequences predictions and evaluations. Illustrations with the release from our severe accident scenario show friendly and informative user's interface for supporting decision makings in nuclear emergency situations. (author)

  2. The study on development of emergency operating procedures based on symptom and risk for accident management

    The Advanced EOP(AEOP) has been developed by focusing on the importance of the operators role in emergency conditions. In the AEOP, to overcome the complexity of current EOPs and maintain the consistency of operators action according to plant emergency conditions, operator's task were allocated according to their duties. As an alternative, the Computerized Operator Aid System (COAS) has been developed to reduce operator's burden and provide detailed instructions of procedure. Probabilistic Safety Assessment (PSA) results were synthesized in the AEOP using the event tree to give the awareness and the prediction of accident progression in advance. In conclusion, the existing EOP with its inherent complexity should be simplified and consolidated using computerized operator support system and task allocation to prevent more severe accidents and to reduce operator cognitive overload in emergency conditions

  3. Emergency Responses and Health Consequences after the Fukushima Accident; Evacuation and Relocation.

    Hasegawa, A; Ohira, T; Maeda, M; Yasumura, S; Tanigawa, K

    2016-04-01

    The Fukushima accident was a compounding disaster following the strong earthquake and huge tsunami. The direct health effects of radiation were relatively well controlled considering the severity of the accident, not only among emergency workers but also residents. Other serious health issues include deaths during evacuation, collapse of the radiation emergency medical system, increased mortality among displaced elderly people and public healthcare issues in Fukushima residents. The Fukushima mental health and lifestyle survey disclosed that the Fukushima accident caused severe psychological distress in the residents from evacuation zones. In addition to psychiatric and mental health problems, there are lifestyle-related problems such as an increase proportion of those overweight, an increased prevalence of hypertension, diabetes mellitus and dyslipidaemia and changes in health-related behaviours among evacuees; all of which may lead to an increased cardiovascular disease risk in the future. The effects of a major nuclear accident on societies are diverse and enduring. The countermeasures should include disaster management, long-term general public health services, mental and psychological care, behavioural and societal support, in addition to efforts to mitigate the health effects attributable to radiation. PMID:26876459

  4. State of emergency medicine in Azerbaijan

    Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

    2008-01-01

    Background There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the “specialty” model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. Aims The Emergency Medicine De...

  5. Emergency response and nuclear risk governance. Nuclear safety at nuclear power plant accidents

    The present study entitled ''Emergency Response and Nuclear Risk Governance: nuclear safety at nuclear power plant accidents'' deals with issues of the protection of the population and the environment against hazardous radiation (the hazards of nuclear energy) and the harmful effects of radioactivity during nuclear power plant accidents. The aim of this study is to contribute to both the identification and remediation of shortcomings and deficits in the management of severe nuclear accidents like those that occurred at Chernobyl in 1986 and at Fukushima in 2011 as well as to the improvement and harmonization of plans and measures taken on an international level in nuclear emergency management. This thesis is divided into a theoretical part and an empirical part. The theoretical part focuses on embedding the subject in a specifically global governance concept, which includes, as far as Nuclear Risk Governance is concerned, the global governance of nuclear risks. Due to their characteristic features the following governance concepts can be assigned to these risks: Nuclear Safety Governance is related to safety, Nuclear Security Governance to security and NonProliferation Governance to safeguards. The subject of investigation of the present study is as a special case of the Nuclear Safety Governance, the Nuclear Emergency governance, which refers to off-site emergency response. The global impact of nuclear accidents and the concepts of security, safety culture and residual risk are contemplated in this context. The findings (accident sequences, their consequences and implications) from the analyses of two reactor accidents prior to Fukushima (Three Mile Iceland in 1979, Chernobyl in 1986) are examined from a historical analytical perspective and the state of the Nuclear Emergency governance and international cooperation aimed at improving nuclear safety after Chernobyl is portrayed by discussing, among other topics, examples of &apos

  6. The nuclear medicine department in the emergency management plan: a referent structure for the nuclear and radiological risks

    Each french public or private hospital has to establish guidelines for an immediate response to mass casualties (Emergency Management Plan or 'White' Plan). For a nuclear accident or terrorist attack, the staff of the Nuclear Medicine Department may be adequately prepared and equipped. This paper presents the nuclear and radiological risks section of the final draft of the White Plan developed at Bordeaux University Hospital. (author)

  7. Outline of emergency care in a radiation accident and topics for further discussion

    Medical management in a criticality accident is described based on the authors' experiences, and some suggestions are made. The JCO criticality accident occurred in Tokai-mura on September 30, 1999, and the Ministry of Health and Welfare dispatched the authors to the site. They consulted with other experts and carried out medical examinations on people living within 350 m of the JCO site. They explained the gamma-radiation survey and about health hazards. Then they framed a public health plan of action before leaving Tokai-mura. At the time, there was no adequate system for interpreting the situation of for preparing for accidents. Based on these experiences, the authors concluded that good training, a care manual, and a system for the emergency phase and the follow-up phase are necessary. (K.H.)

  8. Education Scholarship and its Impact on Emergency Medicine Education

    Jonathan Sherbino

    2015-11-01

    Full Text Available Emergency medicine (EM education is becoming increasingly challenging as a result of changes to North American medical education and the growing complexity of EM practice. Education scholarship (ES provides a process to develop solutions to these challenges. ES includes both research and innovation. ES is informed by theory, principles and best practices, is peer reviewed, and is disseminated and archived for others to use. Digital technologies have improved the discovery of work that informs ES, broadened the scope and timing of peer review, and provided new platforms for the dissemination and archiving of innovations. This editorial reviews key steps in raising an education innovation to the level of scholarship. It also discusses important areas for EM education scholars to address, which include the following: the delivery of competency-based medical education programs, the impact of social media on learning, and the redesign of continuing professional development.

  9. Functional Somatic Syndromes: Emerging Biomedical Models and Traditional Chinese Medicine

    Steven Tan

    2004-01-01

    Full Text Available The so-called functional somatic syndromes comprise a group of disorders that are primarily symptom-based, multisystemic in presentation and probably involve alterations in mind-brain-body interactions. The emerging neurobiological models of allostasis/allostatic load and of the emotional motor system show striking similarities with concepts used by Traditional Chinese Medicine (TCM to understand the functional somatic disorders and their underlying pathogenesis. These models incorporate a macroscopic perspective, accounting for the toll of acute and chronic traumas, physical and emotional stressors and the complex interactions between the mind, brain and body. The convergence of these biomedical models with the ancient paradigm of TCM may provide a new insight into scientifically verifiable diagnostic and therapeutic approaches for these common disorders.

  10. Emergency planning practices and criteria in the OECD countries after the Chernobyl accident

    This critical review has been prepared at the request of the Committee on Radiation Protection and Public Health (CRPPH), on the basis of information collected from Member countries on their emergency planning practices and criteria, and on changes being considered as a consequence of the Chernobyl accident. This information was officially provided to the Secretariat in response to a questionnaire. Other material has also been used, such as official papers describing national practices and reports presented at meetings organised by the NEA. In these cases the sources are given in the list of references. The information in this report reflects the situation in the Member countries at the end of 1987 and it might well be that additional changes were introduced in the emergency planning practices and criteria of several countries after the answers were sent to the Secretariat. It should also be noted that several of the questions were mainly relevant to nuclear power reactor operations. However, the basic philosophy for emergency planning is general, i.e. radiological criteria, emergency organisation, medical assistance, information to the public, etc., and applies in similar ways to different emergencies. Therefore, the information in the report should be valid for different types of radiological emergencies, although emphasis is placed in the report is on nuclear power reactor emergencies. For non-nuclear power Member countries the information refers mainly to plans to cope with other types of radiation emergencies, and to emergencies of a transboundary origin. Finally, the information covers only the off-site part of emergency planning, apart from some reflections in Chapter 1 on on-site emergency planning and the measures taken at nuclear facilities to prevent an accident or mitigate its consequences

  11. The Fukushima Daiichi Accident. Technical Volume 3/5. Emergency Preparedness and Response. Annexes

    The Fukushima Daiichi Accident consists of a Report by the IAEA Director General and five technical volumes. It is the result of an extensive international collaborative effort involving five working groups with about 180 experts from 42 Member States with and without nuclear power programmes and several international bodies. It provides a description of the accident and its causes, evolution and consequences, based on the evaluation of data and information from a large number of sources available at the time of writing. The Fukushima Daiichi Accident will be of use to national authorities, international organizations, nuclear regulatory bodies, nuclear power plant operating organizations, designers of nuclear facilities and other experts in matters relating to nuclear power, as well as the wider public. The set contains six printed parts and five supplementary CD-ROMs. Contents: Report by the Director General; Technical Volume 1/5, Description and Context of the Accident; Technical Volume 2/5, Safety Assessment; Technical Volume 3/5, Emergency Preparedness and Response; Technical Volume 4/5, Radiological Consequences; Technical Volume 5/5, Post-accident Recovery; Annexes. The Report by the Director General is available separately in Arabic, Chinese, English, French, Russian, Spanish and Japanese

  12. Potential and limitations of e-learning in emergency medicine.

    Roe, David; Carley, Simon; Sherratt, Cathy

    2010-02-01

    This paper describes the potential benefits, pitfalls and barriers to adopting e-learning in emergency medicine. While the benefits relating to access, engagement and quality assurance are clear, caution is urged in embracing e-learning for e-learning's sake. It is argued that, if educational strategies are to change, this must be to the benefit of learners and not just for the convenience of access or record keeping. A variety of e-learning approaches are available, but those that promote group discussion or provide feedback from an educator are more likely to lead to successful learning than stand-alone feedback-free modules. A blended approach to learning is advocated where e-learning opportunities form an important but limited part of the overall educational experience. Shop floor and workshop-based teaching should be enhanced with e-learning, not replaced by it. PMID:20156859

  13. ANSI/ANS-8.23-1997: nuclear criticality accident emergency planning and response

    American National Standard ANSUANS-8.23 was developed to expand upon the basic emergency response guidance given in American National Standard, 'Administrative Practices for Nuclear Criticality Safety' ANSI/ANS-8.19-1996 (Ref. 1). This standard provides guidance for minimizing risks to personnel during emergency response to a nuclear criticality accident outside reactors. This standard is intended to apply to those facilities for which a criticality accident alarm system, as specified in American National Standard, 'Criticality Accident Alarm System', ANSI/ANS-8.3-1997 (Ref. 2) is in use. The Working Group was established in 1990, with Norman L. Pruvost as chairman. The Working Group had up to twenty-three members representing a broad range of the nuclear industry, and has included members from Canada, Japan and the United Kingdom. The initial edition of ANSI/ANS-8.23 was approved by the American National Standards Institute on December 30, 1997. It provides guidance for the following topics: (1) Management and technical staff responsibilities; (2) Evaluation of a potential criticality accident; (3) Emergency plan provisions; (4) Evacuation; (5) Re-entry, rescue and stabilization; and (6) Classroom training, exercises and evacuation drills. This guidance is not for generic emergency planning issues, but is specific to nuclear criticality accidents. For example, it assumes that an Emergency Plan is already established at facilities that implement the standard. During the development of the initial edition of ANSI/ANS-8.23, each Working Group member evaluated potential use of the standard at a facility with which the member was familiar. This revealed areas where a facility could have difficulty complying with the standard. These reviews helped identify and eliminate many potential problems and ambiguities with the guidance. The Working Group has received very limited feedback from the user community since the first edition of the standard was published. Suggestions

  14. ANSI/ANS-8.23-1997: nuclear criticality accident emergency planning and response.

    Baker, J. S. (James S.)

    2004-01-01

    American National Standard ANSUANS-8.23 was developed to expand upon the basic emergency response guidance given in American National Standard, 'Administrative Practices for Nuclear Criticality Safety' ANSI/ANS-8.19-1996 (Ref. 1). This standard provides guidance for minimizing risks to personnel during emergency response to a nuclear criticality accident outside reactors. This standard is intended to apply to those facilities for which a criticality accident alarm system, as specified in American National Standard, 'Criticality Accident Alarm System', ANSI/ANS-8.3-1997 (Ref. 2) is in use. The Working Group was established in 1990, with Norman L. Pruvost as chairman. The Working Group had up to twenty-three members representing a broad range of the nuclear industry, and has included members from Canada, Japan and the United Kingdom. The initial edition of ANSI/ANS-8.23 was approved by the American National Standards Institute on December 30, 1997. It provides guidance for the following topics: (1) Management and technical staff responsibilities; (2) Evaluation of a potential criticality accident; (3) Emergency plan provisions; (4) Evacuation; (5) Re-entry, rescue and stabilization; and (6) Classroom training, exercises and evacuation drills. This guidance is not for generic emergency planning issues, but is specific to nuclear criticality accidents. For example, it assumes that an Emergency Plan is already established at facilities that implement the standard. During the development of the initial edition of ANSI/ANS-8.23, each Working Group member evaluated potential use of the standard at a facility with which the member was familiar. This revealed areas where a facility could have difficulty complying with the standard. These reviews helped identify and eliminate many potential problems and ambiguities with the guidance. The Working Group has received very limited feedback from the user community since the first edition of the standard was

  15. Ecological safety during radiological accidents. Analysis and evaluation of emergency situations at radiologically dangerous objects

    The risk of radiological accidents at dangerous objects is minimal when with the help of technical and organizational means it is guaranteed that indoor and outdoor radiation doses are not exceeded. Also, it is necessary to ensure that the quantity of radiological products in the environment doesn't exceed allowed levels both at a normal exploitation of an object and during an accident. In regions with high radiological loads it is necessary to pay enough attention to the safety of dangerous objects in the situations of accidents. An example given in the paper on how to deal with accidents is based on a situation in the Archangelsk region. Analysis was implemented at 23 radiologically dangerous objects. The results of the analysis allowed to determine objects that are dangerous in an ecological sense. Relying on that, methodology of evaluating the situation in the region was created. The main thing is that evaluation of an ecological situation is judged relying on an emergency situation at a radiologically dangerous object. The first step of the methodology preparation is identification of particularly dangerous objects, and modeling of radiological load on an investigated area. The second step of the work is to review the second stage of the methodology which would be dedicated to the analysis and evaluation of emergency situations at radiologically dangerous objects. (author)

  16. The first aid management of epistaxis by accident and emergency department staff.

    McGarry, G W; Moulton, C

    1993-01-01

    Most nose bleeds can be controlled by compressing the ala nasi, thus applying direct pressure over Little's area. The ability to demonstrate the correct position for this manoeuvre was assessed in 115 members of the staff of the accident and emergency (A&E) department of a major teaching hospital. Overall, the correct response rate was only 33% and even trained medical and nursing staff achieved less than a 50% success rate. Increased awareness of this simple and effective technique is recomm...

  17. The diagnosis of ectopic pregnancy in an accident and emergency department.

    Clancy, M J; Illingworth, R N

    1989-01-01

    The correct diagnosis was initially suspected in 32 (53%) of 60 patients with ectopic pregnancy who attended an accident and emergency department. Incorrect diagnoses were made because ectopic pregnancy was not considered or because relevant symptoms and signs were missed or misinterpreted. Three patients had been 'sterilized'. Twenty-four patients (40%) had abdominal pain or vaginal bleeding for more than 1 week before attending. Fever and leucocytosis were wrongly attributed to pelvic infec...

  18. Consent to treatment by minors attending accident and emergency departments: guidelines.

    Williams, L; Harris, A.; Thompson, M.; Brayshaw, A

    1997-01-01

    The absolute right to refuse medical treatment, even if the reasons are irrational, is confined to competent adults. Children under 16 years can give legal consent to treatment in the absence of consent from those with parental responsibility. Children under 18 years do not, however, have an absolute right to consent, or refuse to consent, to treatment. The views of children assume increasing importance with age and maturity. Accident and emergency medical and nursing staff may face difficult...

  19. Deliberate self harm assessment by accident and emergency staff--an intervention study.

    Crawford, M J; Turnbull, G; Wessely, S

    1998-01-01

    OBJECTIVE: To examine the impact of specific training for accident and emergency (A&E) staff on the quality of psychosocial assessment of deliberate self harm patients. METHODS: A non-randomised intervention study that compared the psychosocial assessment of deliberate self harm patients before and after a one hour teaching session for the A&E departments nursing and junior medical staff. Adequacy of psychosocial assessment was judged by examining A&E case notes. The records of the hospital's...

  20. An examination of the accident and emergency management of deliberate self harm.

    Dennis, M; BEACH, M; Evans, P A; Winston, A.; Friedman, T.

    1997-01-01

    OBJECTIVE: To examine the adequacy of assessment and management of deliberate self harm (DSH) undertaken by accident and emergency (A&E) medical staff. METHODS: The records for attendances to the Leicester Royal Infirmary A&E department with a diagnosis of "self inflicted" injury for the 12 month period April 1994 to March 1995 were scrutinised. If the episode was identified as DSH, then assessment and management were examined, using an instrument based on the Royal College of Psychiatrists' ...

  1. Report of an audit of nurse triage in an accident and emergency department.

    Wong, T W; Tseng, G; Lee, L W

    1994-01-01

    The nurse triage process in an accident and emergency (A&E) department was audited as part of the nursing quality assurance programme. It was found that in most cases documentation was adequate and guidelines had been adhered to. Triage decisions were accurate in most cases using the discharge diagnosis as a bench-mark. Waiting time improvements were also seen. Triage audit was a useful tool in the continuous quality improvement effort.

  2. Organ donation in the accident and emergency department: a study of relatives' views.

    Wellesley, A.; Glucksman, E.; Crouch, R

    1997-01-01

    OBJECTIVE: To determine whether recently bereaved people would object to being asked about organ donation immediately after the death of their relative. METHODS: A telephone interview of 78 recently bereaved relatives of people who had died in an inner city accident and emergency (A&E) department; 68 (87%) agreed to participate in the study and were sent a questionnaire. Outcome measures were views on being asked about organ donation in the A&E department immediately after the death of a rela...

  3. A review of 7 years of complaints in an inner-city accident and emergency department.

    Hunt, M T; Glucksman, M E

    1991-01-01

    In 7 years between 1982-88, 122 complaints were lodged against the Accident and Emergency department of King's College Hospital. A high percentage mentioned more than one aspect per complaint. Commonest were those regarding attitude (37.7%), missed diagnosis (36.6%), waiting time (32.8%), cursory examination (14.7%) and poor communication (11.5%). These causes of complaint are amenable to improvement. Training in interpersonal skills may reduce complaints of attitude. A high index of suspicio...

  4. History of aid provision during radiation accidents in the Czech Republic and of radiation emergency reporting

    The history of radiation accidents and reported elevated exposures divided into the 1954-1978, 1979-1994 and 1995-2012 periods is described in detail. The spectrum of reported radiation events has changed during the years, now including e.g. retrieval of orphan sources, illicit traffic, etc. Since 1995 the agenda of radiation protection has been dealt with by the State Office of Nuclear Safety, where an Emergency Coordination Centre was established.

  5. Proposal optimization in nuclear accident emergency decision based on IAHP

    On the basis of establishing the multi-layer structure of nuclear accident emergency decision, several decision objectives are synthetically analyzed, and an optimization model of decision proposals for nuclear accident emergency based on interval analytic hierarchy process is proposed in the paper. The model makes comparisons among several emergency decision proposals quantified, and the optimum proposal is selected out, which solved the uncertain and fuzzy decision problem of judgments by experts' experiences in nuclear accidents emergency decision. Case study shows that the optimization result is much more reasonable, objective and reliable than subjective judgments, and it could be decision references for nuclear accident emergency. (authors)

  6. Emergency plans for nuclear power accidents

    The report presents an evaluation of an exercise of emergency services during a simulated accident at the nuclear power plant of Barsebaeck, Sweden. The aim of the exercise was to test Swedish and Danish organizations and various collaborative co-ordinations. Recommendations for future exercises are given. (G.B.)

  7. Tissue donation after death in the accident and emergency department: an opportunity wasted?

    Magrath, H P; Boulstridge, L J

    1999-01-01

    OBJECTIVE: To investigate whether the accident and emergency department (A&E) is a potential source of tissues for donation, from non-heart beating donors (NHBDs). METHODS: A telephone survey of 30 A&E departments was conducted to determine current tissue harvesting practices from NHBDs. The potential number of tissue donors in our own medium sized district general hospital A&E department was estimated. Senior nursing staff were asked to complete a questionnaire to establish their knowledge, ...

  8. The use of music therapy in reducing anxiety on patients attending accident and emergency department

    So, Wing-hong; 蘇永康

    2013-01-01

    In Hong Kong, there has about 70% patients who attend Accident and Emergency Department (AED) is categorized as semi- or non-urgent cases. The medical conditions with the relative longer waiting time provoke the anxiety level. Furthermore the anxiety is worsen by the noisy waiting environment. These phenomena not only affect the psychological but also the physiological changes of patients. Therefore, there is a need to develop an evidence-based intervention that can effectively reduce the anx...

  9. Notification of infectious diseases by junior doctors in accident and emergency departments.

    Spedding, R L; Jenkins, M G; O'Reilly, S A

    1998-01-01

    OBJECTIVE: To assess the knowledge about notifiable infectious diseases by accident and emergency (A&E) senior house officers. METHODS: A telephone questionnaire of senior house officers was carried out over a one week period at the end of their six month attachment in A&E departments in Northern Ireland. RESULTS: 81 (91%) of the senior house officers participated in the study; 23 (29%) realised that the doctor diagnosing the notifiable disease had a statutory duty to notify that disease; nin...

  10. Personalized peer-comparison feedback and its effect on emergency medicine resident ultrasound scan numbers

    Hempel, Dorothea; Pivetta, Emanuele; Kimberly, Heidi H

    2014-01-01

    Background: Clinician-performed ultrasound has become a widely utilized tool in emergency medicine and is a mandatory component of the residency curricula. We aimed to assess the effect of personalized peer-comparison feedback on the number of ultrasound scans performed by emergency medicine residents. Findings: A personalized peer-comparison feedback was performed by sending 44 emergency medicine residents a document including personally identified scan numbers and class averages. The number...

  11. Decision making process and emergency management in different phases of a nuclear accident

    EVATECH, Information Requirements and Countermeasure Evaluation Techniques in Nuclear Emergency Management, was a research project in the key action 'Nuclear Fission' of the fifth EURATOM Framework Programme (FP5). The overall objective of the project was to enhance the quality and coherence of response to nuclear emergencies in Europe by improving the decision support methods, models and processes in ways that take into account the expectations and concern of the many different parties involved - stake holders both in managing the emergency response and those who are affected by the consequences of nuclear emergencies. The project had ten partners from seven European countries. The development of the real-time online decision support system RODOS has been one of the major items in the area of radiation protection within the European Commission's Framework Programmes. The main objectives of the RODOS project have been to develop a comprehensive and integrated decision support system that is generally applicable across Europe and to provide a common framework for incorporating the best features of existing decision support systems and future developments. Furthermore the objective has been to provide greater transparency in the decision process to: improve public understanding and acceptance of off-site emergency measures, to facilitate improved communication between countries of monitoring data, predictions of consequences, etc., in the event of any future accident, and to promote, through the development and use of the system, a more coherent, consistent and harmonised response to any future accident that may affect Europe. (authors)

  12. Convention on early notification of a nuclear accident and convention on assistance in the case of a nuclear accident or radiological emergency

    The document refers to the Convention on Early Notification of a Nuclear Accident (CENNA) (IAEA-INFCIRC-335) and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (CANARE) (IAEA-INFCIRC-336). Part I contains the status list as of 31 December 1996, Part II contains the texts of reservations/declarations made upon or following expressing consent to be bound and objections thereto, and Part III contains the texts of reservations/declarations made upon signature

  13. Convention on early notification of a nuclear accident and convention on assistance in the case of a nuclear accident or radiological emergency

    The document refers to the Convention on Early Notification of a Nuclear Accident (CENNA) (IAEA-INFCIRC-335) and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (CANARE) (IAEA-INFCIRC-336). Part I contains the status lists as of 10 September 1992, part II contains the texts of reservations/declarations made upon expressing consent to be bound and objections there to, and part III contains the texts of reservations/declarations made upon signature

  14. Emergency preparedness and response to 'not-in-a-facility' radiological accidents

    The paper provides an overview of lessons learned from the past radiological accidents, which have not occurred in an operating facility, i.e. 'not-in-a-facility' radiological emergencies. A method to analyze status of prevention of accidents is proposed taking into account the experiences and findings from the past events. The main emergency planning items are discussed, which would render effective response in case of such emergencies. Although the IAEA has published many documents about establishing an adequate emergency response capability, it is not an easy task to bring these recommendations into life. This paper gives some hints how to overcome the most obvious difficulties while users of these documents trying to adapt the guidance to their own needs. The special cases of alpha emitters and radiological dispersal devices were considered separately. The balanced approach to emergency response is promoted throughout the text, which means that a level of preparedness should be commensurate to the threat and the existing resources should be used to the extent possible. (author)

  15. Emergency preparedness and response to 'Not-in-a-Facility' radiological accidents

    The paper provides an overview of lessons learned from the past radiological accidents, which have not occurred in an operating facility, i.e. 'not-in-a-facility' radiological emergencies. A method to analyze status of prevention of accidents is proposed taking into account the experiences and findings from the past events. The main emergency planning items are discussed, which would render effective response in case of such emergencies. Although the IAEA has published many documents about establishing an adequate emergency response capability, it is not an easy task to bring these recommendations into life. This paper gives some hints how to overcome the most obvious difficulties while users of these documents trying to adapt the guidance to their own needs. The special cases of alpha emitters and radiological dispersal devices were considered separately. The balanced approach to emergency response is promoted throughout the text, which means that a level of preparedness should be commensurate to the threat and the existing resources should be used to the extent possible. (author)

  16. Convention on early notification of a nuclear accident and convention on assistance in the case of a nuclear accident or radiological emergency

    The document refers to the Convention on Early Notification of a Nuclear Accident (IAEA-INFCIRC-335) and to the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (IAEA-INFCIRC-336). Part I contains the status lists as of August 31, 1991. Part II contains reservations/declarations made upon expressing consent to be bound and objections there to. Part III contains reservations/declarations made upon signature

  17. Medical treatment of radiation damages and medical emergency planning in case of nuclear power plant incidents and accidents

    Medical measures in case of radiation damages are discussed on the basis of five potential categories of radiation incidents and accidents, respectively, viz. contaminations, incorporations, external local and general radiation over-exposures, contaminated wounds, and combinations of radiation damages and conventional injuries. Considerations are made for diagnostic and therapeutic initial measures especially in case of minor and moderate radiation accidents. The medical emergency planning is reviewed by means of definations used in the practical handling of incidents or accidents. The parameters are: extent of the incident or accident, number of persons involved, severity of radiation damage. Based on guiding symptoms the criteria for the classification into minor, moderate or severe radiation accidents are discussed. Reference is made to the Medical Radiation Protection Centers existing in the Federal Republic of Germany and the possibility of getting advices in case of radiation incidents and accidents. (orig.)

  18. Convention on Early Notification of a Nuclear Accident and Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency

    Part I: Status lists as of 31 December 1996. A. Convention on Early Notification of a Nuclear Accident (Notification Convention). B. Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention). PART II: Texts of reservations/declarations made upon or following expressing consent to be bound and objections thereto Part III: Texts of reservations/declarations made upon signature

  19. Emergency response to a nuclear facility accident: preplanning and preparedness by off-site organizations

    The subject is discussed under the headings: introduction ('defence-in-depth' concept); accident assessment (prompt notification of off-site authorities); time factors associated with accidents leading to radiological releases off-site; radiological characteristics of releases; emergency communications; an adequate planning basis; training. (U.K.)

  20. Advanced Topics in Emergency Medicine: Curriculum Development and Initial Evaluation

    Sorabh Khandelwal

    2011-05-01

    Full Text Available Background: Emergency medicine (EM is a young specialty and only recently has a recommended medical student curriculum been developed. Currently, many schools do not require students to complete a mandatory clerkship in EM, and if one is required, it is typically an overview of the specialty. Objectives: We developed a 10-month longitudinal elective to teach subject matter and skills in EM to fourth-year medical students interested in the specialty. Our goal was producing EM residents with the knowledge and skills to excel at the onset of their residency. We hoped to prove that students participating in this rigorous 10-month longitudinal EM elective would feel well prepared for residency. Methods: We studied the program with an end-of-the-year, Internet-based, comprehensive course evaluation completed by each participant of the first 2 years of the course. Graduates rated each of the course components by using a 5-point Likert format from ‘‘strongly disagree’’ to ‘‘strongly agree,’’ either in terms of whether the component was beneficial to them or whether the course expectations were appropriate, or their perceptions related to the course. Results: Graduates of this elective have reported feeling well prepared to start residency. The resident-led teaching shifts, Advanced Pediatric Life Support certification, Grand Rounds presentations, Advanced Cardiovascular Life Support proficiency testing, and ultrasound component, were found to be beneficial by all students. Conclusions: Our faculty believes that participating students will be better prepared for an EM residency than those students just completing a 1-month clerkship. Our data, although limited, lead us to believe that a longitudinal, immersion-type experience assists fourth-year medical students in preparation for residency. [West J Emerg Med. 2011;12(4:543–550.

  1. Build-up forces at Military Institute of Medical Radiology and Oncology for emergency medical response to some eventualities of radiological accidents - some suggestions

    Nowadays, the use of various nuclear sources in some fields of the life has brought many practical advantages in general; especially in the next several years, our country will begin construction of the first nuclear plant. However, if there were user carelessness or objective disadvantageous factors (earthquake, tsunami, etc.), that disadvantages could lead to a radiation accident or nuclear accident which causes damages not only for economy but also for public health. Therefore, the emergency response to radiation accident, especially the emergency medical response that has a great important position. To satisfy this real demand, in 1996, Vietnam Ministry of Defence made the decision to establish Center for Nuclear Medicine and Radiation Protecting (now becomes Military Institute of Medical Radiology and Oncology) with the main missions are research, applying radiation protecting methods and organizing treatments to radiation injured victims. To fulfill above main missions, with the help of Vietnam Atomic Energy Institute (VAEI), Vietnam Agency for Radiation and Nuclear Safety (VARANS), the doctors and staffs of our Institute have been participated in the international training courses and workshops that organized in Vietnam or in regional countries about emergency medical response to radiation accidents, they get valuable information, knowledge and documents from these courses and workshops. Depending on the principles of radiation emergency medical response to nuclear/ radiation accidents that International Atomic Energy Agency (IAEA) guided, and with the experience learned from other countries in Asia region, our Institute have been gradually improving on organization and curing processes for the radiation victims and also setting the preparedness for emergency medical response to radiation accidents if maybe they could occur. (author)

  2. Pre-hospital emergency medicine.

    Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E

    2015-12-19

    Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes. The transfer of skills and procedures from hospital care to pre-hospital medicine enables early advanced care across a range of disciplines. The variety of possible pathologies, challenges of environmental factors, and hazardous situations requires management that is tailored to the patient's clinical need and setting. Pre-hospital clinicians should be generalists with a broad understanding of medical, surgical, and trauma pathologies, who will often work from locally developed standard operating procedures, but who are able to revert to core principles. Pre-hospital emergency medicine consists of not only clinical care, but also logistics, rescue competencies, and scene management skills (especially in major incidents, which have their own set of management principles). Traditionally, research into the hyper-acute phase (the first hour) of disease has been difficult, largely because physicians are rarely present and issues of consent, transport expediency, and resourcing of research. However, the pre-hospital phase is acknowledged as a crucial period, when irreversible pathology and secondary injury to neuronal and cardiac tissue can be prevented. The development of pre-hospital emergency medicine into a sub-specialty in its own right should bring focus to this period of care. PMID:26738719

  3. Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents

    Mariana Gonçalves de Freitas; Palmira de Fátima Bonolo; Edgar Nunes de Moraes; Carla Jorge Machado

    2015-01-01

    The article aims to describe the profile of elderly victims of falls and traffic accidents from the data of the Surveillance Survey of Violence and Accidents (VIVA). The VIVA Survey was conducted in the emergency health-services of the Unified Health System in the capitals of Brazil in 2011. The sample of elderly by type of accident was subjected to the two-step cluster procedure. Of the 2463 elderly persons in question, 79.8% suffered falls and 20.2% were the victims of traffic accidents. Th...

  4. Use of the emergency ambulance service to an inner city accident and emergency department--a comparison of general practitioner and '999' calls.

    Pennycook, A. G.; Makower, R M; Morrison, W G

    1991-01-01

    Over a 2-week period a prospective study was undertaken of patients brought to an inner city accident and emergency department by the emergency ambulance service. Criteria for assessing the appropriateness of use of the emergency ambulance service are not well defined and at worst entirely subjective. The author's finding that, of patients attending after a '999' call, 49.8% were discharged with no follow-up suggests that many of these journeys represented inappropriate use of the emergency a...

  5. Emerging nanotechnology approaches in tissue engineering and regenerative medicine

    Kim ES

    2014-05-01

    Full Text Available Eung-Sam Kim,1,2 Eun Hyun Ahn,3,4 Tal Dvir,5,6 Deok-Ho Kim1,4,71Department of Bioengineering, University of Washington, Seattle, WA, USA; 2Department of Biological Sciences, Chonnam National University, Gwangju, Korea; 3Department of Pathology, 4Institute of Stem Cell and Regenerative Medicine, School of Medicine, University of Washington, Seattle, WA, USA; 5Department of Molecular Microbiology and Biotechnology, 6Center for Nanoscience and Nanotechnology, Tel Aviv University, Tel Aviv, Israel; 7Center for Cardiovascular Biology, University of Washington, Seattle, WA, USAThe history of human kind suggests that there has been a correlation between global population growth and major events in science and technology over the last three centuries. Sharp increases in the world’s population have been triggered by the industrial revolution and scientific and technological breakthroughs including: the advent of the railways, discovery of penicillin and deoxyribonucleic acid (DNA, and the invention of the computer.1 Since the 20th century, interdisciplinary areas in the physical and biological sciences have accelerated the progress of biomedical applications. The recent integration of emerging nanotechnology into biology and biomedicine has resulted in a range of innovative nanoengineering efforts for the repair and regeneration of tissues and organs.2 Thus, it is expected that nanoengineering approaches to biomedical applications can contribute to addressing the present issue of personal and global health care and its economic burden for more than 7 billion people.Why are we paying attention to nanoengineering for biomedical applications? The size of most biomolecules ranges from 0.2 nm to 200 nm (Figure 1. Research has focused on control of the interaction and localization of biomolecules even at the single-molecule level using ever-evolving nanotechnology.3 The evidence indicates that cells can respond to nanoscale changes in the dynamic

  6. Radiation accidents and their management: emphasis on the role of nuclear medicine professionals

    Bomanji, Jamshed B.; NOVRUZOV, Fuad; Vinjamuri, Sobhan

    2014-01-01

    Large-scale radiation accidents are few in number, but those that have occurred have subsequently led to strict regulation in most countries. Here, different accident scenarios involving exposure to radiation have been reviewed. A triage of injured persons has been summarized and guidance on management has been provided in accordance with the early symptoms. Types of casualty to be expected in atomic blasts have been discussed. Management at the scene of an accident has been described, with e...

  7. The emergency medical programs of japan and foreign countries for radiation accidents in nuclear power stations

    In our country, the medical emergency programs for the people living near nuclear power stations are well organized, however, preparation of medical staffs who are well trained is considered to be not sufficient. In the USA, on call 24 hours response to a radiological emergency is provided and funded by Department of Energy(DOE) or electric companies. Especially, REAC/TS is a part of DOE response network, in which there are provided well-trained physicians, nurses, health physicists, coordinators and support personnels. In United Kingdom, National Radiological Protection Board(NRPB) is responsible to a radiological emergency program. Each nuclear power station has its own emergency program consisting of a team of physicians, nurses and health physicists. In France, French Atomic Energy Commission (CEA) is a responsible agency for a radiological emergency program. On call 24 hours response to a radiological emergency is provided in Fontenay-aux Roses Institute and Curie Institute. Curie Institute also responds to radiological emergencies in other countries at the request of WHO. In Germany(West Germany), compulsory assurance system covers a radiological emergency program and a radiological protection. There are seven centers in West Germany, in which well-trained medical staffs are provided against radiological injuries. In this report, I tried to propose a new concept about emergency medical programs for nuclear power station accidents in Japan. I think it is a very urgent theme to provide on call 24 hours radiological emergency program, in which patients suffered from acute radiation sickness with internal contamination or contaminated radiation burns will be treated without any trouble. We have to make our best efforts to complete basic or clinical research about radiation injuries including bone marrow transplantation, radioprotectors, chelating agents and radiation burns etc. (J.P.N.)

  8. Use of anti-D in an accident and emergency department.

    Huggon, A M; Watson, D P

    1993-01-01

    A retrospective study was made of the use of anti-D in an accident and emergency (A&E) department in 1 month. Patients who are discharged home with a diagnosis of threatened miscarriage should have their blood group determined and anti-D should be given to those who are rhesus negative. We found that only 8/29 patients discharged from the department had their blood group determined and none of the rhesus negative patients was given anti-D. We have introduced a practical method of reminding me...

  9. Telephone advice in the accident and emergency department: a survey of current practice.

    Evans, R J; McCabe, M; Allen, H.; Rainer, T; Richmond, P. W.

    1993-01-01

    The objective of this study was to assess the standard of advice given by telephone by accident and emergency (A&E) departments following patients' enquiries. In order to do this patient enquiries were simulated and a telephone questionnaire was carried out. The study was carried out in 18 major and 16 minor A&E departments in Wales. Results achieved were that overall, correct telephone advice was given to 72 of 97 simulated patients (74%). Sixty calls were dealt with by the nursing staff (62...

  10. The cost of overseas visitors to an inner city accident and emergency department.

    Colville, J.; Burgess, A; Kermani, C; Touquet, R; Fothergill, J

    1996-01-01

    OBJECTIVE: To estimate, in a metropolitan accident and emergency (A&E) department, the annual cost of treating overseas visitors whose countries of origin do not have reciprocal arrangements with Britain. METHODS: The study was retrospective. A 24 h period (00.01 h to 24.00 h inclusive) on consecutive days in consecutive weeks (that is, Monday in week 1, Tuesday in week 2, etc) was costed over 52 weeks (1.8.92-31.7.93 inclusive) and extrapolated to 365 days. All visitors between those dates w...

  11. An analysis of telephone calls to an inner-city accident and emergency department.

    Crouch, R; Patel, A; Williams, S.; Dale, J

    1996-01-01

    The general public in the UK often telephone accident and emergency (A&E) departments for medical advice. Such calls are usually dealt with by nursing staff in an informal manner (often with no written record of the call being made). The specific questions addressed in this study are who was calling for advice, when did they call, what were their presenting complaints, and what was the outcome of the call? In addition, the study provided an opportunity to test the implementation of a new syst...

  12. Audit of telephone advice in a paediatric accident and emergency department.

    Molyneux, E; Jones, N.; Aldom, G; Molyneux, B

    1994-01-01

    This paper audits the telephone requests for advice to a paediatric accident and emergency (A&E) Department over a 4-week period. All calls were answered by senior nurses. Most calls were received in the early evenings when the A&E department was busy. Parents were the most frequent callers and the majority of calls were for children under 5 years of age. The problems presented were wide ranging but advice over the telephone meant that many unnecessary visits to hospital were prevented. The p...

  13. Regulatory requirements on accident management and emergency preparedness - concept of nuclear and radiation safety during beyond-design-basis accidents

    Actual practice the and proposals for further activities in the field of Accident Management (AM) in the member countries of the Co-operation Forum of WWER regulators and in Western countries have been assessed. Further the results of the last working group on AM , the overview of interactions of severe accident research and the regulatory positions in various countries, IAEA reports, practice in Switzerland and Finland, were taken into consideration. From this information, the working group derived recommendations on Accident Management. The general proposals correspond to the present state of the art on AM. They do not describe the whole spectra of recommendations on AM for NPPs with WWER reactors. A basis for the implementation of an AM program is given, which could be extended in a follow-up working group. The developments and research concerning AM have to be continued. The positions of various countries with regard to the 'Interactions of severe accident research and the regulatory positions' are given. On the basis of the working group proposals, the WWER regulators could set regulatory requirements and support further developments of AM strategies, making use of the benefits of common features of NPPs with WWER reactors. Concerted actions in the field of AM between the WWER regulators would bundle the development of a unified concept of recommendations and speed up the implementation of AM measures in order to minimise the risks involved in nuclear power generation

  14. Intentional Poisoning as a Cause of Admission to Accident and Emergency in a Tertiary Care Hospital within a Year

    Niveditha

    2011-10-01

    Full Text Available Introduction: Poisoning is a common medico social problem nowadays and is often distressing for both family members and medical staff. The present study aims to evaluate the pattern of self poisoning with special preference to psychoactive drugs. Methodology: Study sample comprised of all episodes of self poisoning that had resulted in admission between January to December 2008.Pateints taking any toxic/pharmacological substance by accident or ignorance were excluded. Results: Out of 1206 patients admitted to accident and emergency during the study period, 140 were due to intentional poisoning (11.6% Age of the patients varied from 16-65 years. The maximum incidence was between 21-30 years. The male: female ratio was 1.18:1.Most common substance used was organophosphate compound (OPC (31.7% followed by benzodiazepines (BZD (20.7% and household articles comprised of 18.5%. Multiple drug combinations with alcohol was 30%.Around 13.5% had history of mental illness. Conclusion: At present due to vast development in all fields of life like industries, medicine and agriculture, a significant number of new compounds have appeared as new poisonous substances, which have led to more number of poisoning cases. Although there are restrictions on sale of drugs in India, vulnerability to insecticide cannot be ignored.

  15. Mutual emergency assistance for radiation accidents

    A revised document on ''Mutual Emergency Assistance for Radiation Accidents'' jointly prepared by the Agency with the participation of the World Health Organization (WHO), the Food and Agricultural Organization of the United Nations (FAO), the International Labour Organisation (ILO) and the Office of the United Nations Disaster Relief Co-ordinator (UNDRO) was issued in 1980 as TECDOC-237. The present document lists the additional information received after publication of the 1980 edition and is issued as a Supplement to TECDOC-237 (1980 Edition). Some useful information contained in TECDOC-237 such as the IAEA arrangement and the WHO Collaborating Centres for Radiation Emergency Assistance are reprinted for ready reference

  16. A transatlantic comparison of training in emergency medicine.

    Wyatt, J. P.; Weber, J E

    1998-01-01

    The system of training in accident and emergency (A&E) medicine in the United Kingdom is at a critical and much earlier stage of development than in the United States. Transatlantic comparison offers the opportunity to explore possible ways of improving training in the United Kingdom. Comparison revealed deficiencies in the UK training system in the following: prehospital care training, formal theoretical teaching, close supervision in a clinical setting, and in-service training examinations....

  17. Radioactivity material release mechanism and emergency radiation monitor requirements of personnel in core meltdown accident for submarine nuclear power plants

    Some release mechanism of fission products from core meltdown accident of submarine nuclear power plants is described, which include gas-gap, melting, vaporization, steam and explosion. The further release process of them to cabins and environment is described too. The basic requirements and contents of emergency radiation monitor for personnel are approached. A tentative idea of forming emergency radiation monitor net of submarine nuclear power plants and the issue of neutron monitor and protect in the nuclear accident emergency rescue are put forward

  18. A radioactive waste transportation package monitoring system for normal transport and accident emergency response conditions

    Shipments of radioactive material (RAM) constitute but a small fraction of the total hazardous materials shipped in the United States each year. Public perception, however, of the potential consequences of a release from a transportation package containing RAM has resulted in significant regulation of transport operations, both to ensure the integrity of a package in accident conditions and to place operational constraints on the shipper. Much of this attention has focused on shipments of spent nuclear fuel and high level wastes which, although comprising a very small number of total shipments, constitute a majority of the total curies transported on an annual basis. Shipment of these highly radioactive materials is made in what is described in the regulations as a Type B packaging. Type B transportation packages are designed to withstand a sequence of accident scenarios, including drop, puncture, fire, and immersion with virtually no release of contents. Due to the quantities of spent fuel and high level wastes carried in Type B casks and the public perception and apprehension regarding the potential consequences of a release, involvement of a packaging containing spent fuel or high level wastes in any accident will result in a very cautious emergency response until it can be determined that the integrity of the cask is maintained. Typically this involves closure of the transport link or pathway, evacuation of all unnecessary personnel, diversion of traffic from the area, and subsequent investigative and mitigative procedures from trained specialists. An onboard instrumentation/communications package has been developed that, when affixed to a radioactive materials cask, can monitor key indicators of the integrity of the cask and communicate these parameters to emergency responders through modules on the vehicle. Entitled the Transportation Intelligent Monitoring System (TRANSIMS), this package enables remote monitoring of the status and integrity of the cask

  19. Emergency medicine in Vietnam.

    Richards, J R

    1997-04-01

    The Socialist Republic of Vietnam is one of the poorest countries in the world. Recent economic developments, as the country attempts to start a market economy, have had a profound impact on its health care system. This report describes the state of prehospital and emergency medical care in Vietnam and possibilities for the future. PMID:9095019

  20. Emergency room management of radiation accidents

    Emergency room management of radioactively contaminated patients who have an associated medical injury requiring immediate attention must be handled with care. Radioactive contamination of the skin of a worker is not a medical emergency and is usually dealt with at the plant. Effective preplanning and on-the-scene triage will allow the seriously injured and contaminated patients to get the medical care they need with a minimum of confusion and interference. Immediate medical and surgical priorities always take precedence over radiation injuries and radioactive contamination. Probably the most difficult aspect of emergency management is the rarity of such accidents and hence the unfamiliarity of the medical staff with the appropriate procedures. The authors discuss how the answer to these problems is preplanning, having a simple and workable procedure and finally having 24-h access to experts

  1. The use of a new design irrigator for the emergency treatment of chemical eye injuries in an accident and emergency department.

    Watts, M T; Mulira, A

    1989-01-01

    The introduction of a hand-held drench hose into a district general hospital accident and emergency department, for the emergency irrigation of chemically injured eyes is reported. The hose is described, together with the technique of irrigation. The advantages that a high-flow, low pressure system affords over conventional irrigation methods are discussed. The system appears to offer a simple, immediately available, effective tool for emergency eye care, which is suitable for use by a variet...

  2. Emergency medicine residents’ attitudes and opinions of in-training exam preparation

    Eastin, Travis R.; Bernard, Aaron W.

    2013-01-01

    Purpose Emergency Medicine (EM) residents take the American Board of Emergency Medicine (ABEM) in-training exam, and performance on this exam has been shown to correlate to performance on the ABEM qualifying exam. Though many residencies have in-training exam preparation activities, there is little data on the effectiveness of these efforts. This study aimed to elicit resident perspectives about the exam and exam preparation in order to generate hypotheses and better inform future preparation...

  3. A digest of the nuclear safety division report on the Fukushima Dai-ichi NPP accident seminar (5). Lessons learned on emergency preparedness and response and related issues

    In the Fukushima Daiichi Power Plant Accident, the lessons learned on the correspondence to emergency are explained from the view point of the radiation protection. The lessons on the INES evaluation, the cooperation and connection in the accident, and the renewal of accident information are mentioned. (M.H.)

  4. FOAMSearch.net: A custom search engine for emergency medicine and critical care

    Raine, T.; Thoma, B; Chan, TM; Lin, M.

    2015-01-01

    © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine. The number of online resources read by and pertinent to clinicians has increased dramatically. However, most healthcare professionals still use mainstream search engines as their primary port of entry to the resources on the Internet. These search engines use algorithms that do not make it easy to find clinician-oriented resources. FOAMSearch, a custom search engine (CSE), was developed to find...

  5. Construction of a technique plan repository and evaluation system based on AHP group decision-making for emergency treatment and disposal in chemical pollution accidents

    Highlights: • Different chemical pollution accidents were simplified using the event tree analysis. • Emergency disposal technique plan repository of chemicals accidents was constructed. • The technique evaluation index system of chemicals accidents disposal was developed. • A combination of group decision and analytical hierarchy process (AHP) was employed. • Group decision introducing similarity and diversity factor was used for data analysis. - Abstract: The environmental pollution resulting from chemical accidents has caused increasingly serious concerns. Therefore, it is very important to be able to determine in advance the appropriate emergency treatment and disposal technology for different types of chemical accidents. However, the formulation of an emergency plan for chemical pollution accidents is considerably difficult due to the substantial uncertainty and complexity of such accidents. This paper explains how the event tree method was used to create 54 different scenarios for chemical pollution accidents, based on the polluted medium, dangerous characteristics and properties of chemicals involved. For each type of chemical accident, feasible emergency treatment and disposal technology schemes were established, considering the areas of pollution source control, pollutant non-proliferation, contaminant elimination and waste disposal. Meanwhile, in order to obtain the optimum emergency disposal technology schemes as soon as the chemical pollution accident occurs from the plan repository, the technique evaluation index system was developed based on group decision-improved analytical hierarchy process (AHP), and has been tested by using a sudden aniline pollution accident that occurred in a river in December 2012

  6. Emergency preparedness of Research Center for Radiation medicine and its hospital to admit and treat the patients with signs of acute radiation sickness

    After the Chernobyl accident, the Research Center for Radiation Medicine (RCRM) was established in Kiev (Ukraine). Its main task was to maintain a high level of emergency preparedness and be ready to examine and treat patients who suffer as a result of hypothetical radiation accident. Based on the previous experience, this institution's specialists worked out new diagnostic criteria and drug treatment schemata for acute radiation sickness, created a database on 75 patients with this diagnosis and improved educational programmes for medical students and physicians working in the field of radiation medicine. RCRM collaborates fruitfully with western partners through the joint research projects and connects with the World Health Organisation's Radiation Emergency Medical Preparedness and Assistance Network centre. Collaboration with Kiev Center for Bone Marrow Transplantation allows RCRM to use aseptic wards having highly filtered air for the treatment of most severely irradiated patients. (authors)

  7. Development of Educational and Training Simulator for Emergency Response to Chinese Nuclear Accidents

    Kim, Juyub; Kim, Juyoul; Kim, Sukhoon; Lee, Seunghee; Yoon, Taebin [FNC Technology Co., Ltd., Yongin (Korea, Republic of); Cliff, Li-Chi [Micro-Simulation Technology, Montville (United States)

    2015-05-15

    One of the lessons in the emergency response category is that information on the nuclear power plants of neighboring countries should be organized and the consequence can be assessed. In addition, many reactors have been constructed and are under construction on the eastern coast of China recently. Korea might be directly affected by an accident of Chinese nuclear power plant since Korea is located in the westerly belt. performed with the PCTRAN/CPR-1000 module. The result showed that normal operation and DBA conditions were simulated swiftly with the speed of 16 times faster than real time. Thus, it would be a good source term estimation module for the educational and training simulator.

  8. Development of Educational and Training Simulator for Emergency Response to Chinese Nuclear Accidents

    One of the lessons in the emergency response category is that information on the nuclear power plants of neighboring countries should be organized and the consequence can be assessed. In addition, many reactors have been constructed and are under construction on the eastern coast of China recently. Korea might be directly affected by an accident of Chinese nuclear power plant since Korea is located in the westerly belt. performed with the PCTRAN/CPR-1000 module. The result showed that normal operation and DBA conditions were simulated swiftly with the speed of 16 times faster than real time. Thus, it would be a good source term estimation module for the educational and training simulator

  9. Activities, projects and emergency planning etc. at the National Institute of Radiation Hygiene in connection with the Chernobyl reactor accident

    The National Institute of Radiation Hygiene (SIS) is the competent authority for radiation hygiene in Norway according to Act No.1 of 18 June 1938 and regulations given pursuant to the act. Legislation on duties specific to radiological emergencies in general has not been issued in Norway. The report describes how SIS organized the fallout survey and summarizes the different projects implemented by the institute after the Chernobyl accident. Furthermore, the institutes view on an alert system for detection of radiactive contamination and on emergency planning for radiation accidents is expressed

  10. [Sepsis in Emergency Medicine].

    Christ, Michael; Geier, Felicitas; Bertsch, Thomas; Singler, Katrin

    2016-07-01

    Sepsis is defined as "life-threatening organ dysfunction caused by a dysregulated host-response to infection". Presence of organ dysfunction is associated with a mortality of 10% and higher in hospitalized sepsis patients.Introduction of standards in diagnosis and treatment of sepsis in intensive care units has not considerably reduced sepsis mortality. About 80% of patients with sepsis are transferred to intensive care units from usual care wards and emergency departments. Thus, it is tempting to speculate whether opportunities for further improvement of sepsis management exist outside of intensive care units. Performing a "quick sequential organ assessment" (qSOFA; two of following criteria have to be present: respiratory rate >22/min; sytolic blood pressure <100mmHg; altered mental status) supports to identify patients with suspicion of an infection and an increased risk of death within the hospital. Subsequent treatment according to current guidelines on sepsis management will reduce in-hospital mortality of sepsis patients. Indeed, we were able to show a substantial decrease of in-hospital mortality of about 20% in patients presenting with community acquired pneumonia to the emergency department.In summary, decision of further management of sepsis patients has to be done outside intensive care units at the time of initial presentation to professional care givers. Sepsis management in acute care settings should include a structured and standardized protocol to further improve survival in affected patients with even mild organ dysfunction. PMID:27464279

  11. State of emergency medicine in Rwanda 2015: an innovative trainee and trainer model.

    Mbanjumucyo, Gabin; DeVos, Elizabeth; Pulfrey, Simon; Epino, Henry M

    2015-01-01

    The 1994 Rwandan war and genocide left more than 1 million people dead; millions displaced; and the country's economic, social, and health infrastructure destroyed. Despite remaining one of the poorest countries in the world, Rwanda has made remarkable gains in health, social, and economic development over the last 20 years, but modern emergency care has been slow to progress. Rwanda has recently established the Human Resources for Health program to rapidly build capacity in multiple sectors of its healthcare delivery system, including emergency medicine. This project involves multiple medical and surgical residencies, nursing programs, allied health professional trainings, and hospital administrative support. A real strength of the program is that trainers work with international faculty at Rwanda's referral hospital, but also as emergency medicine specialty trainers when returning to their respective district hospitals. Rwanda's first emergency medicine trainees are playing a unique and important role in the implementation of emergency care systems and education in the country's district hospitals. While there has been early vital progress in building emergency medicine's foundations in Rwanda, there remains much work to be done. This will be accomplished with careful planning and strong commitment from the country's healthcare and emergency medicine leaders. PMID:26101554

  12. Brief interventions for hazardous and harmful alcohol consumption in accident and emergency departments

    Marcin eWojnar

    2014-11-01

    Full Text Available The prevalence of alcohol abuse among patients treated in accident and emergency departments (A&E is considered substantial. This paper is a narrative review of studies investigating the effectiveness of brief interventions (BI for hazardous and harmful alcohol consumption in A&E. A&E departments in hospitals (and other health care infrastructures are commonly the place where serious consequences of alcohol drinking are seen and need to be tackled, supporting the suggested theoretical usefulness of delivering brief interventions in this environment. Available research shows that brief interventions (BI may be considered a valuable technique for dealing with alcohol-related problems. However, it is suggested that the usefulness of BI may depend significantly on the target population to be dealt with. BI have proved to be beneficial for male individuals and those patients who do not abuse other psychoactive substances. In contrast, evidence indicates that brief interventions in A&E settings are not effective at all when dealing with men admitted as a consequence of a violence-related event. In addition, some studies were unable to confirm the effectiveness of BI in female population, in emergency setting. Studies investigating the association between drinking patterns and the effectiveness of brief interventions also present inconsistent results. Most studies assessing the effectiveness of BI in A&E settings only adopted a short perspective (looking at the impact up to a maximum of twelve months after the BI was delivered. When assessing the effects of BI, both the amount of alcohol consumed as well as expected reductions in alcohol consequences, such as injuries, can be taken into account. Evidence on the implementation of brief intervention in emergency departments remains inconclusive as to whether there are clear benefits. A variety of outcome measures and assessing procedures were used in the different studies, which have investigated this

  13. Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents.

    de Freitas, Mariana Gonçalves; Bonolo, Palmira de Fátima; de Moraes, Edgar Nunes; Machado, Carla Jorge

    2015-03-01

    The article aims to describe the profile of elderly victims of falls and traffic accidents from the data of the Surveillance Survey of Violence and Accidents (VIVA). The VIVA Survey was conducted in the emergency health-services of the Unified Health System in the capitals of Brazil in 2011. The sample of elderly by type of accident was subjected to the two-step cluster procedure. Of the 2463 elderly persons in question, 79.8% suffered falls and 20.2% were the victims of traffic accidents. The 1812 elderly who fell were grouped together into 4 clusters: Cluster 1, in which all had disabilities; Cluster 2, all were non-white and falls took place in the home; Cluster 3, younger and active seniors; and Cluster 4, with a higher proportion of seniors 80 years old or above who were white. Among cases of traffic accidents, 446 seniors were grouped into two clusters: Cluster 1 of younger elderly, drivers or passengers; Cluster 2, with higher age seniors, mostly pedestrians. The main victims of falls were women with low schooling and unemployed; traffic accident victims were mostly younger and male. Complications were similar in victims of falls and traffic accidents. Clusters allow adoption of targeted measures of care, prevention and health promotion. PMID:25760111

  14. Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents

    Mariana Gonçalves de Freitas

    2015-03-01

    Full Text Available The article aims to describe the profile of elderly victims of falls and traffic accidents from the data of the Surveillance Survey of Violence and Accidents (VIVA. The VIVA Survey was conducted in the emergency health-services of the Unified Health System in the capitals of Brazil in 2011. The sample of elderly by type of accident was subjected to the two-step cluster procedure. Of the 2463 elderly persons in question, 79.8% suffered falls and 20.2% were the victims of traffic accidents. The 1812 elderly who fell were grouped together into 4 clusters: Cluster 1, in which all had disabilities; Cluster 2, all were non-white and falls took place in the home; Cluster 3, younger and active seniors; and Cluster 4, with a higher proportion of seniors 80 years old or above who were white. Among cases of traffic accidents, 446 seniors were grouped into two clusters: Cluster 1 of younger elderly, drivers or passengers; Cluster 2, with higher age seniors, mostly pedestrians. The main victims of falls were women with low schooling and unemployed; traffic accident victims were mostly younger and male. Complications were similar in victims of falls and traffic accidents. Clusters allow adoption of targeted measures of care, prevention and health promotion.

  15. Emergency preparedness and response in case of a fire accident with (UF6) packages tracking Suez Canal

    Egypt has a unique problem - the Suez Canal. Radioactive cargo passing regularly through the canal carrying new and spent reactor fuel. Moreover there are also about 1000 metric tons of uranium hexaflouride (UF6) passing through the canal every year. In spite of all precautions taken in the transportation, accidents with packages containing (UF6) and shipped through the Suez Canal, accidents may arise even though the probability is minimal. These accidents, may be accompanied by injuries or death of persons and damage to property. Due to the radiation and criticality hazards of (UF6) and its high risk of chemical toxicity. The probability of a fire accident with a cargo carrying (UF6) during its crossing the Suez Canal can cause serious chemical toxic and radiological hazards, particularly if the accident occurred close or near to one of the three densely populated cities (Port-Said, Ismailia, and Suez), which are located along the Suez Canal, west bank. The government of Egypt has elaborated a national radiological emergency plan inorder to face probable radiological accidents, which may be arised inside the country. Arrangements have been also elaborated for the medical care of any persons who, might be injured or contaminated, or who, have been exposed to severe radiation doses. The motivation of the present paper was undertaken to visualize a fire accident scenario occurring in industrial packages containing UF6 on board of a Cargo crossing the Suez Canal near Port-Said City. The accident scenario and emergency response actions taken during the different phases of the accident are going to be presented and discussed. The proposed emergency response actions taken to face the accident are going to be also presented. The work presented had revealed the importance of public awareness will be needed for populations located in densely populated areas along Suez Canal bank inorder to react timely and effectively to avoid the toxic and radiological hazards araised in

  16. Emergency preparedness and response in case of a fire accident with (UF{sub 6}) packages tracking Suez Canal

    Salama, M. [National Center for Nuclear Safety and Radiation Control (NCNSRC), Nasr City, Cairo (Egypt)

    2004-07-01

    Egypt has a unique problem - the Suez Canal. Radioactive cargo passing regularly through the canal carrying new and spent reactor fuel. Moreover there are also about 1000 metric tons of uranium hexaflouride (UF6) passing through the canal every year. In spite of all precautions taken in the transportation, accidents with packages containing (UF{sub 6}) and shipped through the Suez Canal, accidents may arise even though the probability is minimal. These accidents, may be accompanied by injuries or death of persons and damage to property. Due to the radiation and criticality hazards of (UF{sub 6}) and its high risk of chemical toxicity. The probability of a fire accident with a cargo carrying (UF{sub 6}) during its crossing the Suez Canal can cause serious chemical toxic and radiological hazards, particularly if the accident occurred close or near to one of the three densely populated cities (Port-Said, Ismailia, and Suez), which are located along the Suez Canal, west bank. The government of Egypt has elaborated a national radiological emergency plan inorder to face probable radiological accidents, which may be arised inside the country. Arrangements have been also elaborated for the medical care of any persons who, might be injured or contaminated, or who, have been exposed to severe radiation doses. The motivation of the present paper was undertaken to visualize a fire accident scenario occurring in industrial packages containing UF6 on board of a Cargo crossing the Suez Canal near Port-Said City. The accident scenario and emergency response actions taken during the different phases of the accident are going to be presented and discussed. The proposed emergency response actions taken to face the accident are going to be also presented. The work presented had revealed the importance of public awareness will be needed for populations located in densely populated areas along Suez Canal bank inorder to react timely and effectively to avoid the toxic and radiological

  17. A case-control study estimating accident risk for alcohol, medicines and illegal drugs.

    Kim Paula Colette Kuypers

    Full Text Available BACKGROUND: The aim of the present study was to assess the risk of having a traffic accident after using alcohol, single drugs, or a combination, and to determine the concentrations at which this risk is significantly increased. METHODS: A population-based case-control study was carried out, collecting whole blood samples of both cases and controls, in which a number of drugs were detected. The risk of having an accident when under the influence of drugs was estimated using logistic regression adjusting for gender, age and time period of accident (cases/sampling (controls. The main outcome measures were odds ratio (OR for accident risk associated with single and multiple drug use. In total, 337 cases (negative: 176; positive: 161 and 2726 controls (negative: 2425; positive: 301 were included in the study. RESULTS: Main findings were that 1 alcohol in general (all the concentrations together caused an elevated crash risk; 2 cannabis in general also caused an increase in accident risk; at a cut-off of 2 ng/mL THC the risk of having an accident was four times the risk associated with the lowest THC concentrations; 3 when ranking the adjusted OR from lowest to highest risk, alcohol alone or in combination with other drugs was related to a very elevated crash risk, with the highest risk for stimulants combined with sedatives. CONCLUSION: The study demonstrated a concentration-dependent crash risk for THC positive drivers. Alcohol and alcohol-drug combinations are by far the most prevalent substances in drivers and subsequently pose the largest risk in traffic, both in terms of risk and scope.

  18. Emergency preparedness and response in case of a fire accident with UF6 packages traversing the Suez Canal

    Egypt has a unique problem, the Suez Canal. Radioactive cargo passes regularly through the canal carrying new and spent reactor fuel. There are also about 1000 metric tonnes of uranium hexafluoride (UF6) passing through the canal every year. In spite of all the precautions taken in the transport, accidents with packages containing UF6 shipped through the Suez Canal may arise, even though the probability is minimal. Such accidents may be accompanied by injuries to or death of persons and damage to property including radiation and criticality hazards and high chemical toxicity, particularly if the accident occurred close to one of the three densely populated cities (Port Said, Ismailia and Suez), which are located along the west bank of the Suez Canal. The government of Egypt has established a national radiological emergency plan in order to deal with any radiological accidents which may arise inside the country. This paper considers the effect of a fire accident to industrial packages containing UF6 on board a cargo ship passing along the Suez Canal near Port Said City. The accident scenario and emergency response actions taken during the different phases of the accident are presented and discussed. The paper highlights the importance of public awareness for populations located in densely populated areas along the bank of the Suez Canal, in order to react in a timely and effective way to avoid the toxic and radiological hazards resulting from such a type of accident. The possibility of upgrading the capabilities of civil defence and fire-fighting personnel is also discussed (author)

  19. Development and application of a random walk model of atmospheric diffusion in the emergency response of nuclear accidents

    CHI Bing; LI Hong; FANG Dong

    2007-01-01

    Plume concentration prediction is one of the main contents of radioactive consequence assessment for early emergency response to nuclear accidents. Random characteristics of atmospheric diffusion itself was described, a random walk model of atmospheric diffusion (Random Walk) was introduced and compared with the Lagrangian puff model (RIMPUFF) in the nuclear emergency decision support system (RODOS) developed by the European Community for verification. The results show the concentrations calculated by the two models are quite close except that the plume area calculated by Random Walk is a little smaller than that by RIMPUFF. The random walk model for atmospheric diffusion can simulate the atmospheric diffusion in case of nuclear accidents, and provide more actual information for early emergency and consequence assessment as one of the atmospheric diffusion module of the nuclear emergency decision support system.

  20. Current Trends in Geriatric Emergency Medicine.

    Kahn, Joseph H; Magauran, Brendan G; Olshaker, Jonathan S; Shankar, Kalpana N

    2016-08-01

    The number of geriatric visits to United States emergency departments continues to rise. This article reviews demographics, statistics, and future projections in geriatric emergency medicine. Included are discussions of US health care spending, geriatric emergency departments, prehospital care, frailty of geriatric patients, delirium, geriatric trauma, geriatric screening and prediction tools, medication safety, long-term care, and palliative care. PMID:27475008

  1. Qualitative Research on Emergency Medicine Physicians

    Paltved, Charlotte; Musaeus, Peter

    2012-01-01

    with qualitative research. Methods: Electronic databases of English peer-reviewed articles were searched from 1971 to 2012 using Medline through PubMed and PsychINFO. This search was supplemented with hand-searches of Academic Emergency Medicine and Emergency Medicine Journal from 1999 to 2012 and...... cross references were reviewed. The key words used were emergency medicine, qualitative, ethnography, observation, interview, video, anthropology, simulation, and simulation-based. Results: 820 papers were identified and 46 studies were included in this review. This literature review found that the......Aim: This study aims to systematically review the qualitative research studying Emergency Medicine (EM) physicians in Emergency Departments (ED). Background: Qualitative research aims to study complex social phenomena. EM is a highly complex medical and social environment that can be investigated...

  2. Radiographers and radiologists reporting plain radiograph requests from accident and emergency and general practice

    AIM: To assess selectively trained radiographers and consultant radiologists reporting plain radiographs for the Accident and Emergency Department (A and E) and general practitioners (GPs) within a typical hospital setting. METHODS: Two radiographers, a group of eight consultant radiologists, and a reference standard radiologist independently reported under controlled conditions a retrospectively selected, random, stratified sample of 400 A and E and 400 GP plain radiographs. An independent consultant radiologist judged whether the radiographer and radiologist reports agreed with the reference standard report. Clinicians then assessed whether radiographer and radiologist incorrect reports affected confidence in their diagnosis and treatment plans, and patient outcome. RESULTS: For A and E and GP plain radiographs, respectively, there was a 1% (95% confidence interval (CI) -2 to 5) and 4% (95% CI -1 to 8) difference in reporting accuracy between the two professional groups. For both A and E and GP cases there was an 8% difference in the clinicians' confidence in their diagnosis based on radiographer or radiologist incorrect reports. For A and E and GP cases, respectively, there was a 2% and 8% difference in the clinicians' confidence in their management plans based on radiographer or radiologist incorrect reports. For A and E and GP cases, respectively, there was a 1% and 11% difference in effect on patient outcome of radiographer or radiologist incorrect reports. CONCLUSION: There is the potential to extend the reporting role of selectively trained radiographers to include plain radiographs for all A and E and GP patients. Further research conducted during clinical practice at a number of sites is recommended

  3. Emergency monitoring strategy and radiation measurements. Working document of the NKS project emergency management and radiation monitoring in nuclear and radiological accidents (EMARAD)

    This report is one of the deliverables of the NKS Project Emergency management and radiation monitoring in nuclear and radiological accidents (EMARAD) (20022005). The project and the overall results are briefly described in the NKS publication 'Emergency Management and Radiation Monitoring in Nuclear and Radiological Accidents. Summary Report on the NKS Project EMARAD' (NKS-137, April 2006). In a nuclear or radiological emergency, all radiation measurements must be performed efficiently and the results interpreted correctly in order to provide the decision-makers with adequate data needed in analysing the situation and carrying out countermeasures. Managing measurements in different situations in a proper way requires the existence of pre-prepared emergency monitoring strategies. Preparing a comprehensive yet versatile strategy is not an easy task to perform because there are lots of different factors that have to be taken into account. The primary objective of this study was to discuss the general problematics concerning emergency monitoring strategies and to describe a few important features of an efficient emergency monitoring system as well as factors affecting measurement activities in practise. Some information concerning the current situation in the Nordic countries has also been included. (au)

  4. Emergency monitoring strategy and radiation measurements document of the NKS project emergency management and radiation monitoring in nuclear and radiological accidents (EMARAD)

    Lahtinen, J. [Radiation and Nuclear Safety Authority (STUK) (Finland)

    2006-04-15

    This report is one of the deliverables of the NKS Project Emergency management and radiation monitoring in nuclear and radiological accidents (EMARAD) (20022005). The project and the overall results are briefly described in the NKS publication 'Emergency Management and Radiation Monitoring in Nuclear and Radiological Accidents. Summary Report on the NKS Project EMARAD' (NKS-137, April 2006). In a nuclear or radiological emergency, all radiation measurements must be performed efficiently and the results interpreted correctly in order to provide the decision-makers with adequate data needed in analysing the situation and carrying out countermeasures. Managing measurements in different situations in a proper way requires the existence of pre-prepared emergency monitoring strategies. Preparing a comprehensive yet versatile strategy is not an easy task to perform because there are lots of different factors that have to be taken into account. The primary objective of this study was to discuss the general problematics concerning emergency monitoring strategies and to describe a few important features of an efficient emergency monitoring system as well as factors affecting measurement activities in practise. Some information concerning the current situation in the Nordic countries has also been included. (au)

  5. Zika virus and the never-ending story of emerging pathogens and Transfusion Medicine

    Marano, Giuseppe; Pupella, Simonetta; Vaglio, Stefania; Liumbruno, Giancarlo M.; Grazzini, Giuliano

    2016-01-01

    In the last few years, the transfusion medicine community has been paying special attention to emerging vector-borne diseases transmitted by arboviruses. Zika virus is the latest of these pathogens and is responsible for major outbreaks in Africa, Asia and, more recently, in previously infection-naïve territories of the Pacific area. Many issues regarding this emerging pathogen remain unclear and require further investigation. National health authorities have adopted different prevention stra...

  6. Review of off-site emergency preparedness and response plan of Indian NPPs based on experience of Fukushima nuclear accident

    Nuclear power plants in India are designed, constructed and operated based on the principle of the highest priority to nuclear safety. To deal with any unlikely situation of radiological emergency, the emergency preparedness and response plans are ensured to be in place at all NPPs prior to their commissioning. These plans are periodically reviewed and tested by conducting emergency exercise with the participation of various agencies such as Nuclear Power Corporation of India Limited, NDMA, district authorities, regulatory body and general public. On March 11, 2011 an earthquake of magnitude 9.0 hit the Fukushima Dai-ichi and Dai-ni followed by tsunami waves of height 15 meters above reference sea level. This resulted in large scale release of radioactive material from Fukushima Dai-ichi NPS. This led to the evacuation of a large number of people from the areas surrounding the affected nuclear power plants. The event was rated as level 7 event in International Nuclear Event Scale (INES). The event also revealed the challenges in handling radiological emergency situation in adverse environmental conditions, The experience of managing radiological emergency situation during Fukushima nuclear accident provides opportunities to review and improve emergency preparedness and response programme. The present paper presents the chronology of the emergency situation, challenges faced and handled in Fukushima. Even though the possibility of a Fukushima type nuclear accident in India is very remote due to the low probability of a high intensity earthquake followed by tsunami at NPP sites, the efforts needs to be initiated from the regulatory point of view for an effective Nuclear and Radiological Emergency Preparedness and Response Plans. The Emergency Preparedness and Response Plans of NPP sites were reviewed in the light of unique challenges of accident at Fukushima. It is realized that multi unit events are the realities that must be addressed as part of Emergency

  7. Emergency Medicine for medical students world wide!

    Perinpam, Larshan; Thi Huynh, Anh-Nhi

    2015-01-01

    A guest blog from Larshan Perinpam (President of ISAEM) and Anh-Nhi Thi Huynh (Vice president of external affairs, ISAEM) - http://blogs.bmj.com/emj/2015/04/17/emergency-medicine-for-medical-students-world-wide/......A guest blog from Larshan Perinpam (President of ISAEM) and Anh-Nhi Thi Huynh (Vice president of external affairs, ISAEM) - http://blogs.bmj.com/emj/2015/04/17/emergency-medicine-for-medical-students-world-wide/...

  8. Needlestick injury among medical personnel in Accident and Emergency Department of two teaching hospitals.

    Ng, Y W; Hassim, I Noor

    2007-03-01

    Needlestick injury has been recognized as one of the occupational hazards which results in transmission of bloodborne pathogens. A cross-sectional study was carried out among 136 health care workers in the Accident and Emergency Department of two teaching hospitals from August to November 2003 to determine the prevalence of cases and episodes of needlestick injury. In addition, this study also assessed the level of knowledge of blood-borne diseases and Universal Precautions, risk perception on the practice of Universal Precautions and to find out factors contributing to needlestick injury. Prevalence of needlestick injury among the health care workers in the two hospitals were found to be 31.6% (N = 43) and 52.9% (N = 87) respectively. Among different job categories, medical assistants appeared to face the highest risk of needlestick injury. Factors associated with needlestick injury included shorter tenure in one's job (p risk of needlestick injury while performing procedures on patients. Therefore, comprehensive infection control strategies should be applied to effectively reduce the risk of needlestick injury. PMID:17682562

  9. An exploration of nurses experience of alcohol related violence and caring for intoxicated patients in Accident and Emergency

    Locker, Emily

    2008-01-01

    This study aims to explore the violence that Accident and Emergency nurses encounter. Current literature and health policies emphasis the seriousness and prevalence of violent attacks on nurses in A&E. There is also a push towards a new Government agenda based on Zero-tolerance. The study adopted a qualitative approach using semi-structured interviews. It contained six participants who were asked about their experiences of violence encountered in the A&E department. They were also asked to lo...

  10. HYSPLIT's Capability for Radiological Aerial Monitoring in Nuclear Emergencies: Model Validation and Assessment on the Chernobyl Accident

    Jung, Gunhyo; Kim, Juyoul [Seoul National University, Seoul (Korea, Republic of); Shin, Hyeongki [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2007-10-15

    The Chernobyl accident took place on 25 April 1986 in Ukraine. Consequently large amount of radionuclides were released into the atmosphere. The release was a widespread distribution of radioactivity throughout the northern hemisphere, mainly across Europe. A total of 31 persons died as a consequence of the accident, and about 140 persons suffered various degrees of radiation sickness and health impairment in the acute health impact. The possible increase of cancer incidence has been a real and significant increase of carcinomas of the thyroid among the children living in the contaminated regions as the late health effects. Recently, a variety of atmospheric dispersion models have been developed and used around the world. Among them, HYSPLIT (HYbrid Single-Particle Lagrangian Integrated Trajectory) model developed by NOAA (National Oceanic and Atmospheric Administration)/ARL (Air Resources Laboratory) is being widely used. To verify the HYSPLIT model for radiological aerial monitoring in nuclear emergencies, a case study on the Chernobyl accident is performed.

  11. Comparison of intramuscular glucagon and intravenous dextrose in the treatment of hypoglycaemic coma in an accident and emergency department.

    Patrick, A W; Collier, A.; Hepburn, D A; Steedman, D. J.; Clarke, B F; Robertson, C.

    1990-01-01

    Hypoglycaemia remains a serious and much feared complication of insulin therapy. In this study, patients attending an accident and emergency department in hypoglycaemic coma were randomized to treatment with either intravenous dextrose (25g) or intramuscular glucagon (1mg), administered into the right thigh. Restoration of normal conscious level was slower after glucagon than dextrose (9.0 vs 3.0 min, P less than 0.01), although the average duration of hypoglycaemic coma was 120 min. Two pati...

  12. Introduction to special issue of Body & Society, 'Medicine, Bodies, Politics: Experimentation and Emergence'

    Michael, Mike; Rosengarten, Marsha

    2012-01-01

    In this introduction, we address some of the complexities associated with the emergence of medicine’s bodies, not least as a means to ‘working with the body’ rather than simply producing a critique of medicine. We provide a brief review some of the recent discussions on how to conceive of medicine and its bodies, noting the increasing attention now given to medicine as a technology or series of technologies active in constituting a multiplicity of entities—bodies, diseases, experimental objec...

  13. Protected clinical teaching time and a bedside clinical evaluation instrument in an emergency medicine training program.

    Shayne, Philip; Heilpern, Katherine; Ander, Douglas; Palmer-Smith, Victoria

    2002-11-01

    In a process that has evolved over the last four years, the Emory University Emergency Medicine Education Committee has developed an "academic attending" teaching shift incorporating a formatted lecture series with a clinical evaluation exercise (CEE). The program structures the approach to clinical teaching at the bedside, provides an objective clinical evaluation tool specific to emergency medicine residents, and provides targeted learning for medical students and residents rotating in the emergency department (ED). The CEE instrument was designed to be quick and efficient, satisfy requirements of assessment of the Accreditation Council for Graduate Medical Education (ACGME) general competencies, and incorporate the language of the "Model of the Clinical Practice of Emergency Medicine." The original program called for unstructured bedside teaching three days a week, by faculty freed from clinical duties, combined with a limited series of introductory emergency medicine lectures. The program proved more successful when concentrated in a once weekly structured educational program. The prepared, repeating lecture series has been expanded to include many of the most common ED presenting chief complaints and has significantly advanced a curriculum for medical students and visiting interns. A CEE was developed to evaluate and provide immediate feedback to residents on many of the core ACGME competencies. The CEE has been successfully used to structure the bedside educational encounter. This dedicated non-clinical "teaching" shift appears effective in meeting the educational goals of the authors' academic ED. This is a description of the program and its evolution; the program has not been formally evaluated. PMID:12414493

  14. Can You Multitask? Evidence and Limitations of Task Switching and Multitasking in Emergency Medicine.

    Skaugset, L Melissa; Farrell, Susan; Carney, Michele; Wolff, Margaret; Santen, Sally A; Perry, Marcia; Cico, Stephen John

    2016-08-01

    Emergency physicians work in a fast-paced environment that is characterized by frequent interruptions and the expectation that they will perform multiple tasks efficiently and without error while maintaining oversight of the entire emergency department. However, there is a lack of definition and understanding of the behaviors that constitute effective task switching and multitasking, as well as how to improve these skills. This article reviews the literature on task switching and multitasking in a variety of disciplines-including cognitive science, human factors engineering, business, and medicine-to define and describe the successful performance of task switching and multitasking in emergency medicine. Multitasking, defined as the performance of two tasks simultaneously, is not possible except when behaviors become completely automatic; instead, physicians rapidly switch between small tasks. This task switching causes disruption in the primary task and may contribute to error. A framework is described to enhance the understanding and practice of these behaviors. PMID:26585046

  15. Accident at Three Mile Island: the contribution of the social sciences to the evaluation of emergency preparedness and response

    At 4:00 A.M. on 28 March 1979, a serious accident occurred in the nuclear-power plant at Three Mile Island near Middletown, Pennsylvania. It was caused by mechanical malfunctions in the plant, and for the next four days the extent and severity of the accident were not clear. Because it raised serious concerns about the safety of nuclear power, on 11 April President Carter established a commission to study and investigate the accident. Several aspects of the formation and evolution of the commission are particularly relevant to the social sciences. One was the way the original problem was defined for the commission by the presidential executive order. A second was the commission's own definition of the problem that evolved as the investigation progressed. As that definition became more inclusive, the body of social science literature relating to emergencies became increasingly relevant

  16. Mutual emergency assistance for radiation accidents

    In 1963 the International Atomic Energy Agency (IAEA) issued a document, WP.35, dated 23 November 1963, based on information provided by a number of its Member States on the type of radiological assistance that they might be able to make available in the event of a radiation emergency in another country at the request of that country. The document was subsequently revised in 1968 and 1971 with the participation of the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO) and the International Labour Organisation (ILO). In 1979, an expanded questionnaire to ascertain what could be required by the State in the event of a major radiation accident, was sent jointly by these organizations with the participation of the Office of the United Nations Disaster Relief Co-ordinator (UNDRO), to all their Member States. The text of the expanded questionnaire is reproduced. The present document lists all the information, received up to mid 1980, that contains offers of assistance made by a State. It also lists information on the assistance that might be required by the State. In general, the replies have been reproduced in the form in which they were received, although a few changes in presentation have been introduced in the interest of brevity and clarity. Some countries have pointed out that their replies are necessarily of a general character and that the full extent of the assistance they would be capable of providing could be determined only after a specific request had been received. The information given in this document should therefore be regarded only as a guide to the type of radiological assistance that might be available and/or needed. Other available international assistance includes that provided by the Agency through the IAEA Radiation (Emergency) Assistance Procedures, by WHO through its system of Collaborating Centres on human radiation pathology, and by various States via regional or inter-countries' agreements on

  17. Useulness of B Natriuretic Peptides and Procalcitonin in Emergency Medicine

    P. Ray

    2008-01-01

    Full Text Available Congestive heart failure (CHF is the main cause of acute dyspnea in patients presented to an emergency department (ED, and it is associated with high morbidity and mortality. B-type natriuretic peptide (BNP is a polypeptide, released by ventricular myocytes directly proportional to wall tension, for lowering renin-angiotensin-aldosterone activation. For diagnosing CHF, both BNP and the biologically inactive NT-proBNP have similar accuracy. Threshold values are higher in elderly population, and in patients with renal dysfunction. They might have also a prognostic value. Studies demonstrated that the use of BNP or NT-proBNP in dyspneic patients early in the ED reduced the time to discharge, total treatment cost. BNP and NT-proBNP should be available in every ED 24 hours a day, because literature strongly suggests the beneficial impact of an early appropriate diagnosis and treatment in dyspneic patients. Etiologic diagnosis of febrile patients who present to an ED is complex and sometimes difficult. However, new evidence showed that there are interventions (including early appropriate antibiotics, which could reduce mortality rate in patients with sepsis. For diagnosing sepsis, procalcitonin (PCT is more accurate than C-reactive protein. Thus, because of its excellent specificity and positive predictive value, an elevated PCT concentration (higher than 0.5 ng/mL indicates ongoing and potentially severe systemic infection, which needs early antibiotics (e.g. meningitis. In lower respiratory tract infections, CAP or COPD exacerbation, PCT guidance reduced total antibiotic exposure and/or antibiotic treatment duration.

  18. Applications of nano-fluids to enhance LWR accidents management in in-vessel retention and emergency core cooling systems

    Water-based nano-fluid, colloidal dispersions of nano-particles in water; have been shown experimentally to increase the critical heat flux and surface wettability at very low concentrations. The use of nano-fluids to enhance accidents management would allow either to increase the safe margins in case of severe accidents or to upgrade the power of an existing power plant with constant margins. Building on the initial work, computational fluid dynamics simulations of the nano-fluid injection system have been performed to evaluate the feasibility of a nano-fluid injection system for in-vessel retention application. A preliminary assessment was also conducted on the emergency core cooling system of the European Pressurized Reactor (EPR) to implement a nano-fluid injection system for improving the management of loss of coolant accidents. Several design options were compared/or their respective merits and disadvantages based on criteria including time to injection, safety impact, and materials compatibility. (authors)

  19. Global Emergency Medicine Journal Club: A Social Media Discussion About the Lack of Association Between Press Ganey Scores and Emergency Department Analgesia

    Westafer, L; Hensley, J.; Shaikh, S; Lin, M.

    2016-01-01

    © 2015 American College of Emergency Physicians. Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM), to host a public discussion featuring the 2014 Annals article on the association between Press Ganey scores and emergency department (ED) analgesia by Schwartz etal. The objective was to curate a 14-day (December 1 through 14, 2014) worldwide academic dialogue among clinicians in regard to preselected questions about the article....

  20. A Template for Authoring and Adapting Genomic Medicine Content in the eMERGE Infobutton Project

    Overby, Casey L.; Rasmussen, Luke V.; Hartzler, Andrea; Connolly, John J.; Peterson, Josh F.; Hedberg, RoseMary E.; Robert R Freimuth; Brian H Shirts; Denny, Joshua C.; Larson, Eric B; Chute, Christopher G.; Jarvik, Gail P.; Ralston, James D.; Shuldiner, Alan R; Starren, Justin

    2014-01-01

    The Electronic Medical Records and Genomics (eMERGE) Network is a national consortium that is developing methods and best practices for using the electronic health record (EHR) for genomic medicine and research. We conducted a multi-site survey of information resources to support integration of pharmacogenomics into clinical care. This work aimed to: (a) characterize the diversity of information resource implementation strategies among eMERGE institutions; (b) develop a master template contai...

  1. Compassion Fatigue is Similar in Emergency Medicine Residents Compared to other Medical and Surgical Specialties

    Bellolio, M. Fernanda; Cabrera, Daniel; Sadosty, Annie T.; Hess, Erik P.; Campbell, Ronna L.; Lohse, Christine M.; Sunga, Kharmene L

    2014-01-01

    Introduction: Compassion fatigue (CF) is the emotional and physical burden felt by those helping others in distress, leading to a reduced capacity and interest in being empathetic towards future suffering. Emergency care providers are at an increased risk of CF secondary to their first responder roles and exposure to traumatic events. We aimed to investigate the current state of compassion fatigue among emergency medicine (EM) resident physicians, including an assessment of contributing facto...

  2. Radiological review of accident and emergency radiographs: A 1-year audit

    AIM: To assess the impact and cost effectiveness of a system of radiological review of accident and emergency (A and E) plain films. MATERIALS AND METHODS: Review documentation was studied retrospectively over a 1-year period. Six hundred and eighty-four actual or suspected errors in the initial radiological interpretation by A and E staff were highlighted by radiologists in training. These selected 'red reports' were then further reviewed by a musculoskeletal radiologist and a more senior member of the A and E team. RESULTS: Three hundred and fifty-one missed or strongly suspected fractures were detected, with ankle, finger and elbow lesions predominating. Other errors included 11 missed chest radiograph abnormalities and 24 A and E false-positives. Radiologists in training tended to over-report abnormalities with an 18% false-positive rate when compared to the subsequent musculoskeletal radiology opinion. Following review, further action was taken by A and E staff in 286 (42.6%) of cases. No operative intervention was required in those patients with a delayed or missed A and E diagnosis. Consideration is given to the cost of providing this form of review and the impact of medico-legal factors. CONCLUSION: Compared with the large numbers of patients seen and radiographed in a busy A and E department, the number of radiological errors was small. There were even fewer changes in management. Despite this, concern over litigation, clinical governance and future work patterns in A and E make this form of review a useful means of risk reduction in a teaching hospital. Williams, S.M. (2000). Clinical Radiology 55, 861-865

  3. ETH-RISKMONITOR: Linking plant on-line monitoring to rule-based assessment and emergency planning for nuclear accidents

    The ETH-RISKMONITOR is a DSS designed to assist real case on-line remote monitoring of nuclear power plants for abnormal event categorizing based on plant condition, and its evolvement, issuing of recommended alert grades, prompt determination of endangered/exposed sectors in a territory and on dose and health effects mapping. It is an application on linking plant on-line monitoring to rule-based assessment and emergency planning for nuclear accidents

  4. Haematoma block or Bier's block for Colles' fracture reduction in the accident and emergency department--which is best?

    Kendall, J. M.; Allen, P.; Younge, P.; Meek, S M; McCabe, S E

    1997-01-01

    OBJECTIVE: To offer clear guidance on the anaesthetic management of Colles' fractures in the accident and emergency (A&E) department in the light of the conflict between existing reports and current trends, and to address the issue of alkalinisation of haematoma blocks. METHODS: This was a two centre, prospective, randomised clinical trial with consecutive recruitment of adult patients with Colles' fractures requiring manipulation to receive either Bier's block or haematoma block. There was s...

  5. Accident and emergency radiological interpretation using the radiographer opinion form (ROF)

    The red dot system of radiographer opinion giving about the result of an x-ray examination in the accident and emergency (A and E) department has been around for about 15 years in various forms. However, it does not require that the radiographer accurately identify the site and nature of the suspected pathology. In developing a study to measure the ability of radiographers to interpret plain A and E radiographs a new data collection instrument was successfully used, the Radiographer Opinion Form (ROF). The ROF allows radiographers to indicate firstly whether they suspect a pathology or not, and secondly what they the suspected pathology is in their opinion. In a study of 820 A and E cases undertaken at the John Hunter Hospital (JHH) using the ROF radiographers had an overall accuracy of 93 per cent in identifying the presence or absence of pathology compared to the 100 per cent gold standard of the radiologists' reports. Even taking into account a positive selection bias recognised in the study this was comparably with results found in previous studies both in Australia and overseas. The radiographers performed better in less complex anatomical regions, such as the upper extremity (96.3 per cent), compared to other examinations like the chest (90.7 per cent) and the abdomen (87,5 per cent), where the anatomy is more complex and the differential diagnosis is more varied. The ROF proved a useful research tool, however, it may also have valuable clinical applications as a means of conveying the radiographers opinion about suspected abnormalities to referring doctors in the first instance, and ultimately to the reporting radiologists. Copyright (2002) Australian Institute of Radiography

  6. Funding strategies for emergency medicine research.

    Carden, D L; Dronen, S C; Gehrig, G; Zalenski, R J

    1998-02-01

    The importance of adequate funding for sustaining research efforts cannot be overemphasized. This article addresses funding strategies for emergency physicians, including the necessity of establishing a research track record, developing a well-written grant proposal, and anticipating the grant review process. Funding sources are reviewed with an emphasis on federal institute support and private foundations (including the Emergency Medicine Foundation) in the United States. Sources of current grant support information available from the Internet are provided. Recommendations for enhancing research funding in emergency medicine (EM) are made, including enhancement of formal research training, promotion of EM research and investigators, federal study section membership, and collaboration with established investigators. PMID:9492141

  7. Critical Emergency Medicine Procedural Skills: A Comparative Study of Methods for Teaching and Assessment.

    Chapman, Dane M.; And Others

    Three critical procedural skills in emergency medicine were evaluated using three assessment modalities--written, computer, and animal model. The effects of computer practice and previous procedure experience on skill competence were also examined in an experimental sequential assessment design. Subjects were six medical students, six residents,…

  8. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

    Stoneking LR

    2016-08-01

    Full Text Available LR Stoneking,1 AL Waterbrook,1 J Garst Orozco,2 D Johnston,1 A Bellafiore,1 C Davies,3 T Nuño,1 J Fatás-Cabeza,4 O Beita,5 V Ng,1 KH Grall,6 W Adamas-Rappaport7 1Department of Emergency Medicine, University of Arizona, Tucson, AZ, 2Department of Emergency Medicine, Sinai Health System, Chicago, IL, 3Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, 4Department of Spanish and Portuguese, University of Arizona, Tucson, AZ, 5Department of Family and Community Medicine, University of Arizona, Tucson, AZ, 6Department of Emergency Medicine, Regions Hospital, St Paul, MN, 7Department of Surgery, University of Arizona, Tucson, AZ, USA Background: After emergency department (ED discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit.Objectives: To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency.Methods: Our ED has two Emergency Medicine Residency Programs, University Campus (UC and South Campus (SC. SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions.Results: Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study

  9. Use of anti-D immunoglobulin in the treatment of threatened miscarriage in the accident and emergency department

    Weinberg, L

    2001-01-01

    Background—The UK guidelines for the use of anti-D immunoglobulin for rhesus prophylaxis have been revised. Anti-D immunoglobulin is no longer recommended for Rh D negative women after a threatened miscarriage less than 12 weeks gestation. These patients are at risk of rhesus immunisation, and there should be a policy for their treatment in the accident and emergency (A&E) department.

  10. Emergency Management and Radiation Monitoring in Nuclear and Radiological Accidents. Summary Report on the NKS Project EMARAD

    In order to manage various nuclear or radiological emergencies the authorities must have pre-prepared plans. The purpose of the NKS project EMARAD (Emergency Management and Radiation Monitoring in Nuclear and Radiological Accidents) was to produce and gather various data and information that could be useful in drawing up emergency plans and radiation monitoring strategies. One of the specific objectives of the project was to establish a www site that would contain various radiation-threat and radiation-monitoring related data and documents and that could be accessed by all Nordic countries. Other important objectives were discussing various factors affecting measurements in an emergency, efficient use of communication technology and disseminating relevant information on such topics as urban dispersion and illicit use of radiation. The web server is hosted by the Radiation and Nuclear Safety Authority (STUK) of Finland. The data stored include pre-calculated consequence data for nuclear power plant accidents as well as documents and presentations describing e.g. general features of monitoring strategies, the testing of the British urban dispersion model UDM and the scenarios and aspects related to malicious use of radiation sources and radioactive material. As regards the last item mentioned, a special workshop dealing with the subject was arranged in Sweden in 2005 within the framework of the project. (au)

  11. Differences between attendance in emergency care of male and female victims of traffic accidents in Porto alegre, Rio Grande do Sul state, Brazil

    Raquel Forgiarini Saldanha; Flavio Pechansky; Daniela Benzano; Carlos Alberto Sampaio Martins de Barros; Raquel Brandini De Boni

    2014-01-01

    Driving under the influence of alcohol/ drugs (DUI) is a well-established risk factor for traffic accidents, and men and women have different consumption patterns. The scope of this paper is to analyze differences in alcohol and drug consumption, as well as on behavior associated with traffic accidents among men and women. A cross-sectional study was conducted with 609 sequential traffic accident victims attended in emergency care from Porto Alegre. Subjects gave a structured interview, were ...

  12. Criticality accident in uranium fuel processing plant. Emergency medical care and dose estimation for the severely overexposed patients

    Akashi, Makoto; Ishigure, Nobuhito [National Inst. of Radiological Sciences, Chiba (Japan)

    2000-08-01

    A criticality accident occurred in JCO, a plant for nuclear fuel production in 1999 and three workers were exposed to extremely high-level radiation (neutron and {gamma}-ray). This report describes outlines of the clinical courses and the medical cares for the patients of this accident and the emergent medical system for radiation accident in Japan. One (A) of the three workers of JCO had vomiting and diarrhea within several minutes after the accident and another one (B) had also vomiting within one hour after. Based on these evidences, the exposure dose of A and B were estimated to be more than 8 and 4 GyEq, respectively. Generally, acute radiation syndrome (ARS) is assigned into three phases; prodromal phase, critical or manifestation phase and recovery phase or death. In the prodromal phase, anorexia, nausea, vomiting and diarrhea often develop, whereas the second phase is asymptotic. In the third phase, various syndromes including infection, hemorrhage, dehydration shock and neurotic syndromes are apt to occur. It is known that radiation exposure at 1 Gy or more might induce such acute radiation syndromes. Based on the clinical findings of Chernobyl accident, it has been thought that exposure at 0.5 Gy or more causes a lowering of lymphocyte level and a decrease in immunological activities within 48 hours. Lymphocyte count is available as an indicator for the evaluation of exposure dose in early phase, but not in later phase The three workers of JCO underwent chemical analysis of blood components, chromosomal analysis and analysis of blood {sup 24}Na immediately after the arrival at National Institute of Radiological Sciences via National Mito Hospital specified as the third and the second facility for the emergency medical care system in Japan, respectively. (M.N.)

  13. Microgrants - a method of facilitating research in emergency medicine

    Hallas, Peter; Brabrand, Mikkel; Folkestad, Lars

    2010-01-01

    ABSTRACT: Microgrants is a novel concept where small grants are used to facilitate research. The concept might have a place in developing emergency medicine research, especially in countries where emergency medicine in not established or in new areas of research. Two examples of the beneficial...... effects of microgrants in emergency medicine research are described. Emergency medicine interest groups and foundations should consider setting up microgrant schemes....

  14. Microfinance as a method of facilitating research in emergency medicine

    Folkestad Lars

    2010-04-01

    Full Text Available Abstract Microgrants are a novel concept where small grants are used to facilitate research. The concept might have a place in developing emergency medicine research, especially in countries where emergency medicine is not established or in new areas of research. Two examples of the beneficial effects of microgrants in emergency medicine research are described. Emergency medicine interest groups and foundations should consider setting up microgrant schemes.

  15. Microfinance as a method of facilitating research in emergency medicine.

    Hallas, Peter; Brabrand, Mikkel; Folkestad, Lars

    2010-01-01

    Microgrants are a novel concept where small grants are used to facilitate research. The concept might have a place in developing emergency medicine research, especially in countries where emergency medicine is not established or in new areas of research. Two examples of the beneficial effects of microgrants in emergency medicine research are described. Emergency medicine interest groups and foundations should consider setting up microgrant schemes. PMID:20412571

  16. Emergency response planning for transport accidents involving radioactive materials

    The document presents a basic discussion of the various aspects and philosophies of emergency planning and preparedness along with a consideration of the problems which might be encountered in a transportation accident involving a release of radioactive materials. Readers who are responsible for preparing emergency plans and procedures will have to decide on how best to apply this guidance to their own organizational structures and will also have to decide on an emergency planning and preparedness philosophy suitable to their own situations

  17. Management options for food production systems affected by a nuclear accident. Task 4: emergency monitoring and processing of milk

    This report evaluates three possible ways in which the quantity of milk designated as waste could be reduced following a nuclear accident. The three approaches considered were: the development of an emergency monitoring programme to release milk with activity concentrations less than the intervention levels back into the foodchain that would otherwise be held up under Government precautionary advice; the direct decontamination of milk for re-introduction into the foodchain; and the processing of contaminated milk into products suitable for consumption or disposal. This work was carried out under the Environmental Assessments Department and Emergency Response Group Quality Management System which is certified to ISO 9001:2000, certificate No. 956546. (author)

  18. Multi-objective evolutionary emergency response optimization for major accidents

    Emergency response planning in case of a major accident (hazardous material event, nuclear accident) is very important for the protection of the public and workers' safety and health. In this context, several protective actions can be performed, such as, evacuation of an area; protection of the population in buildings; and use of personal protective equipment. The best solution is not unique when multiple criteria are taken into consideration (e.g. health consequences, social disruption, economic cost). This paper presents a methodology for multi-objective optimization of emergency response planning in case of a major accident. The emergency policy with regards to protective actions to be implemented is optimized. An evolutionary algorithm has been used as the optimization tool. Case studies demonstrating the methodology and its application in emergency response decision-making in case of accidents related to hazardous materials installations are presented. However, the methodology with appropriate modification is suitable for supporting decisions in assessing emergency response procedures in other cases (nuclear accidents, transportation of hazardous materials) or for land-use planning issues.

  19. Designing of an emergency call system for traffic accidents

    Ziya Ekşi; Murat Çakıroğlu

    2013-01-01

    In our country, many people have been seriously injured or died in traffic accidents. Fatal accidents often occur because of not complying with traffic rules or carelessness. Except these driver mistakes, heavy injuries can result in deaths because of emergency aid teams failing to arrive to accident scene in time. In this study, an accident emergency call system is designed to help injured people's treatment as soon as possible by notifying emercengy team automatically in accidents. The desi...

  20. Review of the emergency response exercise organized during the Erpet training course on off-site emergency planning and response for nuclear accidents

    An international training course on off-site emergency planning and response for nuclear accidents has been organized by the SCK/CEN (Studie Centrum voor Kernenergie - Centre d'Etude de l'Energie Nucleaire) at Mol (Belgium) from 9 to 13 september 1991. One of the major events of this training course was a full-day emergency exercise. An emergency response exercise organized in the frame of a general course has more specific aspects, regarding the role of the participants and the absence of a specific emergency plan or procedures. This paper describes the practical organization, the scenario and the communication with the participants. The decisions proposed by the participants and the results of their radiological evaluations are discussed

  1. The new approach of the radiological emergency response team at the Brazilian National Nuclear Energy Commission's Institute of Radiation Protection and Dosimetry after the Goiania accident

    The evaluation of the emergency actions taken during the Goiania accident caused a complete revision of the Brazilian Nuclear Energy Commission's Institute of Radiation Protection and Dosimetry Emergency Response Team. The changes were in both the scope of the emergency responsibilities and in the organization of the emergency team. This new organization permits an emergency response to accidents in nuclear installations such as nuclear reactors or fuel cycle facilities, or accidents involving radiation sources in hospitals, industry, etc. The organization takes into account all the emergency phases, with emphasis on a quick response in the initial phase. Of a total emergency team of one hundred and four people, there are twenty-six members on call twenty-four hours a day. (author). 1 fig

  2. A model national emergency plan for radiological accidents

    The IAEA has supported several projects for the development of a national response plan for radiological emergencies. As a result, the IAEA has developed a model National Emergency Response Plan for Radiological Accidents (RAD PLAN), particularly for countries that have no nuclear power plants. This plan can be adapted for use by countries interested in developing their own national radiological emergency response plan, and the IAEA will supply the latest version of the RAD PLAN on computer diskette upon request

  3. A model national emergency response plan for radiological accidents

    The IAEA has supported several projects for the development of a national response plan for radiological emergencies. As a results, the IAEA has developed a model National Emergency Response Plan for Radiological Accidents (RAD PLAN), particularly for countries that have no nuclear power plants. This plan can be adapted for use by countries interested in developing their own national radiological emergency response plan, and the IAEA will supply the latest version of the RAD PLAN on computer diskette upon request. 2 tabs

  4. TRACE - a time-dependent and realistic accident consequence evaluation module for use in emergency response planning

    Following the identification of an off-normal condition at nuclear power plant, the plant operators have one over-riding responsibility: protection of the offsite population. In discharging this responsibility, the operators utilize a set of emergency operating procdedures. A. Immediately following the identification of the off-normal condition, the operators primary actions are focused on establishing a safe, stable shutdown condition for the reactor. B. The plant condition is categorized according to the perceived severity of the event based on a broad overview of the plant conditions, and the information is transmitted to appropriate governmental authorities. C. Estimations of potential environmental releases of radioactivity, based on design basis accident results, are performed and transmitted to the governmental authorities. The TRACE package was developed to provide the operators with the tools to make realistic predictions of the range of possible releases of radioactivity to the environment during all phases of an off-normal condition, including severe accident situations. The TRACE package provides a means to project, during the early stages of an accident, the potential range of possible fission product releases on a realistic and time-dependent basis. The TRACE package also provides a means to update previous evaluations of the potential range of radioactivity releases as plant conditions change or a new information (on accident sequence or plant parameters) becomes available. (orig./HSCH)

  5. Attitudes of Dublin accident and emergency department doctors and nurses towards the services offered by local general practitioners.

    Gibney, D; Murphy, A W; Smith, M.; Bury, G; Plunkett, P K

    1995-01-01

    Good communication at the accident and emergency (A&E)-general practice interface is important. Such communication will be affected by the attitudes of A&E staff towards local general practitioners (GPs). The objectives of this study were to establish and compare, using a questionnaire, the attitudes of Dublin A&E doctors and nurses towards the services offered by local GPs. A questionnaire was sent to all nurses and non-consultant doctors working in four of the six Dublin A&E departments. Co...

  6. Public Health Education for Emergency Medicine Residents

    Betz, Marian E.; Bernstein, Steven L.; Gutman, Deborah; Tibbles, Carrie D.; Joyce, Nina; Lipton, Robert; Schweigler, Lisa; Fisher, Jonathan

    2011-01-01

    Emergency medicine (EM) has an important role in public health, but the ideal approach for teaching public health to EM residents is unclear. As part of the national regional public health–medicine education centers-graduate medical education (RPHMEC-GM) initiative from the CDC and the American Association of Medical Colleges, three EM programs received funding to create public health curricula for EM residents. Curricula approaches varied by residency. One program used a modular, integrative...

  7. A personal view on systems medicine and the emergence of proactive P4 medicine: predictive, preventive, personalized and participatory.

    Hood, Leroy; Flores, Mauricio

    2012-09-15

    Systems biology and the digital revolution are together transforming healthcare to a proactive P4 medicine that is predictive, preventive, personalized and participatory. Systems biology - holistic, global and integrative in approach - has given rise to systems medicine, a systems approach to health and disease. Systems medicine promises to (1) provide deep insights into disease mechanisms, (2) make blood a diagnostic window for viewing health and disease for the individual, (3) stratify complex diseases into their distinct subtypes for a impedance match against proper drugs, (4) provide new approaches to drug target discovery and (5) generate metrics for assessing wellness. P4 medicine, the clinical face of systems medicine, has two major objectives: to quantify wellness and to demystify disease. Patients and consumers will be a major driver in the realization of P4 medicine through their participation in medically oriented social networks directed at improving their own healthcare. P4 medicine has striking implications for society - including the ability to turn around the ever-escalating costs of healthcare. The challenge in bringing P4 medicine to patients and consumers is twofold: first, inventing the strategies and technologies that will enable P4 medicine and second, dealing with the impact of P4 medicine on society - including key ethical, social, legal, regulatory, and economic issues. Managing the societal problems will pose the most significant challenges. Strategic partnerships of a variety of types will be necessary to bring P4 medicine to patients. PMID:22450380

  8. Human Mobility and Accident and Emergency (A&E) Department: A contribution to the knowledge of invisible flows

    Bertazzoni, Beatrice; Bertazzoni, Giuliano; Montanari, Armando

    2016-01-01

    This article provides a full report of the results of a feasibility study for a project based on the combination of clinical figures with socio-economic data on human mobility within the metropolitan area of Rome. Acknowledging that Accident and Emergency (A&E) Departments represent privileged observatories of health issues of a given territory, the point of departure of this study is the patient register dataset of the A&E Department of the Policlinico Umberto I for the period 2000-2013. The...

  9. Are mental health problems associated with use of Accident and Emergency and health-related harm?

    Keene, Jan; Rodriguez, Jorge

    2007-01-01

    Background: Previous findings indicate that mental health problems are common in Emergency departments; however, there are few studies of the extent of health-related problems and emergency service use in mental health populations as a whole. Methods: Record linkage methods were used to map the association between mental health, age, gender, and health-related harm across total health and mental health care populations in one geographical area, over three years. By examining patterns of healt...

  10. Teaching and evaluating multitasking ability in emergency medicine residents - what is the best practice?

    Heng, Kenneth WJ

    2014-01-01

    Multitasking is an essential skill to develop during Emergency Medicine (EM) residency. Residents who struggle to cope in a multitasking environment risk fatigue, stress, and burnout. Improper management of interruption has been causally linked with medical errors. Formal teaching and evaluation of multitasking is often lacking in EM residency programs. This article reviewed the literature on multitasking in EM to identify best practices for teaching and evaluating multitasking amongst EM res...

  11. Towards integration of general practitioner posts and accident and emergency departments: a case study of two integrated emergency posts in the Netherlands

    Kamphuis Helen CM

    2008-11-01

    Full Text Available Abstract Background Accident and emergency (A&E departments and general practitioner (GP posts are often used inappropriately, leading to overcrowding. In the Netherlands, increasingly more integrated emergency posts (IEPs are being created, integrating the care provided by GP posts and A&E departments, in order to improve the provision of the emergency care. Methods This explorative study compares the efficiency and patient and employee satisfaction in IEPs with those in two GP posts and two A&E departments. To this end, information was retrieved from hospital and GP patient records for the first quarter of the year before and of the year after the creation of IEPs. Patients and employees were sent a questionnaire to measure their satisfaction. Lastly, groups of hospital doctors, GPs, GP assistants, and nurses were interviewed. Results After the creation of IEPs, there was a shift of more than fifteen percent from secondary care to primary care for emergency consultations and waiting/consultation times were shortened by more than ten percent. Compared with the control settings, patients were more satisfied about telephone contact with an IEP, but professionals working at the IEP were less satisfied with several aspects of their work. Conclusion IEPs could be a promising innovation to organize emergency care more efficiently; however, it might take time to convince professionals of the possible advantages. Studies involving more IEPs and longer follow-up times are needed to determine whether such integration should be stimulated.

  12. What is the Prevalence and Success of Remediation of Emergency Medicine Residents?

    Mark Silverberg; Moshe Weizberg; Tiffany Murano; Smith, Jessica L.; John C. Burkhardt; Santen, Sally A.

    2015-01-01

    Introduction: The primary objective of this study was to determine the prevalence of remediation, competency domains for remediation, the length, and success rates of remediation in emergency medicine (EM). Methods: We developed the survey in SurveymonkeyTM with attention to content and response process validity. EM program directors responded how many residents had been placed on remediation in the last three years. Details regarding the remediation were collected inclu...

  13. Electrocardiography interpretation training in emergency medicine: methods, resources, competency assessment, and national standardization

    Özel, Betül Akbuğa; Demircan, Ahmet; Keleş, Ayfer; Bildik, Fikret; Özel, Deniz; Ergin, Mehmet; Günaydin, Gül Pamukçu

    2015-01-01

    Objective(s). The aim of this study was to evaluate the status of electrocardiography (ECG) training in emergency medicine residency programs in Turkey, and the attitude of the program representatives towards standardization of such training. Methods. This investigation was planned as a cross-sectional study. An 18-item questionnaire was distributed to directors of residency programs. Responses were evaluated using SPSS (v.16.0), and analyzed using the chi-square test. Results. Thirty...

  14. Assessment of emergency response planning and implementation in the aftermath of major natural disasters and technological accidents

    Emergency planning around nuclear power plants represents some of the most mature and well developed emergency planning in the United States. Since the implementation of NUREG-0654 / FEMA-REP-1, Rev. 1, A Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants (NRC, 1980a) the licensees, local, and State agencies have developed detailed Radiological Emergency Response Programs. An important component of these plans is the evacuation of the population in the event of a general emergency condition at the plant. In January 2005, the U.S. Nuclear Regulatory Commission (NRC) published the landmark report, 'Identification and Analysis of Factors Affecting Emergency Evacuations' (NUREG/CR 6864/), which represented the most comprehensive investigation of public evacuations in the United States in more than 15 years. Since the completion of this research, several high profile evacuations have occurred, including Hurricane Katrina in New Orleans, Hurricane Rita in Houston, as well as major wildfires across the western U.S. The NRC commissioned an update to its 2005 evacuation case study publication to evaluate the evacuation experience of the selected communities (e.g., timeliness, related injuries, hazard avoidance); the level of preplanning that was in place for the affected areas and extent that the pre planned requirements were implemented during the emergency response; the critical factors contributing to the efficiency of or impediments to the evacuations (e.g., training, drills, preparedness, experience, resources, facilities, and organizational structure); and additional factors that may have contributed to less than satisfactory public response (i.e., availability of personal transportation, use of public transportation, lack of availability of shelters, etc.). The comprehensive report will be published in fall of 2008 as NUREG/CR-6981, Assessment of Emergency Response Planning and

  15. Frequency of Burnout, Sleepiness and Depression in Emergency Medicine Residents with Medical Errors in the Emergency Department

    Alireza Aala

    2014-07-01

    Full Text Available Aims: Medical error is a great concern of the patients and physicians. It usually occurs due to physicians’ exhaustion, distress and fatigue. In this study, we aimed to evaluate frequency of distress and fatigue among emergency medicine residents reporting a medical error.Materials and Methods: The study population consisted of emergency medicine residents who completed an emailed questionnaire including self-assessment of medical errors, the Epworth Sleepiness Scale (ESS score, the Maslach Burnout Inventory, and PRIME-MD validated depression screening tool.  Results: In this survey, 100 medical errors were reported including diagnostic errors in 53, therapeutic errors in 24 and following errors in 23 subjects. Most errors were reported by males and third year residents. Residents had no signs of depression, but all had some degrees of sleepiness and burnout. There were significant differences between errors subtypes and age, residency year, depression, sleepiness and burnout scores (p<0.0001.  Conclusion: In conclusion, residents committing a medical error usually experience burnout and have some grades of sleepiness that makes them less motivated increasing the probability of medical errors. However, as none of the residents had depression, it could be concluded that depression has no significant role in medical error occurrence and perhaps it is a possible consequence of medical error.  Keywords: Residents; Medical error; Burnout; Sleepiness; Depression

  16. Development of emergency response support system for accident management

    Specific measures for the accident management (AM) are proposed to prevent the severe accident and to mitigate their effects in order to upgrade the safety of nuclear power plants even further. To ensure accident management effective, it is essential to grasp the plant status accurately. In consideration of the above mentioned background, the Emergency Response Support System (ERSS) was developed as a computer assisted prototype system by a joint study of Japanese BWR group. This system judges and predicts the plant status at the emergency condition in a nuclear power plant. This system displays the results of judgment and prediction. The effectiveness of the system was verified through the test and good prospects for applying the system to a plant was obtained. 7 refs., 10 figs

  17. Pattern of Sexual Offences Attended at Accident and Emergency Department of HUSM from Year 2000 to 2003: A Retrospective Study

    Islam, Mohammed Nasimul; See, Khoo Lay; Ting, Lai Chin; Khan, Jesmine

    2006-01-01

    This paper investigates the pattern of sexual offence cases attended at the One Stop Crisis Center (OSCC) of the Accident and Emergency Department, Hospital Universiti Sains Malaysia (HUSM), Kelantan. A total of 439 reported sexual offence cases were examined over a period of 4 years from 2000 to 2003. Sexual offence constituted by male partner or boyfriend in 18.9%, by relatives in 27.3% and by “others” in 53.8% of cases. Only 0.7% of victims did not attempt to lodge a police report. There i...

  18. Accidents, risks and consequences

    Although the accident at Chernobyl can be considered as the worst accident in the world, it could have been worse. Other far worse situations are considered, such as a nuclear weapon hitting a nuclear reactor. Indeed the accident at Chernobyl is compared to a nuclear weapon. The consequences of Chernobyl in terms of radiation levels are discussed. Although it is believed that a similar accident could not occur in the United Kingdom, that possibility is considered. It is suggested that emergency plans should be made for just such an eventuality. Even if Chernobyl could not happen in the UK, the effects of accidents are international. The way in which nuclear reactor accidents happen is explored, taking the 1957 Windscale fire, Three Mile Island and Chernobyl as examples. Reactor designs and accident scenarios are considered. The different reactor designs are listed. As well as the Chernobyl RBMK design it is suggested that the light water reactors also have undesirable features from the point of view of safety. (U.K.)

  19. Emergency medicine residents' attitudes and opinions of in-training exam preparation

    Eastin TR

    2013-08-01

    Full Text Available Travis R Eastin, Aaron W BernardDepartment of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH, USAPurpose: Emergency Medicine (EM residents take the American Board of Emergency Medicine (ABEM in-training exam, and performance on this exam has been shown to correlate to performance on the ABEM qualifying exam. Though many residencies have in-training exam preparation activities, there is little data on the effectiveness of these efforts. This study aimed to elicit resident perspectives about the exam and exam preparation in order to generate hypotheses and better inform future preparation efforts.Methods: Second- and third-year EM residents at a single institution were interviewed using a semi-structured format. Qualitative methodology was used to analyze the data.Results: Thirteen EM residents participated in the study. Eight major themes and 18 sub-themes were identified. These were further characterized as relating to the exam itself or to exam preparation. Residents generally value the in-training exam. Sixty-nine percent noted that it provided an assessment of their current knowledge and deficiencies. Thirty-eight percent noted that it improved familiarity with the qualifying exam. Regarding exam preparation, residents stated that a question format was preferred, especially when accompanying explanations were of high quality. Additionally, practical considerations, such as portability, impacted resident selection of study tools.Conclusion: Residents value the in-training exam as a marker of their academic progress and for their ability to gain familiarity with the qualifying exam. They prefer question-based preparation over text-based learning, as long as there is a detailed explanation of each answer. Educators creating structured in-training review may want to focus on question-based material with detailed explanations.Keywords: examination preparation, graduate medical education, in-training examination

  20. Use of a virtual learning environment for training in maxillofacial emergencies: impact on the knowledge and attitudes of staff in accident and emergency departments.

    Elledge, Ross; McAleer, Sean; Thakar, Meera; Begum, Fathema; Singhota, Sanjeet; Grew, Nicholas

    2016-02-01

    Many graduates will take up junior roles in accident and emergency (A&E) departments to which a large proportion of patients present with facial injuries caused by interpersonal violence. However, it is widely recognised that undergraduates and postgraduates have few opportunities for training in oral and maxillofacial surgery. We aimed to assess the impact of a specifically designed maxillofacial emergencies virtual learning environment (VLE) on the knowledge and confidence of junior doctors in two A&E departments. They were given free access to the VLE for one month, and were asked to complete multiple choice questions and to rate their confidence to deal with 10 common situations on visual analogue scales (VAS) at baseline and one month after training. A total of 29 doctors agreed to pilot the website, 21 (72%) completed both sets of questions, and 18 (62%) completed both VAS assessments. The mean (SD) multiple choice score improved from 10 (2.52) to 13 (3.56) out of a maximum of 20 (p=0.004) and the mean (SD) VAS improved from 29.2 (19.2) mm to 45.7 (16.6) mm out of a maximum of 100 mm (p=0.007). This was a small pilot study with limited numbers, but it showed improvements in the knowledge of maxillofacial emergencies and in confidence, although the latter remained low. Further work is needed to examine how these brief educational interventions affect the attitudes of frontline staff to maxillofacial emergencies. PMID:26725011

  1. Development of supporting system for emergency response to maritime transport accidents involving radioactive material

    National Maritime Research Institute has developed a supporting system for emergency response of competent authority to maritime transport accidents involving radioactive material. The supporting system for emergency response has functions of radiation shielding calculation, marine diffusion simulation, air diffusion simulation and radiological impact evaluation to grasp potential hazard of radiation. Loss of shielding performance accident and loss of sealing ability accident were postulated and impact of the accidents was evaluated based on the postulated accident scenario. Procedures for responding to emergency were examined by the present simulation results

  2. Radiation safety for the emergency situation of the power plant accident. Radiation safety in society and its education

    Great East Japan Earthquake and Tsunamis, and following Fukushima Daiichi Nuclear Power Accident brought about great impact on society in Japan. Accident analysis of inside reactor was studied by reactor physics or reactor engineering knowledge, while dissipation of a large amount of radioactive materials outside reactor facilities, and radiation and radioactivity effects on people by way of atmosphere, water and soil were dealt with radiation safety or radiation protection. Due to extremely low frequency and experience of an emergency, there occurred a great confusion in the response of electric power company concerned, relevant regulating competent authorities, local government and media, and related scholars and researchers, which caused great anxieties amount affected residents and people. This article described radiation safety in the society and its education. Referring to actual examples, how radiation safety or radiation protection knowledge should be dealt with emergency risk management in the society was discussed as well as problem of education related with nuclear power, radiation and prevention of disaster and fostering of personnel for relevant people. (T. Tanaka)

  3. Setting up and functioning of an Emergency Medicine Department: Lessons learned from a preliminary study

    K Asish

    2016-01-01

    Full Text Available Background and Aims: Tertiary care teaching hospitals remain referral centres for victims of trauma and mass casualty. Often specialists from various disciplines manage these crowded casualty areas. These age old casualty areas are being replaced, throughout the country by Emergency Medicine Departments (EMDs, presumed to be better planned to confront a crisis. We aimed to gather basic data contributive in setting up of an EMD at a tertiary care teaching hospital from the lessons learned from functioning existent systems. Methods: This is primarily a questionnaire-based descriptive study at tertiary care referral centres across the country, which was purposively selected.The study models included one from a hospital without designated EMD and the other four from hospitals with established EMDs. Direct observation and focus group meetings with experienced informants at these hospitals contributed to the data. In the absence of a validated hospital preparedness assessment scale, comparison was done with regard to quantitative, qualitative and corroborative parameters using descriptive analysis. Results: The EMDs at best practice models were headed by specialist in Emergency Medicine assisted by organised staff, had protocols for managing mass casualty incident (MCI, separate trauma teams, ergonomic use of infrastructure and public education programmes. In this regard, these hospitals seemed well organised to manage MCIs and disasters. Conclusion: The observation may provide a preliminary data useful in setting up an EMD. In the absence of published Indian literature, this may facilitate further research in this direction. Anaesthesiologists, presently an approved Faculty in Emergency Medicine training can provide creative input with regard to its initial organisation and functioning, thus widening our horizons in a country where there is a severe dearth of trained emergency physicians.

  4. Research on problems in nuclear accident emergency rescue for nuclear power submarine

    This paper presents a description of nuclearpowered submarine accident types and an analysis of accident emergency rescue characteristics, including a special number of problems associated with emergencyrescue, such as emergency situation and emergency planning zone, technical rescue resources and task, protection against compound radiation inside and outside port plume zone, on-sea nuclear rescue equipment and technical assurance capacity, and other problesms related to in-accident nuclear submarine disposal. (authors)

  5. Guidelines for mutual emergency assistance arrangements in connection with a nuclear accident or radiological emergency

    The document contains the recommendations of a group of experts from 22 Member States and three international organizations which met in April 1983. These recommendations may serve as guidelines for use by states for the negotiation of bilateral or regional agreements relating to emergency assistance in the event of a nuclear accident or radiological emergency

  6. Emergency medicine rural rotations: a program director's guide.

    Casaletto, Jennifer J; Wadman, Michael C; Ankel, Felix K; Bourne, Christina L; Ghaemmaghami, Chris A

    2013-05-01

    The Institute of Medicine's 2006 report titled "Hospital-Based Emergency Care: At the Breaking Point" called national attention to the lack of specialty-trained emergency care practitioners, particularly in rural America. One suggested strategy for narrowing the gap between the prevalence of residency-trained, board-certified emergency physicians practicing in rural and urban emergency departments is the development of rural clinical experiences for emergency medicine residents during the course of their training. This article addresses promotion of a rural emergency medicine rotation to hospital leadership and resident recruits, examines funding sources, discusses medical liability and disability insurance options, provides suggestions for meeting faculty and planned educational activity residency review committee requirements, and offers guidance about site selection to direct emergency medicine academic leaders considering or planning a new rural emergency medicine rotation. PMID:23083967

  7. Helicopter emergency medical services accident rates in different international air rescue systems

    J Hinkelbein

    2010-04-01

    Full Text Available J Hinkelbein1,2, M Schwalbe2, H V Genzwuerker2,31Department for Anesthesiology and Intensive Care Medicine, University Hospital Cologne, Germany; 2Working Group “Emergency Medicine and Air Rescue”, German Society of Aviation and Space Medicine (DGRLM eV; 3Clinic of Anesthesiology and Intensive Care Medicine, Neckar-Odenwald-Kliniken gGmbH, Hospitals Buchen and Mosbach, Buchen, GermanyAim: Each year approximately two to four helicopter emergency medical services (HEMS crashes occur in Germany. The aim of the present study was to compare crash rates and fatal crash rates in Germany to rates in other countries.Materials and methods: A MEDLINE search from 1970 to 2009 was performed using combinations of the keywords “HEMS”, “rescue helicopter”, “accident”, “accident rate”, “crash”, and “crash rate”. The search was supplemented by additional published data. Data were compared on the basis of 10,000 missions and 100,000 helicopter flying hours. These data were allocated to specific time frames for analyis.Results: Eleven relevant studies were identified. Five studies (three from Germany, one from the US, one from Australia analyzing HEMS accidents on the basis of 10,000 missions were identified. Crash rates per 10,000 missions ranged between 0.4 and 3.05 and fatal crash rates between 0.04 and 2.12. In addition, nine studies (six from the US, two from Germany, one from Australia used 100,000 flying hours as a denominator. Here, crash rates ranged between 1.7 and 13.4 and fatal crash rates between 0.91 and 4.7.Conclusions: Data and accident rates were inhomogeneous and differed significantly. Data analysis was impeded by publication of mean data, use of different time frames, and differences in HEMS systems.Keywords: fatal accident rate, rescue helicopter, fatal crash rate, helicopter emergency medical system, accident analysis

  8. Lessons learned from Fukushima accident in relation to emergency management

    The latest accident in Fukushima, Japan, which involved concurrent accidents at multiple nuclear facilities due to the earthquakes and tsunami, as well as station blackouts for an extended period of time, demonstrated the need for an overall review of existing prevention measures. These measures include emergency protection measures for residents beyond the emergency planning zone, the application of radiation protection criteria that consider the release of radioactive materials to the environment over an extended period and the disposal of large-scale radioactive wastes and radiation protection criteria to be applied upon recovery. Accordingly, Japan has taken improvement initiatives in the area of prevention by submitting a government report on the Fukushima accident prior to the IAEA Ministerial Conference on Nuclear Safety in June last year, and the US has devised a regulatory system of its own, including directions for improvement through the NRC, which operated a temporary taskforce specifically for this purpose. This study examined how Japan is responding to the Fukushima accident and investigated directions that countries around the world can take to improve the area of nuclear protection in order to enhance Korea's own radiological emergency management system

  9. FOAMSearch.net: A custom search engine for emergency medicine and critical care.

    Raine, Todd; Thoma, Brent; Chan, Teresa M; Lin, Michelle

    2015-08-01

    The number of online resources read by and pertinent to clinicians has increased dramatically. However, most healthcare professionals still use mainstream search engines as their primary port of entry to the resources on the Internet. These search engines use algorithms that do not make it easy to find clinician-oriented resources. FOAMSearch, a custom search engine (CSE), was developed to find relevant, high-quality online resources for emergency medicine and critical care (EMCC) clinicians. Using Google™ algorithms, it searches a vetted list of >300 blogs, podcasts, wikis, knowledge translation tools, clinical decision support tools and medical journals. Utilisation has increased progressively to >3000 users/month since its launch in 2011. Further study of the role of CSEs to find medical resources is needed, and it might be possible to develop similar CSEs for other areas of medicine. PMID:25939364

  10. Individual feature identification method for nuclear accident emergency decision-making

    According to the individual feature identification method and combining with the characteristics of nuclear accident emergency decision-making, the evaluation index system of the nuclear accident emergency decision-making was determined on the basis of investigation and analysis. The effectiveness of the nuclear accident emergency decision-making was evaluated based on the individual standards by solving the individual features of the individual standard identification decisions. The case study shows that the optimization result is reasonable, objective and reliable, and it can provide an effective analysis method and decision-making support for optimization of nuclear accident emergency protective measures. (authors)