WorldWideScience

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

    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.

  5. 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

  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. 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

  12. 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.

  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. 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

  2. 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.

  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

    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.

  7. 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

  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. 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

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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

  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. 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

  5. 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...

  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. 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

  10. 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.

  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. 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...

  18. 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...

  19. 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' ...

  20. 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...

  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. 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...

  6. 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

  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. 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...

  9. 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...

  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. 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

  17. 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

  18. 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....

  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. 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.)

  3. 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...

  4. 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

  5. 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...

  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. 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

  8. 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/...

  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. 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

  13. 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

  14. 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...

  15. 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

  16. 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

  17. 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)

  18. 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.

  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. 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...

  1. 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...

  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. 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

  5. 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...

  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. 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.

  9. 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)

  10. 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

  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. 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

  13. 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...

  14. 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...

  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. 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

  20. 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

  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)

  11. Short-term associations between outdoor air pollution and visits to accident and emergency departments in London for respiratory complaints.

    Atkinson, R W; Anderson, H R; Strachan, D P; Bland, J M; Bremner, S A; Ponce de Leon, A

    1999-02-01

    Many epidemiological studies have shown positive short-term associations between health and current levels of outdoor air pollution. The aim of this study was to investigate the association between air pollution and the number of visits to accident and emergency (A&E) departments in London for respiratory complaints. A&E visits include the less severe cases of acute respiratory disease and are unrestricted by bed availability. Daily counts of visits to 12 London A&E departments for asthma, other respiratory complaints, and both combined for a number of age groups were constructed from manual registers of visits for the period 1992-1994. A Poisson regression allowing for seasonal patterns, meteorological conditions and influenza epidemics was used to assess the associations between the number of visits and six pollutants: nitrogen dioxide, ozone, sulphur dioxide, carbon monoxide, and particles measured as black smoke (BS) and particles with a median aerodynamic diameter of <10 microm (PM10). After making an allowance for the multiplicity of tests, there remained strong associations between visits for all respiratory complaints and increases in SO2: a 2.8% (95% confidence interval (CI) 0.7-4.9) increase in the number of visits for a 18 microg x (-3) increase (10th-90th percentile range) and a 3.0% (95% CI 0.8-5.2) increase for a 31 microg x m(-3) increase in PM10. There were also significant associations between visits for asthma and SO2, NO2 and PM10. No significant associations between O3 and any of the respiratory complaints investigated were found. Because of the strong correlation between pollutants, it was difficult to identify a single pollutant responsible for the associations found in the analyses. This study suggests that the levels of air pollution currently experienced in London are linked to short-term increases in the number of people visiting accident and emergency departments with respiratory complaints. PMID:10065665

  12. A framework for implementation, education, research and clinical use of ultrasound in emergency departments by the Danish Society for Emergency Medicine

    Laursen, Christian B; Nielsen, Klaus; Riishede, Minna; Tiwald, Gerhard; Møllekær, Anders; Aagaard, Rasmus; Posth, Stefan; Weile, Jesper

    2014-01-01

    The first Danish Society for Emergency Medicine (DASEM) recommendations for the use of clinical ultrasound in emergency departments has been made. The recommendations describes what DASEM believes as being current best practice for training, certification, maintenance of acquired competencies, quality assurance, collaboration and research in the field of clinical US used in an ED.

  13. Bulgarian emergency response system in case of nuclear accident: description, performance and verification

    A PC-oriented Emergency Response System (ERS) is developed and works in National Institute of Meteorology and Hydrology with Bulgarian Academy of Science. The creation and the development of ERS was highly stimulated by the CEC/IAEA/WMO project ETEX (European Tracer EXperiment). ERS comprises of two main parts - operational and accidental ones, realized for both regions 'Europe' and 'Northern Hemisphere'. The operational part runs automatically. It consists of the following modules: selection of proper meteorological data (analyses and forecast) received via the Global Telecommunication System (GTS) of WMO; preparation of input meteorological files used by both trajectory and dispersion models (so called operational data base); completion of the respective meteorological archives, trajectory calculations for selected NPP in Europe and Northern Hemisphere; visualization of the results and putting the pictures in a specialized Web-site. The operational part runs every 12 hours, after new meteorological information is received. The accidental part is activated manually when a real radioactive releases in occurred or during emergency exercises. Two Bulgarian dispersion models - LED and EMAP are a core of the accidental part, LED (Lagrangean-Eulerian Diffusion) being a typical puff-model, wile EMAP (Eulerian Model for Air Pollution) is a 3-D dispersion model. The source input is specified by the user - Bulgarian emergency authorities, and the visualized output (pollution distribution maps) is sent back via fax and FTP. In the paper, the ERS overall structure and its modules are described and an ERS application in emergency management is shown. (authors)

  14. Emergency response to a nuclear power reactor accident

    The Province of Ontario recently reviewed its plans for an emergency response to a possible nuclear power reactor accident that might contaminate some of the surrounding countryside with radioactivity. The Province requested some comments from a small Panel (the present authors) that was formed for this purpose by the Royal Society of Canada and the Canadian Academy of Engineering. This note is a summary of our findings. It presents, first, a short account of the probabilistic risk assessment of accidents and the probability and severity of accidents for which response training should be undertaken; and second, the mitigation of possible harmful effects of escaped radiation and the radiation level at which action should be taken. (author)

  15. Conceptual design of emergency communication system to cope with severe accidents in NPPs and its performance evaluation

    Highlights: • The emergency communication system requires the performances of the throughput of 1 Mbps, BER of 10−6 and network configuration of 1:12 communication. • The emergency communication system consists of the terrestrial communication and satellite communication system. • In the terrestrial communication system, at least two wireless repeaters are needed to secure LOS and the throughput and delay time are 16 Mbps and 16 ms, respectively. • In the satellite communication system, DSSS and FDMA are used and the fade margin range is from 1.3 to 16 dB. - Abstract: The Fukushima accident induced by the great earthquake and tsunami reveals the vulnerability of I and C System. In the severe environment, the normal I and C system did not work properly and results in false information about the internal situation in NPP. Eventually the accident was not properly handled at the early stage. Therefore advanced emergency response system using a wireless channel is necessary to cope with the severe accident. In this paper, we introduce the ERS consisting of the HMS and MCS the ECS linking the HMS with MCS and the performance requirement of the ECS is analyzed. The ECS satisfying the requirement is designed conceptually and the performance of the ECS is evaluated through analysis and simulator. To secure a reliable and diverse configuration, the ECS is configured as the dual system which consists of the terrestrial communication and satellite communication. The terrestrial communication system is designed based on the IEEE 802.11. Analyzed performance results prove that the performance requirement can be sufficiently achieved. But if the scalability of data capacity is considered later, use of the advanced 802.11 standard such as 802.11n and multiple signal paths between the HMS and MCS are necessary. In the satellite communication system, the FDMA is used in the status link and the DSSS is used in the control link. The network supporting various data rates is

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

    Stoneking, LR; Waterbrook, AL; Garst Orozco, J; Johnston, D; Bellafiore, A; Davies, C; Nuño, T; Fatás-Cabeza, J; Beita, O; Ng, V; Grall, KH; Adamas-Rappaport, W

    2016-01-01

    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. Complete outcome data were available for 55 patients. Overall, resident physicians spoke Spanish 58% of the time. SC resident physicians spoke Spanish with 66% of the patients versus 45% for UC resident physicians. Patients rated resident physician Spanish ability as very good in 13% of encounters – 17% for SC versus 5% for UC. Patient satisfaction with their ED visit was rated as very good in 35% of encounters – 40% for SC resident physicians versus 25% for UC resident physicians. Of the 13 patients for whom Spanish was the language used during the medical encounter who followed medical recommendations, ten (77%) of these encounters were with SC resident physicians

  17. E-learning as educational tool in emergency and disaster medicine teaching.

    Della Corte, F; La Mura, F; Petrino, R

    2005-05-01

    E-learning is a new project for education based on the adoption of new computerised, multimedia and telematic technologies. Its application has deeply changed the concept of a teacher-based teaching to a student-centred educational project. It offers a great flexibility in the educational methodology, in the administration of contents, in the synchronous and/or asynchronous interaction between teachers and students, in the organisation and in the structure of the course, in the educational plans, in the support, the tracking and the evaluation of the student. E-learning could represent a great resource and a possible revolution in the concept of education and in the field of medical education as well. In some specific fields of application, as Emergency and Disaster Medicine, where the interaction between the student, the teacher and the patient, even if of great importance, are difficult to obtain in a quiet setting and have a lot of organizing, technical and economic troubles, e-learning approach could find a fertile field of application. In this paper we present a new program of educational activities we started in the field of Emergency and Disaster Medicine together with a review of the history of the instructional design and related technologies, ranging from the development of computer aided instruction to modern e-learning applications as teaching methodologies, and their impact on pedagogic and operative aspects. PMID:15834347

  18. Fuel and fuel channel behaviour in loss of coolant accident without the availability of the emergency coolant injection system

    Safety Analysis of CANDU reactors assesses fuel and fuel channel behaviour under high temperature transient accident conditions. The basic purpose of the analysis is to establish the channel integrity (a sufficient, but not necessary condition) even when the Emergency Cooling Injection System is presumed to be unavailable. For such severe accident conditions, the channel is heated to temperatures where it deforms and creates a heat removal path from the fuel through the pressure tube and calandria tube to the moderator. The moderator in CANDU reactor is a separate system and can provide heat removal for the heat produced within the channel. This occurs through pressure tube deformation either by circumferential strain or sag whereby the pressure tube contacts the calandria tube and allowing heat to be conducted directly to the moderator. It is found that the heat generated within the channel is transported to the moderator, and that the implied modes of channel (pressure tube) deformation are physically possible, and do not lead to failure of the pressure tube (i.e. of the pressure boundary). This paper considers the fuel and channel thermal and mechanical behaviour at very high temperatures. It discusses modelling of fission product release from fuel, deformation of the pressure tube and calandria tube, and hydrogen production insofar as it affects the fuel analysis and the containment analysis. (author)

  19. Electronic Whiteboards in Emergency Medicine

    Rasmussen, Rasmus

    2012-01-01

    As more and more Emergency Departments replace the manual dry-erase whiteboards used for coordination of patient care and communication among clinicians with IT-based electronic whiteboards a need to clarify the effects of implementing these systems arises. This paper seeks to answer this question...... by systematically reviewing studies on electronic whiteboards. The results of the review indicate that electronic whiteboards influence the work at Emergency Departments in various different ways e.g. changes to work practice and changes to whiteboard information accuracy. Also, the review finds that...

  20. Feedback in the Emergency Medicine Clerkship

    Bernard, Aaron W; Kman, Nicholas E.; Khandelwal, Sorabh

    2011-01-01

    Objective Feedback is a technique used in medical education to help develop and improve clinical skills. A comprehensive review article specifically intended for the emergency medicine (EM) educator is lacking, and it is the intent of this article to provide the reader with an in-depth, up-to-date, and evidence-based review of feedback in the context of the EM clerkship. Methods The review article is organized in a progressive manner, beginning with the definition of feedback, the importance ...

  1. Feedback in the Emergency Medicine Clerkships

    Bernard, Aaron W; Kman, Nicholas E.; Khandelwal, Sorabh

    2011-01-01

    Objective: Feedback is a technique used in medical education to help develop and improve clinical skills. A comprehensive review article specifically intended for the emergency medicine (EM) educator is lacking, and it is the intent of this article to provide the reader with an in-depth, up-to-date, and evidence-based review of feedback in the context of the EM clerkship. Methods: The review article is organized in a progressive manner, beginning with the definition of feedback, the importanc...

  2. Nanotechnology in medicine emerging applications

    Koprowski, Gene

    2012-01-01

    This book will describe some of the most recent breakthroughs and promising developments in the search for improved diagnostics and therapies at the very small scales of living biological systems. While still very much a technology in the research and development stage, nanotechnology is already transforming today's medicine. This book, written by a general science author, provides a general overview of medical treatment potentials of nanotechnology in new, more effective drug delivery systems, in less invasive, ultra-small scale medical tools, and in new materials that can mimic or enhance na

  3. Improving interunit transitions of care between emergency physicians and hospital medicine physicians: a conceptual approach.

    Beach, Christopher; Cheung, Dickson S; Apker, Julie; Horwitz, Leora I; Howell, Eric E; O'Leary, Kevin J; Patterson, Emily S; Schuur, Jeremiah D; Wears, Robert; Williams, Mark

    2012-10-01

    Patient care transitions across specialties involve more complexity than those within the same specialty, yet the unique social and technical features remain underexplored. Further, little consensus exists among researchers and practitioners about strategies to improve interspecialty communication. This concept article addresses these gaps by focusing on the hand-off process between emergency and hospital medicine physicians. Sensitivity to cultural and operational differences and a common set of expectations pertaining to hand-off content will more effectively prepare the next provider to act safely and efficiently when caring for the patient. Through a consensus decision-making process of experienced and published authorities in health care transitions, including physicians in both specialties as well as in communication studies, the authors propose content and style principles clinicians may use to improve transition communication. With representation from both community and academic settings, similarities and differences between emergency medicine and internal medicine are highlighted to heighten appreciation of the values, attitudes, and goals of each specialty, particularly pertaining to communication. The authors also examine different communication media, social and cultural behaviors, and tools that practitioners use to share patient care information. Quality measures are proposed within the structure, process, and outcome framework for institutions seeking to evaluate and monitor improvement strategies in hand-off performance. Validation studies to determine if these suggested improvements in transition communication will result in improved patient outcomes will be necessary. By exploring the dynamics of transition communication between specialties and suggesting best practices, the authors hope to strengthen hand-off skills and contribute to improved continuity of care. PMID:23035952

  4. Electronic Whiteboards in Emergency Medicine

    Rasmussen, Rasmus

    2012-01-01

    As more and more Emergency Departments replace the manual dry-erase whiteboards used for coordination of patient care and communication among clinicians with IT-based electronic whiteboards a need to clarify the effects of implementing these systems arises. This paper seeks to answer this questio...

  5. First Responders and Criticality Accidents

    Valerie L. Putman; Douglas M. Minnema

    2005-11-01

    Nuclear criticality accident descriptions typically include, but do not focus on, information useful to first responders. We studied these accidents, noting characteristics to help (1) first responders prepare for such an event and (2) emergency drill planners develop appropriate simulations for training. We also provide recommendations to help people prepare for such events in the future.

  6. System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals

    Japanese system for radiation emergency medicine is primarily built up by Cabinet Nuclear Safety Commission in 2001 based on previous Tokai JCO Accident (1999) and is composed from the primary, secondary and tertiary medical organizations. This paper describes mainly about roles and actions of the tertiary facilities at Fukushima Nuclear Power Plant Accident and tasks to be improved in future. The primary and secondary organizations in the system above are set up in the prefectures with or neighboring the nuclear facility, and tertiary ones, in two parts of western and eastern Japan. The western organization is in Hiroshima University having its cooperating 7 hospitals, and is responsible for such patients as exposed to high dose external radiation, having serious complication, and difficult to treat in the primary/secondary hospitals. The eastern is in National Institute of Radiological Sciences (NIRS) with 6 cooperating hospitals and responsible for patients with internal radiation exposure difficult to treat, with contaminated body surface with difficulty in decontamination and/or with causable of secondary contamination, and difficult to treat in the secondary hospitals. The tertiary organizations have made efforts for the education and training of medical staff, for network construction among the primary, secondary and other medicare facilities, for establishment of transferring system of patients, and for participation to the international network by global organizations like Response Assistance Network (RANET) in International Atomic Energy Agency (IAEA), and Radiation Emergency Preparedness and Network (REMPAN) in World Health Organization (WHO). At the Fukushima Accident, staffs of the two tertiary hospitals began to conduct medicare on site (Mar. 12-) and learned following tasks to be improved in future: the early definition of medicare and its network system, and Emergency Planning Zone (EPZ); urgent evacuation of residents weak to disaster like elderly

  7. Explanation of procedure on site medical emergency response for nuclear accident

    National occupational health standard-Procedure on Site Medical Emergency Response for Nuclear Accident has been approved and issued by the Ministry of Health. This standard is formulated according to the Emergency Response Law of the People's Republic of China, Law of the People 's Republic of China on Prevention and Control of Occupational Diseases, Regulations on Emergency Measures for Nuclear Accidents at Nuclear Power Plants, and Health Emergency Plans for Nuclear and Radiological Accidents of Ministry of Health, supporting the use of On-site Medical Emergency Planning and Preparedness for Nuclear Accidents and Off-site Medical Emergency Planning and Preparedness for Nuclear Accidents. Nuclear accident on-site medical response procedure is a part of the on-site emergency plan. The standard specifies the basic content and requirements of the nuclear accident on-site medical emergency response procedures of nuclear facilities operating units to guide and regulate the work of nuclear accident on-site medical emergency response of nuclear facilities operating units. The criteria-related contents were interpreted in this article. (authors)

  8. Experience-based teaching of acute medicine for extra motivated medical students and young physicians – 4th Emergency Medicine Course and 6th AKUTNĚ.CZ Congress

    Petr Štourač

    2014-12-01

    Full Text Available Faculty of Medicine of the Masaryk University (MU, and especially its departments focusing on acute medicine, make an active effort to find and to support extra motivated students by organising courses and congresses with simulation-based learning sessions for them. 4th Emergency Medicine Course (EMC and 6th AKUTNĚ.CZ Congress were organised during 2014. EMC was held during a weekend in mid-April for 80 medical students. The congress was held on 22nd November 2014. A group of more than 700 enthusiastic professionals including physicians, nursing staff and medical students interested in acute medicine met again in Brno at the University Campus Bohunice. We also report the evaluation of effectiveness of different types of sessions, as well as its influence on practical skills and the fixation of memory footprint. The website AKUTNĚ.CZ (www.akutne.cz is freely accessible, and anyone can find and watch all the videos and presentations there.

  9. Uncertainties under emergency conditions in Hiroshima and Nagasaki in 1945 and Bikini accident in 1954

    who were trained at Narashino Chemical School were assigned, at least one, to each unit (brigade and higher) of the Japanese Army. Chemical Weapons Control unit was organised at the headquarters in the centre of Hiroshima. After atomic bombing some vessels of mustard gas stored underground were found cracked and leaked. Judging from these findings it may be possible that some chemical weapons were released to the environment from the military facilities on ground at the time they were destroyed by the atomic bombing and the survivors were exposed to poison gases to a smaller or larger extent. There was no drinking water and they had to drink rain water which fell heavily soon after the atomic bombing. It is highly possible that the rainwater was also contaminated by various toxic substances including chemical weapons. These effects combined with the irradiation by atomic radiation are difficult to quantify accurately at present, many years after atomic bombings. But if all these adverse effects were ascribed solely to the ionizing radiation, the effects of radiation may be overestimated in Hiroshima and Nagasaki. In using the Hiroshima and Nagasaki data for establishing radiation safety standard in peaceful uses of atomic energy, we should keep these possibilities of overestimation in mind. At the Bikini accident, where Japanese fishing boat was showered by strongly radioactive ash due to thermonuclear test on March 1, 1954 in the Pacific, some crew tested the ash to see what it is. The amount of intake is uncertain. Depending on the assumption, a widely different result would be obtained. (author)

  10. Uncertainties under emergency conditions in Hiroshima and Nagasaki in 1945 and Bikini accident in 1954

    Nishiwaki, Y. [Universitaet Wien, Institut fuer Medizinische Physik, Vienna (Austria); Kawai, H. [Atomic Energy Research Institute of Kinki Univ., Osaka (Japan); Shono, N. [Hiroshima Jogakuin Univ., Hiroshima (Japan); Fujita, S. [Radiation Effects Research Foundation, Department of Statistics, Hiroshima (Japan); Matsuoka, H. [Japan Atomic Energy Research Institute, Earth Simulator Research and Development Center, Tokyo (Japan); Fujiwara, S. [Japan Nuclear Cycle Development Institute, Ibaraki (Japan); Hosoda, T. [Chiyoda Technol Corporation, Tokyo (Japan)

    2000-05-01

    who were trained at Narashino Chemical School were assigned, at least one, to each unit (brigade and higher) of the Japanese Army. Chemical Weapons Control unit was organised at the headquarters in the centre of Hiroshima. After atomic bombing some vessels of mustard gas stored underground were found cracked and leaked. Judging from these findings it may be possible that some chemical weapons were released to the environment from the military facilities on ground at the time they were destroyed by the atomic bombing and the survivors were exposed to poison gases to a smaller or larger extent. There was no drinking water and they had to drink rain water which fell heavily soon after the atomic bombing. It is highly possible that the rainwater was also contaminated by various toxic substances including chemical weapons. These effects combined with the irradiation by atomic radiation are difficult to quantify accurately at present, many years after atomic bombings. But if all these adverse effects were ascribed solely to the ionizing radiation, the effects of radiation may be overestimated in Hiroshima and Nagasaki. In using the Hiroshima and Nagasaki data for establishing radiation safety standard in peaceful uses of atomic energy, we should keep these possibilities of overestimation in mind. At the Bikini accident, where Japanese fishing boat was showered by strongly radioactive ash due to thermonuclear test on March 1, 1954 in the Pacific, some crew tested the ash to see what it is. The amount of intake is uncertain. Depending on the assumption, a widely different result would be obtained. (author)

  11. Road Accident Prevention with Instant Emergency Warning Message Dissemination in Vehicular Ad-Hoc Network

    P. Gokulakrishnan; Ganeshkumar, P.

    2015-01-01

    A Road Accident Prevention (RAP) scheme based on Vehicular Backbone Network (VBN) structure is proposed in this paper for Vehicular Ad-hoc Network (VANET). The RAP scheme attempts to prevent vehicles from highway road traffic accidents and thereby reduces death and injury rates. Once the possibility of an emergency situation (i.e. an accident) is predicted in advance, instantly RAP initiates a highway road traffic accident prevention scheme. The RAP scheme constitutes the following activities...

  12. Nordic Mutual Emergency Assistance Agreement in Connection with Radiation Accidents

    The text of the Nordic Mutual Emergency Assistance Agreement in Connection with Radiation Accidents, which was signed on 17 October 1963 by the Director General and by representatives of the Governments of Denmark, Finland, Norway and Sweden, is reproduced in this document for the information of all Members. The entry into force of the Agreement in accordance with Article IX will be notified to Members in an Addendum to this document

  13. Radiological emergencies arising from accidents in Italy

    The Nuclear Safety and Health Protection Directorate (DISP) of ENEA has organized a structure of officers and technicians on call whenever an accident related to the activity of ENEA-DISP should occur. The most frequent events arise from natural misfortunes, crime, and deficiencies in public services. As regards technical operations such as measurements, removals, decontaminations and transport, DISP requests utilization of the different structures and equipment available to ENEA research centres and, in particular and most frequently, of the Safety and Radioprotection Division of the main ENEA centre: the Casaccia Research Centre. The technicians of this division are always available via telephone or radio, with the firm duty to be present within one hour from the call. The co-operation between these two structures enables timely and efficient intervention in many circumstances so that population and environmental risks can be avoided. Typical accidental situations are earthquakes, adverse atmospheric events, landslides, collapses, railway and road accidents, lost sources discovery, and seizure of illegally detained sources by judicial power. The paper briefly describes some of the situations which have occurred, and the actions carried out to recover sources and to re-establish safe environmental conditions. (author)

  14. Key regulatory and safety issues emerging NEA activities. Lessons Learned from Fukushima Dai-ichi NPS Accident - Key Regulatory and Safety Issues

    intervention and performance under extreme conditions; evaluations of metallic components and structures under high-seismic loads; risks assessments for natural external initiating events; and defence-in-depth, including the robustness of electrical systems. A recent joint research project has also been started that will include a benchmarking study of accident codes and the collection of data from the damaged reactors at the Fukushima Daiichi NPS. CRPPH activities in response to the Fukushima Daiichi NPS accident include an update of report on Short-term Countermeasures in Case of a Nuclear or Radiological Emergency that was last updated in 2003; the performance of a survey on emergency management lessons learned; developing lesson learned in the management of occupational exposure in high-radiation areas; and providing support to the Japanese Government by co-ordination and participation in workshops on decontamination and recovery and other technical topics

  15. Supervision and feedback for junior medical staff in Australian emergency departments: findings from the emergency medicine capacity assessment study

    Weiland Tracey J

    2010-11-01

    Full Text Available Abstract Background Clinical supervision and feedback are important for the development of competency in junior doctors. This study aimed to determine the adequacy of supervision of junior medical staff in Australian emergency departments (EDs and perceived feedback provided. Methods Semi-structured telephone surveys sought quantitative and qualitative data from ED Directors, Directors of Emergency Medicine Training, registrars and interns in 37 representative Australian hospitals; quantitative data were analysed with SPSS 15.0 and qualitative data subjected to content analysis identifying themes. Results Thirty six of 37 hospitals took part. Of 233 potential interviewees, 95 (40.1% granted interviews including 100% (36/36 of ED Directors, and 96.2% (25/26 of eligible DEMTs, 24% (19/81 of advanced trainee/registrars, and 17% (15/90 of interns. Most participants (61% felt the ED was adequately supervised in general and (64.2% that medical staff were adequately supervised. Consultants and registrars were felt to provide most intern supervision, but this varied depending on shift times, with registrars more likely to provide supervision on night shift and at weekends. Senior ED medical staff (64% and junior staff (79% agreed that interns received adequate clinical supervision. Qualitative analysis revealed that good processes were in place to ensure adequate supervision, but that service demands, particularly related to access block and overcrowding, had detrimental effects on both supervision and feedback. Conclusions Consultants appear to provide the majority of supervision of junior medical staff in Australian EDs. Supervision and feedback are generally felt to be adequate, but are threatened by service demands, particularly related to access block and ED overcrowding.

  16. Short-term associations between outdoor air pollution and visits to accident and emergency departments in London for respiratory complaints

    Atkinson, R.W.; Anderson, H.R.; Strachan, D.P.; Bland, J.M.; Bremner, S.A. [St. George`s Hospital Medical School, Dept. of Public Health Sciences, London (United Kingdom); Ponce de Leon, A. [IME/UERJ Rua Sao Francisco Xavier, Dept. de Estatistica, Maracana Rio de Janeiro (Brazil)

    1999-02-01

    Many epidemiological studies have shown positive short-term associations between health and current levels of outdoor air pollution. The aim of this study was to investigate the association between air pollution and the number of visits to accident and emergency (A and E) departments in London for respiratory complaints. A and E visits include the less severe cases of acute respiratory disease and are unrestricted by bed availability. Daily counts of visits to 12 London A and E departments for asthma, other respiratory complaints, and both combined for a number of age groups were constructed from manual registers of visits for the period 1992-1994. A poison regression allowing for seasonal patterns meteorological conditions and influenza epidemics was used to assess the associations between the number of visits and six pollutants: nitrogen dioxide, ozone, sulphur dioxide, carbon monoxide, and particles measured as black smoke (BS) and particles with a median aerodynamic diameter of <10 {mu}m (PM10). After making an allowance for the multiplicity of tests, there remained strong associations between visits for all respiratory complaints and increases in SO{sub 2}: a 2.8% (95% confidence interval (CI) 0.7-4.9) increase in the number of visits for a 18 {mu}g{sup .}m{sup -3} increase (10th-90th percentile range) and a 3.0% (95% Cl 0.8-5.2) increase for a 31 {mu}g{sup .}m{sup -3} increase in PM10. There were also significant associations between visits for asthma and SO{sub 2}, NO{sub 2} and PM10. No significant associations between O{sub 3} and any of the respiratory complaints investigated were found. Because of the strong correlation between pollutants, it was difficult to identify a single pollutant responsible for the associations found in the analyses. This study suggests that the levels of air pollution currently experienced in London are linked to short-term increases in the number of people visiting accident and emergency departments with respiratory complaints

  17. Short-term associations between outdoor air pollution and visits to accident and emergency departments in London for respiratory complaints

    Atkinson, R.W.; Anderson, H.R.; Strachan, D.P.; Bland, J.M.; Bremner, S.A. [St. George' s Hospital Medical School, Dept. of Public Health Sciences, London (United Kingdom); Ponce de Loen, A. [IME/UERJ Rua Sao Francisco Xavier, Dept. de Estatistica, Maracana Rio de Janeiro , RJ (Brazil)

    1999-07-01

    Many epidemiological studies have shown positive short-term associations between health and current levels of outdoor air pollution. The aim of this study was to investigate the association between air pollution and the number of visits to accident and emergency (A and E) departments in London for respiratory complaints. A and E visits include the less severe cases of acute respiratory disease and are unrestricted by bed availability. Daily counts of visits to 12 London A and E departments for asthma, other respiratory complaints, and both combined for a number of age groups were constructed from manual registers of visits for the period 1992-1994. A Poisson regression allowing for seasonal patterns, meteorological conditions and influenza epidemics was used to assess the associations between the number of visits and six pollutants: nitrogen dioxide, ozone, sulphur dioxide, carbon monoxide, and particles measured as black smoke (BS) and particles with a median aerodynamic diameter of <10 {mu}m (PM10). After making an allowance for the multiplicity of tests, there remained strong associations between visits for all respiratory complaints and increases in SO{sub 2}: a 2.8% (95% confidence interval (CI) 0.7-4.9) increase in the number of visits for a 18 {mu}g{sup .}m{sup -3} increase (10th-90th percentile range) and a 3.0% (95% CI 0.8-5.2) increase for a 31 {mu}g{sup .}m{sup -3} increase in PM10. There were also significant associations between visits for asthma and SO{sub 2}, NO{sub 2} and PM10. No significant associations between O{sub 3} and any of the respiratory complaints investigated were found. Because of the strong correlation between pollutants, it was difficult to identify a single pollutant responsible for the associations found in the analyses. This study suggests that the levels of air pollution currently experineced in London are linked to short-term increases in the number of people visiting accident and emergency departments with respiratory

  18. Emergency Medicine-bound medical student performance on the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination and Versions 1 and 2 of the National Emergency Medicine M4 exams

    Katherine Hiller

    2015-11-01

    Full Text Available Introduction: In April 2013, the National Board of Medical Examiners (NBME released an Advanced Clinical Examination (ACE in emergency medicine (EM. In addition to this new resource, CDEM (Clerkship Directors in EM provides two online, high-quality, internally validated examinations. National usage statistics are available for all three examinations, however, it is currently unknown how students entering an EM residency perform as compared to the entire national cohort. This information may help educators interpret examination scores of both EM-bound and non-EM-bound students. Objectives: The objective of this study was to compare EM clerkship examination performance between students who matched into an EM residency in 2014 to students who did not. We made comparisons were made using the EM-ACE and both versions of the National fourth year medical student (M4 EM examinations. Method: In this retrospective multi-institutional cohort study, the EM-ACE and either Version 1 (V1 or 2 (V2 of the National EM M4 examination was given to students taking a fourth-year EM rotation at five institutions between April 2013 to February 2014. We collected examination performance, including the scaled EM-ACE score, and percent correct on the EM M4 exams, and 2014 NRMP Match status. Student t-tests were performed on the examination averages of students who matched in EM as compared with those who did not. Results: A total of 606 students from five different institutions took both the EM-ACE and one of the EM M4 exams; 94 (15.5% students matched in EM in the 2014 Match. The mean score for EM-bound students on the EM-ACE, V1 and V2 of the EM M4 exams were 70.9 (n=47, SD=9.0, 84.4 (n=36, SD=5.2, and 83.3 (n=11, SD=6.9, respectively. Mean scores for non-EM-bound students were 68.0 (n=256, SD=9.7, 82.9 (n=243, SD=6.5, and 74.5 (n=13, SD=5.9. There was a significant difference in mean scores in EM-bound and non-EM-bound student for the EM-ACE (p=0.05 and V2 (p<0.01 but

  19. Radiation accidents on human in the nuclear installations and their medical emergency procedures, (1)

    Present nuclear installations are one of the safest installations among industrial facilities, being equipped with various safety instruments. Since X-ray was discovered in 1895, however, many radiation injuries of various degrees and kinds occurred. Among dangerous nuclides often observed as radioactivity pollutions in nuclear installations, the exposure to β-ray such as 90Sr, 106Ru, 95Zr, 131I, 144Ce, etc, is considered to be serious problems. When they affect wounds or are inhaled into lungs, only symptomatic treatment is practicable at present, and usually nothing can be depended upon, but spontaneous eliminating ability. As the mass inhalation of α nuclides, especially transuranium nuclides, is quite dangerous, the treatment by lung-irrigation now under development is most effective as the emergency treatment. When trans-uranium nuclides were accidentally observed from wounds, they should be eliminated by the injection of chelating agent. (Kobatake, H.)

  20. Loss-of-coolant accidents with impaired emergency coolant injection

    This report describes work on loss-of-coolant accidents in CANDU reactors in which emergency coolant injection is indefinitely delayed. Two situations are considered, one in which additional heat sinks (moderator, moderator cooling system, etc.) are available and effective and the other in which they are not. For the situation in which additional heat sinks are available, the computer program IMPECC has been used for the analysis. Certain corrections and modifications to IMPECC are described and recommendations on the maximum time steps to use are given. For CANDU reactors in which calandria tubes remain submerged, should local CHF occur when a pressure tube sags onto a calandria tube, which is highly improbable, the dry patch caused would not spread beyond 100 and rewetting would occur rapidly. Calandria tube and pressure tube integrity will almost certainly be maintained. This conclusion is not affected even if the contact strip between pressure and calandria tubes is very wide, which is unlikely. For the situation in which additional heat sinks are not available, a simplified event tree has been developed to examine possible accident sequences. Two accident sequences have been selected for study: loss of moderator cooling system and loss of moderator heat sink. A detailed description of the analytical steps for the loss of moderator cooling system accident sequence is given

  1. Overtesting and the Downstream Consequences of Overtreatment: Implications of "Preventing Overdiagnosis" for Emergency Medicine.

    Carpenter, Christopher R; Raja, Ali S; Brown, Michael D

    2015-12-01

    Overtesting, the downstream consequences of overdiagnosis, and overtreatment of some patients are topics of growing debate within emergency medicine (EM). The "Preventing Overdiagnosis" conference, hosted by The Dartmouth Institute for Health Policy and Clinical Practice, with sponsorship from consumer organizations, medical journals, and academic institutions, is evidence of an expanding interest in this topic. However, EM represents a compellingly unique environment, with increased decision density tied to high stakes for patients and providers with missed or delayed diagnoses in a professional atmosphere that does not tolerate mistakes. This article reviews the relevance of this reductionist paradigm to EM, provides a first-hand synopsis of the first "Preventing Overdiagnosis" conference, and assesses barriers to moving the concept of less test ordering to reality. PMID:26568269

  2. Antiviral therapies against Ebola and other emerging viral diseases using existing medicines that block virus entry.

    Long, Jason; Wright, Edward; Molesti, Eleonora; Temperton, Nigel; Barclay, Wendy

    2015-01-01

    Emerging viral diseases pose a threat to the global population as intervention strategies are mainly limited to basic containment due to the lack of efficacious and approved vaccines and antiviral drugs. The former was the only available intervention when the current unprecedented Ebolavirus (EBOV) outbreak in West Africa began. Prior to this, the development of EBOV vaccines and anti-viral therapies required time and resources that were not available. Therefore, focus has turned to re-purposing of existing, licenced medicines that may limit the morbidity and mortality rates of EBOV and could be used immediately. Here we test three such medicines and measure their ability to inhibit pseudotype viruses (PVs) of two EBOV species, Marburg virus (MARV) and avian influenza H5 (FLU-H5). We confirm the ability of chloroquine (CQ) to inhibit viral entry in a pH specific manner. The commonly used proton pump inhibitors, Omeprazole and Esomeprazole were also able to inhibit entry of all PVs tested but at higher drug concentrations than may be achieved in vivo. We propose CQ as a priority candidate to consider for treatment of EBOV. PMID:26069727

  3. Coping with Unanticipated Accidents using Emergency Operating Procedures

    Kim, Yochan; Jung, Wondea [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-05-15

    In, unsafe acts associated with a literal following of a procedure were reported. A report of the Fukushima accident also revealed that a tendency to adhere to procedures and prior practices can impede applying effective countermeasures. To overcome the conflicts between benefit and jeopardy of procedures during unanticipated accidents, we reviewed the literature on the perspectives of cognitive engineering and artificial intelligence. From the insights about human planning of the literatures, we also proposed an approach of how to train operators to effectively use EOPs during unanticipated accidents. There are three key processes required to effectively cope with emergency situations: how correctly the operators are aware of the occurring situations, how properly they develop corresponding plans for the situations, and how accurately they execute the plans. This paper presents a way to develop the plans using EOPs from some literature of human planning. Even if professional operators have implicitly shaped good structures of procedures already, it is expected that this approach will provide a more systematic and concrete training strategy. If the operators are trained with this strategy, a higher level of human reliability would be ensured in unanticipated accidents.

  4. 300-Area accident analysis for Emergency Planning Zones

    The Department of Energy has requested SRL assistance in developing offsite Emergency Planning Zones (EPZs) for the Savannah River Plant, based on projected dose consequences of atmospheric releases of radioactivity from potential credible accidents in the SRP operating areas. This memorandum presents the assessment of the offsite doses via the plume exposure pathway from the 300-Area potential accidents. 8 refs., 3 tabs

  5. Loss of coolant accident analysis and evolution of emergency core cooling system for an inpile irradiation facility

    This paper deals with the Loss of Coolant Accident (LOCA) analysis of an inpile facility using RELAP4/MOD6 computer code. The present study is the culmination of a three part LOCA analysis done earlier by the authors. Blowdown analysis had been extended to include reflood part of the transient. Based on the analysis an Emergency Core Cooling System (ECCS) has been evolved. (author). 5 figs., 2 tabs

  6. Stress in accident and post-accident management at Chernobyl

    The effects of the Chernobyl nuclear accident on the psychology of the affected population have been much discussed. The psychological dimension has been advanced as a factor explaining the emergence, from 1990 onwards, of a post-accident crisis in the main CIS countries affected. This article presents the conclusions of a series of European studies, which focused on the consequences of the Chernobyl accident. These studies show that the psychological and social effects associated with the post-accident situation arise from the interdependency of a number of complex factors exerting a deleterious effect on the population. We shall first attempt to characterise the stress phenomena observed among the population affected by the accident. Secondly, we will be presenting an anlysis of the various factors that have contributed to the emerging psychological and social features of population reaction to the accident and in post-accident phases, while not neglecting the effects of the pre-accident situation on the target population. Thirdly, we shall devote some initial consideration to the conditions that might be conducive to better management of post-accident stress. In conclusion, we shall emphasise the need to restore confidence among the population generally. (Author)

  7. Nuclear accident and medical staff

    Described is the commentary concerning normative action of medical staff at radiation emergency and actual actions taken/to be taken for the Nuclear Power Plant Accident (NPPA) in Fukushima. The normative medical staff's action at radiation emergency is essentially based on rules defined by such international authorities as United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), International Commission of Radiological Protection (ICRP), International Atomic Energy Agency (IAEA) and Basic Safety Standard (BSS) and by network in IAEA, World Health Organization (WHO) and so on. The rules stand on past atomic events like those in Hiroshima, Nagasaki, Three Mile Isl., Chernobyl, and in Japanese Tokai JCO accident. The action above is required as a medical teamwork over specialized doctors. At Fukushima NPPA, medicare flowed from the on-site first-aid station (doctors for industry and labors), then the base for patient transfer (doctors of Japanese Association of Acute Medicine and Tokyo Electric Power Comp.), to the primary hospital for acute exposure (Iwaki Kyoritsu Hos.), from which patients were further transported to the secondary (contamination detected or severe trauma, Fukushima Medical Univ.) and/or tertiary facilities (serious contamination or acute radiation injury, National Institute of Radiological Sciences (NIRS) and Hiroshima Univ.). The flow was built up by the previous lead of national official guidance and by urgent spontaneous network among medical facilities; exempli gratia (e.g.), Fukushima Medical Univ. rapidly specialized in coping with the radiation medicare by partial discontinuance of daily clinical practice. Specialists of acute radiation medicare are generally rare, for which measures for it are more desirable along with health risk communication in facilities concerned. The professional function and endowment required for medical staff at emergency are concluded to be their guts and devotion as well as medical

  8. ESR accident dosimetry using medicine tablets coated with sugar

    Properties of radiation-induced radicals in medicine tablets were investigated using electron spin resonance (ESR). A sharp ESR signal sensitive to gamma ray irradiation was observed in the sugar coating part of the tablets. The signal has anisotropic g values of g1 = 2.0009, g2 = 2.0007 and g3 = 2.0002. The signal grows linearly with dose at least up to about 20 Gy. No fading was observed at room temperature even when exposed to sunlight. The dose to artificially irradiated tablets was estimated using the signal intensity and a previously determined calibration curve. The signal in sugar coated tablets can be utilised for dose measurements. In particular, the wide distribution of sugar coated tablets allows the use of the tablets as accident dosemeters. (author)

  9. Emergency feature. Great east Japan earthquake disaster Fukushima Daiichi accident

    The Tohoku Pacific Ocean earthquake occurred in March 11, 2011. The disastrous tsunami attacked Fukushima Daiichi nuclear power plants after automatically shutdown by the earthquake and all motor operated pumps became inoperable due to station black out. Despite the strenuous efforts of operators, if caused serious accident such as loss of cooling function, hydrogen explosion and release of large amount of radioactive materials into the environment, leading to nuclear power emergency that ordered resident to evacuate or remain indoors. This emergency feature consisted of four articles. The first was the interview with the president of JAIF (Japan Atomic Industrial Forum) on how to identify the cause of the accident completely, intensify safety assurance measures and promote discussions on a role of nuclear power in the nation's entire energy policy toward the reconstruction. Others were reactor states and events sequence after the accident with trend data of radiation in the reactor site, statement of president of AESJ (Atomic Energy Society of Japan) on nuclear crisis following Tohoku Pacific Ocean earthquake our response and my experience in evacuation life. (T. Tanaka)

  10. Chart Smart: A Need for Documentation and Billing Education Among Emergency Medicine Residents?

    Brian Dawson, MD

    2010-05-01

    Full Text Available Objective: The healthcare chart is becoming ever more complex, serving clinicians, patients, third party payers, regulators, and even medicolegal parties. The purpose of this study was to identify our emergency medicine (EM resident and attending physicians’ current knowledge and attitudes about billing and documentation practices. We hypothesized that resident and attending physicians would identify billing and documentation as an area in which residents need further education.Methods: We gave a 15-question Likert survey to resident and attending physicians regarding charting practices, knowledge of billing and documentation, and opinions regarding need for further education.Results: We achieved a 100% response rate, with 47% (16/34 of resident physicians disagreeing or strongly disagreeing that they have adequate training in billing and documentation, while 91% (31/34 of residents and 95% (21/22 of attending physicians identified this skill as important to a resident’s future practice. Eighty-two percent (28/34 of resident physicians and 100% of attending physicians recommended further education for residents.Conclusion: Residents in this academic EM department identified a need for further education in billing and documentation practices. [West J Emerg Med. 2010;11(2: 116-119.

  11. Violence and verbal abuse against staff in accident and emergency departments: a survey of consultants in the UK and the Republic of Ireland.

    Jenkins, M. G.; Rocke, L G; McNicholl, B P; Hughes, D M

    1998-01-01

    OBJECTIVES: To determine the incidence of verbal abuse and physical violence in accident and emergency (A&E) departments and to discover the extent of provision of security measures and instructions for staff on how to deal with these problems. DESIGN: A postal questionnaire. SETTING: A&E departments in the UK and the Republic of Ireland. SUBJECTS: Two hundred and seventy three consultants named in charge of 310 departments. MAIN OUTCOME MEASURES: Frequency of physical violence and verbal abu...

  12. Radiological accidents: education for prevention and confrontation

    The purpose of this work is to train and inform on radiological accidents as a preventive measure to improve the people life quality. Radiological accidents are part of the events of technological origin which are composed of nuclear and radiological accidents. As a notable figure is determined that there have been 423 radiological accidents from 1944 to 2005 and among the causes prevail industrial accidents, by irradiations, medical accidents and of laboratories, among others. Latin American countries such as Argentina, Brazil, Mexico and Peru are some where most accidents have occurred by radioactivity. The radiological accidents can have sociological, environmental, economic, social and political consequences. In addition, there are scenarios of potential nuclear accidents and in them the potential human consequences. Also, the importance of the organization and planning in a nuclear emergency is highlighted. Finally, the experience that Cuba has lived on the subject of radiological accidents is described

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

    M. Fernanda Bellolio

    2014-09-01

    Full Text Available 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 factors. Methods: We distributed a validated electronic questionnaire consisting of the Professional Quality of Life Scale with subscales for the three components of CF (compassion satisfaction, burnout and secondary traumatic stress, with each category scored independently. We collected data pertaining to day- versus night-shift distribution, hourly workload and child dependents. We included residents in EM, neurology, orthopedics, family medicine, pediatrics, obstetrics, and general surgery. Results: We surveyed 255 residents, with a response rate of 75%. Of the 188 resident respondents, 18% worked a majority of their clinical shifts overnight, and 32% had child dependents. Burnout scores for residents who worked greater than 80 hours per week, or primarily worked overnight shifts, were higher than residents who worked less than 80 hours (mean score 25.0 vs 21.5; p=0.013, or did not work overnight (mean score 23.5 vs 21.3; p=0.022. EM residents had similar scores in all three components of CF when compared to other specialties. Secondary traumatic stress scores for residents who worked greater than 80 hours were higher than residents who worked less than 80 hours (mean score 22.2 vs 19.5; p=0.048, and those with child dependents had higher secondary traumatic stress than those without children (mean score 21.0 vs 19.1; p=0.012. Conclusion: CF scores in EM residents are similar to residents in other surgical and medical specialties. Residents working primarily

  14. Driving Forces Behind the Past and Future Emergence of Personalized Medicine

    Jan Simon Steffen; Julius Alexander Steffen

    2013-01-01

    Personalized medicine can be seen as a continuously developing approach to tailoring treatments according to the individual characteristics of a patient. In some way, medicine has always been personalized. During the last decade, however, scientific and technological progress have made truly personalized healthcare increasingly become reality. Today’s personalized medicine involves targeted therapies and diagnostic tests. The development of targeted agents represents a major investm...

  15. Emergency response and nuclear risk governance. Nuclear safety at nuclear power plant accidents; Notfallschutz und Risk Governance. Zur nuklearen Sicherheit bei Kernkraftwerksunfaellen

    Kuhlen, Johannes

    2014-07-01

    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

  16. Top 10 mobile apps in Emergency Medicine

    M. Lin; Rezaie, S; I. Husain

    2014-01-01

    Mobile apps are increasingly being used at the bedside as a part of clinical care. With almost 300 Emergency Medicine-related apps available in the Apple App Store, it can be overwhelming deciding which are most useful for Emergency Department providers. A Top 10 list of apps is highlighted which illustrate the many ways that quality apps can positively impact the care of Emergency Department patients.

  17. MORBIDITY AND MORTALITY AMONG EMERGENCY WORKERS OF THE CHERNOBYL ACCIDENT: ASSESSMENT OF RADIATION RISKS FOR THE FOLLOW-UP PERIOD OF 1992-2008

    V. K. Ivanov

    2011-01-01

    Full Text Available Morbidity and mortality among emergency workers of the Chernobyl accident for the follow- up period of 199Morbidity and mortality among the emergency workers of the Chernobyl accident for the follow-up period of 1992-2008 is analyzed in the article. The cohort consists of 47141 emergency workers of 1986-1987. Radiation risks for cancer morbidity (ERR/Gy is 0.76; 95% CI: 0.19; 1.42, p-value=0008 and cancer mortality (ERR/Gy is 0.95; 95% CI: 0.19; 1.89, p-value=0.01 are statistically significant. Radiation risk for vascular diseases is assessed as well.

  18. Study on the offsite emergency planning against an accident in NPP

    - Proposing effective local nuclear emergency preparedness system against nuclear/radiological accidents. - Proposing improved preparation/operation scheme on emergency response facilities, installations and equipment. - Establishing protection scheme on the general public against nuclear/radiological accidents. - Proposing effective preparation/operation scheme on local radioactive monitoring system. - Establishing effective training/drill scheme on the nuclear emergency preparedness. - Proposing effective technical administrative system of the local government (Busan metropolitan city)

  19. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    Wilcox, Susan R.; Tania D. Strout; Jeffrey I. Schneider; Mitchell, Patricia M.; Smith, Jessica; Lutfy-Clayton, Lucienne; Marcolini, Evie G.; Aydin, Ani; Seigel, Todd A.; Jeremy B. Richards

    2016-01-01

    Introduction: Although emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) education or clinical practice. The objective of this study was to quantify EM attendings’ education, experience, and knowledge regarding mechanical ventilation in the emergency department. Methods: We developed a survey of academic EM attendings’ educational experiences with ventilators and a knowledge assessme...

  20. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    Wilcox, Susan R.; Tania D. Strout; Jeffrey I. Schneider; Mitchell, Patricia M.; Jessica Smith; Lucienne Lutfy-Clayton; Marcolini, Evie G.; Ani Aydin; Seigel, Todd A.; Jeremy B. Richards

    2016-01-01

    Introduction: Although emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) education or clinical practice. The objective of this study was to quantify EM attendings’ education, experience, and knowledge regarding mechanical ventilation in the emergency department. Methods: We developed a survey of academic EM attendings’ educational experiences with ventilators and a knowledge assessment tool with nine ...

  1. The accident analysis in the framework of emergency provisions

    The first part of the report describes the demands on and bases of a reactor emergency plan and outlines the technical characteristics of a nuclear power plant with light-water moderated pressurized-water reactor with special regard to reactor safety. In the second part the failure and risk potentials of a pressurized-water plant are described and discussed. The third part is dedicated to a representation of the analytical method in a stricter sense, according to the current state of technology. Finally the current degree of effectiveness of the reactor accident analysis method is critically discussed and perspectives of future development are pointed out. (orig.)

  2. Learning Curves for Direct Laryngoscopy and GlideScope® Video Laryngoscopy in an Emergency Medicine Residency

    Sakles, John C.; Mosier, Jarrod M.; Patanwala, Asad E.; Dicken, John M.

    2014-01-01

    Introduction: Our objective is to evaluate the resident learning curves for direct laryngoscopy (DL) and GlideScope® video laryngoscopy (GVL) over the course of an emergency medicine (EM) residency training program. Methods: This was an analysis of intubations performed in the emergency department (ED) by EM residents over a seven-year period from July 1, 2007 to June 30, 2014 at an academic ED with 70,000 annual visits. After EM residents perform an intubation in the ED...

  3. History and Guideline of Emergency Medicine Residency Discipline in Shahid Beheshti University of Medical Sciences, Iran; Review of 2014

    Majid Shojaee

    2014-09-01

    Full Text Available Introduction: Since many years ago several problems have been felt in emergency departments (ED of hospitals. In fact, none of physicians in the hospital have accepted the direct responsibility of patients’ management in the EDs and emergency wards of University centers have been managed by residents of various disciplines. Thus, the first line of therapy does not have guardian and several consultants with various specialists have been performed regarding patient’s management. The necessity of physician training was noticed for the first time in 1950 and after 24 years in 1974, the academic emergency medicine was established in United States of America (USA in response to people expectations for overnight accessibility to specialized and quality medical cares. It was performed with foundation of the first period of resident’s training in emergency medicine discipline at University of Cincinnati, Ohio. At beginning, specialists of different fields such as internal medicine, surgery, anesthesia, orthopedics, and neurosurgery initiated the training of emergency medicine residents together which could be responsible to most of referees. Finally, with formal accepting the specialty board in 1978, this field has been officially identified as the 23th discipline in USA. Today the EDs of most hospitals in European and American countries has been managing by emergency medicine specialists which leads to improve the quality of education and treatment, significantly. Also in Iran the request of establishing this major has been presented in the secretariat of the council for graduate medical education for the first time in 1996. This request was approved and principles of its initiating recognized officially by the ministry of health. But, considering to lack of an appropriate infrastructure, it postponed until 2000 that again this discipline was missioned for initiating to the council for graduate medical education by the minister and its outcome was

  4. 核或辐射事故应急威胁评估兼论其它%On Nuclear or Radiological Accident Emergency Threat Assessment and Related Aspects

    卢盛甲

    2013-01-01

    It was presented for object of nuclear or radiological accident emergency, according to national regulations of nuclear or radiological emergency, and base on IAEA Safety Standards for requirement for preparedness of a nuclear or radiological emergency in the paper. To avoid empty in nuclear or radiological accident emergency arrangement, propose to set up regions arrangement for nuclear or radiological accidents emergency in on threat I or II of provinces according to IAEA threat category IV exist situation in Sino.%  本文根据国家核或辐射应急相关法规,参照国际子能机构有关安全出版物对核或辐射应急准备与响应的要求,提出国内核或辐射事故应急准备和应急响应的目标。鉴国际子能机构划分的核或辐射威胁类型 IV 各国和地区都存在的事实,建议我国在无威胁类型 I 和 II 的省份,考虑区应急管理,避免部分省或地区核或辐射事故应急管理出现盲区。

  5. Synthesis of public authorities organisation in case of emergency and in a post-event situation (following a nuclear accident or a radiological attack) in France and abroad

    After having briefly recalled how an emergency situation (notably in case of nuclear accident or radiological attack) is taken into account in the organisation of public authorities through specific plans (PPI or plans particuliers d'intervention, intervention specific plans), this report also describes how the situation is handled by these authorities after the end of the emergency situation (i.e. when the risk of new radioactive releases is over). This post-event stage is split into two phases: a transition phase which lasts several weeks or months, and a long term consequence management phase (over months or years). The author first describes the specificities of a nuclear or radiological event (accident or attack). He recalls the global public organisation and the involved actors. For the post-event period, he indicates the various actions, describes the interdepartmental coordination and the various aspects of the program designed to manage accident consequences on the long term. He also describes the roles of permanent bodies, agencies and institutes (ASN, ASND, MSNR, IRSN, INVS, ADEME, AFSSA, Meteo France, CEA, ANDRA, AREVA, EDF, ministries). The last part describes the action of public authorities in case of a nuclear accident occurring abroad. This includes relationship with European and international bodies

  6. Leukaemia and thyroid cancer in emergency workers of the Chernobyl accident:. Estimation of radiation risks (1986-1995)

    Ivanov, V.K. [Russian Academy of Medical Sciences, Medical Radiological Research Center, Obninsk (Russian Federation); Tsyb, A.F. [Russian Academy of Medical Sciences, Medical Radiological Research Center, Obninsk (Russian Federation); Gorsky, A.I. [Russian Academy of Medical Sciences, Medical Radiological Research Center, Obninsk (Russian Federation); Maksyutov, M.A. [Russian Academy of Medical Sciences, Medical Radiological Research Center, Obninsk (Russian Federation); Rastopchin, E.M. [Russian Academy of Medical Sciences, Medical Radiological Research Center, Obninsk (Russian Federation); Konogorov, A.P. [Russian Academy of Medical Sciences, Medical Radiological Research Center, Obninsk (Russian Federation); Korelo, A.M. [Russian Academy of Medical Sciences, Medical Radiological Research Center, Obninsk (Russian Federation); Biryukov, A.P. [Russian Academy of Medical Sciences, Medical Radiological Research Center, Obninsk (Russian Federation); Matyash, V.A. [Russian Academy of Medical Sciences, Medical Radiological Research Center, Obninsk (Russian Federation)

    1997-02-01

    This work focuses on the direct epidemiological assessment of the risks of radiation-induced leukaemia and thyroid cancer in emergency workers (EW) after the Chernobyl accident. The Russian National Medical Dosimetric Registry (RNMDR) contains data for 168 000 EW as of January 1, 1996. The analysis relates to 48 leukaemias and 47 thyroid cancers, diagnosed and verified. Radiation risks are estimated by comparing the EW data with national data for a male population of the same age distribution. For leukaemia, an excess relative risk per Gy (ERR/Gy) of 4.30 (95% CI: 0.83, 7.75) is obtained, while the excess absolute risk per 10{sup 4} person-years (PY) Gy (EAR/10{sup 4} PY Gy) is found to be 1.31 (95% CI: 0.23, 2.39); for thyroid cancer an ERR/Gy of 5.31 (95% CI: 0.04, 10.58) is obtained, and an EAR/10{sup 4} PY Gy of 1.15 (95% CI: 0.08, 2.22). (orig.). With 9 figs., 10 tabs.

  7. Evaluation of Social Media Use by Emergency Medicine Residents and Faculty

    David Pearson

    2015-10-01

    Full Text Available Introduction: Clinicians and residency programs are increasing their use of social media (SM websites for educational and promotional uses, yet little is known about the use of these sites by residents and faculty. The objective of the study is to assess patterns of SM use for personal and professional purposes among emergency medicine (EM residents and faculty. Methods: In this multi-site study, an 18-question survey was sent by e-mail to the residents and faculty in 14 EM programs and to the Council of Emergency Medicine Residency Directors (CORD listserv via the online tool SurveyMonkey™. We compiled descriptive statistics, including assessment with the chi-square test or Fisher’s exact test. StatsDirect software (v 2.8.0, StatsDirect, Cheshire, UK was used for all analyses. Results: We received 1,314 responses: 63% of respondents were male, 40% were <30 years of age, 39% were between the ages 31 and 40, and 21% were older than 40. The study group consisted of 772 residents and 542 faculty members (15% were program directors, 21% were assistant or associate PDs, 45% were core faculty, and 19% held other faculty positions. Forty-four percent of respondents completed residency more than 10 years ago. Residents used SM markedly more than faculty for social interactions with family and friends (83% vs 65% [p<0.0001], entertainment (61% vs 47% [p<0.0001], and videos (42% vs 23% [p=0.0006]. Residents used Facebook™ and YouTube™ more often than faculty (86% vs 67% [p<0.001]; 53% vs 46% [p=0.01], whereas residents used Twitter™ (19% vs 26% [p=0.005] and LinkedIn™ (15% vs 32% [p<0.0001] less than faculty. Overall, residents used SM sites more than faculty, notably in daily use (30% vs 24% [p<0.001]. For professional use, residents were most interested in its use for open positions/hiring (30% vs 18% [p<0.0001] and videos (33% vs 26% [p=0.005] and less interested than faculty with award postings (22% vs 33% [p<0.0001] or publications (30

  8. Modeling and assessment of accident consequences; development of RODOS, a real-time on-line decision support system for nuclear emergencies in Europe

    In cooperation with NRPB (UK), the first version 1.0 of PC COSYMA for use on advanced PCs has been released; during a training course in mid 1993, future users were educated in operating the software. The main frame version of the program package COSYMA has been up-dated with new dose conversion factors and fodd-chain data and was distributed to some 20 institutes in Europe and abroad. The comparative calculations performed within the international OECD(NEA)/CEC intercomparison of accident consequence assessment codes were analysed and documented in three reports. Furtheron, consequence assessments have been performed for the research reactor BER II (two source terms) and documented; the influence on individual doses and emergency actions of inplant accident management measures in future EPRs was quantified; within th scope of a EC/US-study on the external costs of the energy cycle, accident consequences were assessed for three source terms. (orig.)

  9. Demographic, epidemiologic and clinical profile of snake bite cases, presented to Emergency Medicine department, Ahmedabad, Gujarat

    Bhavesh Jarwani

    2013-01-01

    Full Text Available Aim: Snake bite is a common medical emergency faced mainly by the rural populations in tropical and subtropical countries with heavy rainfall and humid climate. Although India is a single largest contributor of snake bite cases, reporting is very poor. There is hardly any publication of the same from Gujarat state that is developing at a good pace. Hence, we aimed to study the snake bite cases with particular attention to demography, epidemiology, and clinical profile. Settings and Design: The present descriptive, observational study was carried out at the Emergency Medicine Department of a tertiary care center in Ahmedabad, Gujarat. This department is one if the firsts to get recognized by the Medical Council of India. Materials and Methods: This is a cross-sectional single-center study. Cases were entered into the prescribed form, and detailed information regarding demographic, epidemiologic, and clinical parameters was entered. Statistical Method: Data were analyzed using Epi2000. Means and frequencies for each variable were calculated. Results: Majority (67.4% of the snake bite victims were in the age group between 15 and 45 years. Majority were male victims (74.2%. 71% victims of snake bite lived in rural areas. Farmers and laborers were the main victims. 61.2% incidents took place at night time or early morning (before 6 a.m.. 64% patients had bite mark on the lower limb. 40% victims had seen the snake. Eight patients had snake bite, but were asymptomatic. 52% had neuroparalytic manifestation, 34% were asymptomatic, and 9.6% had hemorrhagic manifestation. 14% cases received treatment within 1 h of the bite and 64.84% within 1-6 h after the bite. First aid given was in the form of application of tourniquet (16.2%, local application of lime, chillies, herbal medicine, etc., (1%. 2.20% cases were sensitive to anti-snake venom. Only three patients died. Conclusion: In this region (Gujarat, neuroparalytic manifestation of snake bite is more

  10. Risk analysis of emergent water pollution accidents based on a Bayesian Network.

    Tang, Caihong; Yi, Yujun; Yang, Zhifeng; Sun, Jie

    2016-01-01

    To guarantee the security of water quality in water transfer channels, especially in open channels, analysis of potential emergent pollution sources in the water transfer process is critical. It is also indispensable for forewarnings and protection from emergent pollution accidents. Bridges above open channels with large amounts of truck traffic are the main locations where emergent accidents could occur. A Bayesian Network model, which consists of six root nodes and three middle layer nodes, was developed in this paper, and was employed to identify the possibility of potential pollution risk. Dianbei Bridge is reviewed as a typical bridge on an open channel of the Middle Route of the South to North Water Transfer Project where emergent traffic accidents could occur. Risk of water pollutions caused by leakage of pollutants into water is focused in this study. The risk for potential traffic accidents at the Dianbei Bridge implies a risk for water pollution in the canal. Based on survey data, statistical analysis, and domain specialist knowledge, a Bayesian Network model was established. The human factor of emergent accidents has been considered in this model. Additionally, this model has been employed to describe the probability of accidents and the risk level. The sensitive reasons for pollution accidents have been deduced. The case has also been simulated that sensitive factors are in a state of most likely to lead to accidents. PMID:26433361

  11. Prehospital Emergency Service for Internal Medicine Problems in Pediatrics; Causes, Time Indices and Outcomes

    Hamid Reza Khoddami Vishteh

    Full Text Available Objective: Although pediatric pre-hospital emergency medical services (EMS are a main challenge of health care systems, few data exists over it. Current study of ambulance calls for medical causes relating to children in Tehran was conducted with the following aims: 1 assessment of the frequency of causes of EMS call, 2 assessment of time indices of service providing by EMS, and 3 to assess the correlation between outcomes and time indices.Material & Methods: In this retrospective study, all calls to Tehran EMS system (Dial 115 for medical causes of children =<15 years old in Tehran between December 2005 and May 2006 were extracted. Demographic variables, accident type, patient outcome before hospital arrival, and ambulance time indices (response time, scene time, total run time, total run time hospital, transport time, round trip time were registered.Findings: 1052 (15.5% calls were for children. From these, 717 (68% were due to problems of medic problems. The most frequent problem was epilepsy (26.8%, unconsciousness (18.1% and respiratory disorders (15.2%. 12 (5. 6% subjects died before ambulance arrival, but no one died between scene and hospital arrival. Mean (SD delay time, response time and scene time were 3.8 ± 1.8, 15.1 ± 6.9, and 23.5 ± 10.9, respectively. The pre-hospital mortality was not correlated with any of the time intervals. Conclusion: One of six ambulance calls in Tehran is related to pediatric patients, most of them with a medical cause. Epilepsy, unconsciousness and respiratory disorders as the most frequent causes for EMS calls for medical problems highlights the need for planning for training of the EMS personnel with these problems. There is still a need for further improvement in time intervals of EMS services, which may be possible by proper management and equipping by more ambulances.

  12. The Social Media Index: Measuring the Impact of Emergency Medicine and Critical Care Websites

    Thoma, Brent

    2015-03-01

    Full Text Available Introduction: The number of educational resources created for emergency medicine and critical care (EMCC that incorporate social media has increased dramatically. With no way to assess their impact or quality, it is challenging for educators to receive scholarly credit and for learners to identify respected resources. The Social Media index (SMi was developed to help address this. Methods: We used data from social media platforms (Google PageRanks, Alexa Ranks, Facebook Likes, Twitter Followers, and Google+ Followers for EMCC blogs and podcasts to derive three normalized (ordinal, logarithmic, and raw formulas. The most statistically robust formula was assessed for 1 temporal stability using repeated measures and website age, and 2 correlation with impact by applying it to EMCC journals and measuring the correlation with known journal impact metrics. Results: The logarithmic version of the SMi containing four metrics was the most statistically robust. It correlated significantly with website age (Spearman r=0.372; p<0.001 and repeated measures through seven months (r=0.929; p<0.001. When applied to EMCC journals, it correlated significantly with all impact metrics except number of articles published. The strongest correlations were seen with the Immediacy Index (r=0.609; p<0.001 and Article Influence Score (r=0.608; p<0.001. Conclusion: The SMi’s temporal stability and correlation with journal impact factors suggests that it may be a stable indicator of impact for medical education websites. Further study is needed to determine whether impact correlates with quality and how learners and educators can best utilize this tool. [West J Emerg Med. 2015;16(2:242–249.

  13. Isolated scaphotrapeziotrapezoid osteoarthritis: Prevalence, symptomatology and associated scapholunate ligament disruption in a population presenting to an accident and emergency department with acute wrist injuries

    AIM: To determine the prevalence of isolated scaphotrapeziotrapezoid osteoarthritis in a population presenting to an Accident and Emergency Department of Leicester Royal Infirmary with acute wrist injuries. Also to identify the presence of scapholunate ligament disruption in this patient group and quantify symptoms and loss of function in terms of the modified system of Green and O'Brien, a recognized clinical scoring system. MATERIALS AND METHODS: A total of 1711 radiographs of patients attending the Accident and Emergency Department were prospectively reviewed over a 5-month period. Those patients with isolated scaphotrapeziotrapezoid osteoarthritis were invited for clinical review. RESULTS: Sixteen patients were identified with isolated scaphotrapeziotrapezoid osteoarthritis. Two had a poor Green and O'Brien score and evidence of scapholunate ligament disruption (P < 0.05). CONCLUSION: Isolated scaphotrapeziotrapezoid osteoarthritis has a prevalence of 1% in a population presenting to an Accident and Emergency Department with acute wrist injuries over the age of 30 years. Isolated scaphotrapeziotrapezoid osteoarthritis may be asymptomatic even though the changes in the joint are severe. Scapholunate ligament disruption is associated with a poor Green and O'Brien score, but is not present in the majority of cases. Higginson, A.P. et al. (2001)

  14. Improving Knowledge and Process for International Emergency Medicine Fellowship Applicants: A Call for a Uniform Application

    Gabrielle A. Jacquet

    2013-01-01

    Full Text Available Background. There are currently 34 International Emergency Medicine (IEM fellowship programs. Applicants and programs are increasing in number and diversity. Without a standardized application, applicants have a difficulty approaching programs in an informed and an organized method; a streamlined application system is necessary. Objectives. To measure fellows’ knowledge of their programs’ curricula prior to starting fellowship and to determine what percent of fellows and program directors would support a universal application system. Methods. A focus group of program directors, recent, and current fellows convened to determine the most important features of an IEM fellowship application process. A survey was administered electronically to a convenience sample of 78 participants from 34 programs. Respondents included fellowship directors, fellows, and recent graduates. Results. Most fellows (70% did not know their program’s curriculum prior to starting fellowship. The majority of program directors and fellows support a uniform application service (81% and 67%, resp. and deadline (85% for both. A minority of program directors (35% and fellows (30% support a formal match. Conclusions. Program directors and fellows support a uniform application service and deadline, but not a formalized match. Forums for disseminating IEM fellowship information and for administering a uniform application service and deadline are currently in development to improve the process.

  15. Dose limit for emergency workers. Application of Fukushima-Daiichi NPP accident and problems for the future

    Described are details of management for workers' personal exposure dose, of problems raised and of their solutions taken under various complicated conditions of Fukushima Daiichi Nuclear Power Plant (NPP) Accident (Mar. 2011). As the entrance/exit (en/ex) for the NPP site with regular control were impossible due to the hydrogen explosion which expanded the control area to 20 km distance from the site, Japan Football Village (J-Village) localizing at the border and Important Anti-seismic Building in the site were defined to be the bases of en/ex and of their control, respectively. Flooded 5,000 alarm pocket dosimeters (APD) by tsunami were not usable and only 320 APD remained available. At the quite early stage of working at the site, one representative worker in a group had only one APD. Management of internal exposure was also difficult essentially because the power source of the whole body counter was unavailable. At an early emergent stage alone, workers with higher dose than the limit (100 mSv for emergency) were observed, but >90% of workers were exposed to <50 mSv (the limit for the radiation worker). Six male Tokyo Electric Power Company (TEPCO) personnel were exposed to 250 mSv (specially defined dose limit) or more with the maximum 678.80 mSv, in whom the internal exposure due to radioiodine largely attributed. They were examined for their health by the expert doctors in National Institute of Radiological Sciences, were found free of abnormality and were to be followed up thereafter. Out of 19 female TEPCO personnel, two had exceeded the dose limit 5 mSv/3 mo and other 2, the annual limit 1 mSv. They received the examination by the industrial doctor, were found free of abnormality, but were decided not to work at the site. Recently, about 5,000 APD have been purchased for personal usage and dose management is conducted by bar-coding of individual workers, and internal exposure is managed with 11 whole body counters by once a month measurement in J

  16. Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine.

    Venkat, Arvind; Asher, Shellie L; Wolf, Lisa; Geiderman, Joel M; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

    2015-05-01

    The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. PMID:25903144

  17. Elements of a national emergency response system for nuclear accidents

    The purpose of this paper is to suggest elements for a general emergency response system, employed at a national level, to detect, evaluate and assess the consequences of a radiological atmospheric release occurring within or outside of national boundaries. These elements are focused on the total aspect of emergency response ranging from providing an initial alarm to a total assessment of the environmental and health effects. Elements of the emergency response system are described in such a way that existing resources can be directly applied if appropriate; if not, newly developed or an expansion of existing resources can be employed. The major thrust of this paper is toward a philosophical discussion and general description of resources that would be required to implementation. If the major features of this proposal system are judged desirable for implementation, then the next level of detail can be added. The philosophy underlying this paper is preparedness - preparedness through planning, awareness and the application of technology. More specifically, it is establishment of reasonable guidelines including the definition of reference and protective action levels for public exposure to accidents involving nuclear material; education of the public, government officials and the news media; and the application of models and measurements coupled to computer systems to address a series of questions related to emergency planning, response and assessment. It is the role of a proven national emergency response system to provide reliable, quality-controlled information to decision makers for the management of environmental crises

  18. Accuracy of radiographers red dot or triage of accident and emergency radiographs in clinical practice: a systematic review

    AIM: To determine the accuracy of radiographers red dot or triage of accident and emergency (A and E) radiographs in clinical practice. MATERIALS AND METHODS: Eligible studies assessed radiographers red dot or triage of A and E radiographs in clinical practice compared with a reference standard and provided accuracy data to construct 2x2 tables. Data were extracted on study eligibility and characteristics, quality, and accuracy. Pooled sensitivities and specificities and chi-square tests of heterogeneity were calculated. RESULT: Three red dot and five triage studies were eligible for inclusion. Radiographers' red dot of A and E radiographs in clinical practice compared with a reference standard is 0.87 [95% confidence interval (CI) 0.85-0.89] and 0.92 (0.91-0.93) sensitivity and specificity, respectively. Radiographers' triage of A and E radiographs of the skeleton is 0.90 (0.89-0.92) and 0.94 (0.93-0.94) sensitivity and specificity, respectively; and for chest and abdomen is 0.78 (0.74-0.82) and 0.91 (0.88-0.93). Radiographers' red dot of skeletal A and E radiographs without training is 0.71 (0.62-0.79) and 0.96 (0.93-0.97) sensitivity and specificity, respectively; and with training is 0.81 (0.72-0.87) and 0.95 (0.93-0.97). Pooled sensitivity and specificity for radiographers without training for the triage of skeletal A and E radiographs is 0.89 (0.88-0.91) and 0.93 (0.92-0.94); and with training is 0.91 (0.88-0.94) and 0.95 (0.93-0.96). CONCLUSION: Radiographers red dot or triage of A and E radiographs in clinical practice is affected by body area, but not by training

  19. Traffic Congestion and Accidents

    Schrage, Andrea

    2006-01-01

    Obstructions caused by accidents can trigger or exacerbate traffic congestion. This paper derives the efficient traffic pattern for a rush hour with congestion and accidents and the corresponding road toll. Compared to the model without accidents, where the toll equals external costs imposed on drivers using the road at the same time, a new insight arises: An optimal toll also internalizes the expected increase in future congestion costs. Since accidents affect more drivers if traffic volumes...

  20. Morbidity and Mortality Conference in Emergency Medicine Residencies and the Culture of Safety

    Emily L. Aaronson

    2015-10-01

    Full Text Available Introduction: Morbidity and mortality conferences (M+M are a traditional part of residency training and mandated by the Accreditation Counsel of Graduate Medical Education. This study’s objective was to determine the goals, structure, and the prevalence of practices that foster strong safety cultures in the M+Ms of U.S. emergency medicine (EM residency programs. Methods: The authors conducted a national survey of U.S. EM residency program directors. The survey instrument evaluated five domains of M+M (Organization and Infrastructure; Case Finding; Case Selection; Presentation; and Follow up based on the validated Agency for Healthcare Research & Quality Safety Culture survey. Results: There was an 80% (151/188 response rate. The primary objectives of M+M were discussing adverse outcomes (53/151, 35%, identifying systems errors (47/151, 31% and identifying cognitive errors (26/151, 17%. Fifty-six percent (84/151 of institutions have anonymous case submission, with 10% (15/151 maintaining complete anonymity during the presentation and 21% (31/151 maintaining partial anonymity. Forty-seven percent (71/151 of programs report a formal process to follow up on systems issues identified at M+M. Forty-four percent (67/151 of programs report regular debriefing with residents who have had their cases presented. Conclusion: The structure and goals of M+Ms in EM residencies vary widely. Many programs lack features of M+M that promote a non-punitive response to error, such as anonymity. Other programs lack features that support strong safety cultures, such as following up on systems issues or reporting back to residents on improvements. Further research is warranted to determine if M+M structure is related to patient safety culture in residency programs.

  1. The knowledge of emergency contraception and dispensing practices of Patent Medicine Vendors in South West Nigeria.

    Fayemi, Mojisola M; Oduola, Olufemi L; Ogbuji, Queen C; Osinowo, Kehinde A; Oyewo, Adejoke E; Osiberu, Olabimpe M

    2010-09-01

    Patent Medicine Vendors (PMVs) can play a critical role in increasing access to emergency contraceptive pills (ECPs) in developing countries, but few studies have examined their knowledge and dispensing practices. Using cluster sampling, the authors selected and interviewed 97 PMVs (60.8 per cent female) in Oyo and Ogun States of Nigeria to assess their knowledge, dispensing practices, and referral for ECPs. About one-third (27.8 per cent) of respondents were not aware of ECPs, and only half knew that ECPs could prevent pregnancy. Forty per cent had ever dispensed ECPs. Reasons proffered by those who do not dispense ECPs included barriers from the State Ministry of Health, police, other regulatory agencies, and religious beliefs. Only 50.5 per cent have referral arrangements for clients. Strategies to increase access to ECPs through PMVs include training on counseling techniques and referral, effective government regulation, and community involvement. Where unsafe abortion is a major cause of maternal mortality, these strategies offer protection for many women in the future. PMID:20805800

  2. ACCIDENT AT «FUKUSHIMA-I» NPP: FIRST RESULTS OF EMERGENCY RESPONSE. REPORT 1: GENERAL INFORMATION ABOUT THE ACCIDENT AND RADIATION SITUATION

    G. G. Onischenko

    2011-01-01

    Full Text Available The article presents preliminary assessment of the accident scale, level of its radiation effect on the population and response of national authorities of various countries for the population radiation protection provisions. High levels of the environmental radioactive contamination demanded the application of complex measures for the radiation protection of the population from adjacent territories of Japan. Radionuclides from the region of damaged NPP can get to the other countries by means of the long-distant air and sea water mass transfer. Specific activity of cesium radionuclides in the sea biota can reach the level recommended by the Codex Alimentarius Commission as the safe level for the international trade or exceed it. Significant radioactive contamination of the territories of other countries resulting from the «Fukushima-I» NPP accident did not occur. Many world countries applied measures of the Japanese food products import control on the base of the radiation monitoring data. These prohibitions are consequently remitted following the radiation situation improvement.

  3. Improving service quality by understanding emergency department flow: a White Paper and position statement prepared for the American Academy of Emergency Medicine.

    Eitel, Dave R; Rudkin, Scott E; Malvehy, M Albert; Killeen, James P; Pines, Jesse M

    2010-01-01

    Emergency Department (ED) crowding is a common problem in the United States and around the world. Process reengineering methods can be used to understand factors that contribute to crowding and provide tools to help alleviate crowding by improving service quality and patient flow. In this article, we describe the ED as a service business and then discuss specific methods to improve the ED quality and flow. Methods discussed include demand management, critical pathways, process-mapping, Emergency Severity Index triage, bedside registration, Lean and Six Sigma management methods, statistical forecasting, queuing systems, discrete event simulation modeling and balanced scorecards. The purpose of this review is to serve as a background for emergency physicians and managers interested in applying process reengineering methods to improving ED flow, reducing waiting times, and maximizing patient satisfaction. Finally, we present a position statement on behalf of the American Academy of Emergency Medicine addressing these issues. PMID:18514465

  4. Big data as a new approach in emergency medicine research

    Ho Ting Wong; QianYin; Ying Qi Guo; Kristen Murray; Dong Hau Zhou; Diana Slade

    2015-01-01

    Big data is a hot topic in the academic sector, and healthcare researchers are definitely not an exception. This article aims to provide a showcase in emergency medicine research to demonstrate the advantages of conducting such research using big data. Big data is a new and cost-effective research approach, and emergency medicine researchers could benefit from using this approach and by doing so producing high-quality research at a faster pace.

  5. Emergency response to a highway accident in Springfield, Massachusetts, on December 16, 1991

    On December 16, 1991, a truck carrying unirradiated (fresh) nuclear fuel was involved in an accident on US Interstate 91, in Springfield, Massachusetts. This report describes the emergency response measures undertaken by local, State, Federal, and private parties. The report also discusses ''lessons learned'' from the response to the accident and suggests areas where improvements might be made

  6. Emergency response to a highway accident in Springfield, Massachusetts, on December 16, 1991

    1992-06-01

    On December 16, 1991, a truck carrying unirradiated (fresh) nuclear fuel was involved in an accident on US Interstate 91, in Springfield, Massachusetts. This report describes the emergency response measures undertaken by local, State, Federal, and private parties. The report also discusses lessons learned'' from the response to the accident and suggests areas where improvements might be made.

  7. Emergency response to a highway accident in Springfield, Massachusetts, on December 16, 1991

    1992-06-01

    On December 16, 1991, a truck carrying unirradiated (fresh) nuclear fuel was involved in an accident on US Interstate 91, in Springfield, Massachusetts. This report describes the emergency response measures undertaken by local, State, Federal, and private parties. The report also discusses ``lessons learned`` from the response to the accident and suggests areas where improvements might be made.

  8. Prophylaxis and pharmacologic correction of body functions under influence of emergency factors of large-scale radioactive accidents

    The experience of Chernobyl's accidents response showed the necessity of adaptation of troops radiative protection medical system to the conditions of peacetime. The article describes the tests working out the optimal use scheme of time-table medical means of protection under conditions of large-scale radiative accidents. The state of neuropsychical activity, cardiovascular, respiratory, hemopoietic, immune and other body systems have been studied, perspective ways of drug application as means of body resistance increase under such conditions have been estimated. 6 figs

  9. The use of action research as an appropriate method of introducing and evaluating change in nursing care in an accident & emergency unit in Durban – Part 2

    Kerr, D.

    1996-01-01

    This 2-part article discussed firstly in Curationis 19.3 this year, the general characteristics of action research, compares several strategies of approach and describes the author's chosen method of applying action research to particular aspects of nursing care in an Accident & Emergency Unit in a Durban hospital. This second part describes identification of problems within the unit, the implementation of change and the limitations and potential of such study to nursing practice.

  10. The impact of nationally distributed guidelines on the management of paracetamol poisoning in accident and emergency departments. National Poison Information Service.

    Bialas, M. C.; Evans, R J; Hutchings, A D; Alldridge, G; Routledge, P. A.

    1998-01-01

    OBJECTIVE: To assess the impact of the treatment guidelines on the management of paracetamol self poisoning in accident and emergency (A&E) departments. METHODS: 24 A&E departments in Wales and England provided details of their management of paracetamol poisoning before and after the distribution of national treatment guidelines to all A&E departments in the United Kingdom. RESULTS: Significant increases were seen in the availability of formal written policies, the display of treatment nomogr...

  11. Statutory Instrument No 144 of 1992. Convention on assistance in the case of a nuclear accident or radiological emergency (privileges and immunities) order, 1992

    This Order is made by the power conferred on the Government by Section 42A of the Diplomatic Relations and Immunities Acts, 1967 and 1976. It enables the Government to afford immunity from legal action and exemption from taxes to foreign rescue workers as required under Article 8 of the Convention on Assistance in the case of a Nuclear Accident or Radiological Emergency to which the State is a party

  12. Osteopathic Emergency Medicine Programs Infrequently Publish in High-Impact Emergency Medicine Journals

    Sean M. Baskin

    2014-11-01

    Full Text Available Introduction: Both the Accreditation Council for Graduate Medical Education (ACGME and the American Osteopathic Association (AOA require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM programs. Methods: We performed a retrospective literature review using the Journal Citation Report database and identified the top five journals in the category of ‘Emergency Medicine’ by their 2011 Impact Factor. We examined all publications from each journal for 2011. For each article we recorded article type, authors’ names, position of authorship (first, senior or other, the author’s degree and affiliated institution. We present the data in raw numbers and percentages.  Results: The 2011 EM journals with the highest impact factor were the following: Annals of Emergency Medicine, Resuscitation, Journal of Trauma, Injury, and Academic Emergency Medicine. Of the 9,298 authors published in these journals in 2011; 1,309 (15% claimed affiliation with U.S.-based EM programs, of which 16 (1% listed their affiliations with eight different osteopathic EM programs. The 16 authors claimed affiliation with 8 of 46 osteopathic EM programs (17%, while 1,301 authors claimed affiliation with 104 of 148 (70% U.S.-based allopathic programs.   Conclusion: Authors from osteopathic EM programs are under-represented in the top EM journals. With the pending ACGME/AOA merger, there is a significant opportunity for improvement in the rate of publication of osteopathic EM programs in top tier EM journals. [West J Emerg Med. 2014;15(7:-0.

  13. Integrating quantitative and qualitative methodologies for the assessment of health care systems: emergency medicine in post-conflict Serbia

    VanRooyen Michael J

    2005-02-01

    Full Text Available Abstract Background Due to the complexity of health system reform in the post-conflict, post-disaster, and development settings, attempts to restructure health services are fraught with pitfalls that are often unanticipated because of inadequate preliminary assessments. Our proposed Integrated Multimodal Assessment – combining quantitative and qualitative methodologies – may provide a more robust mechanism for identifying programmatic priorities and critical barriers for appropriate and sustainable health system interventions. The purpose of this study is to describe this novel multimodal assessment using emergency medicine in post-conflict Serbia as a model. Methods Integrated quantitative and qualitative methodologies – system characterization and observation, focus group discussions, free-response questionnaires, and by-person factor analysis – were used to identify needs, problems, and potential barriers to the development of emergency medicine in Serbia. Participants included emergency and pre-hospital personnel from all emergency medical institutions in Belgrade. Results Demographic data indicate a loosely ordered network of part-time emergency departments supported by 24-hour pre-hospital services and an academic emergency center. Focus groups and questionnaires reveal significant impediments to delivery of care and suggest development priorities. By-person factor analysis subsequently divides respondents into distinctive attitudinal types, compares participant opinions, and identifies programmatic priorities. Conclusions By combining quantitative and qualitative methodologies, our Integrated Multimodal Assessment identified critical needs and barriers to emergency medicine development in Serbia and may serve as a model for future health system assessments in post-conflict, post-disaster, and development settings.

  14. 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 is a significant relationship between occupation and the risk of experiencing sexual violence. Students were mostly targeted by the perpetrator throughout the study period. Among the offences, rape cases were the highest in number, among those who attended at the OSCC, HUSM with a total of 72.7%; followed by 27.3% of incest; 26.4% of child sexual abuse; 4.8% of sodomy and lastly 1.6% of gerontophilia cases. Only 70% of the specimens obtained from sexual offences victims were sent for laboratory analysis. The result remained negative in 82.4% specimens and thus the laboratory analysis result is merely functioning as a supportive evidence for sexual offence cases attended at OSCC. The studies showed that most of the sexual assault perpetrators were known to the victims. The place of crime was also known to the perpetrators. Health sectors of various levels should be working in conjunction to promote a societal changes to improve more of the women's right and thus to reduce the violence crime. PMID:22589588

  15. Expectations of an emergency medicine clerkship director.

    Rogers, Robert L; Wald, David A; Lin, Michelle; Zun, Leslie S; Christopher, Theodore; Manthey, David E

    2011-05-01

    The clerkship director (CD) serves as a faculty leader within a school of medicine and plays a vital role in the hierarchy of undergraduate medical education. Collectively, CDs across specialties serve a multitude of roles and are responsible for clerkship administration, curricular development, teaching, mentoring, and advising students. The emergency medicine (EM) CD has a vitally important role to play in the future development of medical students. EM CDs should be valued and supported, because they often represent our specialty within the medical school and play a vital role in training the physicians of tomorrow. Opportunities and resources must be made available to CDs to run and maintain a successful EM clerkship, while also balancing their clinical duties and academic endeavors. In addition, EM CDs need support from their respective medical schools and departments to run highly successful medical student rotations. This article was prepared with the objective of establishing the importance of the EM CD, defining the job description of the CD, explaining the importance of adequate release time to perform the role of the CD, and describing the necessary resources and support for the position. With EM becoming an increasingly popular and integral rotation for medical students, it is likely that additional emphasis will be placed on the role of the EM CD. This reference document serves as a template for the job description and expectations of an EM CD. PMID:21521403

  16. RaCon: a software tool serving to predict radiological consequences of various types of accident in support of emergency management and radiation monitoring management

    The RaCon software system, developed by the Nuclear Research Institute Rez, is described and its application when addressing various tasks in the domain of radiation accidents and nuclear safety (accidents at nuclear facilities, transport of radioactive material, terrorist attacks) are outlined. RaCon is intended for the prediction and evaluation of radiological consequences to population and rescue teams and for optimization of monitoring actions. The system provides support to emergency management when evaluating and devising actions to mitigate the consequences of radiation accidents. The deployment of RaCon within the system of radiation monitoring by mobile emergency teams or remote controlled UAV is an important application. Based on a prediction of the radiological situation, RaCon facilitates decision-making and control of the radiation monitoring system, and in turn, refines the prediction based on observed values. Furthermore, the system can perform simulations of evacuation patterns at the Dukovany NPP and at schools in the vicinity of the power plant and can provide support to emergency management should any such situation arise. (orig.)

  17. Emerging paradigms in mind-body medicine.

    Shang, C

    2001-02-01

    The emerging paradigms in medicine can be seen through mind-body interactions. Observations in many meditative traditions suggest a series of objective indicators of health beyond absence of disease. Several of the physical signs have been confirmed by research or are consistent with modern science. Further correlation with long term health outcome is needed. Integration of meditation with conventional therapy has enriched psychotherapy with parallels drawn between the Nine Step Qigong and Freudian developmental psychology. A unified theory of the chakra system and the meridian system widely used in traditional mind-body interventions and acupuncture is presented in terms of modern science based on the morphogenetic singularity theory. Acupuncture points originate from the organizing centers in morphogenesis. Meridians and chakras are related to the underdifferentiated, interconnected cellular network that regulates growth and physiology. This theory explains the distribution and nonspecific activation of organizing centers and acupuncture points; the high electric conductance of the meridian system; the polarity effect of electroacupuncture; the side-effect profile of acupuncture; and the ontogeny, phylogeny, and physiologic function of the meridian system and chakra system. It also successfully predicted several findings in conventional biomedical science. These advances have implications in many disciplines of medicine. PMID:11246939

  18. Application of nanomedicine in emergency medicine; Point-of-care testing and drug delivery in twenty - first century

    Pourmand Ali

    2012-09-01

    Full Text Available Abstract Abstract The application of emerging nanotechnology to the practice of medicine represents a frontier of nanomedicine. Nanomedicine has been defined as a science which emphasizes the use of nanoscale tools in conjunction with background knowledge of the human body for medical diagnosis and treatment. Application of nanomedicine in EM may give EM providers the opportunity to diagnose and treat life-threatening diseases in a shorter period of time. These applications include diagnostic utilities, preventive medicine, targeted pharmacotherapy, and tissue regeneration.

  19. Nanorobots: The Emerging tools in Medicinal

    Dron P. Modi

    2013-09-01

    Full Text Available Nowadays medical science is more and more improving with the blessings of new scientific discoveries. Nanotechnology is such a field which is changing vision of medical science. New automated procedures are being discovered with new aspects of self-guided nanorobots. Nanorobot is an excellent tool for future medicine. We can envision a day when you could inject billions of these nanorobots that would float around in your body. Nanorobots could carry and deliver drugs into defected cells. These nanorobots will be able to repair tissues, clean blood vessels and airways, transform our physiological capabilities, and even potentially counter act the aging process. Many scientists working on this bright field of nanorobots especially on Alzheimer disease and cancer treatments. The engineering of molecular products needs to be carried out by robotic devices, which have been termed Nano robots. Nano robotics, sometimes referred to as molecular robotics, is an emerging research area as evidenced by recent topics in the literature. A multifunctional platform based on nanorobots, with various types of nanomachines will surely fight against major diseases like cancer, HIV etc. In this review, we will summarize briefly about nanorobots and its tools, mechanism, approaches and main futuristic applications of the same which mainly useful for medicinal and to develop new formulations related to nanotechnology to cure the major diseases.

  20. Psychological reactions to catastrophes: fear as a reaction to accidents and emergencies in industriel complexes

    This paper addresses the subject 'stress' and its effects on the personality. Specific types of behavior, which the human develops in a fearful situation are demonstrated by means of the psychoanalytical personality model. In the conclusion possible methods of alleviating fear, shock and panic reactions are described. 7 figs., 2 tabs., 9 refs

  1. Axillary brachial plexus block--an underused technique in the accident and emergency department.

    MacKay, C A; Bowden, D F

    1997-01-01

    OBJECTIVE: To compare axillary brachial plexus block and Bier's block as methods of providing upper limb anaesthesia. METHODS: Axillary brachial plexus or Bier's blocks were performed on all patients requiring upper limb anaesthesia in a three month period. For Bier's block, a single cuff tourniquet and 3 mg/kg 0.5% prilocaine were used. For axillary plexus block, 40 ml 1% lignocaine with adrenaline (1:200,000) were used, given by perivascular or transarterial technique. Prospective analysis ...

  2. Public health education for emergency medicine residents.

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

    2011-10-01

    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 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 approach to combine public health and EM clinical topics during usual residency didactics, one partnered with local public health organizations to provide real-world experiences for residents, and one drew on existing national as well as departmental resources to seamlessly integrate more public health-oriented educational activities within the existing residency curriculum. The modular and integrative approaches appeared to have a positive impact on resident attitudes toward public health, and a majority of EM residents at that program believed public health training is important. Reliance on pre-existing community partnerships facilitated development of public health rotations for residents. External funding for these efforts was critical to their success, given the time and financial restraints on residency programs. The optimal approach for public health education for EM residents has not been defined. PMID:21961671

  3. Mathematical modelling of patient flow through an accident and emergency department

    Coats, T; Michalis, S

    2001-01-01

    Objectives—The objectives of this project; (1) to evaluate the method, (2) to assess the information required for a more detailed model, and (3) to determine if it was worthwhile to undertake the data collection needed for a more detailed model.

  4. The Milch technique for reduction of anterior shoulder dislocations in an accident and emergency department.

    Johnson, G; Hulse, W; Mcgowan, A.

    1992-01-01

    Following the introduction of the Milch technique as the preferred method of reduction of anterior shoulder dislocations in an A&E department, a retrospective study of the technique was carried out. A total of 187 patients with anterior shoulder dislocations were included. The Milch technique was attempted in 142 cases with a success rate of 86%. There was no statistical difference in the success rates of junior and senior staff. In 73% of the Milch cases either no analgesia or sedation or En...

  5. A Model Longitudinal Observation Medicine Curriculum for an Emergency Medicine Residency.

    Wheatley, Matthew; Baugh, Christopher; Osborne, Anwar; Clark, Carol; Shayne, Philip; Ross, Michael

    2016-04-01

    The role of observation services for emergency department patients has increased in recent years. Driven by changing health care practices and evolving payer policies, many hospitals in the United States currently have or are developing an observation unit (OU) and emergency physicians are most often expected to manage patients in this setting. Yet, few residency programs dedicate a portion of their clinical curriculum to observation medicine. This knowledge set should be integrated into the core training curriculum of emergency physicians. Presented here is a model observation medicine longitudinal training curriculum, which can be integrated into an emergency medicine (EM) residency. It was developed by a consensus of content experts representing the observation medicine interest group and observation medicine section, respectively, from EM's two major specialty societies: the Society for Academic Emergency Medicine (SAEM) and the American College of Emergency Physicians (ACEP). The curriculum consists of didactic, clinical, and self-directed elements. It is longitudinal, with learning objectives for each year of training, focusing initially on the basic principles of observation medicine and appropriate observation patient selection; moving to the management of various observation appropriate conditions; and then incorporating further concepts of OU management, billing, and administration. This curriculum is flexible and designed to be used in both academic and community EM training programs within the United States. Additionally, scholarly opportunities, such as elective rotations and fellowship training, are explored. PMID:26806664

  6. Scribe Impacts on Provider Experience, Operations, and Teaching in an Academic Emergency Medicine Practice

    Jeremy J. Hess

    2015-10-01

    Full Text Available Introduction: Physicians dedicate substantial time to documentation. Scribes are sometimes used to improve efficiency by performing documentation tasks, although their impacts have not been prospectively evaluated. Our objective was to assess a scribe program’s impact on emergency department (ED throughput, physician time utilization, and job satisfaction in a large academic emergency medicine practice. Methods: We evaluated the intervention using pre- and post-intervention surveys and administrative data. All site physicians were included. Pre- and post-intervention data were collected in fourmonth periods one year apart. Primary outcomes included changes in monthly average ED length of stay (LOS, provider-specific average relative value units (RVUs per hour (raw and normalized to volume, self-reported estimates of time spent teaching, self-reported estimates of time spent documenting, and job satisfaction. We analyzed data using descriptive statistics and appropriate tests for paired pre-post differences in continuous, categorical, and ranked variables. Results: Pre- and post-survey response rates were 76.1% and 69.0%, respectively. Most responded positively to the intervention, although 9.5% reported negative impressions. There was a 36% reduction (25%-50%; p<0.01 in time spent documenting and a 30% increase (11%-46%, p<0.01 in time spent in direct patient contact. No statistically significant changes were seen in job satisfaction or perception of time spent teaching. ED volume increased by 88 patients per day (32-146, p=0.04 pre- to post- and LOS was unchanged; rates of patients leaving against medical advice dropped, and rates of patients leaving without being seen increased. RVUs per hour increased 5.5% and per patient 5.3%; both were statistically significant. No statistically significant changes were seen in patients seen per hour. There was moderate correlation between changes in ED volume and changes in productivity metrics

  7. What is the prevalence and success of remediation of Emergency Medicine residents?

    Mark Silverberg

    2015-10-01

    Full Text Available 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 including indication, length and success. We reported descriptive data and estimated a multinomial logistic regression model. Results: We obtained 126/158 responses (79.7%. Ninety percent of programs had at least one resident on remediation in the last three years. The prevalence of remediation was 4.4%. Indications for remediation ranged from difficulties with one core competency to all six competencies (mean 1.9. The most common were medical knowledge (MK (63.1% of residents, patient care (46.6% and professionalism (31.5%. Mean length of remediation was eight months (range 1-36 months. Successful remediation was 59.9% of remediated residents; 31.3% reported ongoing remediation. In 8.7%, remediation was deemed “unsuccessful.” Training year at time of identification for remediation (post-graduate year [PGY] 1, longer time spent in remediation, and concerns with practice-based learning (PBLI and professionalism were found to have statistically significant association with unsuccessful remediation. Conclusion: Remediation in EM residencies is common, with the most common areas being MK and patient care. The majority of residents are successfully remediated. PGY level, length of time spent in remediation, and the remediation of the competencies of PBLI and professionalism were associated with unsuccessful remediation.

  8. Feedback in the Emergency Medicine Clerkships

    Sorabh Khandelwal

    2011-05-01

    Full Text Available Objective: Feedback is a technique used in medical education to help develop and improve clinical skills. A comprehensive review article specifically intended for the emergency medicine (EM educator is lacking, and it is the intent of this article to provide the reader with an in-depth, up-to-date, and evidence-based review of feedback in the context of the EM clerkship. Methods: The review article is organized in a progressive manner, beginning with the definition of feedback, the importance of feedback in medical education, and the obstacles limiting the effective delivery of feedback, and the techniques to overcome these obstacles then follows. The article concludes with practical recommendations to implement feedback in the EM clerkship. To advance the literature on feedback, the concept of receiving feedback is introduced. Results: The published literature regarding feedback is limited but generally supportive of its importance and effectiveness. Obstacles in the way of feedback include time constraints, lack of direct observation, and fear of negative emotional responses from students. Feedback should be timely, expected, focused, based on first-hand data, and limited to behaviors that are remediable. Faculty development and course structure can improve feedback in the EM clerkship. Teaching students to receive feedback is a novel educational technique that can improve the feedback process. Conclusion: Feedback is an important educational technique necessary to improve clinical skills. Feedback can be delivered effectively in the EM clerkship. [West J Emerg Med. 2011;12(4:537–542.

  9. Emergency treatment and nursing management of group patients of traffic accident%成批车祸事故患者的急救与护理管理

    黄宁静

    2015-01-01

    目的 分析成批车祸事故患者的急救与护理.方法 采取2013年7月份至2014年10月份本院收治的4批车祸事故患者共94例,回顾性分析这94例患者的临床资料,总结患者的急救与护理措施.结果 通过采取相应的急救与护理管理后,94例患者中,88例抢救脱险,2例现场死亡,4例抢救无效死亡,死亡率为6.4%.结论 有效的急救与护理管理能有效地降低成批车祸事故中的死亡率,提高车祸事故患者的生存率.%Objective analyze emergency treatment and nursing of group patients of trafifc accident.Method review and analyze 94 patients treated in our hospital from July 2013 to October 2014, 4 groups of patients with trafifc accidents. Summarize their clinical data and emergency treatment and nursing measures.Result after taking corresponding measures of emergency treatment and nursing management, 88 cases of 94 patients survived, 2 cases died on the spot, 4 cases died after emergency treatment, mortality was 6.4%.Conclusion effective emergency management and nursing management can effectively reduce mortality and improve survival rate of patients with trafifc accident.

  10. Acidentes e violências entre mulheres atendidas em Serviços de Emergência Sentinela - Brasil, 2009 Accidents and violence among women attended in Sentinel Emergency Services - Brazil, 2009

    Celeste de Souza Rodrigues

    2012-09-01

    Full Text Available As causas externas afetam de maneira desigual as populações humanas. O presente artigo tem como objetivo analisar os atendimentos de emergência em mulheres vítimas de acidentes e violências. Foram analisados dados do inquérito de Vigilância de Violências e Acidentes em 74 Unidades de Emergência de 23 capitais e no Distrito Federal em 2009. Analisaram-se 6.965 atendimentos de mulheres adultas comparando-se as faixas de 20-39 e 40-59 anos, em relação a ocorrência de acidentes e violências. Os acidentes foram mais frequentes em mulheres jovens (20 a 39 anos, de cor negra e com escolaridade maior que 9 anos de estudo. A ocorrência de violência também foi predominante em mulheres jovens e negras, porém com menor escolaridade. Entre os acidentes predominaram as quedas (38,6%, seguidas de acidentes de transporte. As violências foram mais frequentes no domicílio (p Accidents from external causes affect the human population in different ways. This article seeks to analyze emergency care for women who are victims of accidents and violence. Data from the Surveillance System for Violence and Accidents were analyzed. This study was carried out in 74 emergency units of 23 state capitals and the Federal District in 2009 and included 6,965 women aged from 20-59 years. The age groups of 20-39 and 40-59 years were compared for the occurrence of accidents and violence. Accidents were more frequent among young black women (20-39 years with more than nine years of schooling. The occurrence of violence was also prevalent in young black women but with less schooling. Falls were the most frequent accidents (38.6%, followed by traffic accidents. The occurrence of violence was more frequent in the home (p <0.000 and the mention of alcohol abuse among victims of violence was predominant. The most frequent type of violence was aggression (84.6%, in which the aggressor was male (79.1% and identified as an intimate partner (44.1%. It is increasingly

  11. National radiological emergency response to the Fukushima Daiichi Nuclear Power Plant accident

    The Fukushima nuclear power plant accident occurred on March 11, 2011, when two natural disasters of unprecedented strengths, an earthquake with magnitude 9 followed one hour later by a powerful tsunami struck northeastern Japan and felled the external power supply and the emergency diesel generators of the Fukushima Daiichi nuclear power station, resulting in a loss of coolant accident. There were core meltdowns in three nuclear reactors with the release of radioactivity estimated to be 1/10 of what was released to the environment during the Chernobyl nuclear power plant accident in April 1986. The Fukushima nuclear accident tested the capability of the Philippine Nuclear Research Institute (PNRI) and the National Disaster Risk Reduction and Management Council (NDRRMC) in responding to such radiological emergency as a nuclear power plant accident. The PNRI and NDRRMC activated the RADPLAN for possible radiological emergency. The emergency response was calibrated to the status of the nuclear reactors on site and the environmental monitoring undertaken around the site and off-site, including the marine environment. This orchestrated effort enabled the PNRI and the national agencies concerned to reassure the public that the nuclear accident does not have a significant impact on the Philippines, both on the health and safety of the people and on the safety of the environment. National actions taken during the accident will be presented. The role played by the International Atomic Energy Agency as the central UN agency for nuclear matters will be discussed. (author)

  12. Nuclear power plant accident handbook. A CNSC emergency operations centre tool

    In response to the Fukushima Nuclear Emergency and the subsequent Emergency Operations Centre (EOC) response, the Canadian Nuclear Safety Commission (CNSC) Fukushima Task Force recommended that hardcopy and electronic version reference packages for all Canadian nuclear reactor sites are readily available to the Technical Support Team. CNSC staff, in a cooperative agreement with Atomic Energy of Canada Limited at Chalk River Laboratories (AECL-CRL), has begun implementing this recommendation through the development of the Nuclear Power Plant (NPP) Accident Handbook. The NPP Accident Handbook will provide readily available reference material for technical staff involved in EOC operations. The NPP Accident Handbook will assist technical staff in finding site-specific and accident-specific details that will help them provide expert advice to the EOC team during a nuclear power plant accident. (author)

  13. Nuclear power plant accident handbook: a CNSC emergency operations centre tool

    In response to the Fukushima Nuclear Emergency and the subsequent Emergency Operations Centre (EOC) response, the Canadian Nuclear Safety Commission (CNSC) Fukushima Task Force recommended that hardcopy and electronic version reference packages for all Canadian nuclear reactor sites are readily available to the Technical Support Team. CNSC staff, in a cooperative agreement with Atomic Energy of Canada Limited at Chalk River Laboratories (AECL-CRL), has begun implementing this recommendation through the development of the Nuclear Power Plant (NPP) Accident Handbook. The NPP Accident Handbook will provide readily available reference material for technical staff involved in EOC operations. The NPP Accident Handbook will assist technical staff in finding site-specific and accident-specific details that will help them provide expert advice to the EOC team during a nuclear power plant accident. (author)

  14. 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

    2014-09-01

    Full Text Available 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 breathalyzed and had a saliva test for alcohol/drug screening. Results showed that women were mainly passengers or pedestrians (p < 0.001. There was no significant difference in positive blood alcohol concentration. However, men reported more binge drinking and THC use, while women had more benzodiazepine in their saliva (p<0.05. This is the first Brazilian study to compare alcohol and drug use among men and women who were the victims of traffic accidents. Results point to differences in the pattern of substance abuse, as well on risk behavior. Data may be useful for specific prevention strategies that take gender differences into consideration.

  15. Targeted Needs Assessment of Off Service Residents in Emergency Medicine

    Kessler, Chad S

    2010-12-01

    Full Text Available Purpose: The purpose of this study is to evaluate the needs of internal medicine residents rotating through the emergency department (ED.Methods: A survey was distributed to 100 internal medicine residents (post-graduate years 2 and 3 from two different residency programs before the start of their emergency medicine (EM rotation. Residents ranked the level of importance and the level of preparedness for 23 different EM topics, using a Likert-type scale ranging from 1 (least important/least prepared to 4 (most important/most prepared. We calculated delta values (Δ from the difference between importance and preparedness and undertook significance testing of this difference.Results: A total of 71 out of 100 surveys were completed properly and returned. Internal medicine residents felt most ill-prepared in the areas of orthopedics, environmental emergencies, otolaryngology, airway management, and ophthalmology. The largest perceived gaps between importance and preparedness lay within the areas of airway management ( Δ=1.30, ophthalmology ( Δ=1.10, environmental emergencies (Δ=0.96, and orthopedics ( Δ=0.96.Conclusion: Our data suggest that internal medicine residents are inadequately prepared for EM topics that they feel are important to their education, specifically airway management, ophthalmology, environmental emergencies and orthopedics. It is quite possible that other specialty residents are also poorly prepared for similar core EM topics. These data will hopefully guide future curricular change for off-service residents in the ED. [West J Emerg Med. 2010;11(5:470-473.

  16. Education and training for medicines development, regulation, and clinical research in emerging countries.

    Kerpel-Fronius, Sandor; Rosenkranz, Bernd; Allen, Elizabeth; Bass, Rolf; Mainard, Jacques D; Dodoo, Alex; Dubois, Dominique J; Hela, Mandisa; Kern, Steven; Massud, Joao; Silva, Honorio; Whitty, Jeremy

    2015-01-01

    The aim of this satellite workshop held at the 17th World Congress of Basic and Clinical Pharmacology (WCP2014) was to discuss the needs, optimal methods and practical approaches for extending education and teaching of medicines development, regulation, and clinical research to Low and Middle Income Countries (LMICs). It was generally agreed that, for efficiently treating the rapidly growing number of patients suffering from non-communicable diseases, modern drug therapy has to become available more widely and with a shorter time lag in these countries. To achieve this goal many additional experts working in medicines development, regulation, and clinical research have to be trained in parallel. The competence-oriented educational programs designed within the framework of the European Innovative Medicine Initiative-PharmaTrain (IMI-PhT) project were developed with the purpose to cover these interconnected fields. In addition, the programs can be easily adapted to the various local needs, primarily due to their modular architecture and well defined learning outcomes. Furthermore, the program is accompanied by stringent quality assurance standards which are essential for providing internationally accepted certificates. Effective cooperation between international and local experts and organizations, the involvement of the industry, health care centers and governments is essential for successful education. The initiative should also support the development of professional networks able to manage complex health care strategies. In addition it should help establish cooperation between neighboring countries for jointly managing clinical trials, as well as complex regulatory and ethical issues. PMID:25926798

  17. Thorax, Trachea, and Lung Ultrasonography in Emergency and Critical Care Medicine: Assessment of an Objective Structured Training Concept

    Raoul Breitkreutz

    2013-01-01

    Full Text Available Background and Study objective. Focused lung ultrasound (LUS examinations are important tools in critical care medicine. There is evidence that LUS can be used for the detection of acute thoracic lesions. However, no validated training method is available. The goal of this study was to develop and assess an objective structured clinical examination (OSCE curriculum for focused thorax, trachea, and lung ultrasound in emergency and critical care medicine (THOLUUSE. Methods. 39 trainees underwent a one-day training course in a prospective educational study, including lectures in sonoanatomy and -pathology of the thorax, case presentations, and hands-on training. Trainees’ pre- and posttest performances were assessed by multiple choice questionnaires, visual perception tests by interpretation video clips, practical performance of LUS, and identification of specific ultrasound findings. Results. Trainees postcourse scores of correct MCQ answers increased from 56±4% to 82±2% (mean± SD; P<0.001; visual perception skills increased from 54±5% to 78±3% (P<0.001; practical ultrasound skills improved, and correct LUS was performed in 94%. Subgroup analysis revealed that learning success was independent from the trainees’ previous ultrasound experience. Conclusions. THOLUUSE significantly improves theoretical and practical skills for the diagnosis of acute thoracic lesions. We propose to implement THOLUUSE in emergency medicine training.

  18. Education and training for medicines development, regulation and clinical research in emerging countries.

    Sandor - Kerpel-Fronius

    2015-04-01

    Full Text Available The aim of this satellite workshop held at the 17th World Congress of Basic and Clinical Pharmacology (WCP2014 was to discuss the needs, optimal methods and practical approaches for extending education teaching of medicines development, regulation and clinical research to Low and Middle Income Countries (LMIC’s. It was generally agreed that, for efficiently treating the rapidly growing number of patients suffering from non-communicable diseases, modern drug therapy has to become available more widely and with a shorter time lag in these countries. To achieve this goal many additional experts working in medicines development, regulation and clinical research have to be trained in parallel. The competence-oriented educational programs designed within the framework of the European Innovative Medicine Initiative-PharmaTrain (IMI-PhT project were developed with the purpose to cover these interconnected fields. In addition, the programs can be easily adapted to the various local needs, primarily due to their modular architecture and well defined learning outcomes. Furthermore, the program is accompanied by stringent quality assurance standards which are essential for providing internationally accepted certificates. Effective cooperation between international and local experts and organizations, the involvement of the industry, health care centers and governments is essential for successful education. The initiative should also support the development of professional networks able to manage complex health care strategies. In addition it should help establish cooperation between neighboring countries for jointly managing clinical trials, as well as complex regulatory and ethical issues.

  19. Emerging medicolegal issues in the practice of pediatric sleep medicine.

    Sachdeva, Ramesh C; D'Andrea, Lynn A

    2009-10-01

    With the rapid growth in the field of pediatric sleep medicine, health care providers need to be aware of several emerging legal issues that have the potential of impacting their clinical practice. This article provides an overview of emerging legal areas that might impact the practice of pediatric sleep medicine, and discusses civil liability emerging from medical malpractice, issues that health care providers must be aware of including issues related to providing care for minors, and newer areas that relate to legal prosecution for health care fraud as it may relate to violations of quality of care. PMID:19836702

  20. Emergency planning and the Control of Major Accident Hazards (COMAH/Seveso II) Directive: An approach to determine the public safety zone for toxic cloud releases

    The EU Control of Major Accidents Hazards Directive (Seveso II) requires an external emergency plan for each top tier site. This paper sets out a method to build the protection of public health into emergency planning for Seveso sites in the EU. The method involves the review of Seveso site details prescribed under the directive. The site safety report sets out the potential accident scenarios. The safety report's worst-case scenario, and chemical involved, is used as the basis for the external emergency plan. A decision was needed on the appropriate threshold value to use as the level of concern to protect public health. The definitions of the regulatory standards (air quality standards and occupational standards) in use were studied, how they are derived and for what purpose. The 10 min acute exposure guideline level (AEGL) for a chemical is recommended as the threshold value to inform decisions taken to protect public health from toxic cloud releases. The area delimited by AEGL 1 defines the population who may be concerned about being exposed. They need information based on comprehensive risk assessment. The area delimited by AEGL 2 defines the population for long-term surveillance when indicated and may include first responders. The area delimited by AEGL 3 defines the population who may present acutely to the medical services. It ensures that the emergency responders site themselves safely. A standard methodology facilitates discussions with plant operators and concerned public. Examples show how the methodology can be adapted to suit explosive risk and response to fire

  1. Management of Pneumothorax in Emergency Medicine Departments: Multicenter Trial

    Ince, Abdulkadir; Ozucelik, Dogac Niyazi; Avci, Akkan; Nizam, Ozgur; Dogan, Halil; Topal, Mehmet Ali

    2013-01-01

    Background: Pneumothorax is common and life-threatening clinical condition which may require emergency treatment in Emergency Medicine Departments. Objectives: We aimed to reveal the epidemiological analysis of the patients admitted to the Emergency Department with pneumothorax. Material and Methods: This case-control and multi-center study was conducted in the patients treated with the diagnosis of pneumothorax between 01.01.2010-31.12.2010. Patient data were collected from hospital automati...

  2. Soil sampling and analytical strategies for mapping fallout in nuclear emergencies based on the Fukushima Dai-ichi Nuclear Power Plant accident

    The Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident resulted in extensive radioactive contamination of the environment via deposited radionuclides such as radiocesium and 131I. Evaluating the extent and level of environmental contamination is critical to protecting citizens in affected areas and to planning decontamination efforts. However, a standardized soil sampling protocol is needed in such emergencies to facilitate the collection of large, tractable samples for measuring gamma-emitting radionuclides. In this study, we developed an emergency soil sampling protocol based on preliminary sampling from the FDNPP accident-affected area. We also present the results of a preliminary experiment aimed to evaluate the influence of various procedures (e.g., mixing, number of samples) on measured radioactivity. Results show that sample mixing strongly affects measured radioactivity in soil samples. Furthermore, for homogenization, shaking the plastic sample container at least 150 times or disaggregating soil by hand-rolling in a disposable plastic bag is required. Finally, we determined that five soil samples within a 3 m × 3-m area are the minimum number required for reducing measurement uncertainty in the emergency soil sampling protocol proposed here. - Highlights: • Emergency soil sampling protocol was proposed for nuclear hazards. • Various sampling procedures were tested and evaluated in Fukushima area. • Soil sample mixing procedure was of key importance for measured radioactivity. • Minimum number of sampling was determined for reducing measurement uncertainty

  3. Communication and industrial accidents

    As, Sicco van

    2001-01-01

    This paper deals with the influence of organizational communication on safety. Accidents are actually caused by individual mistakes. However the underlying causes of accidents are often organizational. As a link between these two levels - the organizational failures and mistakes - I suggest the concept of role distance, which emphasizes the organizational characteristics. The general hypothesis is that communication failures are a main cause of role distance and accident-proneness within orga...

  4. A microcomputer teaching and decision-support system for emergency medicine: use of hypermedia and artificial intelligence in combination.

    Thoreux, P H; Cléret, M; Jouannic, I; Denier, P; Bouget, J; Le Beux, P

    1996-01-01

    Hospital emergency units are submitted to a continuous intensive and polyvalent practice of medicine. In addition to the few experienced physicians, the medical staff is often made up of young and unskilled students and residents. The ability to reach at any time a wide and flexible knowledge is of the utmost importance to improve the quality of care given to patients and to perfect bedside teaching. The purpose of this work was to present a computerized system, a kind of shell, using, in combination, artificial intelligence and hypertext/hypermedia tools. A modular architecture is presented integrating two entities: an illustrated encyclopedic hypertext network and several expert modules based on production rules concerning well-limited fields of medicine (basic clinical problem-solving, metabolic and acid-base disorders). An interface using the World Wide Web (WWW) will soon be proposed. PMID:8871896

  5. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

    Wilson Briana

    2011-07-01

    Full Text Available Abstract Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the

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

    Westafer, Lauren; Hensley, Justin; Shaikh, Sameed; Lin, Michelle

    2016-01-01

    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 et al. 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. Five online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and Google Hangout. Comments across the social media platforms were curated for this report, as framed by the 4 preselected questions. Engagement was tracked through Web analytic tools and analysis of tweets. Blog comments, tweets, and video expert commentary involving the featured article are summarized and reported. The dialogue resulted in 978 page views from 342 cities in 33 countries on the ALiEM Web site, 464,345 Twitter impressions, and 83 views of the video interview with experts. Of the unique 169 identified tweets, discussion (53.3%) and learning points (32.5%) were the most common category of tweets identified. Common themes that arose in the open-access multimedia discussions included Press Ganey data validity and the utility of patient satisfaction in determining pain treatment efficacy. This educational approach using social media technologies demonstrates a free, asynchronous means to engage a worldwide scholarly discourse. PMID:26003003

  7. Nuclear accidents and epidemiology

    A consultation on epidemiology related to the Chernobyl accident was held in Copenhagen in May 1987 as a basis for concerted action. This was followed by a joint IAEA/WHO workshop in Vienna, which reviewed appropriate methodologies for possible long-term effects of radiation following nuclear accidents. The reports of these two meetings are included in this volume, and cover the subjects: 1) Epidemiology related to the Chernobyl nuclear accident. 2) Appropriate methodologies for studying possible long-term effects of radiation on individuals exposed in a nuclear accident. Figs and tabs

  8. Can Simulation Measure Differences in Task-Switching Ability Between Junior and Senior Emergency Medicine Residents?

    Dustin Smith, MD

    2016-03-01

    Full Text Available Introduction: Work interruptions during patient care have been correlated with error. Task-switching is identified by the Accreditation Council for Graduate Medical Education (ACGME as a core competency for emergency medicine (EM. Simulation has been suggested as a means of assessing EM core competencies. We assumed that senior EM residents had better task-switching abilities than junior EM residents. We hypothesized that this difference could be measured by observing the execution of patient care tasks in the simulation environment when a patient with a ST-elevation myocardial infarction (STEMI interrupted the ongoing management of a septic shock case. Methods: This was a multi-site, prospective, observational, cohort study. The study population consisted of a convenience sample of EM residents in their first three years of training. Each subject performed a standardized simulated encounter by evaluating and treating a patient in septic shock. At a predetermined point in every sepsis case, the subject was given a STEMI electrocardiogram (ECG for a separate chest pain patient in triage and required to verbalize an interpretation and action. We scored learner performance using a dichotomous checklist of critical actions covering sepsis care, ECG interpretation and triaging of the STEMI patient. Results: Ninety-one subjects participated (30 postgraduate year [PGY]1s, 32 PGY2s, and 29 PGY3s. Of those, 87 properly managed the patient with septic shock (90.0% PGY1s, 100% PGY2, 96.6% PGY 3s; p=0.22. Of the 87 who successfully managed the septic shock, 80 correctly identified STEMI on the simulated STEMI patient (86.7% PGY1s, 96.9% PGY2s, 93.1% PGY3s; p=0.35. Of the 80 who successfully managed the septic shock patient and correctly identified the STEMI, 79 provided appropriate interventions for the STEMI patient (73.3% PGY1s, 93.8% PGY2s, 93.8% PGY3s; p=0.07. Conclusion: When management of a septic shock patient was interrupted with a STEMI ECG in a

  9. Mentoring During Medical School and Match Outcome Among Emergency Medicine Residents

    Erin Dehon

    2015-11-01

    Full Text Available Introduction: Few studies have documented the value of mentoring for medical students, and research has been limited to more subjective (e.g., job satisfaction, perceived career preparation rather than objective outcomes. This study examined whether having a mentor is associated with match outcome (where a student matched based on their rank order list [ROL]. Methods: We sent a survey link to all emergency medicine (EM program coordinators to distribute to their residents. EM residents were surveyed about whether they had a mentor during medical school. Match outcome was assessed by asking residents where they matched on their ROL (e.g., first choice, fifth choice. They were also asked about rank in medical school, type of degree (MD vs. DO, and performance on standardized tests. Residents who indicated having a mentor completed the Mentorship Effectiveness Scale (MES, which evaluates behavioral characteristics of the mentor and yields a total score. We assessed correlations among these variables using Pearson’s correlation coefficient. Post-hoc analysis using independent sample t-test was conducted to compare differences in the MES score between those who matched to their first or second choice vs. third or higher choice. Results: Participants were a convenience sample of 297 EM residents. Of those, 199 (67% reported having a mentor during medical school. Contrary to our hypothesis, there was no significant correlation between having a mentor and match outcome (r=0.06, p=0.29. Match outcome was associated with class rank (r=0.13, p=0.03, satisfaction with match outcome (r= -0.37, p<0.001, and type of degree (r=0.12, p=0.04. Among those with mentors, a t-test revealed that the MES score was significantly higher among those who matched to their first or second choice (M=51.31, SD=10.13 compared to those who matched to their third or higher choice (M=43.59, SD=17.12, t(194=3.65, p<0.001, d=0.55. Conclusion: Simply having a mentor during medical

  10. Definition of Specific Functions and Procedural Skills Required by Cuban Specialists in Intensive Care and Emergency Medicine.

    Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R

    2015-07-01

    INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to

  11. Experience with Emergency Ultrasound Training by Canadian Emergency Medicine Residents

    Daniel J. Kim

    2014-05-01

    Full Text Available Introduction: Starting in 2008, emergency ultrasound (EUS was introduced as a core competency to the Royal College of Physicians and Surgeons of Canada (Royal College emergency medicine (EM training standards. The Royal College accredits postgraduate EM specialty training in Canada through 5-year residency programs. The objective of this study is to describe both the current experience with and the perceptions of EUS by Canadian Royal College EM senior residents. Methods: This was a web-based survey conducted from January to March 2011 of all 39 Canadian Royal College postgraduate fifth-year (PGY-5 EM residents. Main outcome measures were characteristics of EUS training and perceptions of EUS. Results: Survey response rate was 95% (37/39. EUS was part of the formal residency curriculum for 86% of respondents (32/37. Residents most commonly received training in focused assessment with sonography for trauma, intrauterine pregnancy, abdominal aortic aneurysm, cardiac, and procedural guidance. Although the most commonly provided instructional material (86% [32/37] was an ultrasound course, 73% (27/37 of residents used educational resources outside of residency training to supplement their ultrasound knowledge. Most residents (95% [35/37] made clinical decisions and patient dispositions based on their EUS interpretation without a consultative study by radiology. Residents had very favorable perceptions and opinions of EUS. Conclusion: EUS training in Royal College EM programs was prevalent and perceived favorably by residents, but there was heterogeneity in resident training and practice of EUS. This suggests variability in both the level and quality of EUS training in Canadian Royal College EM residency programs.

  12. Why and when to use CT in children: perspective of a pediatric emergency medicine physician

    The Emergency Department is a risk-laden environment for clinicians caring for children. A number of factors can increase the risk of medical errors and adverse events, including lack of standardized medication dosing because of size variation in the pediatric age range, unique physical and developmental characteristics of children that affect treatment strategies, and the inability of young or non-verbal children to provide a medical history or to clearly communicate pain and other symptoms. The Emergency Department (ED) setting is often hectic and chaotic, with lots of interruptions. Many EDs lack the pediatric-specific supplies deemed essential for managing pediatric emergencies, and long hours or overnight shifts, while necessary for maintaining 24-hour emergency services, can cause provider fatigue that can lead to increased medical errors. It is in this environment that ED physicians make decisions about the use of CT scans in children, often without evidence-based guidelines to help them weigh risks and benefits. Although recent efforts have raised the awareness of the risk of exposure to radiation, many pediatric providers and families lack adequate information to guide decisions about the use of CT. Pediatricians and emergency physicians need to collaborate with radiologists to maintain current knowledge of the risks and benefits of CT scans, to advocate for pediatric protocols and evidence-based guidelines, and to engage families in decisions regarding the evaluation and treatment of pediatric patients in the Emergency Department. (orig.)

  13. Design of nuclear accident emergency monitoring system based on GPS/CDMA

    A mobile real-time data monitoring system is designed for nuclear accident emergency, and is composed of three subsystems: vehicle-mounted radiation environment field data monitoring system, wireless data transmission system, and data processing system in the monitoring center. It is confirmed, by many times practical test, that such system satisfies the requirements of nuclear emergency monitoring. (authors)

  14. Development of a novel sports medicine rotation for emergency medicine residents

    Waterbrook AL

    2016-04-01

    Full Text Available Anna L Waterbrook,1 T Gail Pritchard,2 Allison D Lane,1 Lisa R Stoneking,1 Bryna Koch,2 Robert McAtee,1 Kristi H Grall,1 Alice A Min,1 Jessica Prior,1 Isaac Farrell,1 Holly G McNulty,1 Uwe Stolz1 1Department of Emergency Medicine, 2Office of Medical Student Education, The University of Arizona, Tucson, AZ, USA Abstract: Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC and University Campus (UC. The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the

  15. Organization of accident medical service in emergency situations in the system of Federal administration board for medical-biological and emergency problems at the Ministry of public health and medical industry of Russia

    Federal Administration Board for medical-biological problems at the Ministry of Public Health and Medical Industry of Russia, in accordance with the entrusted functions, provides medical-sanitary service for the workers of the branches of industry with especially dangerous labour conditions. For these purpose, there is functioning in its system a network of therapeutic-prophylactic, sanitary, scientific-research, educational and other establishments. A high degree of accident danger of the attended industrial plants determines the state policy of organizations and administrations as well as scientific-practical establishments of the Federal Administration Board in respect of elaboration and introduction of a complex of measures which would enable to guarantee the safe functioning of the plants. All sub-administration establishments have the necessary structures, settle the questions of liquidation of medical-sanitary after-effects of accidents at the attended plants, and are regarded to be the organizations of specialized emergency medical aid of the Federal Administration Board

  16. Chernobyl accident and Danmark

    The report describes the Chernobyl accident and its consequences for Denmark in particular. It was commissioned by the Secretary of State for the Environment. Volume 1 contains copies of original documents issued by Danish authorities during the first accident phase and afterwards. Evaluations, monitoring data, press releases, legislation acts etc. are included. (author)

  17. Chernobyl accident and Denmark

    The report describes the Chernobyl accident and its consequences for Denmark in particular. It was commissioned by The Secretary of State for the Environment. Volume 2 contains copies of original documents issued by Danish authorities during the first accident phase and afterwards. Evaluations, monitoring data, press releases, legislation acts etc. are included. (author)

  18. Courses on emergency preparedness and medical procedures in case of a nuclear accident organised in Zagreb, Croatia

    As a part of the postgraduate education at the Medical School of the University of Zagreb, different short courses are offered. It has been realised that the knowledge about radiation and its uses among the Croatian doctors is more than insufficient, especially if any action for treatment of radiation victims will ever be needed. The specialised courses of the I. category, offered and described bellow, are meant to provide the sufficient theoretical knowledge about ionising radiations as well as practical workshops and exercises in treatment of persons accidentally injured in a nuclear power plant or similar accident. (author)

  19. Soil sampling and analytical strategies for mapping fallout in nuclear emergencies based on the Fukushima Dai-ichi Nuclear Power Plant accident.

    Onda, Yuichi; Kato, Hiroaki; Hoshi, Masaharu; Takahashi, Yoshio; Nguyen, Minh-Long

    2015-01-01

    The Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident resulted in extensive radioactive contamination of the environment via deposited radionuclides such as radiocesium and (131)I. Evaluating the extent and level of environmental contamination is critical to protecting citizens in affected areas and to planning decontamination efforts. However, a standardized soil sampling protocol is needed in such emergencies to facilitate the collection of large, tractable samples for measuring gamma-emitting radionuclides. In this study, we developed an emergency soil sampling protocol based on preliminary sampling from the FDNPP accident-affected area. We also present the results of a preliminary experiment aimed to evaluate the influence of various procedures (e.g., mixing, number of samples) on measured radioactivity. Results show that sample mixing strongly affects measured radioactivity in soil samples. Furthermore, for homogenization, shaking the plastic sample container at least 150 times or disaggregating soil by hand-rolling in a disposable plastic bag is required. Finally, we determined that five soil samples within a 3 m × 3-m area are the minimum number required for reducing measurement uncertainty in the emergency soil sampling protocol proposed here. PMID:24965965

  20. Communication and industrial accidents

    As, Sicco van

    2001-01-01

    This paper deals with the influence of organizational communication on safety. Accidents are actually caused by individual mistakes. However the underlying causes of accidents are often organizational. As a link between these two levels - the organizational failures and mistakes - I suggest the conc

  1. Emergency medical management of radiation accident. Lessons learned from the JCO criticality accident

    A criticality accident occurred at the JCO nuclear fuel processing plant in Tokai-mura, Japan at 10:35 am on September 30, 1999. Three workers while working nearby were exposed to high doses of radiation, especially rich in neutron. They suffered from the acute radiation syndrome and two of them were still under medical treatment. This criticality accident taught us significant lessons of radiation protection for the personnels, e.g. physicians, nurses and firemen who are expected to rescue radiation-exposed patients in radiation accidents. In this article, medical management of radiation accident, e.g. treatment of patient, with high-dosed radiation-exposure and with internal contamination of radioactive nuclides and estimation of individual radiation dose, were briefly explained. The Japanese Association for Medical Management of Radiation Accident was founded on August 29, 1997, in order to promote the mutual communication of physicians who have to be engaged in treatment of radiation-exposed patients. (author)

  2. Emerging Applications of Stem Cell and Regenerative Medicine to Sports Injuries

    Ajibade, David A.; Vance, Danica D; Hare, Joshua M.; Kaplan, Lee D.; Lesniak, Bryson P.

    2014-01-01

    Background: The treatment of sports-related musculoskeletal injuries with stem cells has become more publicized because of recent reports of high-profile athletes undergoing stem cell procedures. There has been increased interest in defining the parameters of safety and efficacy and the indications for potential use of stem cells in clinical practice. Purpose: To review the role of regenerative medicine in the treatment of sports-related injuries. Study Design: Review. Method: Relevant studie...

  3. Effectiveness of emergency medicine in longitudinal integrated clerkships

    Banh, Kenny; Ramirez, Rene; Thabit, Christina

    2014-01-01

    Objective: This study investigated third-year students’ experience with the emergency medicine (EM) component in integrated longitudinal programs. The study aimed to see if EM could be integrated into third-year integrated longitudinal programs while addressing accreditation standards and increasing interest in EM.Methods: The authors surveyed students who participated in an integrated longitudinal program at University of California San Francisco School of Medicine (UCSF) from 2010 to 2012. ...

  4. Emerging Glycolysis Targeting and Drug Discovery from Chinese Medicine in Cancer Therapy

    Zhiyu Wang

    2012-01-01

    Full Text Available Molecular-targeted therapy has been developed for cancer chemoprevention and treatment. Cancer cells have different metabolic properties from normal cells. Normal cells mostly rely upon the process of mitochondrial oxidative phosphorylation to produce energy whereas cancer cells have developed an altered metabolism that allows them to sustain higher proliferation rates. Cancer cells could predominantly produce energy by glycolysis even in the presence of oxygen. This alternative metabolic characteristic is known as the “Warburg Effect.” Although the exact mechanisms underlying the Warburg effect are unclear, recent progress indicates that glycolytic pathway of cancer cells could be a critical target for drug discovery. With a long history in cancer treatment, traditional Chinese medicine (TCM is recognized as a valuable source for seeking bioactive anticancer compounds. A great progress has been made to identify active compounds from herbal medicine targeting on glycolysis for cancer treatment. Herein, we provide an overall picture of the current understanding of the molecular targets in the cancer glycolytic pathway and reviewed active compounds from Chinese herbal medicine with the potentials to inhibit the metabolic targets for cancer treatment. Combination of TCM with conventional therapies will provide an attractive strategy for improving clinical outcome in cancer treatment.

  5. The core content of emergency medical services medicine.

    Perina, Debra G; Pons, Peter T; Blackwell, Thomas H; Bogucki, Sandy; Brice, Jane H; Cunningham, Carol A; Delbridge, Theodore R; Gausche-Hill, Marianne; Gerard, William C; Gratton, Matthew C; Mosesso, Vincent N; Pirrallo, Ronald G; Rinnert, Kathy J; Sahni, Ritu; Harvey, Anne L; Kowalenko, Terry; Buckendahl, Chad W; O'Leary, Lisa S; Stokes, Myisha

    2012-01-01

    On September 23, 2010, the American Board of Medical Specialties (ABMS) approved emergency medical services (EMS) as a subspecialty of emergency medicine. As a result, the American Board of Emergency Medicine (ABEM) is planning to award the first certificates in EMS medicine in the fall of 2013. The purpose of subspecialty certification in EMS, as defined by ABEM, is to standardize physician training and qualifications for EMS practice, to improve patient safety and enhance the quality of emergency medical care provided to patients in the prehospital environment, and to facilitate integration of prehospital patient treatment into the continuum of patient care. In February 2011, ABEM established the EMS Examination Task Force to develop the Core Content of EMS Medicine (Core Content) that would be used to define the subspecialty and from which questions would be written for the examinations, to develop a blueprint for the examinations, and to develop a bank of test questions for use on the examinations. The Core Content defines the training parameters, resources, and knowledge of the treatment of prehospital patients necessary to practice EMS medicine. Additionally, it is intended to inform fellowship directors and candidates for certification of the full range of content that might appear on the examinations. This article describes the development of the Core Content and presents the Core Content in its entirety. PMID:22233528

  6. Updated tool for nuclear criticality accident emergency response

    Some 20 yr ago a hand-held slide rule was developed at the Oak Ridge Y-12 Plant to aid in the response to several postulated nuclear criticality accidents. These assumed accidents involved highly enriched uranium in either a bare metal or a uranyl nitrate system. The slide rule consisted of a sliding scale based on the total fission yield and four corresponding dose indicators: (1) a prompt radiation dose relationship as a function of distance; (2) a delayed fission product gamma dose rate relationship as a function of time and distance; (3) the total dose relationship with time and distance; and (4) the I-min integrated dose relationship with time and distance. The original slide rule was generated assuming very simplistic numerical procedures such as the inverse-square relationship of dose with distance and the Way-Wigner relationship to express the time dependence of the dose. The simple prescriptions were tied to actual dose measurements from similar systems to yield a meaningful, yet simple approach to emergency planning and response needs. This paper describes the application of an advanced procedure to the updating of the original slide rule for five critical systems. These five systems include (a) an unreflected sphere of 93.2 wt% enriched uranium metal, (b) an unreflected sphere of 93.2 wt% enriched uranyl nitrate solution with a H/235U ratio of 500, (c) an unreflected sphere of damp 93.2 wt% enriched uranium oxide with a H/235U ratio of 10, (d) an unreflected sphere of 4.95 wt% enriched uranyl fluoride solution having a H/235U ratio of 410, and (e) an unreflected sphere of damp 5 wt% enriched uranium dioxide having a H/235U ratio of 200

  7. Improving outcomes for ill and injured children in emergency departments: protocol for a program in pediatric emergency medicine and knowledge translation science

    Shaw Nicola

    2009-09-01

    Full Text Available Abstract Approximately one-quarter of all Canadian children will seek emergency care in any given year, with the two most common medical problems affecting children in the emergency department (ED being acute respiratory illness and injury. Treatment for some medical conditions in the ED remains controversial due to a lack of strong supporting evidence. The purpose of this paper is to describe a multi-centre team grant in pediatric emergency medicine (PEM that has been recently funded by the Canadian Institutes of Health Research (CIHR. This program of research integrates clinical research (in the areas of acute respiratory illness and injury and knowledge translation (KT. This initiative includes seven distinct projects that address the objective to generate new evidence for clinical care and KT in the pediatric ED. Five of the seven research projects in this team grant make significant contributions to knowledge development in KT science, and these contributions are the focus of this paper. The research designs employed in this program include: cross-sectional surveys, randomized controlled trials (RCTs, quasi-experimental designs with interrupted time-series analysis and staggered implementation strategies, and qualitative designs. This team grant provides unique opportunities for making important KT methodological developments, with a particular focus on developing a better theoretical understanding of the causal mechanisms and effect modifiers of different KT interventions.

  8. Accident management in the case of serious emergencies in nuclear power plant

    On-site emergency planning comprises all action taken in a nuclear power station to identify beyond-design base accidents at an early stage and reliably, to keep it under control and overcome it with the minimum of damage. The individual papers set out the basic terminology, the thermohydraulic processes in the cooling circuits during severe incidents, action to maintain the integrity of the containment, the potential of expert systems, simulator training and new developments for simulating accident conditions. (DG)

  9. Status of the RODOS system for off-site emergency management after nuclear and radiological accidents and its enhancement under the EURANOS project

    Full text: Under the auspices of its Euratom Research Framework Programmes, the European Commission (EC) has supported the development of the RODOS (Real-time On-line Decision Support) system for off-site emergency management after nuclear accidents for more than a decade. Significant additional funds have been provided by many national RTD programmes, research institutes and industrial collaborators. In particular, the German Ministry of Environment, Nature Conservation and Reactor Safety (BMU) financially contributed to the project with emphasis on early emergency response. As a result of these collaborative actions, a comprehensive decision support system (RODOS) has been developed which can be applied generally within and across Europe. The current version of the system has been, or is being, installed in national emergency centres in several European countries for (pre-operational) use (Germany, Finland, Spain, Portugal, Austria, the Netherlands, Poland, Hungary, Slovakia, Ukraine, Slovenia, and the Czech Republic). Installation is foreseen or under consideration in Switzerland, Greece, Romania, Bulgaria, and Russia within the next few years. RODOS provides coherent support at all stages of an accident (i.e., before, during and after a release), including the long term management and restoration of contaminated areas. The system is able to support decisions about the introduction of a wide range of potentially useful countermeasures (e.g., sheltering and evacuation of people, distribution of iodine tablets, food restrictions, agricultural countermeasures, relocation, decontamination, restoration, etc.) mitigating the consequences of an accident with respect to health, the environment, and the economy. It can be applied to accidental releases into the atmosphere and into various aquatic environments. Appropriate interfaces exist with local and national radiological monitoring data, meteorological measurements and forecasts, and for adaptation to local, regional

  10. Emergency preparation and maneuver of HFETR

    The report presents the emergency document formation, emergency organization establishment, emergency facilities preparation and emergency accident maneuver onsite of High Flux Engineering Test Reactor (HFETR). The result of emergency preparations and maneuver is summarized. (authors)

  11. Status of the Real-time On-line Decision Support (RODOS) system for off-site emergency management after nuclear and radiological accidents

    Under the auspices of its EURATOM Research Framework Programmes, the European Commission (EC) has supported the development of the comprehensive decision support system RODOS (Real-time On-line Decision Support) for off-site emergency management after nuclear accidents for more than a decade. Many national research programmes, research institutes and industrial collaborators contributed to the project, in particular the German Ministry of Environment, Nature Conservation and Reactor Safety (B MU). The RODOS system can be applied to accidental releases into the atmosphere and various aquatic environments within and across Europe. It provides coherent support before, during and after such a release to assist analysis of the situation and decision making about short and long-term countermeasures for mitigating the consequences with respect to health, the environment, and the economy. Appropriate interfaces exist with local and national radiological monitoring data systems, meteorological measurements and forecasts, and for the adaptation to local, regional and national conditions in Europe. Within the European Integrated Project EURANOS of the sixth Framework Programme, the RODOS system is being enhanced, among others, for radiological emergencies such as dirty bombs attacks, transport accidents and satellite crashes by extensions of the nuclide list, the source term characteristics and the atmospheric dispersion model

  12. Mobile real-time data monitoring system for nuclear accident emergency

    A mobile real-time data monitoring system is designed for nuclear accident emergency, accomplished real-time data acquisition and transmission. For its special application, the system realized the real-time data acquisition of multi-serial device, GPS orientation and route record of the emergency monitoring vehicle, wireless data communications based on CDMA 1X network, database, etc. It is confirmed, by many times practical test, that such system satisfies the requirements of nuclear emergency monitoring. (authors)

  13. Evaluation and Prediction present of radionuclide for surface wipe sample in Emergency Related with Fukushima Nuclear Accident

    Surface wipe samples of aircraft and container from Japan that were exposed to radioactive dust fallout due to Fukushima nuclear accident has been analysed using gamma spectrometry systems. The samples were analysed to determine their contamination levels. The surface of aircraft and container might be exposed to short and long lived fission and activation products. Thus, good evaluations, as well as a reliable and reasonable judgment were needed in order to determine the presence of fission and activation products. A work procedure has been developed to evaluate and predict the presence of fission and activation products in surface wipe samples. Good references, skilled and experienced level in analysis, a well calibrated and validated detector system were the important factors in determining the presence of fission and activation products in surface wipe samples. (author)

  14. Medical procedures in the event of nuclear power plant accidents. Guidelines for: Medical consultants for emergency response commander; physicians in emergency care centres; physicians in outpatient and inpatient care

    The author of the contribution under consideration reports on medical procedures in the event of nuclear power plant accidents. This contribution consists of the following sections: protective measures, tasks of radiation protection physicians, emergency care centres. It has been pointed out that differentiation of the hospitals is acquired which accept radiation accident patients. However, only a small number of hospitals will be able to professionally treat patients with suspected gastrointestinal or pronounced (muco)cutaneous type of hospitals with haemotological-oncological departments. Thus they should be able to treat patients who have been exposed to radiation doses between 1 and 6 Gy without any difficulties. Even larger is the number of hospitals which can accept patients who were exposed to a radiation dose of less than 1 Gy, but suffer from other complicating diseases (injuries, general diseases)

  15. Emergency planning and the Control of Major Accident Hazards (COMAH/Seveso II) Directive: an approach to determine the public safety zone for toxic cloud releases.

    O'Mahony, Mary T; Doolan, Donal; O'Sullivan, Alice; Hession, Michael

    2008-06-15

    The EU Control of Major Accidents Hazards Directive (Seveso II) requires an external emergency plan for each top tier site. This paper sets out a method to build the protection of public health into emergency planning for Seveso sites in the EU. The method involves the review of Seveso site details prescribed under the directive. The site safety report sets out the potential accident scenarios. The safety report's worst-case scenario, and chemical involved, is used as the basis for the external emergency plan. A decision was needed on the appropriate threshold value to use as the level of concern to protect public health. The definitions of the regulatory standards (air quality standards and occupational standards) in use were studied, how they are derived and for what purpose. The 10 min acute exposure guideline level (AEGL) for a chemical is recommended as the threshold value to inform decisions taken to protect public health from toxic cloud releases. The area delimited by AEGL 1 defines the population who may be concerned about being exposed. They need information based on comprehensive risk assessment. The area delimited by AEGL 2 defines the population for long-term surveillance when indicated and may include first responders. The area delimited by AEGL 3 defines the population who may present acutely to the medical services. It ensures that the emergency responders site themselves safely. A standard methodology facilitates discussions with plant operators and concerned public. Examples show how the methodology can be adapted to suit explosive risk and response to fire. PMID:18078713

  16. Developing and implementing a computer assisted emergency facility for assessing off-site consequences due to accidents in UK nuclear power reactors

    This paper outlines considerations in the development of the RAD computer code as used in the Emergency Room at HM NII for assessing off-site consequences of accidents in UK civil nuclear power reactors. A wide range of requirements have been accommodated within the facility, particularly the need of HM NII to meet its responsibilities by producing realistic and timely estimates of a suitably high quality for propagating advice. The development of the computer code has required the balancing of many competing factors. Valuable experience has been gained by using the code during emergency exercises. Importance is laid on the feedback of field measurements to enhance the accuracy of estimated radiological consequences. (author)

  17. Medical emergency planning in case of severe nuclear power plant accidents

    This paper is an attempt to discuss a three-step-plan on medical emergency planning in case of severe accidents at nuclear power plants on the basis of own experiences in the regional area as well as on the basis of recommendations of the Federal Minister of the Interior. The medical considerations take account of the severity and extension of an accident whereby the current definitions used in nuclear engineering for accident situations are taken as basis. A comparison between obligatory and actual state is made on the possibilities of medical emergency planning, taking all capacities of staff, facilities, and equipment available in the Federal Republic of Germany into account. To assure a useful and quick utilization of the existing infra-structure as well as nation-wide uniform training of physicians and medical assistants in the field of medical emergency in case of a nuclear catastrophe, a federal law for health protection is regarded urgently necessary. (orig.)

  18. Radiation dose awareness and disclosure practice in paediatric emergency medicine: how far have we come?

    Boutis, Kathy; Thomas, Karen E

    2016-05-01

    The past decade has brought increasing coverage in the medical literature and lay media of the potential association between low-level radiation from diagnostic imaging and an increased lifetime cancer risk. Both physician and public opinion increasingly favour a greater discussion of benefit and risk with patients and their families when such imaging is being considered. Particular attention has been directed towards CT, its use in children and the emergency department setting. We will review the evolution of radiation dose awareness and knowledge among emergency physicians (EPs) alongside the parallel increase in public awareness. We will then discuss expectations for risk disclosure and the challenges faced by EPs and radiologists as we strive to provide this in a clinically balanced and meaningful way. PMID:26828973

  19. Help guides for post-accident consequence management: farm activities and exiting the emergency phase; Les guides d'aide a la gestion des consequences post-accidentelles: activites agricoles et sortie de la phase d'urgence

    Cessac, B.; Reales, N. [Institut de Radioprotection et de Surete Nucleaire, BP 17 - 92262 Fontenay-aux-Roses (France); Mehl-Auget, I. [Autorite de Surete Nucleaire - 6, place du Colonel Bourgoin - 75012 Paris (France)

    2010-07-01

    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

  20. Filovirus Emergence and Vaccine Development: A Perspective for Health Care Practitioners in Travel Medicine

    Sarwar, Uzma N.; Sitar, Sandra; Ledgerwood, Julie E.

    2010-01-01

    Recent case reports of viral hemorrhagic fever in Europe and the United States have raised concerns about the possibility for increased importation of filoviruses to non-endemic areas. This emerging threat is concerning because of the increase in global air travel and the rise of tourism in central and eastern Africa and the greater dispersion of military troops to areas of infectious disease outbreaks. Marburg viruses (MARV) and Ebola viruses (EBOV) have been associated with outbreaks of sev...

  1. Social Media in the Emergency Medicine Residency Curriculum: Social Media Responses to the Residents' Perspective Article

    Hayes, BD; Kobner, S; Trueger, NS; S. Yiu; Lin, M.

    2015-01-01

    © 2015 American College of Emergency Physicians. In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant i...

  2. What Can Emergency Medicine Learn From Kinetics: Introducing an Alternative Evaluation and a Universal Criterion Standard for Emergency Department Performance.

    Pan, Chih-Long; Chang, Chin-Fu; Chiu, Chun-Wen; Chi, Chih-Hsien; Tian, Zhong; Wen, Jyh-Horng; Wen, Jet-Chau

    2016-03-01

    This research focuses on developing an improved and robust measurement for emergency department (ED) performance and a criterion standard for global use via kinetic analysis.Based on kinetic approach, the input-throughput-output conceptual model of ED crowding is compared to the procedure of enzyme catalysis. All in average, the retented patients in EDs are defined as substrate ((Equation is included in full-text article.)), whereas the patients who depart the EDs as product ((Equation is included in full-text article.)). Therefore, the average ED departure velocity ((Equation is included in full-text article.)) can be presented as (Equation is included in full-text article.)divided by a given time (t) of the ED length of stay (LOS). The (Equation is included in full-text article.)and (Equation is included in full-text article.)plots are depicted hourly for the kinetic analysis. The long-term stability of the kinetic parameters is ascertained by the method of coefficient of variation (CV). The participants collected for this study are from the EDs of Changhua Christian Medical Center and the five branched hospitals, all located in Taiwan.Based on the (Equation is included in full-text article.)plot analysis, the results clearly show 2 curves, an upper and a lower curve. The timeline of the lower curve includes approximately the total ED busy hours, and thus it can be used for the subsequent kinetic analysis. In order to explore the adequate kinetic parameters for ED performance, the try-and-error process was followed in this study. As a result, the (Equation is included in full-text article.)plots adapted from the lower curves show the best linear regression of (Equation is included in full-text article.)on (Equation is included in full-text article.)with a good coefficient of determination (R). The Pan-Wen constant (PW), which is the slope of the liner regression line, and the ED medical personnel unit turnover number (EDMPU TON) were deduced from the kinetic

  3. An eMERGE Clinical Center at Partners Personalized Medicine

    Jordan W. Smoller

    2016-01-01

    Full Text Available The integration of electronic medical records (EMRs and genomic research has become a major component of efforts to advance personalized and precision medicine. The Electronic Medical Records and Genomics (eMERGE network, initiated in 2007, is an NIH-funded consortium devoted to genomic discovery and implementation research by leveraging biorepositories linked to EMRs. In its most recent phase, eMERGE III, the network is focused on facilitating implementation of genomic medicine by detecting and disclosing rare pathogenic variants in clinically relevant genes. Partners Personalized Medicine (PPM is a center dedicated to translating personalized medicine into clinical practice within Partners HealthCare. One component of the PPM is the Partners Healthcare Biobank, a biorepository comprising broadly consented DNA samples linked to the Partners longitudinal EMR. In 2015, PPM joined the eMERGE Phase III network. Here we describe the elements of the eMERGE clinical center at PPM, including plans for genomic discovery using EMR phenotypes, evaluation of rare variant penetrance and pleiotropy, and a novel randomized trial of the impact of returning genetic results to patients and clinicians.

  4. Antiviral therapies against Ebola and other emerging viral diseases using existing medicines that block virus entry

    Long, Jason; Wright, Edward; Molesti, Eleonora; Temperton, Nigel J.; Barclay, Wendy

    2015-01-01

    Emerging viral diseases pose a threat to the global population as intervention strategies are mainly limited to basic containment due to the lack of efficacious and approved vaccines and antiviral drugs. The former was the only available intervention when the current unprecedented Ebolavirus (EBOV) outbreak in West Africa began. Prior to this, the development of EBOV vaccines and anti-viral therapies required time and resources that were not available. Therefore, focus has turned to re-purpos...

  5. 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 ...

  6. The Prevalence and Characteristics of Emergency Medicine Patient Use of New Media

    Post, Lori Ann; Vaca, Federico E.; Biroscak, Brian J; Dziura, James; Brandt, Cynthia; Bernstein, Steven L.; Taylor, Richard, imp.; Jagminas, Liudvikas; D'Onofrio, Gail

    2015-01-01

    Background Little is known about “new media” use, defined as media content created or consumed on demand on an electronic device, by patients in emergency department (ED) settings. The application of this technology has the potential to enhance health care beyond the index visit. Objective The objectives are to determine the prevalence and characteristics of ED patients’ use of new media and to then define and identify the potential of new media to transcend health care barriers and improve t...

  7. Recovery operations in the event of a nuclear accident or radiological emergency

    Much progress has been made over the last decade in the field of emergency planning and preparedness, including the development of guidance, criteria, training programmes, regulations and comprehensive plans in the support of nuclear facilities. To provide a forum for international review and discussion of actual experiences gained and lessons learned from the different aspects of recovery techniques and operations in response to serious accidents at nuclear facilities and accidents associated with radioactive materials, the IAEA organized the International Symposium on Recovery Operations in the Event of a Nuclear Accident or Radiological Emergency. The symposium was held from 6 to 10 November 1989 in Vienna, Austria, and was attended by over 250 experts from 35 Member State and 7 international organizations. Although the prime focus was on on-site and off-site recovery from nuclear reactor accidents and on recovery from radiological accidents unrelated to nuclear power plants, development of emergency planning and preparedness resources was covered as well. From the experiences reported, lessons learned were identified. While further work remains to be done to improve concepts, plans, materials, communications and mechanisms to assemble quickly all the special resources needed in the event of an accident, there was general agreement that worldwide preparations to handle any possible future radiological emergencies had vastly improved. A special feature of the symposium programme was the inclusion of a full session on an accident involving a chemical explosion in a high level waste tank a a plutonium extraction plant in the Southern Urals in the USSR in 1957. Information was presented on the radioactive release, its dissemination and deposition, the resultant radiation situation, dose estimates, health effects follow-up, and the rehabilitation of contaminated land. This volume contains the full text of the 49 papers presented at the symposium together with a

  8. Development of a novel sports medicine rotation for emergency medicine residents.

    Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

    2016-01-01

    Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational

  9. Development of a novel sports medicine rotation for emergency medicine residents

    Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

    2016-01-01

    Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students’ and residents’ musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their

  10. The operational emergency response model at the Swedish Meteorological and Hydrological Institute: validation using data from ETEX and the Chernobyl accident

    The Eulerian atmospheric tracer transport model MATCH (Mesoscale Atmospheric Transport and Chemistry model) has been extended with a Lagrangian particle model treating the initial dispersion of pollutants from point sources. The model has been implemented at SMHI in an emergency response system for nuclear accidents and can be activated on short notice to provide forecast concentration and deposition fields. This information is then forwarded to the Swedish Radiation Protection Agency (SSI) as a basis for further actions. The model has been used to simulate the transport of the inert species released during the first ETEX experiment and the transport and deposition of 137Cs from the Chernobyl accident. Visual inspection of the results as well as statistical analysis shows that the extent, time of arrival and duration of the cloud, is in good agreement with the observations for both cases, with a tendency to overprediction for the first ETEX release. For the Chernobyl case also the simulated deposition pattern over Scandinavia agrees with observations. (author)

  11. Cost-Effectiveness Analysis and HIV Screening: The Emergency Medicine Perspective

    Hsu, Heather; Walensky, Rochelle P.

    2011-01-01

    Cost-effectiveness analysis is a useful tool for decision makers charged with prioritizing the myriad medical interventions in the emergency department (ED). This analytic approach may be especially helpful for ranking programs that are competing for scarce resources while attempting to maximize net health benefits. In this article, we review the health economics literature on HIV screening in EDs and introduce the methods of cost-effectiveness analysis for medical interventions. We specifica...

  12. [Hyperbaric therapy and diving medicine - hyperbaric therapy part 1: evidence-based emergency care].

    Jüttner, Björn; Tetzlaff, Kay

    2015-10-01

    Hyperbaric oxygen therapy (HBOT), i. e. breathing pure oxygen at elevated ambient pressure, remains the gold standard of care in treating air or gas embolism and decompression illness. Guidelines are less clear on the value of HBOT in acute management of carbon monoxide (CO) poisoning or clostridial necrosis. To evaluate the evidence of clinical efficacy of HBOT we performed a systematic literature review. Part 1 assesses acute indications such as air or gas embolism, decompression sickness, CO-poisoning, clostridialmyonecrosis, necrotizing problem wounds, acute traumatic wounds and arterial retinal occlusion. Part 2 discusses further uses of HBOT as adjuvant treatment and highlights problems in assessing the value of HBOT using evidence-based medicine criteria. PMID:26523604

  13. Emergency Medicine Resident Perceptions of Medical Professionalism

    Jauregui, Joshua; Gatewood, Medley O.; Ilgen, Jonathan S.; Schaninger, Caitlin; Strote, Jared

    2016-01-01

    Introduction Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05). Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05). Conclusion Residents perceive differences in the relative

  14. Emergency Medicine Resident Perceptions of Medical Professionalism

    Joshua Jauregui

    2016-05-01

    Full Text Available Introduction: Medical professionalism is a core competency for emergency medicine (EM trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods: We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results: Of the 114 residents eligible, 100 (88% completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001. Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05. Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05. Conclusion: Residents perceive differences in

  15. Does a third year of emergency medicine training make a difference? Historical cohort study of Queen's University graduates.

    2001-01-01

    OBJECTIVE: To describe outcomes of a third-year residency (PGY-3) program in family medicine/emergency medicine in terms of its graduates' practice characteristics and their self-assessed preparedness for practising emergency medicine. DESIGN: A questionnaire was sent to graduates of Queen's University's family medicine residency programs. SETTING: Recent graduates' practices. PARTICIPANTS: All 30 graduates of Queen's University's Family Medicine/Emergency Medicine Program (PGY-3s) from 1988 ...

  16. Radiation Accident Experience: Causes and Lessons Learned

    Since inception of the nuclear energy program in the United States of America, the Atomic. Energy Commission (USAEC) has maintained an extensive system for the reporting and review of radiation accidents in USAEC federal and licensing activities. Accidents required to be reported fall-into two main categories: (1) Accidents causing or threatening to cause radiation exposure to industrial workers or to the general public; (2) Accidents causing damage to or shutdown of facilities, or damage to public property. While many of the reported accidents carry with them the potential for exposure of persons to radioactivity, the cases reported, in this analysis are limited to those where certain prescribed levels of exposure have been exceeded or where significant uptake by the critical organ has occurred. This paper presents detailed analyses of the accident experience encountered in USAEC programs over the past nine years, including: (1) A breakdown of the types of work activities in the nuclear industry under which radiation accidents have occurred; (2) Characterization of the causes of such accidents as related to the types of work activities; (3) Lessons to be learned both in avoiding such accidents and in emergency planning, should such accidents occur. (author)

  17. An emerging micro-scale immuno-analytical diagnostic tool to see the unseen. Holding promise for precision medicine and P4 medicine.

    Guzman, Norberto A; Guzman, Daniel E

    2016-05-15

    Over the years, analytical chemistry and immunology have contributed significantly to the field of clinical diagnosis by introducing quantitative techniques that can detect crucial and distinct chemical, biochemical and cellular biomarkers present in biosamples. Currently, quantitative two-dimensional hybrid immuno-analytical separation technologies are emerging as powerful tools for the sequential isolation, separation and detection of protein panels, including those with subtle structural changes such as variants, isoforms, peptide fragments, and post-translational modifications. One such technique to perform this challenging task is immunoaffinity capillary electrophoresis (IACE), which combines the use of antibodies and/or other affinity ligands as highly selective capture agents with the superior resolving power of capillary electrophoresis. Since affinity ligands can be polyreactive, i.e., binding and capturing more than one molecule, they may generate false positive results when tested under mono-dimensional procedures; one such application is enzyme-linked immunosorbent assay (ELISA). IACE, on the other hand, is a two-dimensional technique that captures (isolation and enrichment), releases, separates and detects (quantification, identification and characterization) a single or a panel of analytes from a sample, when coupled to one or more detectors simultaneously, without the presence of false positive or false negative data. This disruptive technique, capable of preconcentrate on-line results in enhanced sensitivity even in the analysis of complex matrices, may change the traditional system of testing biomarkers to obtain more accurate diagnosis of diseases, ideally before symptoms of a specific disease manifest. In this manuscript, we will present examples of the determination of biomarkers by IACE and the design of a miniaturized multi-dimensional IACE apparatus capable of improved sensitivity, specificity and throughput, with the potential of being used

  18. Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice

    Jennifer L. Wiler, MD, MBA

    2016-03-01

    Full Text Available In 2007, the Centers for Medicaid and Medicare Services (CMS created a novel payment program to create incentives for physician’s to focus on quality of care measures and report quality performance for the first time. Initially termed “The Physician Voluntary Reporting Program,” various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS. As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the “traditional PQRS” reporting program and the newer “Value Modifier” program (VM. For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children’s Health Insurance Program (CHIP Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians.

  19. Emerging roles of hyaluronic acid bioscaffolds in tissue engineering and regenerative medicine.

    Hemshekhar, Mahadevappa; Thushara, Ram M; Chandranayaka, Siddaiah; Sherman, Larry S; Kemparaju, Kempaiah; Girish, Kesturu S

    2016-05-01

    Hyaluronic acid (HA), is a glycosaminoglycan comprised of repeating disaccharide units of N-acetyl-D-glucosamine and D-glucuronic acid. HA is synthesized by hyaluronan synthases and reaches sizes in excess of 2MDa. It plays numerous roles in normal tissues but also has been implicated in inflammatory processes, multiple drug resistance, angiogenesis, tumorigenesis, water homeostasis, and altered viscoelasticity of extracellular matrix. The physicochemical properties of HA including its solubility and the availability of reactive functional groups facilitate chemical modifications on HA, which makes it a biocompatible material for use in tissue regeneration. HA-based biomaterials and bioscaffolds do not trigger allergies or inflammation and are hydrophilic which make them popular as injectable dermal and soft tissue fillers. They are manufactured in different forms including hydrogels, tubes, sheets and meshes. Here, we review the pathophysiological and pharmacological properties and the clinical uses of native and modified HA. The review highlights the therapeutic applications of HA-based bioscaffolds in organ-specific tissue engineering and regenerative medicine. PMID:26893053

  20. Correlation of the Emergency Medicine Resident In-Service Examination with the American Osteopathic Board of Emergency Medicine Part I

    Levy, David; Dvorkin, Ronald; Schwartz, Adam; Zimmerman, Steven; Li, Feiming

    2014-01-01

    Introduction: Eligible residents during their fourth postgraduate year (PGY-4) of emergency medicine (EM) residency training who seek specialty board certification in emergency medicine may take the American Osteopathic Board of Emergency Medicine (AOBEM) Part 1 Board Certifying Examination (AOBEM Part 1). All residents enrolled in an osteopathic EM residency training program are required to take the EM Resident In-service Examination (RISE) annually. Our aim was to correlate resident ...

  1. [Evaluation of emergency medicine knowledge and procedures after finishing the course "resuscitation specialty"].

    Sefrin, P; Sagmeister, U

    2002-01-01

    Emergency medical services are an indispensable part of out-patient medical care. For this purpose, special qualifications are necessary and these are taught within the framework of a course entitled "Certificate for Emergency Medical Services". These courses are organized either as a block course, that is a one-week course, or as weekend courses in progression. These two types of courses are compared here. Three block courses with 546 participants and five weekend courses with 599 participants were examined. The practical examination took the form of four practice stages, with 95 people from the courses taking the examination. The examination focussed on certain areas such as ECG diagnostics in the case of cardiac arrest, early defibrillation, removing helmets, immobilizing a fractured tibia, respiration with emergency equipment, vein punctures and volume substitution. Of the doctors attending the courses, 59.7% were residents, 35.7% were senior house officers and 4.6% were specialists or general practitioners. Thirty-nine (or 41.1%) of those examined attended a block course and 56 (58.9%) weekend courses. In diagnosing cardiac arrest, those attending a block course were more reliable (92.3% diagnosed correctly, compared with 67.9% in the other group). Fifteen per cent from both groups were not able to correctly diagnose ventricular fibrillation from the ECG. Of the block course participants, 39.1% chose defibrillation with the correct energy, compared with 24.2% of those attending weekend courses. One out of two participants recognized a deliberate fault in the ECG equipment. Thirty-seven per cent of participants of the block course and 35.9% from the weekend courses failed to choose the right size splint for neck immobilization. Regarding respiration, 67.2% of participants of the block course group and 71.4% of the weekend course group carried out manual artificial respiration. When using respirator equipment, 90% from the block course and 72.2% of the other

  2. The system of emergency cards for primary actions in accident at radioactive material transport in Russia

    In the paper are reviewed the current and new designed system of the emergency cards for consignments of radioactive materials in Russian Federation, within the framework of a uniform state system of warning and liquidation of consequences of extraordinary situations and functional subsystem of warning and liquidation of accident situations of Federal Agency for Atomic Energy

  3. The system of emergency cards for primary actions in accident at radioactive material transport in Russia

    Ananiev, V.V. [Div. of the Decommission of Nuclear and Radiation-Hazardous Object of the Federal Agency for Atomic Energy, Moscow (Russian Federation); Ermakov, S.V.; Ershov, V.N.; Stovbur, V.I. [FGUP ' ' Emergency Response Centre of Minatom of Russia' ' , St-Petersburg (Russian Federation); Shvedov, M.O. [Div. of Nuclear and Radiation Safety of the Federal Agency for Atomic Energy, Moscow (Russian Federation)

    2004-07-01

    In the paper are reviewed the current and new designed system of the emergency cards for consignments of radioactive materials in Russian Federation, within the framework of a uniform state system of warning and liquidation of consequences of extraordinary situations and functional subsystem of warning and liquidation of accident situations of Federal Agency for Atomic Energy.

  4. Emergency Response System for Pollution Accidents in Chemical Industrial Parks, China

    Weili Duan; Bin He

    2015-01-01

    In addition to property damage and loss of lives, environment pollution, such as water pollution and air pollution caused by accidents in chemical industrial parks (CIPs) is a significant issue in China. An emergency response system (ERS) was therefore planned to properly and proactively cope with safety incidents including fire and explosions occurring in the CIPs in this study. Using a scenario analysis, the stages of emergency response were divided into three levels, after introducing the ...

  5. Sexual Assault Training in Emergency Medicine Residencies: A Survey of Program Directors

    Sande, Margaret Kramer; Broderick, Kerry B.; Moreira, MD, Maria E.; Bender, Brooke; Hopkins, Emily; Buchanan, Jennie A.

    2013-01-01

    Introduction: There is currently no standard forensic medicine training program for emergency medicine residents. In the advent of sexual assault nurse examiner (SANE) programs aimed at improving the quality of care for sexual assault victims, it is also unclear how these programs impact emergency medicine (EM) resident forensic medicine training. The purpose of this study was togather information on EM residency programs’ training in the care of sexual assault patients and determine what imp...

  6. Development of emergency plans for accidents at civil nuclear sites in the United Kingdom

    This paper is about the management of the off-site consequences of an accident at a UK civil nuclear installation. It describes the measures that would be taken to protect the public in the vicinity of an installation after an emergency had been declared; and it sets out the respective responsibilities of the operator and the various authorities who would be involved in the emergency. (author)

  7. Ten Tips for Engaging the Millennial Learner and Moving an Emergency Medicine Residency Curriculum into the 21st Century

    Shannon L. Toohey

    2016-05-01

    Full Text Available Introduction: Millennial learners are changing the face of residency education because they place emphasis on technology with new styles and means of learning. While research on the most effective way to teach the millennial learner is lacking, programs should consider incorporating educational theories and multimedia design principles to update the curriculum for these new learners. The purpose of the study is to discuss strategies for updating an emergency medicine (EM residency program’s curriculum to accommodate the modern learner. Discussion: These 10 tips provide detailed examples and approaches to incorporate technology and learning theories into an EM curriculum to potentially enhance learning and engagement by residents. Conclusion: While it is unclear whether technologies actually promote or enhance learning, millennials use these technologies. Identifying best practice, grounded by theory and active learning principles, may help learners receive quality, high-yield education. Future studies will need to evaluate the efficacy of these techniques to fully delineate best practices.

  8. Getting back into the emergency department: diversifying general practice while relieving emergency medicine workforce shortages.

    Willcock, Simon M

    2008-07-21

    New medical graduates expect to work in an environment that allows scope for flexibility and change across a career in medicine. Recruitment to general practice is adversely affected by its perceived limited scope of practice. Training in procedural and hospital skills is not difficult to access for general practice trainees, but complex and inconsistent credentialling criteria and protectionist attitudes among some specialist colleges mean that many skilled general practitioners are unable to utilise the full range of their skills in clinical practice. The discipline of emergency medicine is also experiencing difficulty in recruiting trainees. The employment of skilled GPs in emergency departments (including metropolitan departments) could improve vocational satisfaction for GPs and emergency physicians, and possibly also improve patient outcomes and flow through the emergency department. PMID:18637784

  9. Nanorobots: The Emerging tools in Medicinal

    Dron P. Modi; Vishvadeep P. Patel; Patel, Ravi B.; Patel, Jay N.; Bhavin V. Bhimani; Ragin R. Shah

    2013-01-01

    Nowadays medical science is more and more improving with the blessings of new scientific discoveries. Nanotechnology is such a field which is changing vision of medical science. New automated procedures are being discovered with new aspects of self-guided nanorobots. Nanorobot is an excellent tool for future medicine. We can envision a day when you could inject billions of these nanorobots that would float around in your body. Nanorobots could carry and deliver drugs into defected cells. Thes...

  10. Radiation accidents and dosimetry

    On September 2nd 1982 one of the employees of the gamma-irradiation facility at Institute for Energy Technology, Kjeller, Norway entered the irradiation cell with a 65.7 kCi *sp60*Co- source in unshielded position. The victim received an unknown radiation dose and died after 13 days. Using electron spin resonance spectroscopy, the radiation dose in this accident was subsequently determined based on the production of longlived free radicals in nitroglycerol tablets borne by the operator during the accident. He used nitroglycerol for heart problems and free radical are easily formed and trapped in sugar which is the main component of the tablets. Calibration experiments were carried out and the dose given to the tablets during the accident was determined to 37.2 +- 0.5 Gy. The general use of free radicals for dose determinations is discussed. (Auth.)

  11. On-site emergency intervention plan for nuclear accident situation at INR-Pitesti TRIGA reactor

    A nuclear incident is defined as a series of events leading to release of radioactive materials into the environment of sufficient concentration to make necessary protective actions. The decision to initiate a protective action is a complex process. The benefits of taking the action is weighed against the involved risk and constraints. In addition the decision will be made under difficult emergency conditions, probably with little detailed information available. Therefore, considerable planing is necessary to reduce to manageable levels the types of decisions leading to effective responses to protect the public in the event of a nuclear incident. The sequence of events for developing emergency plans and responding to nuclear incidents will vary according to individual circumstances, because the international recommendations and site-specific emergency plans cannot provide detailed guidance for all accident scenarios and variations in local conditions. Flexibility must be maintained in emergency response to reflect the actual circumstances encountered (e.g. source term characteristics, the large number of possible weather conditions and environmental situation such as time of the day, season of the year, land use and soil types, population distribution and economic structures, uncertainties in the availability of technical and administrative support and the behaviour of the population). This further complicates the decision-making process, especially under accident conditions where there are time pressures and psychological stress. Therefore one the most important problems in the case of a nuclear emergency is quantifying all these very different types of off-site consequences. Last years, and in particular since the Chernobyl accident, there has been a considerable increase in the resources allocated to development of computerised systems which allow for predicting the radiological impact of accidents and to provide information in a manageable and effective form to

  12. Approved Instructional Resources Series: A National Initiative to Identify Quality Emergency Medicine Blog and Podcast Content for Resident Education.

    Lin, Michelle; Joshi, Nikita; Grock, Andrew; Swaminathan, Anand; Morley, Eric J; Branzetti, Jeremy; Taira, Taku; Ankel, Felix; Yarris, Lalena M

    2016-05-01

    Background Emergency medicine (EM) residency programs can provide up to 20% of their planned didactic experiences asynchronously through the Individualized Interactive Instruction (III) initiative. Although blogs and podcasts provide potential material for III content, programs often struggle with identifying quality online content. Objective To develop and implement a process to curate quality EM content on blogs and podcasts for resident education and III credit. Methods We developed the Approved Instructional Resources (AIR) Series on the Academic Life in Emergency Medicine website. Monthly, an editorial board identifies, peer reviews, and writes assessment questions for high-quality blog/podcast content. Eight educators rate each post using a standardized scoring instrument. Posts scoring ≥ 30 of 35 points are awarded an AIR badge and featured in the series. Enrolled residents can complete an assessment quiz for III credit. After 12 months of implementation, we report on program feasibility, enrollment rate, web analytics, and resident satisfaction scores. Results As of June 2015, 65 EM residency programs are enrolled in the AIR Series, and 2140 AIR quizzes have been completed. A total of 96% (2064 of 2140) of participants agree or strongly agree that the activity would improve their clinical competency, 98% (2098 of 2140) plan to use the AIR Series for III credit, and 97% (2077 of 2140) plan to use it again in the future. Conclusions The AIR Series is a national asynchronous EM curriculum featuring quality blogs and podcasts. It uses a national expert panel and novel scoring instrument to peer review web-based educational resources. PMID:27168891

  13. 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 ...

  14. [Flight and altitude medicine for anesthetists-part 3: emergencies on board commercial aircraft].

    Graf, Jürgen; Stüben, Uwe; Pump, Stefan

    2013-04-01

    The demographic trend of industrialized societies is also reflected in commercial airlines' passengers: passengers are older nowadays and long-haul flights are routine mode of transport despite considerable chronic and acute medical conditions. Moreover, duration of non-stop flight routes and the number of passengers on board increase. Thus, the probability of a medical incident during a particular flight event increases, too.Due to international regulations minimum standards for medical equipment on board, and first aid training of the crews are set. However, it is often difficult to assess whether a stopover at a nearby airport can improve the medical care of a critically ill passenger. Besides flight operations and technical aspects, the medical infrastructure on the ground has to be considered carefully.Regardless of the amount of experience of a physician medical emergencies on board an aircraft usually represent a particular challenge. This is mainly due to the unfamiliar surroundings, the characteristics of the cabin atmosphere, the often existing cultural and language barriers and legal liability concerns. PMID:23633251

  15. A comparative review of accident studies from recent assessments of emergency planning zone boundaries

    Hazards assessments and accompanying accident and human health and risk calculations are routinely done to establish Emergency Planning Zone (EPZ) boundaries for facilities managing hazardous and/or radioactive materials. This paper reviews the underlying US DOE guidance, assesses the degree of conformance to the guidance in recent hazards assessments performed to support selection of EPZ boundaries, and compares the consistency of the accident analysis approaches and underlying key assumptions. Recommendations are made on the basis of these reviews, as well as from knowledge of the approaches used in safety assessments performed in support of safety analysis reports (SARs) and environmental impact statements (EISs)

  16. GIS-based emergency response system for sudden water pollution accidents

    Rui, Yikang; Shen, Dingtao; Khalid, Shoaib; Yang, Zaigui; Wang, Jiechen

    The frequent occurrence of sudden water pollution accidents brings enormous risks to water environment safety. Therefore, there is great need for the modeling and development of early warning systems and rapid response procedures for current water pollution situation in China. This paper proposes an emergency response system based on the integration of Geographic Information System (GIS) technology and a hydraulic/water-quality model. Using the spatial analysis and three-dimensional visualization capabilities of GIS technology, we calculated pollutant diffusion measures, and visualized and analyzed the simulation results, in order to provide the services of early warning and emergency response for sudden water pollution accidents in the Xiangjia Dam area on the Yangtze River. The results show that the proposed system offers reliable technological support for emergency response to sudden water pollution events, and it shows good potential for wide applications in various aspects of water resources protection.

  17. Typical pedestrian accident scenarios for the development of autonomous emergency braking test protocols.

    Lenard, James; Badea-Romero, Alexandro; Danton, Russell

    2014-12-01

    An increasing proportion of new vehicles are being fitted with autonomous emergency braking systems. It is difficult for consumers to judge the effectiveness of these safety systems for individual models unless their performance is evaluated through track testing under controlled conditions. This paper aimed to contribute to the development of relevant test conditions by describing typical circumstances of pedestrian accidents. Cluster analysis was applied to two large British databases and both highlighted an urban scenario in daylight and fine weather where a small pedestrian walks across the road, especially from the near kerb, in clear view of a driver who is travelling straight ahead. For each dataset a main test configuration was defined to represent the conditions of the most common accident scenario along with test variations to reflect the characteristics of less common accident scenarios. Some of the variations pertaining to less common accident circumstances or to a minority of casualties in these scenarios were proposed as optional or supplementary test elements for an outstanding performance rating. Many considerations are incorporated into the final design and implementation of an actual testing regime, such as cost and the state of development of technology; only the representation of accident data lay within the scope of this paper. It would be desirable to ascertain the wider representativeness of the results by analysing accident data from other countries in a similar manner. PMID:25180785

  18. Evaluation of Emergency Medicine Community Educational Program

    Garcia, Estevan Adan

    2010-12-01

    Full Text Available Out-of-hospital emergencies occur frequently, and laypersons are often the first to respond to these events. As an outreach to our local communities, we developed “Basic Emergency Interventions Everyone Should Know,” a three-hour program addressing cardiopulmonary resuscitation and automated external defibrillator use, heart attack and stroke recognition and intervention, choking and bleeding interventions and infant and child safety. Each session lasted 45 minutes and was facilitated by volunteers from the emergency department staff. A self-administered 13-item questionnaire was completed by each participant before and after the program. A total of 183 participants completed the training and questionnaires. Average score pre-training was nine while the average score post-training was 12 out of a possible 13 (P< .0001. At the conclusion of the program 97% of participants felt the training was very valuable and 100% would recommend the program to other members of their community. [West J Emerg Med. 2010;11(5:416-418.

  19. Zoological medicine and public health.

    Chomel, Bruno B; Osburn, Bennie I

    2006-01-01

    Public-health issues regarding zoological collections and free-ranging wildlife have historically been linked to the risk of transmission of zoonotic diseases and accidents relating to bites or injection of venom or toxins by venomous animals. It is only recently that major consideration has been given worldwide to the role of the veterinary profession in contributing to investigating zoonotic diseases in free-ranging wildlife and integrating the concept of public health into the management activities of game preserves and wildlife parks. At the veterinary undergraduate level, courses in basic epidemiology, which should include outbreak investigation and disease surveillance, but also in population medicine, in infectious and parasitic diseases (especially new and emerging or re-emerging zoonoses), and in ecology should be part of the core curriculum. Foreign diseases, especially dealing with zoonotic diseases that are major threats because of possible agro-terrorism or spread of zoonoses, need to be taught in veterinary college curricula. Furthermore, knowledge of the principles of ecology and ecosystems should be acquired either during pre-veterinary studies or, at least, at the beginning of the veterinary curriculum. At the post-graduate level, master's degrees in preventive veterinary medicine, ecology and environmental health, or public health with an emphasis on infectious diseases should be offered to veterinarians seeking job opportunities in public health and wildlife management. PMID:17035205

  20. Quality Assurance in Emergency Medicine - A Caribbean Perspective

    Sammy, I.A.; Paul, J.F.; Watson, H; Williams-Johnson, J; Bullard, C.

    2013-01-01

    Purpose – Emergency medicine is a new specialty in the Caribbean. With the development of specialist training over the past 20 years, the issues of quality assurance and governance have become more prominent. The purpose of this paper is to explore the successes and challenges of implementing systems of quality assurance in this unique environment, highlighting issues peculiar to the Caribbean setting. Design/methodology/approach – This paper is a review of current practice in the e...

  1. Chernobylsk accident (Causes and Consequences)- Part 2

    The causes and consequences of the nuclear accident at Chernobylsk-4 reactor are shortly described. The informations were provided by Russian during the specialist meeting, carried out at seat of IAEA. The Russian nuclear panorama; the site, nuclear power plant characteristics and sequence of events; the immediate measurements after accident; monitoring/radioactive releases; environmental contamination and ecological consequences; measurements of emergency; recommendations to increase the nuclear safety; and recommendations of work groups, are presented. (M.C.K.)

  2. A decision support system for emergency response to major nuclear accidents

    A methodology for the optimization of the short-term emergency response in the event of a nuclear accident is presented. The method seeks an optimum combination of protective actions in the presence of a multitude of conflicting objectives and under uncertainty. Conflicting objectives arise in the attempt to minimize simultaneously the potential adverse effects of an accident and the associated socioeconomic impacts. Additional conflicting objectives arise whenever an emergency plan tends to decrease a particular health effect, such as acute deaths, while it increases another, such as latent deaths. The uncertainty is due to the multitude of possible accident scenarios and their respective probability of occurrence, the stochastic variability in the weather conditions, and the variability and/or lack of knowledge of the parameters of the risk assessment models. A multiobjective optimization approach is adopted. An emergency protection plan consists of defining a protective action at each spatial cell around the plant. Three criteria are used as the objective functions of the problem, namely, acute fatalities, latent effects, and socioeconomic cost. The optimization procedure defines the efficient frontier, i.e., all emergency plans that are not dominated by another in all three criteria. No value trade-offs are necessary up to this point. The most preferred emergency plan is then chosen among the set of efficient plans. Finally, the methodology is integrated into a computerized decision support system, and its use is demonstrated in a realistic application

  3. Upper respiratory tract illnesses and accidents.

    Smith, A P; Harvey, I; Richmond, P; Peters, T J; Thomas, M; Brockman, P

    1994-07-01

    Anecdotal accounts suggest that colds and influenza may increase human error. This view is supported by laboratory studies of the effects of upper respiratory tract illnesses (URTIs) on performance efficiency, which have shown that both experimentally induced and naturally occurring URTIs reduce aspects of performance efficiency. The present research examined the relationship between accidents and URTIs by studying 923 patients attending an Accident and Emergency department at a time of year when upper respiratory tract viruses were circulating. The results revealed no significant associations between URTIs and workplace accidents, and, similarly, no significant associations emerged when all accidents were compared with other attenders. The only effect which was close to statistical significance was a protective effect of influenza against workplace accidents, which could be explained in terms of a person with influenza or who has recently had influenza being less likely to work and therefore less likely to be at risk of experiencing a workplace accident. Further research must examine this topic with different methodologies, such as selecting controls from fellow workers of the index case, and these studies will provide us with a clearer view as to whether or not there is an association between URTIs and workplace accidents. PMID:7919298

  4. Documentation and Coding Education in Emergency Medicine Residency Programs: A National Survey of Residents and Program Directors

    Pines, Jesse M

    2004-01-01

    Full Text Available Purposes: To assess attitudes and practices of documentation and coding education for emergency medicine residents (EMRs. Methods: Questions regarding documentation teaching methods were formulated into online surveys for program directors (PDs and EMRs. Results: Fifty-three of 104 PDs and 446 of 576 EMRs who received the survey completed it. Although 93% of EMRs and 63% of PDs believe proper chart documentation is an important skill, only 18% of EMRs and 25% of PDs believe their program’s teaching was adequate. Eleven percent of EMRs reported that they were comfortable with their knowledge of documentation. EMRs who received formal lectures and feedback reported higher comfort levels with their knowledge of documentation (3.3 + 1.1 vs. 4.5 + 1.4, p < 0.05 than those who did not receive formal lectures and feedback. Conclusions: Although most physicians who were surveyed agreed that documentation and coding is a vital skill, many EMRs and PDs report inadequate instruction. Resident education may benefit from broader implementation of formal lectures and formal feedback on documentation and coding skills.

  5. ALWR severe accident issue resolution in support of updated emergency planning

    The Advanced Light Water Reactor (ALWR) Program in the U.S. is a cooperative, cost-sharing undertaking between the U.S. government, industry, and a number of international participants, with the objective of developing the next generation of nuclear power plants. The ALWR designs emphasize improvements in safety and operational reliability through simplification, improved safety margins, innovative passive safety systems, enhanced man-machine interfaces, and incorporation of the lessons learned from the operation of existing LWR plants. An important component of the improved safety characteristics of ALWRs is the consideration of severe accidents in the plant design. The U.S. Department of Energy (DOE) initiated the Advanced Reactor Severe Accident Program (ARSAP) to assist in the transfer of severe accident technology from the U.S. national laboratories to the industry to implement this approach. The basic design requirements for this new generation of nuclear power plants were developed, under the management of the Electric Power Research Institute (EPRI) by the utilities and documented in the Utility Requirements Document (URD). The URD safety policy is based on the traditional 'defense-in-depth' approach, which emphasizes prevention through safety systems which prevent accidents from progressing to core damage, and mitigation to ensure that accidents are mitigated and contained. In a major departure from previous practice, severe accidents, including postulated core melt events, are specifically included in the defense-in-depth design considerations for ALWRs. As a result of this approach, the emergency planning assumptions and criteria warrant a review and reevaluation for ALWR designs. ALWRs present a risk profile that is significantly different than that which served as the basis for the emergency planning requirements for operating plants. The determination of this profile necessarily requires the characterization of the severe accident response of ALWRs

  6. Rethinking the engineering concept in response of the severe nuclear accident: the idea of emergency engineering

    The chaotic situation on a site that has suffered a severe nuclear accident gives the feeling of an enduring and endless accident. The resilience of a system is its capacity to adapt its operations in order to keep on assuring very specific functions whatever the situation is or becomes. For instance for a nuclear power plant, one of the specific functions is the cooling of the reactor core. Emergency engineering is defined as a whole of measures that would enable the plant to be resilient. Emergency engineering would imply the use of innovative technology means to face unexpected situations (for instance an ice wall to stop radionuclide ground migration) or temporary organisational changes to get timely decisions and adequate ressources. Emergency engineering may become a new concept of nuclear safety. (A.C.)

  7. Adjusting ability and sensibility for an accident

    Adjusting ability (technical competence) and sensibility (consciousness) are the two most important priorities any staff member of any organization should bear in mind while acting during a nuclear or radiological emergency. The discussion is aimed at the national authorities of states which do not have a major nuclear power reactor programme, and especially at the IAEA and WHO: although a decade has gone by, the lessons from the radiological accident in Goiania have not been fully learned. The events which unravelled in the fall of 1987 took the population of the city of Goiania completely by surprise: they did not comprehend what had happened and failed to grasp what measures needed to be taken, a situation which precipitated a very complex psychological reaction, coupled with discrimination. To ensure the safety of radiation sources and nuclear installations, national and international organizations should direct their efforts towards educating and training staff in developing countries who work with ionizing radiation and promoting organizational capacity. This should be done first, by improving safety qualitatively so as to better control the uses of radioactive materials in medicine, agriculture, industry and research, and secondly, by assisting countries without a major nuclear power reactor programme to develop an objective and realistic emergency response training programme. (author)

  8. Quality of Life in Emergency Medicine Specialists of Teaching Hospitals

    Afshin Amini

    2014-08-01

    Full Text Available Introduction: Quality of life (QOL of emergency medicine specialists can be effective in providing services to patients. The aim of the present study was evaluating the lifestyle of emergency medicine practitioners, understanding their problems, and addressing the solutions to enhance and improve their lifestyles, in teaching hospitals in Iran. Method: This descriptive cross-sectional study was conducted on emergency medicine physicians in 10 teaching hospitals of Iran in 2011. Emergency physicians with at least three years of experience who interested in the study, were enrolled in the project. All participants filled out the consent form and QOL questionnaires, then underwent physical examinations and some medical laboratory tests. Categorical variables were reported as percentages, while continuous variables expressed as means and standard deviations. p <0.05 was considered statistically significant. Results: Totally, 100 subjects participated in the study, of whom 48 were male. The mean and standard deviation of the physicians’ age were 38.7±5.1 years. 43% of physicians had an average QOL, while 37% good. 96% of studied physicians had a good condition regarding habitual history, while 93% of them had a poor condition in performing screening tests. Exercise program and personal health in individuals with normal BMI were correlated with higher levels of QOL. BMI was higher in 40-50 years old subjects than youngers. Hypertension was present in five cases (5%, hypercholesterolemia in six (6%, hypertriglyceridemia in six (6%, increased LDL in four (4%, low HDL in four (4%, and impaired FBS in 4 (4%. Conclusion: The findings showed that 63% of studied emergency physicians had an average level of QOL and other ones good. The majority of physicians had undesirable situation regarding the performance of screening tests.

  9. Radiological accidents, scenarios, planning and answers

    Radiological accidents, scenarios and the importance of a good planning to prevent and control these types of accidents are presented. The radiation can be only one of the risks in an accident, most of dominant radiological risks are not radiological (fire, toxic gases, etc.). The common causes of radiological accidents, potential risks such as external irradiation, internal contamination and the environment pollution are highlighted. In addition, why accidents happen and how they evolve is explained. It describes some incidents with the radiation occurred in Costa Rica from 1993 to 2007. The coordination of emergency management in Costa Rica in relation to a radiological accident, and some mechanisms of action that have practiced in other places are focuses. Among the final considerations are the need to finalize the national plan for radiological emergencies as a tool of empowerment for the teams of emergency care and the availability of information. Likewise the processes of communication, coordination and cooperation to avoid chaos, confusion and crisis are also highlighted

  10. On a scale of a nuclear power plant accident resulting in emergency radiation doses

    Described is the technique to determine an accident scale resulting in emergency radiation doses on area, which do not require special emergency protection (Emergency Reference Level - ERL). Calculation results depend on the following parameters: amount of isotopes released from molten fuel element, amount of activity released from technological equipment; amount of activity released from technological space. It is shown that at 50 km distance a gamma radiation field created by the radioactive inert gases cloud does not produce a dose above 25 rem in the open areas, whatever meteorological conditions. Dangerous is iodine-131 effect through inhalation. At 50 km distance, according to Paskville, under A, B and C weather conditions, dose for children thyroid glands will be below 75 rem whatever accident, under D, E and F conditions, the establisched doses could be exceeded, although that would require 11 - 65% molten fuel elements. The most dangerous is the possible way of irradiation of children thyroid gland through contaminated grass-lands (along food chain: air - grass -cowmilk - thyroid gland). The worst conditions at the 50 km distance will be in F weather condition when accident scale is equal to 0.06%. If contaminated milk is excluded from the food at the settlement beginning from 50 km distance there is no need for activity localization special system. Presented radiation effect evaluations for 4 km distance from nuclear power plant in case of different accident scales show, that the protection against iodine isotopes shoubd be main task in providing technical nuclear power plant safety

  11. Factors Applicants Value when Selecting an Emergency Medicine Residency

    Yarris, Lalena M

    2009-08-01

    Full Text Available Objective: Little is known about the factors important to applicants when selecting an emergency medicine residency. We sought to identify which residency-specific criteria applicants value in selecting a training program.Methods: We conducted an anonymous survey of emergency medicine interviewees at our residency. Applicants were asked to rate each of 18 factors on a four-point scale from 1 (“not at all important” to 4 (“very important” in their selection of a residency.Results: Of 82 interviewees, 73 (89% completed the survey. The factors with the top six mean scores were: how happy the residents seemed (3.9, program personality (3.8, faculty enthusiasm (3.7, geographic location (3.6, experience during interview day (3.5, and pediatrics training (3.5.Conclusion: The top three factors deemed most important to emergency medicine applicants are primarily intangibles, while programs have no control over the fourth most important factor, location.[WestJEM. 2009;10:159-162.

  12. Designing an emergency medicine physician workstation to support risk management in decision making.

    Rucker, D. W.; Johannes, R. S.; Finley, S. W.; Kahane, S. N.

    1996-01-01

    The practice of emergency medicine requires rapid decision making. The speed of decision making in the face of limited information contributes to the high risk of medical malpractice suits. We explore design approaches to an emergency physician electronic medical record product, EMstation, that may reduce the risk of adverse medical events by providing cues and tools while the patient may still be in the emergency department. EMstation is an Emergency Medicine Physician Workstation base on a ...

  13. Development of severe accident management advisory and training simulator (SAMAT)

    The most operator support systems including the training simulator have been developed to assist the operator and they cover from normal operation to emergency operation. For the severe accident, the overall architecture for severe accident management is being developed in some developed countries according to the development of severe accident management guidelines which are the skeleton of severe accident management architecture. In Korea, the severe accident management guideline for KSNP was recently developed and it is expected to be a central axis of logical flow for severe accident management. There are a lot of uncertainties in the severe accident phenomena and scenarios and one of the major issues for developing a operator support system for a severe accident is the reduction of these uncertainties. In this paper, the severe accident management advisory system with training simulator, SAMAT, is developed as all available information for a severe accident are re-organized and provided to the management staff in order to reduce the uncertainties. The developed system includes the graphical display for plant and equipment status, the previous research results by knowledge-base technique, and the expected plant behavior using the severe accident training simulator. The plant model used in this paper is oriented to severe accident phenomena and thus can simulate the plant behavior for a severe accident. Therefore, the developed system may make a central role of the information source for decision-making for a severe accident management, and will be used as the training simulator for severe accident management

  14. Emerging applications of radioisotopes in nuclear medicine

    Advances in the domain of radioisotopes and radiopharmaceuticals has been very noteworthy over the past decade and played a major role in enhancing the Nuclear Medicine practice. A number of them have been employed in the day to day clinical practice and have benefited a large number of patients. For the purpose of systematic discussion, we shall classify into two major heads A. Recent advances in clinical applications of traditional radiotracers. B. Newer Radiopharmaceuticals and their applications. The latter could be further subdivided in to the following: (a) Diagnostic (includes i. PET radiopharmaceuticals and ii. Non-PET radiopharmaceuticals for conventional gamma camera imaging) and (b) Therapeutic advances. In the present communication, we shall explore the major developments emphasizing the country perspective

  15. 高等院校开展院前急救技能培训必要性与可行性的探讨%The approach of feasibility and necessity of pre-hospital emergency medicine education in colleges

    吴向辉; 周树生

    2009-01-01

    院前急救的及时性、院前急救的水平和质量对挽救生命和降低致残率至关重要,而急救知识、急救技能的推广和普及是院前急救成功与否的基础.高校大学生在时间、精力、学习能力等方面都优于其他人群,因此,对他们进行急救知识和急救技能的培训,可以带动全民急救水平的提高.%"People-orientated" is the Chinese Communist Party's philosophy. "life comes before everything else" can be demonstrated obviously in some situations including various natural disasters, pub- lie health emergencies and accidents. The pre-hospital emergency care in good time plays an important role in rescuing lives and reducing disabled rate. Public education of emergency first-aid knowledge and skills is the comer-stone of the successful pre-hospital aid. Compared to other groups in the society, undergraduates have enough time and energy as well as the ability to acquire new information and skills. So, it may im- prove the level of first-aid in public to perform the education program on pre-hospital emergency medicine a- mong college students.

  16. The inverted U curve and emergency medicine: Overdiagnosis and the law of unintended consequences.

    Fatovich, Daniel M

    2016-08-01

    We all think and assume that more is better, but unintended consequences can arise in a complex system. However, in our complex world, everything of consequence follows an inverted U curve. The inverted U curve helps us challenge our natural assumption that more is better. This leads us to the issue of overdiagnosis and the harms that result. Journals are now publishing lists of studies where more medical care caused harm. Changing diagnostic thresholds together with the fear of uncertainty by both patients and doctors has a synergistic and costly effect on the health system. The over-reliance on technology tends to supplant clinical judgement. This intervention bias promotes the overutilisation of diagnostic testing. What patients actually value is thinking doctors who talk to them. Promoting clinical judgement reinforces the mantra that less is more, resulting in positively intended consequences. This essay aims to be a thought-provoking commentary of our practice. PMID:27147556

  17. Critical examination of emergency plans for nuclear accidents

    An analysis of emergency plans of various countries for nuclear installations on- and off-site emergency preparedness is presented. The analysis is focused on the off-site organization and countermeasures to protect public health and safety. A critical examination of the different approaches is performed and recommendations for effectiveness improvement and optimization are formulated. (author)

  18. Accidents and human factors

    When the TMI accident occurred it was 4 a.m., an hour when the error potential of the operators would have been very high. The frequency of car and train accidents in Japan is also highest between 4 a.m. and 6 a.m. The error potential may be classified into five phases corresponding to the electroencephalogramic pattern (EEG). At phase 0, when the delta wave appears, a person is unconscious and in deep sleep; at phase I, when the theta wave appears, he is very tired, sleepy and subnormal; at phase II, when the alpha wave appears, he is normal, relaxed and passive; at phase III, when the beta wave appears, he is normal, clear-minded and active; at phase IV, when the strong beta or epileptic wave appears, he is hypernormal, excited and incapable of normal judgement. Should an accident occur at phase II, the brain condition may jump to phase IV. At this phase the error or accident potential is maximum. The response of the human brain to different types of noises and signals may vary somewhat for different individuals and for different groups of people. Therefore, the possibility that such differences in brain functions may influence the mental structure would be worthy of consideration in human factors and in the design of man-machine systems. Human reliability and performance would be affected by many factors: medical, physiological and psychological, etc. The uncertainty involved in human factors may not necessarily be probabilistic, but fuzzy. Therefore, it would be important to develop a theory by which both non-probabilistic uncertainties, or fuzziness, of human factors and the probabilistic properties of machines can be treated consistently. From the mathematical point of view, probabilistic measure is considered a special case of fuzzy measure. Therefore, fuzzy set theory seems to be an effective tool for analysing man-machine systems. To minimize human error and the possibility of accidents, new safety systems should not only back up man and make up for his

  19. Emergency planning lessons learned from a review of past major radiological accidents

    In examining a range of nuclear accidents from the 1950s to the present that were reported in the literature, the authors have identified a number of contributing factors which affected human judgement during these events. One common thread found in a large number of accidents is the time of occurrence; a second is the adequacy of emergency training. The data show that events, whether severe accidents or operational incidents, appear to occur more frequently during off-normal hours such as the early morning shift, weekends, or holidays. Accidents seldom occur during the day shift when the full management team and senior operations personnel are present. As a result, those facility employees most expert in coping with the situation may not be available, and the normal chain of command may be disrupted. At several nuclear power plants, it was also observed that new or less experienced technicians are often assigned to night shifts. The lack of experienced human resources and the pressure of an accident situation can have an adverse impact on individuals who are faced with making important decisions

  20. Discriminating Between Legitimate and Predatory Open Access Journals: Report from the International Federation for Emergency Medicine Research Committee

    Bhakti Hansoti

    2016-09-01

    Full Text Available Introduction: Open access (OA medical publishing is growing rapidly. While subscription-based publishing does not charge the author, OA does. This opens the door for “predatory” publishers who take authors’ money but provide no substantial peer review or indexing to truly disseminate research findings. Discriminating between predatory and legitimate OA publishers is difficult. Methods: We searched a number of library indexing databases that were available to us through the University of California, Irvine Libraries for journals in the field of emergency medicine (EM. Using criteria from Jeffrey Beall, University of Colorado librarian and an expert on predatory publishing, and the Research Committee of the International Federation for EM, we categorized EM journals as legitimate or likely predatory. Results: We identified 150 journal titles related to EM from all sources, 55 of which met our criteria for OA (37%, the rest subscription based. Of these 55, 25 (45% were likely to be predatory. We present lists of clearly legitimate OA journals, and, conversely, likely predatory ones. We present criteria a researcher can use to discriminate between the two. We present the indexing profiles of legitimate EM OA journals, to inform the researcher about degree of dissemination of research findings by journal. Conclusion: OA journals are proliferating rapidly. About half in EM are legitimate. The rest take substantial money from unsuspecting, usually junior, researchers and provide no value for true dissemination of findings. Researchers should be educated and aware of scam journals.

  1. Emergency Response System for Pollution Accidents in Chemical Industrial Parks, China.

    Duan, Weili; He, Bin

    2015-07-01

    In addition to property damage and loss of lives, environment pollution, such as water pollution and air pollution caused by accidents in chemical industrial parks (CIPs) is a significant issue in China. An emergency response system (ERS) was therefore planned to properly and proactively cope with safety incidents including fire and explosions occurring in the CIPs in this study. Using a scenario analysis, the stages of emergency response were divided into three levels, after introducing the domino effect, and fundamental requirements of ERS design were confirmed. The framework of ERS was composed mainly of a monitoring system, an emergency command center, an action system, and a supporting system. On this basis, six main emergency rescue steps containing alarm receipt, emergency evaluation, launched corresponding emergency plans, emergency rescue actions, emergency recovery, and result evaluation and feedback were determined. Finally, an example from the XiaoHu Chemical Industrial Park (XHCIP) was presented to check on the integrality, reliability, and maneuverability of the ERS, and the result of the first emergency drill with this ERS indicated that the developed ERS can reduce delays, improve usage efficiency of resources, and raise emergency rescue efficiency. PMID:26184260

  2. Emergency Response System for Pollution Accidents in Chemical Industrial Parks, China

    Weili Duan

    2015-07-01

    Full Text Available In addition to property damage and loss of lives, environment pollution, such as water pollution and air pollution caused by accidents in chemical industrial parks (CIPs is a significant issue in China. An emergency response system (ERS was therefore planned to properly and proactively cope with safety incidents including fire and explosions occurring in the CIPs in this study. Using a scenario analysis, the stages of emergency response were divided into three levels, after introducing the domino effect, and fundamental requirements of ERS design were confirmed. The framework of ERS was composed mainly of a monitoring system, an emergency command center, an action system, and a supporting system. On this basis, six main emergency rescue steps containing alarm receipt, emergency evaluation, launched corresponding emergency plans, emergency rescue actions, emergency recovery, and result evaluation and feedback were determined. Finally, an example from the XiaoHu Chemical Industrial Park (XHCIP was presented to check on the integrality, reliability, and maneuverability of the ERS, and the result of the first emergency drill with this ERS indicated that the developed ERS can reduce delays, improve usage efficiency of resources, and raise emergency rescue efficiency.

  3. Ready for discharge? A Survey of Discharge Transition of Care Education and Evaluation in Emergency Medicine Residency Programs

    Fiona E. Gallahue

    2015-11-01

    Full Text Available This study aimed to assess current education and practices of emergency medicine (EM residents as perceived by EM program directors to determine if there are deficits in resident discharge handoff training. This survey study was guided by the Kern model for medical curriculum development. A six-member Council of EM Residency Directors (CORD Transitions of Care task force of EM physicians performed these steps and constructed a survey. The survey was distributed to program residency directors via the CORD listserve and/or direct contact. There were 119 responses to the survey, which were collected using an online survey tool. Over 71% of the 167 American College of Graduate Medical Education (ACGME accredited EM residency programs were represented. Of those responding, 42.9% of programs reported formal training regarding discharges during initial orientation and 5.9% reported structured curriculum outside of orientation. A majority (73.9% of programs reported that EM residents were not routinely evaluated on their discharge proficiency. Despite the ACGME requirements requiring formal handoff curriculum and evaluation, many programs do not provide formal curriculum on the discharge transition of care or evaluate EM residents on their discharge proficiency.

  4. Emerging framework of safety management after Fukushima accident

    Since the Fukushima accident onset, concerned organizations and experts have tried to identify the causes and effects of the incident. Many have formulated new national regulatory measures to strengthen nuclear safety in an effort to protect the general public to the extent of probabilistic cases of the most severe or extreme accidents. The Japanese government is set to install a regulatory authority, comparable to the US NRC, which is completely independent from the promotion of nuclear energy. An official report of the National Diet (or Senate) of Japan in June of 2012 laments a lack of safety culture and insists the accident could have been prevented if due consideration and attention had been provided. Both France and other European countries have performed stress tests to their operating units, and have identified many areas for improvement including that of their regulatory framework. The US NRC also conducted special inspections of all operating reactors. In addition, the NRC established both near and long term specific goals, and issued a policy statement for streamlining patch worked regulatory framework. It is also applying the Risk informed Defense in Depth Design which includes the extended design basis requirements. The IAEA General Conference adopted a Nuclear Safety Action Plan in September 2011 and organized an International Expert Meeting in March 2012 in order to analyze all relevant technical aspects from the Japanese incident in order to prevent a reoccurrence. Korea is not an exception to this trend. She was swift to conduct a special inspection of operating reactors and is now implementing many scheduled measures. Numerous facts and insights are now available, not only those gained from the Japanese incident, but also those gleaned from experts worldwide concerning a wide array of information. Therefore, this is an opportunistic time to summarize the insights that have been identified with respect to nuclear safety management and to overview

  5. Emerging framework of safety management after Fukushima accident

    Lee, Joo Sang [TUV SUD KOCEN, Yongin (Korea, Republic of); Rawls, Scott [EXCEL, JP (United States)

    2012-10-15

    Since the Fukushima accident onset, concerned organizations and experts have tried to identify the causes and effects of the incident. Many have formulated new national regulatory measures to strengthen nuclear safety in an effort to protect the general public to the extent of probabilistic cases of the most severe or extreme accidents. The Japanese government is set to install a regulatory authority, comparable to the US NRC, which is completely independent from the promotion of nuclear energy. An official report of the National Diet (or Senate) of Japan in June of 2012 laments a lack of safety culture and insists the accident could have been prevented if due consideration and attention had been provided. Both France and other European countries have performed stress tests to their operating units, and have identified many areas for improvement including that of their regulatory framework. The US NRC also conducted special inspections of all operating reactors. In addition, the NRC established both near and long term specific goals, and issued a policy statement for streamlining patch worked regulatory framework. It is also applying the Risk informed Defense in Depth Design which includes the extended design basis requirements. The IAEA General Conference adopted a Nuclear Safety Action Plan in September 2011 and organized an International Expert Meeting in March 2012 in order to analyze all relevant technical aspects from the Japanese incident in order to prevent a reoccurrence. Korea is not an exception to this trend. She was swift to conduct a special inspection of operating reactors and is now implementing many scheduled measures. Numerous facts and insights are now available, not only those gained from the Japanese incident, but also those gleaned from experts worldwide concerning a wide array of information. Therefore, this is an opportunistic time to summarize the insights that have been identified with respect to nuclear safety management and to overview

  6. Emergency control system based on the analytical hierarchy process and coordinated development degree model for sudden water pollution accidents in the Middle Route of the South-to-North Water Transfer Project in China.

    Long, Yan; Xu, Guobin; Ma, Chao; Chen, Liang

    2016-06-01

    Water transfer projects are important for realizing reasonable allocation of water resources, but once a water pollution accident occurs during such a project, the water environment is exposed to enormous risks. Therefore, it is critical to determine an appropriate emergency control system (ECS) for sudden water pollution accidents that occur in water transfer projects. In this study, the analytical hierarchy process (AHP) integrated with the coordinated development degree model (CDDM) was used to develop the ECS. This ECS was developed into two parts, including the emergency risk assessment and the emergency control. Feasible emergency control targets and control technology were also proposed for different sudden water pollution accidents. A demonstrative project was conducted in the Fangshui to Puyang channel, which is part of the Beijing-Shijiazhuang Emergency Water Supply Project (BSP) in the Middle Route of the South-to-North Water Transfer Project (MR-SNWTP) in China. However, we could not use an actual toxic soluble pollutant to validate our ECS, so we performed the experiment with sucrose to test the ECS based on its concentration variation. The relative error of peak sucrose concentration was less than 20 %. PMID:26979314

  7. The emergence of trust in clinics of alternative medicine.

    Pedersen, Inge Kryger; Hansen, Vibeke Holm; Grünenberg, Kristina

    2016-01-01

    Demands for alternative medicine have increased since the 1970s in nations in which western scientific evidence has become the basis for health care. This paradox has been the impetus to examine how trust emerges in clinics of alternative medicine. Alternative practitioners are self-regulated and the clients pay out of their own pockets to attend non-authorised treatments with very limited scientific evidence of their effects. Trust is a key issue in this context. However, only a few studies have dealt with the ways in which alternative practitioners win their clients' trust. Drawing on three qualitative studies and informing the empirical findings with a sociological concept of trust, this article provides new empirical insights on how trust emerges in Danish clinics of acupuncture, reflexology and homeopathy. The analysis demonstrates how trust is situational and emerges through both clients' susceptibility and practitioners' individual skill development and strategies, as well as from objects, place and space. Trust is developed on relational and bodily as well as material grounds. It is argued that the dynamics and elements of trust identified do not only minimalise uncertainties but sometimes convert these uncertainties into productive new ways for clients to address their ailments, life circumstances and perspectives. PMID:26403077

  8. Defensive medicine in the emergency department. The clinicians’ perspective

    Gianfranco Cervellin

    2016-05-01

    Full Text Available The overuse of medical services is regarded as a growing problem in Western countries, accounting for up to 30% of all delivered care, and carrying a higher risk of morbidity and mortality. One of the leading drivers toward medical overuse is the so-called defensive medicine, which is commonly defined as ordering of tests, procedures, and visits, or, at variance, avoidance of high-risk patients or procedures, aimed to reduce exposure to malpractice liability. Defensive medicine may increase the amount of care provided to the patients (i.e., additional tests or therapies, change care or setting of care (i.e., patients referred to another specialist or another healthcare facility, or impair the optimal care (i.e., refusing risky patients. Some studies seem to confirm a large utilization of defensive medicine in the emergency departments. This article tries to analyze some key points capable to pave the way to a consistent reduction of defensive medicine, thus defining a hierarchical list of priorities, keeping the patient’s health always at the center of the matter.

  9. A two-stage optimization model for emergency material reserve layout planning under uncertainty in response to environmental accidents.

    Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Liu, Rentao; Wang, Peng

    2016-06-01

    In the emergency management relevant to pollution accidents, efficiency emergency rescues can be deeply influenced by a reasonable assignment of the available emergency materials to the related risk sources. In this study, a two-stage optimization framework is developed for emergency material reserve layout planning under uncertainty to identify material warehouse locations and emergency material reserve schemes in pre-accident phase coping with potential environmental accidents. This framework is based on an integration of Hierarchical clustering analysis - improved center of gravity (HCA-ICG) model and material warehouse location - emergency material allocation (MWL-EMA) model. First, decision alternatives are generated using HCA-ICG to identify newly-built emergency material warehouses for risk sources which cannot be satisfied by existing ones with a time-effective manner. Second, emergency material reserve planning is obtained using MWL-EMA to make emergency materials be prepared in advance with a cost-effective manner. The optimization framework is then applied to emergency management system planning in Jiangsu province, China. The results demonstrate that the developed framework not only could facilitate material warehouse selection but also effectively provide emergency material for emergency operations in a quick response. PMID:26897572

  10. The Nuclear Emergency Assistance Team, a mobile intervention facility for nuclear accidents

    A nuclear emergency assistance team consisting of a vehicle pool and a stock of technical equipment was set up for operation in case of major reactor accidents. The equipment is kept in 6 containers which can be shipped on trucks, by rail or by helicopter or plane. Technical equipment and tasks of each container are briefly explained. Special transport vehicles for remote handling of contaminated material are described. (ORU)

  11. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway

    Staff Trine; Søvik Signe

    2011-01-01

    Abstract Background Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS) documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs). Methods Records from police, Emergency Medical Communication Centers (EMCC), ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS), respiratory rate (RR), and systolic...

  12. A probable radiological emergency in nuclear medicine

    Full text: When a therapeutic dose of 131 I is indicated, especially in the thyroid carcinomas, the authorized doctor must always have present the possibility that the patient eliminates high activities of the radio-active material with the vomit. Keeping in mind that dose of 100 to 200 mCi is habitual in the carcinoma of thyroid, this episode can constitute a true radiological emergency, particularly because the first ones in taking knowledge of the fact can be people without appropriate preparation to this situation, what can cause contaminations difficult to manage them. Because it is not acceptable that a source open of high activity remains without treatment long time, the authorized doctor must act immediately, for that which should be prepared with anticipation, and have the necessary elements, to have an operative routine and to administer the storage of the polluted elements appropriately. To such an effect, we have orchestrated a sequential program of performance of 11 points, in the cases of plentiful vomits, with contamination of floors and things of the room. The program begins with the writing instructions for the patient and the personnel of infirmary in case of feeling desires to vomit, and de program is completed in case of being necessary. The elements are detailed in a handbag that contains for radiological emergencies for vomit. It notes that the low cost of the elements and clothes kind for surgery disposable. It discusses about the necessity of having prepared rooms for to receive patient with treatment with 131 I, in the clinics and public hospitals. (author)

  13. PREPARE: innovative integrated tools and platforms for radiological emergency preparedness and post-accident response in Europe.

    Raskob, Wolfgang; Schneider, Thierry; Gering, Florian; Charron, Sylvie; Zhelezniak, Mark; Andronopoulos, Spyros; Heriard-Dubreuil, Gilles; Camps, Johan

    2015-04-01

    The PREPARE project that started in February 2013 and will end at the beginning of 2016 aims to close gaps that have been identified in nuclear and radiological preparedness in Europe following the first evaluation of the Fukushima disaster. Among others, the project will address the review of existing operational procedures for dealing with long-lasting releases and cross-border problems in radiation monitoring and food safety and further develop missing functionalities in decision support systems (DSS) ranging from improved source-term estimation and dispersion modelling to the inclusion of hydrological pathways for European water bodies. In addition, a so-called Analytical Platform will be developed exploring the scientific and operational means to improve information collection, information exchange and the evaluation of such types of disasters. The tools developed within the project will be partly integrated into the two DSS ARGOS and RODOS. PMID:25227442

  14. PREPARE: innovative integrated tools and platforms for radiological emergency preparedness and post-accident response in Europe

    The PREPARE project that started in February 2013 and will end at the beginning of 2016 aims to close gaps that have been identified in nuclear and radiological preparedness in Europe following the first evaluation of the Fukushima disaster. Among others, the project will address the review of existing operational procedures for dealing with long-lasting releases and cross-border problems in radiation monitoring and food safety and further develop missing functionalities in decision support systems (DSS) ranging from improved source-term estimation and dispersion modelling to the inclusion of hydrological pathways for European water bodies. In addition, a so-called Analytical Platform will be developed exploring the scientific and operational means to improve information collection, information exchange and the evaluation of such types of disasters. The tools developed within the project will be partly integrated into the two DSS ARGOS and RODOS. (authors)

  15. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

    Stell, I M

    1996-01-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirat...

  16. In-Training Practice Patterns of Combined Emergency Medicine/Internal Medicine Residents, 2003-2007

    Todd A Templeman

    2011-05-01

    Full Text Available Introduction: This study seeks to evaluate the practice patterns of current combined emergency medicine/internal medicine (EM/IM residents during their training and compare them to the typical practice patterns of EM/IM graduates. We further seek to characterize how these current residents perceive the EM/IM physician’s niche. Methods: This is a multi-institution, cross-sectional, survey-based cohort study. Between June 2008 and July 2008, all 112 residents of the 11 EM/IM programs listed by the Accreditation Council for Graduate Medical Education were contacted and asked to complete a survey concerning plans for certification, fellowship, and practice setting. Results: The adjusted response rate was 71%. All respondents anticipated certifying in both specialties, with 47% intending to pursue fellowships. Most residents (97% allotted time to both EM and IM, with a median time of 70% and 30%, respectively. Concerning academic medicine, 81% indicated intent to practice academic medicine, and 96% planned to allocate at least 10% of their future time to a university/academic setting. In evaluating satisfaction, 94% were (1 satisfied with their residency choice, (2 believed that a combined residency will advance their career, and (3 would repeat a combined residency if given the opportunity. Conclusion: Current EM/IM residents were very content with their training and the overwhelming majority of residents plan to devote time to the practice of academic medicine. Relative to the practice patterns previously observed in EM/IM graduates, the current residents are more inclined toward pursuing fellowships and practicing both specialties. [West J Emerg Med. 2011;12(4:530–536.

  17. Integrating the Accreditation Council for Graduate Medical Education Core competencies into the model of the clinical practice of emergency medicine.

    Chapman, Dane M; Hayden, Stephen; Sanders, Arthur B; Binder, Louis S; Chinnis, Ann; Corrigan, Kelly; LaDuca, Tony; Dyne, Pam; Perina, Debra G; Smith-Coggins, Rebecca; Sulton, Larry; Swing, Susan

    2004-06-01

    In response to public pressure for greater accountability from the medical profession, a transformation is occurring in the approach to medical education and assessment of physician competency. Over the past 5 years, the Accreditation Council for Graduate Medical Education (ACGME) has implemented the Outcomes and General Competencies projects to better ensure that physicians are appropriately trained in the knowledge and skills of their specialties. Concurrently, the American Board of Medical Specialties, including the American Board of Emergency Medicine (ABEM), has embraced the competency concept. The core competencies have been integral in ABEM's development of Emergency Medicine Continuous Certification and the development of the Model of Clinical Practice of Emergency Medicine (Model). ABEM has used the Model as a significant part of its blueprint for the written and oral certification examinations in emergency medicine and is fully supportive of the effort to more fully define and integrate the ACGME core competencies into training emergency medicine specialists. To incorporate these competencies into our specialty, an Emergency Medicine Competency Taskforce (Taskforce) was formed by the Residency Review Committee-Emergency Medicine to determine how these general competencies fit in the Model. This article represents a consensus of the Taskforce with the input of multiple organizations in emergency medicine. It provides a framework for organizations such as the Council of Emergency Medicine Residency Directors (CORD) and the Society for Academic Emergency Medicine to develop a curriculum in emergency medicine and program requirement revisions by the Residency Review Committee-Emergency Medicine. In this report, we describe the approach taken by the Taskforce to integrate the ACGME core competencies into the Model. Ultimately, as competency-based assessment is implemented in emergency medicine training, program directors, governing bodies such as the ACGME

  18. Salvia divinorum: from Mazatec medicinal and hallucinogenic plant to emerging recreational drug.

    Zawilska, Jolanta B; Wojcieszak, Jakub

    2013-09-01

    Salvia divinorum is a sage endemic to a small region of Mexico and has been traditionally used by the Mazatec Indians for divination and spiritual healing. Recently, it has gained increased popularity as a recreational drug, used by adolescents and young adults as an alternative to marijuana and LSD. Salvinorin A, the major active ingredient of the plant, is considered to be the most potent known hallucinogen of natural origin. This review surveys the current state of knowledge on the neurochemical, pharmacokinetic, and pharmacological properties of salvinorin A, the trends and motivation behind S. divinorum use, and the health problems among users of the plant's products. S. divinorum induces intense, but short-lived, psychedelic-like changes in mood and perception, with concomitant hallucinations and disorientation. Many websites have misinterpreted the limited existing research-based information on the side effects of salvia as evidence for its safety. However, data accumulated over the last few years indicate that potential health risks are associated with the use of S. divinorum, especially by teenagers, users of other substances of abuse, and individuals with underlying psychotic disturbances. Taken together, the data presented in this review point to the need for further basic and clinical studies to create a basis for the development of well-addressed prevention and treatment strategies. PMID:23794315

  19. Effects of a Web-based Educational Module on Pediatric Emergency Medicine Physicians’ Knowledge, Attitudes, and Behaviors Regarding Youth Violence

    Tracy E. Madsen

    2014-08-01

    Full Text Available Introduction: Youth seen in the emergency department (ED with injuries from youth violence (YV have increased risk for future violent injury and death. Pediatric emergency medicine (PEM physicians rarely receive training in, or perform, YV screening and intervention. Our objective was to examine effects of a web-based educational module on PEM physicians’ knowledge, attitudes, and behaviors regarding YV screening and interventions in the ED. Methods: We invited all PEM fellows and attendings at an urban Level I pediatric trauma center to complete an interactive web-based education module (and 1-month booster with information on YV’s public health impact and how to screen, counsel and refer YV-involved patients. Consenting subjects completed electronic assessments of YV prevention knowledge and attitudes (using validated measures when possible before and after the initial module and after the booster. To measure behavior change, chart review identified use of YV-specific discharge instructions in visits by YV-injured PEM patients (age 12–17; identified by E codes 6 months before and after the intervention. We analyzed survey data were analyzed with Fisher’s exact for binary outcomes and Kruskal-Wallis for Likert responses. Proportion of patients given YV discharge instructions before and after the intervention was compared using chi-square. Results: Eighteen (67% of 27 PEM physicians participated; 1 was lost at post-module assessment and 5 at 1 month. Module completion time ranged from 15–30 minutes. At baseline, 50% of subjects could identify victims’ re-injury rate; 28% were aware of ED YV discharge instructions. After the initial module and at 1 month, there were significant increases in knowledge (p,0.001 and level of confidence speaking with patients about avoiding YV (p¼0.01, df¼2. Almost all (94% said the module would change future management. In pre-intervention visits, 1.6% of patients with YV injuries were discharged with

  20. Coherent Raman scattering microscopy: an emerging platform for biology and medicine (Conference Presentation)

    Xie, Sunney S.

    2016-03-01

    Stimulated Raman scattering (SRS) microscopy is a label-free and noninvasive imaging technique using vibration spectroscopy as the contrast mechanism. Recent advances have allowed significant improvements in sensitivity, selectivity, robustness, and cost reduction, opening a wide range of biomedical applications. In particular, it provides instant tissue examination without the need of previous histological staining, and is best suited for imaging small metabolite molecules. An overview will be given to a variety of biomedical applications of SRS microscopy.

  1. Vibrational spectroscopic imaging of living systems: An emerging platform for biology and medicine.

    Cheng, Ji-Xin; Xie, X Sunney

    2015-11-27

    Vibrational spectroscopy has been extensively applied to the study of molecules in gas phase, in condensed phase, and at interfaces. The transition from spectroscopy to spectroscopic imaging of living systems, which allows the spectrum of biomolecules to act as natural contrast, is opening new opportunities to reveal cellular machinery and to enable molecule-based diagnosis. Such a transition, however, involves more than a simple combination of spectrometry and microscopy. We review recent efforts that have pushed the boundary of the vibrational spectroscopic imaging field in terms of spectral acquisition speed, detection sensitivity, spatial resolution, and imaging depth. We further highlight recent applications in functional analysis of single cells and in label-free detection of diseases. PMID:26612955

  2. Stress and Immune Function during Pregnancy: An Emerging Focus in Mind-Body Medicine

    Christian, Lisa M.

    2015-01-01

    Maternal psychosocial stress during pregnancy is associated with risks to maternal health, birth outcomes, as well as adverse health and behavioral outcomes in offspring. Maternal immune dysregulation, particularly disruption of inflammatory processes, is also implicated in adverse perinatal health outcomes, with the greatest evidence in relation to preterm birth. Increasingly, the extent to which psychosocial stress induces dysregulation of inflammatory processes during pregnancy is being co...

  3. Radiation accidents and defence of population

    Full text: Development of nuclear physics, the fundamental and the applied researches in the field of radioactive insured wide possibility for application of radionuclides and ionizing radiation source in the different fields of national economy. Application of radionuclides in chemical, metallurgical, food industry, in agriculture and etc. Fields provide a large economic profit. It's hard to apprise significance of ionizing radiation source using in medicine for diagnostics and treatment of different disease. Nuclear power engineering and nuclear industry are developing intensively. At same time nuclear power, ionizing radiation sources incur potential treat for surroundings and health of population. As even that stage of protective measure development: there is no possibility of that happening of radiation accidents. A radiation accident qualifies as loss of ionizing radiation sources direction, which provoked by disrepair equipment, natural calamity or other causes which could bring to unplanned irradiation of population or radioactive pollution of surroundings. At present some following typical cases connected with radiation accident have been chosen: Contentious using or keeping of ionizing radiation source with breach of established requires; Loss, theft of ionizing radiation sources or radiation plants, instruments; Leaving the sources of ionizing radiation in the holes; Refusal radiation technic exploited in industry, medicine, SRI and etc; Disrepair in nuclear transport means of conveyance; Crashes and accidents at NPP and at other enterprises of nuclear industry. The radiation accidents according to character, degree and scales have been divided into two groups: Radiation accidents not connected with NPP; Accidents in the nuclear engineering and industry; The radiation accidents not connected with NPP according their consequence divide into 5 groups; accidents which do not come to irradiation of personal, persons from population (more PN-permissible norm

  4. 核事故后果评价与应急决策支持系统研究%Study on Nuclear Accident Consequence Assessment and Emergency Decision Support System

    王川; 周昌; 郑谦

    2013-01-01

    The research and development of Nuclear Accident Consequence Assessment System(NACAS)and Nuclear Accident Emergency Decision Support System(NAEDSS)is analyzed all over the world,the paper especially describes the exploitation situation and main features of NARAC(USA),the WSPEEDI(Japan)and RODOS(European Communities).In the paper,development of NAEDSS is discussed through introducing development of nuclear accident emergency decision support system and existing problems all over the world.With more and more attention to nuclear energy in society,we still have a long road to improve our nuclear accident consequence assessment and NAEDSS in recent years.%对比分析了国内外在核事故后果评价/应急决策支持系统领域开展的研究进展与成果,重点介绍了美国的NARAC系统、日本的WSPEEDI系统以及欧共体的RODOS系统的开发情况及主要性能.通过回顾我国核事故决策支持系统的发展概况,以及国内外现有核事故应急决策支持系统亟待解决的问题,讨论了下一代核事故应急决策支持系统的发展方向.

  5. Characterization of victims of aggression and transportation accidents treated at the Forensic Medicine and Dentistry Institute - Campina Grande, Paraíba, Brazil - 2010

    Sergio d'Avila; Ana Cristina Campos; Gigliana Maria Sobral Cavalcante; Carlos Jose de Paula Silva; Lorena Marques da Nóbrega; Efigenia Ferreira e Ferreira

    2015-01-01

    The objective of this cross-sectional census study was to characterize agression and land-based transport accidents in a city in the Northeast of Brazil. Data was analyzed from live victims who were treated at a forensic service (N = 2.379). In the descriptive analysis, the majority of events were represented by aggression (71.6%); which occurred on weekdays (65%), with 35.1% at night. Trauma occurred to the whole body (63.6%) and to soft tissue (74.2%). On the basis of multiple correspondenc...

  6. Smart vital signs and accident monitoring system for motorcyclists embedded in helmets and garments for advanced eCall emergency assistance and health analysis monitoring

    Melcher, Vivien; Diederichs, Frederik; Maestre, Rafael; Hofmann, Christian; Nacenta, Jose-Maria; Gent, Jos van; Kusic, Dragan; Zagar, Bostjan

    2015-01-01

    The EU funded project i-VITAL investigates an advanced eCall system for motorcycles. Within the consortium three participating SME companies, NZI (helmet manufacturer), Lookwell (garment manufacturer) and CAP (polymer manufacturer) are working together with three research institutes (CETEM, Fraunhofer and TECOS) on a novel vital sign monitoring and accident detection system to be seamlessly integrated into helmets and garments. The project develops and tests sensors to measure vital data of r...

  7. Emergency Medicine: On the Frontlines of Medical Education Transformation.

    Holmboe, Eric S

    2015-11-01

    Emergency medicine (EM) has always been on the frontlines of healthcare in the United States. I experienced this reality first hand as a young general medical officer assigned to an emergency department (ED) in a small naval hospital in the 1980s. For decades the ED has been the only site where patients could not be legally denied care. Despite increased insurance coverage for millions of Americans as a result of the Affordable Care Act, ED directors report an increase in patient volumes in a recent survey.1 EDs care for patients from across the socioeconomic spectrum suffering from a wide range of clinical conditions. As a result, the ED is still one of few components of the American healthcare system where social justice is enacted on a regular basis. Constant turbulence in the healthcare system, major changes in healthcare delivery, technological advances and shifting demographic trends necessitate that EM constantly adapt and evolve as a discipline in this complex environment. PMID:26594269

  8. Time-Driven Activity-Based Costing in Emergency Medicine.

    Yun, Brian J; Prabhakar, Anand M; Warsh, Jonathan; Kaplan, Robert; Brennan, John; Dempsey, Kyle E; Raja, Ali S

    2016-06-01

    Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine which interventions might improve value for their patients. Although ongoing research may determine which outcomes are meaningful, an accurate costing system is also needed. This article reviews current costing mechanisms in the ED and their pitfalls. It then describes how time-driven activity-based costing may be superior to these current costing systems. Time-driven activity-based costing, in addition to being a more accurate costing system, can be used for process improvements in the ED. PMID:26365921

  9. School Nurses on the Front Lines of Medicine: Emergencies 101 Ask the E.R. Pediatrician.

    Olympia, Robert P

    2016-03-01

    Pediatric emergencies, such as the exacerbation of medical conditions and injuries, may occur in the school setting. This article introduces the "School Nurses on the Front Lines of Medicine" series by discussing the incidence and the most common emergencies that occur in schools as well as published guidelines for school emergency preparedness. PMID:26847134

  10. Retrospective analysis of the role and performance of family medicine versus emergency medical services in the pre-hospital management of patients with AMI in Banja Luka

    Biljana Lakić

    2016-05-01

    Full Text Available Objective. The aim of this study was to investigate the differences in pre-hospital care of patients with acute myocardial infarction between emergency medical services and family medicine. Patients and methods. This retrospective descriptive study included patients treated for acute myocardial infarction at the University Clinical Centre of Banja Luka, in the period from 1st January to 31st December 2011. The patients were divided into two groups: patients who received a hospital referral from the family medicine service and those who received one from the emergency medical service. Results. The majority of patients (54.8% received pre-hospital care from emergency medical services, while in 24.8% of cases the care was provided by family medicine physicians. The analysis showed that the time that passed from the onset of symptoms to the visit to the health institution of first medical contact was shorter in the emergency medical service (p<0.001. The average time from the onset of symptoms to arrival at the family practice was 24 hours, and to the emergency service 2 hours. The patients who established their first medical contact with the emergency service reported more severe symptoms than the ones who visited a family practice over the same period of time. Conclusion. The severity of symptoms affected the patients’ decisions to seek help in a timely manner and to choose the facility of first medical contact. Interventions to decrease delay must focus on improving public awareness of acute myocardial infarction symptoms and increasing their knowledge of the benefits of early medical contact and treatment. Continuing education of family practitioners in this field is required.

  11. Improvements in emergency management in nuclear power plants after the Fukushima accident: ORE, CAE and CAGE; Mejoras en la gestion de emergencias en centrales nucleares tras el accidente de Fukushima: ORE, CAE y CAGE

    Gimenez Gonzalez, S.; Sanchez Lombardia, A.; Martin Calvarro, J. M.; Calvin Cuartero, M.

    2016-08-01

    After Fukushima accident European NPP safety was checked by means of homogenous stress test promoted by European council. At Spain CSN issued Technical instructions to confirm safety NPP margins were appropriate . As a result of this assessment licensees promoted improving NPP safety by strengthen ERO; a new Support Emergency center (CAE) and construction of a new alternative management centre (CAGE) at each site. European countries have been improving and reinforced NPP safety in a similar way to Spain. (Author)

  12. 49 CFR 835.11 - Obtaining Board accident reports, factual accident reports, and supporting information.

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Obtaining Board accident reports, factual accident... Board accident reports, factual accident reports, and supporting information. It is the responsibility... obtain Board accident reports, factual accident reports, and accompanying accident docket files....

  13. An evidence-based guideline in preventing hypothermia for adult trauma patients in accident and emergency department

    Wong, Lai-hung; 黃麗虹

    2013-01-01

    Hypothermia is commonly found in injured victims who suffer from central nervous system injury, hypovolemic shock, exposure to environment, administration of anesthetic drugs and cold intravenous fluid. All these factors decrease the abilities of trauma victims to maintain normothermia and conserve body heat. Hypothermia in injured victim is a significant contributor to a well known cycle—triad of death and associated with increased mortality, morbidity and length of hospital stay. Hypothermi...

  14. Learning Curves for Direct Laryngoscopy and GlideScope® Video Laryngoscopy in an Emergency Medicine Residency

    John C. Sakles

    2014-11-01

    Full Text Available Introduction: Our objective is to evaluate the resident learning curves for direct laryngoscopy (DL and GlideScope® video laryngoscopy (GVL over the course of an emergency medicine (EM residency training program. Methods: This was an analysis of intubations performed in the emergency department (ED by EM residents over a seven-year period from July 1, 2007 to June 30, 2014 at an academic ED with 70,000 annual visits. After EM residents perform an intubation in the ED they complete a continuous quality improvement (CQI form. Data collected includes patient demographics, operator post- graduate year (PGY, difficult airway characteristics (DACs, method of intubation, device used for intubation and outcome of each attempt. We included in this analysis only adult intubations performed by EM residents using a DL or a standard reusable GVL. The primary outcome was first pass success, defined as a successful intubation with a single laryngoscope insertion. First pass success was evaluated for each PGY of training for DL and GVL. Logistic mixed-effects models were constructed for each device to determine the effect of PGY level on first pass success, after adjusting for important confounders. Results: Over the seven-year period, the DL was used as the initial device on 1,035 patients and the GVL was used as the initial device on 578 patients by EM residents. When using the DL the first past success of PGY-1 residents was 69.9% (160/229; 95% CI 63.5%-75.7%, of PGY-2 residents was 71.7% (274/382; 95% CI 66.9%-76.2%, and of PGY-3 residents was 72.9% (309/424; 95% CI 68.4%-77.1%. When using the GVL the first pass success of PGY-1 residents was 74.4% (87/117; 95% CI 65.5%-82.0%, of PGY-2 residents was 83.6% (194/232; 95% CI 76.7%-87.7%, and of PGY-3 residents was 90.0% (206/229; 95% CI 85.3%-93.5%. In the mixed-effects model for DL, first pass success for PGY-2 and PGY-3 residents did not improve compared to PGY-1 residents (PGY-2 aOR 1.3, 95% CI 0.9-1.9; p

  15. Assessing Knowledge Base on Geriatric Competencies for Emergency Medicine Residents

    Teresita M. Hogan

    2014-07-01

    Full Text Available Introduction: Emergency care of older adults requires specialized knowledge of their unique physiology, atypical presentations, and care transitions. Older adults often require distinctive assessment, treatment and disposition. Emergency medicine (EM residents should develop expertise and efficiency in geriatric care. Older adults represent over 25% of most emergency department (ED volumes. Yet many EM residencies lack curricula or assessment tools for competent geriatric care. Fully educating residents in emergency geriatric care can demand large amounts of limited conference time. The Geriatric Emergency Medicine Competencies (GEMC are high-impact geriatric topics developed to help residencies efficiently and effectively meet this training demand. This study examines if a 2-hour didactic intervention can significantly improve resident knowledge in 7 key domains as identified by the GEMC across multiple programs. Methods: A validated 29-question didactic test was administered at six EM residencies before and after a GEMC-focused lecture delivered in summer and fall of 2009. We analyzed scores as individual questions and in defined topic domains using a paired student t test. Results: A total of 301 exams were administered; 86 to PGY1, 88 to PGY2, 86 to PGY3, and 41 to PGY4 residents. The testing of didactic knowledge before and after the GEMC educational intervention had high internal reliability (87.9%. The intervention significantly improved scores in all 7 GEMC domains (improvement 13.5% to 34.6%; p<0.001. For all questions, the improvement was 23% (37.8% pre, 60.8% post; P<0.001 Graded increase in geriatric knowledge occurred by PGY year with the greatest improvement post intervention seen at the PGY 3 level (PGY1 19.1% versus PGY3 27.1%. Conclusion: A brief GEMC intervention had a significant impact on EM resident knowledge of critical geriatric topics. Lectures based on the GEMC can be a high-yield tool to enhance resident knowledge of

  16. Predictors of unintentional childhood injuries seen at the Accident and Emergency Units of three tertiary health care centres in Jos

    Bulus J

    2015-12-01

    Full Text Available Background: Unintentional childhood injuries pose a major health challenge especially in developing countries. Aim: This study sought to determine the predictors of unintentional childhood injuries in the three tertiary health centres studied. Methods: The study was a cross- sectional study. Sociodemographic data, history and physical examination, type of injury and the outcomes were obtained using structured questionnaire. Results: A total of 174 children were enrolled, 108 (62.1% were males and 66 (37.9% were females; 63 (36.2% were 10 years. Of the injuries observed; 99 (56.9% were by vehicular objects, 15 (8.6% were burns, 41 (23.6% were from falls and 19 (10.9% poisoning. Those who were treated as outpatients were 141 (81.0% and 25 (14.4% were admitted for inpatient care. About ninety four percent (94.3% of the children had no significant effect or disability, 3.4% had short-term disability while 2.3% had long term disabilities or died post-injury. There was no statistically significant relationship between the age of the subjects, gender, duration of the injury prior to presentation and the educational status of their care givers with the pattern of the injury. Conclusion: This study showed that 81% (141 of the children studied were treated as outpatients, 56.9% were by vehicular objects, 62.1% were in males and the pattern of injuries were not related to age, gender, educational status of care givers, place or time of injuries. There is need to incorporate these findings in the provision of preventive messages in school health services and in the interventions targeting the safety of children against injuries. Further studies to identify risk factors and plan necessary interventions will also be necessary.

  17. Medical response and management of radiation accidents

    An overview is provided of educational programs and principles essential to the appropriate medical management of radiation accident victims. Such an education program will provide details of the physical properties of radiation, of the sources of radiation exposure, of radiation protection standards and of biological radiation effects. The medical management of individuals involved in radiation accidents is discussed. Such management includes emergency medical stabilization, locating and quantitating the level and degree of internal and/or external contamination, wound decontamination, medical surveillance and the evaluation and treatment of local radiation injuries

  18. Complementary and Alternative Medicine

    ... Help a Friend Who Cuts? Complementary and Alternative Medicine KidsHealth > For Teens > Complementary and Alternative Medicine Print ... replacement. continue How Is CAM Different From Conventional Medicine? Conventional medicine is based on scientific knowledge of ...

  19. Accidents, probabilities and consequences

    Following brief discussion of the safety of wind-driven power plants and solar power plants, some aspects of the safety of fast breeder and thermonuclear power plants are presented. It is pointed out that no safety evaluation of breeders comparable to the Rasmussen investigation has been carried out and that discussion of the safety aspects of thermonuclear power is only just begun. Finally, as an illustration of the varying interpretations of risk and safety analyses, four examples are given of predicted probabilities and consequences in Copenhagen of the maximum credible accident at the Barsebaeck plant, under the most unfavourable meterological conditions. These are made by the Environment Commission, Risoe Research Establishment, REO (a pro-nuclear group) and OOA (an anti-nuclear group), and vary by a factor of over 1000. (JIW)

  20. Counterregulatory hormones in insulin-treated diabetic patients admitted to an accident and emergency department with hypoglycaemia

    Hvidberg, A; Christensen, N J; Hilsted, Jannik

    1998-01-01

    and 30-120 min after treatment. Pre-treatment counterregulatory hormone concentrations were significantly lower than hormone concentrations during induced hypoglycaemia in healthy control subjects but significantly higher than healthy fasting concentrations for plasma adrenaline (p = 0.020), glucagon......, although to a lesser degree than might be expected. Plasma glucose did not differ significantly between the two treatments at any time point. Despite access to food, one of four patients in group B and one of five patients in group A had plasma glucose below 4.0 mmol l(-1) after 120 min. In conclusion, low...