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.

    OpenAIRE

    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

    International Nuclear Information System (INIS)

    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

    International Nuclear Information System (INIS)

    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

    Energy Technology Data Exchange (ETDEWEB)

    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

    International Nuclear Information System (INIS)

    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

    DEFF Research Database (Denmark)

    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. Occupational accidents and forensic medicine in Turkey.

    Science.gov (United States)

    Ince, Haluk; Ince, Nurhan; Ozyildirim, Bedia Ayhan

    2006-01-01

    In Turkey, evaluation of the ratio of loss of working capacity is made according to various laws and regulations. These laws and regulations use different standards in computing the above-mentioned ratio depending on the professional status of the worker, whether he or she is a member of SSK (Social Security Institution) or ES (The Retirement Pension Institution) system. The aim of this study is to point out at the differences and deficiencies in computing the degree of disability and at the need to bring common standards to these computations. This prospective descriptive research is based on the cases of occupational accidents and occupational diseases brought to the 3rd specialized branch of the Institution of Forensic Medicine (which is the highest ruling instance concerning the decision on this field). Of the 164 accident cases included in this research, 95.1% are males, and 4.9% females. According to distribution by age of the cases, the modal group is respectively (30-39) years for men and (12-19) years for women. 43.8% of the injuries were localized at the hand or wrist. No meaningful statistical relationship could be found between the level of qualification of the workers (skilled-unskilled) and the proportion of those suffering from total disability. For the cases included in the categories 3, 4 and 5 is the ES system; the ratio of disability was similar to those computed according to the SSK system. In conclusion, we would like to insist on the need for our country to amend our laws and regulations according to changing and prevailing conditions and sex differentials and to bring homogeneous standards for all workers.

  8. Guidelines for accident prevention and emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Fthenakis, V.M.; Morris, S.C.; Moskowitz, P.D.

    1993-05-01

    This report reviews recent developments in the guidelines on chemical accident prevention, risk assessment, and management of chemical emergencies, principally in the United States and Europe, and discusses aspects of their application to developing countries. Such guidelines are either in the form of laws or regulations promulgated by governments, or of recommendations from international, professional, or non governmental organizations. In many cases, these guidelines specify lists of materials of concern and methods for evaluating safe usage of these materials and recommend areas of responsibility for different organizations; procedures to be included in planning, evaluation, and response; and appropriate levels of training for different classes of workers. Guidelines frequently address the right of communities to be informed of potential hazards and address ways for them to participate in planning and decision making.

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

    OpenAIRE

    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.

  10. Medical Journalism and Emergency Medicine

    Directory of Open Access Journals (Sweden)

    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.

  11. Diphtheria presenting in the accident and emergency department.

    OpenAIRE

    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 ...

  12. Accident and emergency nursing – clinical audit

    OpenAIRE

    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...

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

    OpenAIRE

    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.

  14. Reconstruction of the Chernobyl emergency and accident management

    International Nuclear Information System (INIS)

    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)

  15. Bioethics and Emergency Medicine: problems and perspectives

    Directory of Open Access Journals (Sweden)

    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.

  16. Emergency planning and preparedness for a nuclear accident

    International Nuclear Information System (INIS)

    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

  17. Medical Journalism and Emergency Medicine

    OpenAIRE

    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 ...

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

    NARCIS (Netherlands)

    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

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

  1. Redundancy in the accident and emergency department.

    Science.gov (United States)

    Durcan, T

    1994-04-01

    Whilst this article was being written, the Government announced that the pay of nurses will be based on productivity. The Trade Unions have announced that they have made a claim to the independent pay review body for a payment of 10% as a pay award, but the RCN indicated that up to 50,000 nursing jobs have been lost between 1992 and 1993. This gives an indication that the future is not so bright for nurses. Under this cloud of uncertainty nurses may deduce that there is a clear message that their job is no longer a job for life. Market forces, contracts, targets and flexibility are the jargon of today's care. Nursing is under threat and attack.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. NKS Seminar on the Fukushima accident and perspectives for Nordic reactor safety and emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-12-15

    The seminar was organized in 5 sessions: 1) The Fukushima accident and international perspectives; 2) Fukushima accident - Nordic emergency response; 3) Fukushima accident - implications for nuclear safety; 4) Way forward - assessments and communication - learning from the past; 5) The future for Nordic nuclear safety and emergency preparedness. 25 presentations from the sessions (PowerPoint presentations) are available from nks.org. (LN)

  4. Human factors and safety in emergency medicine

    Science.gov (United States)

    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.

  5. Medical isotopes and emerging nuclear medicine technologies

    International Nuclear Information System (INIS)

    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.

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

    Science.gov (United States)

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

  9. Human factors and safety in emergency medicine.

    Science.gov (United States)

    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. Scoping accident(s) for emergency planning

    International Nuclear Information System (INIS)

    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)

  11. Saliva alcohol concentrations in accident and emergency attendances

    Science.gov (United States)

    Simpson, T; Murphy, N; Peck, D

    2001-01-01

    Objectives—Although alcohol is known to play a key part in accidents, no UK study has assessed alcohol concentrations in a comprehensive sample of accident and emergency (A&E) attenders. This study set out to do this, and examine the relation between alcohol concentrations and the severity, type and circumstances of presentation, and the sociodemographic characteristics of patients. Methods—A survey was conducted of all new A&E attenders (aged 10 years or over). Two 24 hour periods for each day of the week were covered in 6, 7 or 11 hour sessions over a two month period. Alcohol concentrations were assessed from saliva samples using a disposable device. Data were collected from 638 attenders, of whom 544 provided saliva samples; the remainder refused or were unable to participate. Results—Positive saliva alcohol readings were obtained in 22% of attenders (95%CI 19% to 26%); this increased to 25% if others were included (for example, those who refused to participate but were judged to be intoxicated). Alcohol was associated with 94% of incidents of self harm, 54% of non-specific/multiple complaints, 47% of collapses, 50% of assaults, and 50% of patients admitted to hospital. Higher concentrations of alcohol were found from Friday to Sunday, between midnight and 0900, and in patients aged 41 to 60. Among people with positive alcohol results, those attending with a companion had higher concentrations than those attending alone. There were no significant differences between men and women in alcohol concentrations. Discussion—These findings show that alcohol use is an important factor in A&E attendance, but it should not be assumed that there is a causal relation between alcohol use and injury. Several accident related and sociodemographic variables were predictive of alcohol use before attending. The overall level of prediction was too weak to permit accurate identification of drinkers for screening purposes, but routine alcohol concentration assessments may be

  12. Emerging infectious diseases and travel medicine.

    Science.gov (United States)

    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

  13. Blog and Podcast Watch: Pediatric Emergency Medicine

    Science.gov (United States)

    Zaver, Fareen; Hansen, Michael; Leibner, Evan; Little, Andrew; Lin, Michelle

    2016-01-01

    Introduction By critically appraising open access, educational blogs and podcasts in emergency medicine (EM) using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine) Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM. Methods The Approved Instructional Resources – Professional (AIR-Pro) series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3–5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is comprised of EM faculty and chief residents at various institutions. The scoring instrument contains five measurement outcomes based on 7-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥26 (out of 35) points. An “Honorable Mention” label is awarded if Board members collectively felt that the posts were valuable and the scores were > 20. Results We included a total of 41 blog posts and podcasts. Key educational pearls from the 10 high quality AIR-Pro posts and four Honorable Mentions are summarized. Conclusion The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. Until more objective quality indicators are developed for learners and educators, this series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians. PMID:27625713

  14. Blog and Podcast Watch: Pediatric Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Fareen Zaver

    2016-09-01

    Full Text Available Introduction: By critically appraising open access, educational blogs and podcasts in emergency medicine (EM using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM.    Methods: The Approved Instructional Resources – Professional (AIR-Pro series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3-5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is comprised of EM faculty and chief residents at various institutions. The scoring instrument contains five measurement outcomes based on 7-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥26 (out of 35 points. An “Honorable Mention” label is awarded if Board members collectively felt that the posts were valuable and the scores were > 20. Results: We included a total of 41 blog posts and podcasts. Key educational pearls from the 10 high quality AIR-Pro posts and four Honorable Mentions are summarized. Conclusion: The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. Until more objective quality indicators are developed for learners and educators, this series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians.

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

    International Nuclear Information System (INIS)

    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.)

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

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

    OpenAIRE

    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.

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

    OpenAIRE

    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.

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

    OpenAIRE

    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.

  1. Emergency medicine in space.

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    International Nuclear Information System (INIS)

    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

  5. [The Sino-French emergency and disaster medicine training center].

    Science.gov (United States)

    Pourriat, Jean-Louis; Dahan, Benjamin; Lapandry, Claude

    2012-01-01

    French (AP-HP) and Chinese (Beijing Health Office) hospitals, with support from the French company Total, collaborated in order to improve Chinese doctors' knowledge of emergency and disaster medicine prior to the Beijing Olympic Games. A Sino-French emergency and disaster medicine training center was subsequently opened in Beijing in 2008, with the aim of providing high-level continuous medical training for Chinese specialists in emergency medicine. Teaching in the management of critical situations was based on the use of a latest-generation simulator (Sim 3G; Laerdal). This collaboration has had both pedagogical and diplomatic benefits. PMID:23550459

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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

  12. Technology and work within emergency medicine

    DEFF Research Database (Denmark)

    Kristensen, Margit

    are used and how they are used.   The paper builds on use-driven research carried out through the last 3½ years within the context of the PalCom project (PalCom). As a part of the research we have carried out extensive fieldstudies within the emergency response area, have held interviews and have had...

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

    International Nuclear Information System (INIS)

    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

  14. [Presence and future of emergency medicine in Germany].

    Science.gov (United States)

    Christ, Michael; Dodt, Christoph; Geldner, Götz; Hortmann, Marcus; Stadelmeyer, Uwe; Wulf, Hinnerk

    2010-10-01

    Health care policy has changed duties and responsibilities of hospitals in Germany. The transition zone of in- and outpatient care has been recognized as a critical gateway for the success of hospitals, subsequently leading to the appreciation of the value of professionalized emergency departments. Currently, hospital-based emergency medicine in Germany is organized in a very heterogeneous manner. Due to the key function of emergency departments for the medical and economic success of hospitals, professional expertise in clinical emergency medicine has to be strengthened: We discuss possible models of hospital-based emergency care and present first data that professionalisation of hospital-based emergency medicine in Germany improves treatment quality and outcome of patients presenting with chest-pain or community-acquired pneumonia to the emergency department. Furthermore, those strategies are accompanied with the improvement of economic characteristics. Summing up, professionalisation of hospital-based emergency medicine in Germany is urgently needed and may improve medical and economic success of hospital-based patient care.

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

    International Nuclear Information System (INIS)

    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 planning and preparedness for transport accidents involving radioactive material

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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.

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

    OpenAIRE

    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.

  20. National emergency plan for nuclear accidents

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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

  10. Differences between family and emergency medicine training before sports medicine fellowship.

    Science.gov (United States)

    Christensen, Mark; Christensen, Heidi K

    2015-01-01

    Residency training clearly impacts physicians' approach toward fellowship in Primary Care Sports Medicine. Although the Accreditation Council for Graduate Medical Education sets strict standards for all programs, family medicine and emergency medicine training differ a great deal in general and provide physicians from both backgrounds varied perspectives and skill sets. The family physician acquires a substantial amount of experience in continuity of care and integration of health care into a patient's everyday life. On the other hand, the emergency physician receives exceptional training in the management of acutely ill and injured patients and leadership of a large health care team. Furthermore, while the emergency physician may be skilled in procedures such as fracture reduction and diagnostic ultrasound, the family physician is proficient in developing patient rapport and compliance with a treatment plan. Although physicians from different backgrounds may start with many differences, fellowship training is essential in bridging those gaps.

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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' ...

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

    OpenAIRE

    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...

  17. Chikungunya virus: emerging targets and new opportunities for medicinal chemistry.

    Science.gov (United States)

    Rashad, Adel A; Mahalingam, Suresh; Keller, Paul A

    2014-02-27

    Chikungunya virus is an emerging arbovirus that is widespread in tropical regions and is spreading quickly to temperate climates with recent epidemics in Africa and Asia and documented outbreaks in Europe and the Americas. It is having an increasingly major impact on humankind, with potentially life-threatening and debilitating arthritis. There is no treatment available, and only in the past 24 months have lead compounds for development as potential therapeutics been reported. This Perspective discusses the chikungunya virus as a significant, new emerging topic for medicinal chemistry, highlighting the key viral target proteins and their molecular functions that can be used in drug design, as well as the most important ongoing developments for anti-chikungunya virus research. It represents a complete picture of the current medicinal chemistry of chikungunya, supporting the development of chemotherapeutics through drug discovery and design targeting this virus.

  18. Emergency plans for nuclear power accidents

    International Nuclear Information System (INIS)

    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.)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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.

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

    OpenAIRE

    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...

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

    OpenAIRE

    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, ...

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

    OpenAIRE

    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...

  6. Emergency medicine in Dubai, UAE

    OpenAIRE

    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.

  7. Emergency medicine in Dubai, UAE.

    Science.gov (United States)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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.)

  13. Capabilities for Clinical Management of Radiation Injuries of the Nikiforov Russian Center of Emergency and Radiation Medicine (EMERCOM of Russia).

    Science.gov (United States)

    Aleksanin, S

    2016-09-01

    This article presents an overview of the capabilities for clinical management of radiation injuries available at the Nikiforov Russian Center of Emergency and Radiation Medicine (NRCERM) of the Ministry of the Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters (EMERCOM). NRCERM is a federal state budgetary institution and the Russian Federation's head organization for providing medical assistance for persons overexposed to ionizing radiation, responders to radiation emergencies and people evacuated from radiation contaminated areas. As the WHO Collaborating Center for Treatment and Rehabilitation of Accident Recovery Workers of Nuclear and Other Disasters and a member of the WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN), NRCERM is prepared to provide assistance and technical support in case of a radiation accident. For this purpose, NRCERM hospitals are equipped with technologically advanced facilities and possess well-trained specialist staff.

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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)

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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.)

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    OpenAIRE

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

    Science.gov (United States)

    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

  7. Mutual emergency assistance for radiation accidents

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Review article: burnout in emergency medicine physicians.

    Science.gov (United States)

    Arora, Manit; Asha, Stephen; Chinnappa, Jason; Diwan, Ashish D

    2013-12-01

    Training and the practice of emergency medicine are stressful endeavours, placing emergency medicine physicians at risk of burnout. Burnout syndrome is associated with negative outcomes for patients, institutions and the physician. The aim of this review is to summarise the available literature on burnout among emergency medicine physicians and provide recommendations for future work in this field. A search of MEDLINE (1946-present) (search terms: 'Burnout, Professional' AND 'Emergency Medicine' AND 'Physicians'; 'Stress, Psychological' AND 'Emergency Medicine' AND 'Physicians') and EMBASE (1988-present) (search terms: 'Burnout' AND 'Emergency Medicine' AND 'Physicians'; 'Mental Stress' AND 'Emergency Medicine' AND 'Physicians') was performed. The authors focused on articles that assessed burnout among emergency medicine physicians. Most studies used the Maslach Burnout Inventory to quantify burnout, allowing for cross-study (and cross-country) comparisons. Emergency medicine has burnout levels in excess of 60% compared with physicians in general (38%). Despite this, most emergency medicine physicians (>60%) are satisfied with their jobs. Both work-related (hours of work, years of practice, professional development activities, non-clinical duties etc.) and non-work-related factors (age, sex, lifestyle factors etc.) are associated with burnout. Despite the heavy burnout rates among emergency medicine physicians, little work has been performed in this field. Factors responsible for burnout among various emergency medicine populations should be determined, and appropriate interventions designed to reduce burnout.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. International Federation for Emergency Medicine Model Curriculum for Emergency Medicine Specialists.

    Science.gov (United States)

    Hobgood, Cherri; Anantharaman, Venkataraman; Bandiera, Glen; Cameron, Peter; Halpern, Pinchas; Holliman, C James; Jouriles, Nicholas; Kilroy, Darren; Mulligan, Terrence; Singer, Andrew

    2011-10-01

    To meet a critical and growing need for emergency physicians and emergency medicine resources worldwide, physicians must be trained to deliver time-sensitive interventions and lifesaving emergency care. Currently, there is no globally recognized, standard curriculum that defines the basic minimum standards for specialist trainees in emergency medicine. To address this deficit, the International Federation for Emergency Medicine convened a committee of international physicians, health professionals and other experts in emergency medicine and international emergency medicine development to outline a curriculum for training of specialists in emergency medicine. This curriculum document represents the consensus of recommendations by this committee. The curriculum is designed to provide a framework for educational programmes in emergency medicine. The focus is on the basic minimum emergency medicine educational content that any emergency medicine physician specialist should be prepared to deliver on completion of a training programme. It is designed not to be prescriptive but to assist educators and emergency medicine leadership to advance physician education in basic emergency medicine no matter the training venue. The content of this curriculum is relevant not just for communities with mature emergency medicine systems, but in particular for developing nations or for nations seeking to expand emergency medicine within the current educational structure. We anticipate that there will be wide variability in how this curriculum is implemented and taught. This variability will reflect the existing educational milieu, the resources available, and the goals of the institutions' educational leadership with regard to the training of emergency medicine specialists. PMID:21995468

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

    Science.gov (United States)

    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

  15. 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

    International Nuclear Information System (INIS)

    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.)

  16. Do accident and emergency senior house officers know the British guidelines on the management of acute asthma?

    Science.gov (United States)

    Ulahannan, T; Hardern, R D; Hamer, D W

    1996-03-01

    Avoidable deaths from asthma continue, even in hospital. Since the management of acute severe asthma is often initiated in the Accident and Emergency department, it is crucial that staff there have adequate knowledge. An anonymous questionnaire, containing items based on chart 6 of the UK guidelines, was completed by 66 Accident and Emergency Senior House Officers from the Yorkshire region. The study aim was to establish these doctors' levels of knowledge about the recommended management of acute asthma in Accident and Emergency. The median score was 10 (out of a possible 24) and the interquartile range 8-13. Further efforts are required to implement these guidelines so that the best patient outcomes can be achieved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Shenggang [College of Environmental Science and Engineering, Beijing Forestry University, Beijing 100083 (China); College of Chemistry, Baotou Teachers’ College, Baotou 014030 (China); Cao, Jingcan; Feng, Li; Liang, Wenyan [College of Environmental Science and Engineering, Beijing Forestry University, Beijing 100083 (China); Zhang, Liqiu, E-mail: zhangliqiu@163.com [College of Environmental Science and Engineering, Beijing Forestry University, Beijing 100083 (China)

    2014-07-15

    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.

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons

    Science.gov (United States)

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-01-01

    Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  5. Making the journey safe: recognising and responding to severe sepsis in accident and emergency

    Science.gov (United States)

    Pinnington, Sarah; Atterton, Brigid; Ingleby, Sarah

    2016-01-01

    Severe sepsis is a clinical emergency. Despite the nationwide recognition of the sepsis six treatment bundle as the first line emergency treatment for this presentation, compliance in sepsis six provision remains inadequately low. The project goals were to improve compliance with the implementation of the Sepsis Six in patients with severe sepsis and/or septic shock. In improving timely care delivery it was anticipated improvements would be made in relation to patient safety and experience, and reductions in length of stay (LoS) and mortality. The project intended to make the pathway for those presenting with sepsis safe and consistent, where sepsis is recognised and treated in a timely manner according to best practice. The aim of the project was to understand the what the barriers where to providing safe effective care for the patient presenting with severe sepsis in A&E. Using the Safer Clinical Systems (SCS) tools developed byte Health Foundation and Warwick University, the project team identified the hazards and associated risks in the septic patient pathway. The level of analysis employed enabled the project team to identify the major risks, themes, and factors of influence within this pathway. The analysis identified twenty nine possible interventions, of which six were chosen following option appraisal. Further interventions were recommended to the accident and emergency as part of a business case and further changes in process. Audits identified all severely septic patients presenting to A&E in October 2014 (n=67) and post intervention in September 2015 (n=93). Compared analysis demonstrated an increase in compliance with the implementation of the sepsis six care bundle from 7% to 41%, a reduction in LoS by 1.9 days and a decrease in 30 day mortality by 50%. Additional audit reviewed the management of 10 septic patients per week for the duration of the project to assess the real time impact of the selected interventions.

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

    Directory of Open Access Journals (Sweden)

    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

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

    International Nuclear Information System (INIS)

    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)

  8. Emergency medicine in the United Arab Emirates

    OpenAIRE

    Fares, Saleh; Irfan, Furqan B; Corder, Robert F; Al Marzouqi, Μuneer Abdulla; Al Zaabi, Ahmad Hasan; Idrees, Marwa Mubarak; Abbo, Michael

    2014-01-01

    It has been a decade since emergency medicine was recognized as a specialty in the United Arab Emirates (UAE). In this short time, emergency medicine has established itself and developed rapidly in the UAE. Large, well-equipped emergency departments (EDs) are usually located in government hospitals, some of which function as regional trauma centers. Most of the larger EDs are staffed with medically or surgically trained physicians, with board-certified emergency medicine physicians serving as...

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Workplace violence in emergency medicine

    Directory of Open Access Journals (Sweden)

    A. Chatterjee*

    2013-12-01

    Conclusion: Violence against ED health care workers is a real problem with significant implications to the victims, patients, and departments/institutions. ED WPV needs to be addressed urgently by stakeholders through continued research on effective interventions specific to Emergency Medicine. Coordination, cooperation, and active commitment to the development of such interventions are critical.

  11. Pre-hospital emergency medicine.

    Science.gov (United States)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. How do patients come to the Accident and Emergency Department of RIPAS Hospital?

    Directory of Open Access Journals (Sweden)

    Po Thaw DA

    2012-06-01

    Full Text Available Introduction: The mode and speed of transportation to the Accident and Emergency Department (AED of hospitals is very important for critically ill patients. This study looked at the mode of transportation to the AED at the Raja Isteri Pengiran Anak Saleha (RIPAS Hospital. Materials and Methods: Three different time periods: Period A from 15th May to 31st May 2004, (17 days, n=2,170 without prioritising, Period B from 1st January 2004 to 31st July 2006 (31 months, n=235 dead on arrival and resuscitation cases, and Period C from 20th to 26th November 2006 (7 days, all Priority Cases 1 to 3 were reviewed. Data on mode of transportation and triage categories were extracted from the ambulance response sheets. Results: During Period A, the main mode of transportation to the AED was private vehicles (90.7% followed by ambulance (7.9%, and other transportation (1.4%. During study Period B, the main mode of transportation was also private transports (50.2% followed closely by ambulance (48.5% and other transportation (1.3%. During Period C, Priority 1 cases (life-threatening conditions, n=7, most were transported with private transport (71.4% followed by ambulance (28.6%; Priority 2 (n=232 cases, majority were transported with private transport (89.2%, followed by ambulance (10.3%, and one case used police transportation; and in Priority 3 cases (non-life threatening conditions, n=1,010, almost all were transported with private transport (98.7%, followed by police (0.9% and ambulance (0.4% respectively. Conclusion: Utilisation of designated emergency transportation is low especially for the moderate to seriously ill (Priority 1 and 2 patients when compared to other well developed countries. More needs to be done to improve the usage of emergency transportations especially for the seriously ill cases.

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

    International Nuclear Information System (INIS)

    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

  16. Emerging nanotechnology approaches in tissue engineering and regenerative medicine

    Directory of Open Access Journals (Sweden)

    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

  17. Emergency medicine in pediatric dentistry: preparation and management.

    Science.gov (United States)

    Malamed, Stanley F

    2003-10-01

    Medical emergencies can and do occur in the practice of dentistry. Although most emergencies take place in adults, serious problems can also develop in younger patients. The contemporary dentist must be prepared to manage expeditiously and effectively those few problems that do arise. Basic life support (as necessary) is all that is required to manage many emergency situations, with the addition of specific drug therapy in some others. Preparation of the office and staff includes basic life support (annually), pediatric advanced life support, development of an emergency team, consideration for emergency medical services, and the availability of emergency drugs and equipment with the ability to use these items effectively. As with the adult patient, effective management of pain (local anesthesia) and anxiety (behavioral management, conscious sedation) will minimize the development of medical emergencies.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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

  2. Mutual emergency assistance for radiation accidents

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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)

  6. Emergency medicine in Vietnam.

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

  9. A local perspective to asthma management in the accident and emergency department in Malta

    Directory of Open Access Journals (Sweden)

    Caroline Gouder

    2013-01-01

    Full Text Available Aim: This study was performed to assess the management of adult patients presenting to the Mater Dei Hospital Accident and Emergency (A&E department with acute asthma. Subjects and Methods: Asthmatic patients age 14 or older who presented to A&E department between January and October 2010 with asthma exacerbations were included. Data were collected from the clinical notes and analyzed. Results: A total of 244 patients (67.2% females were included, 126 (51.6% were admitted, 97 (39.8% discharged and 21 (8.6% discharged themselves against medical advice. There was a decline in the presentations between January and July, followed by an upward trend until October (P = 0.42. Pulse oximetry was performed in 207 patients (84.8%, arterial blood gases in 133 (54.5%, peak expiratory flow rate in 106 (43.4% and chest radiography in 206 (84.4% patients. The respiratory rate was documented in 151 (61.8%, heart rate in 204 (83.6% and ability to complete sentences in 123 (50.4% patients. One hundred and ninety six patients (80.3% were given nebulized bronchodilators, 103 (42.2% intravenous corticosteroids, 7 (2.87% oral corticosteroids, 109 (44.7% oxygen, 28 (11.5% antibiotics and 9 (3.69% magnesium. Systemic corticosteroids and antibiotics were more commonly prescribed to patients admitted (P < 0.001. Conclusion: Management of acute asthma in Malta requires optimization in order to compare with international guidelines.

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

    Science.gov (United States)

    Shi, Shenggang; Cao, Jingcan; Feng, Li; Liang, Wenyan; Zhang, Liqiu

    2014-07-15

    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. PMID:24887122

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

    OpenAIRE

    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.

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

    OpenAIRE

    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 ...

  13. Personal experience in pediatric emergency medicine training in Canada and China

    Institute of Scientific and Technical Information of China (English)

    LIN Gang-xi; LUO Yi-ming; Adam CHENG; YANG Shu-yu; WANG Jian-she; Ran-D Goldman

    2012-01-01

    Currently,pediatric emergency medicine (PEM) as practiced in many developed countries is different from ours in China.Chinese pediatric emergency medicine is just children's internal medicine and does not include general surgery,ear-nose-throat,etc.If children have an emergency condition that require specialized treatments they need to go to different departments.However in Canada,the pediatric emergency physicians will first treat the patients whatever the condition,then,if it is a complicated sub specialty problem,they will consult the specialist or let the patient see the specialist later.In addition,resuscitation is done in the pediatric intensive care unit (PICU) in China,but it is done in the emergency room in Canada.This article compares the differences in the pediatric emergency systems in Canada and China and also introduces the international standard system of pediatric triage.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    International Nuclear Information System (INIS)

    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.

  16. Emergency response planning for transport accidents involving radioactive materials

    International Nuclear Information System (INIS)

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

    OpenAIRE

    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...

  18. Advance directives, preemptive suicide and emergency medicine decision making.

    Science.gov (United States)

    Heinrich, Richard L; Morgan, Marshall T; Rottman, Steven J

    2011-01-01

    As the United States population ages, there is a growing group of aging, elderly, individuals who may consider "preemptive suicide"(Prado, 1998). Healthy aging patients who preemptively attempt to end their life by suicide and who have clearly expressed a desire not to have life -sustaining treatment present a clinical and public policy challenge. We describe the clinical, ethical, and medical-legal decision making issues that were raised in such a case that presented to an academic emergency department. We also review and evaluate a decision making process that emergency physicians confront when faced with such a challenging and unusual situation .

  19. [Sepsis in Emergency Medicine].

    Science.gov (United States)

    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

  20. A model national emergency plan for radiological accidents

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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)

  2. Accidents, risks and consequences

    International Nuclear Information System (INIS)

    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.)

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

    OpenAIRE

    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...

  4. Current Trends in Geriatric Emergency Medicine.

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

  6. Zika virus and the never-ending story of emerging pathogens and transfusion medicine.

    Science.gov (United States)

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

    2016-03-01

    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 strategies. The aim of this review article is to discuss the currently available, though limited, information and the potential impact of this virus on transfusion medicine.

  7. Zika virus and the never-ending story of emerging pathogens and transfusion medicine.

    Science.gov (United States)

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

    2016-03-01

    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 strategies. The aim of this review article is to discuss the currently available, though limited, information and the potential impact of this virus on transfusion medicine. PMID:26674815

  8. Development of emergency response support system for accident management

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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. The Role of Family and Emergency Medicine in Undergraduate Medical Education

    OpenAIRE

    Sawchuk, Victor N.

    1980-01-01

    Clinical clerks electing emergency and family medicine rotations during the 1977 and 1978 academic years at the University of Calgary Faculty of Medicine evaluated their clerkships on the opportunities provided to learn new useful medical knowledge, learn new clinical skills and practice them. All rotations were perceived as providing excellent opportunities to learn medical knowledge. However, nearly 20% of students felt that four of the teaching hospital ward based specialty and subspecialt...

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

    International Nuclear Information System (INIS)

    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

  14. Emergency Medicine for medical students world wide!

    DEFF Research Database (Denmark)

    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/...

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

    International Nuclear Information System (INIS)

    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)

  16. Dementia and Traffic Accidents

    DEFF Research Database (Denmark)

    Petersen, Jindong Ding; Siersma, Volkert; Nielsen, Connie Thurøe;

    2016-01-01

    BACKGROUND: As a consequence of a rapid growth of an ageing population, more people with dementia are expected on the roads. Little is known about whether these people are at increased risk of road traffic-related accidents. OBJECTIVE: Our study aims to investigate the risk of road traffic...... Central Research Register, and/or (2) at least one dementia diagnosis-related drug prescription registration in the Danish National Prescription Registry. Police-, hospital-, and emergency room-reported road traffic-related accidents occurred within the study follow-up are defined as the study outcome...... selection bias due to nonparticipation and loss to follow-up. Furthermore, this ensures that the study results are reliable and generalizable. However, underreporting of traffic-related accidents may occur, which will limit estimation of absolute risks....

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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....

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Stoneking LR

    2016-08-01

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

  9. Funding strategies for emergency medicine research.

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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,…

  11. Emergency medicine: beyond the basics.

    Science.gov (United States)

    Malamed, S F

    1997-07-01

    Medical emergencies can arise in the dental office. Preparedness for these emergencies is predicated on an ability to rapidly recognize a problem and to effectively institute prompt and proper management. In all emergency situations, management is based on implementation of basic life support, as needed. The author describes the appropriate management of two common emergency situations: allergy and chest pain.

  12. Assessment of the current computer literacy and future computer needs of emergency medicine residents and faculty.

    Science.gov (United States)

    Debehnke, D J; Valley, V T

    1993-07-01

    The purpose of this study was to assess the current computer literacy and future computer needs of emergency medicine residents and faculty to aid in developing a computer literacy curriculum. All emergency medicine residents and full-time faculty from a random sample of emergency medicine residencies were mailed questionnaires assessing current computer familiarity and future computer needs. Twenty-one residencies were surveyed; 15 resident and 17 faculty questionnaires were returned. Thirty-seven percent (116 of 314) faculty and 29% (135 of 470) resident questionnaires were completed and returned. Eighty percent (12 of 15) of residencies had a designated computer for resident use; 93% (14 of 15) had a computer for use in the emergency department. Forty-seven percent of residents owned their own computer; 68% of faculty had a computer in their home, and 52% had computers in their office. Less than 30% of residents and faculty had formal computer training. Residents and faculty rated the current familiarity and future needs for various software applications on a five-point scale. Data were analyzed using the Wilcoxon-Rank Sum Test. Residents and faculty had the most anticipated need for word processing, graphics, literature searching, data base, and patient management programs. Future computer need was rated significantly higher than current computer familiarity in all computer application areas (P < or = .0002). It seems that emergency medicine residents and faculty have adequate access to computers, but minimal computer training. Residents and faculty have a high anticipated need for various basic computer applications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8216519

  13. Qualitative Research on Emergency Medicine Physicians

    DEFF Research Database (Denmark)

    Paltved, Charlotte; Musaeus, Peter

    2012-01-01

    studies on EM physicians were designed using the following strategies of inquiry: Ethnography, mixed methods, action research, grounded theory, phenomenology, content analysis, discourse analysis, and critical incident analysis. The reviewed studies were categorized into four main themes: Education......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...... 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...

  14. Generational influences in academic emergency medicine: structure, function, and culture (Part II).

    Science.gov (United States)

    Mohr, Nicholas M; Smith-Coggins, Rebecca; Larrabee, Hollynn; Dyne, Pamela L; Promes, Susan B

    2011-02-01

    Strategies for approaching generational issues that affect teaching and learning, mentoring, and technology in emergency medicine (EM) have been reported. Tactics to address generational influences involving the structure and function of the academic emergency department (ED), organizational culture, and EM schedule have not been published. Through a review of the literature and consensus by modified Delphi methodology of the Society for Academic Emergency Medicine Aging and Generational Issues Task Force, the authors have developed this two-part series to address generational issues present in academic EM. Understanding generational characteristics and mitigating strategies can address some common issues encountered in academic EM. By understanding the differences and strengths of each of the cohorts in academic EM departments and considering simple mitigating strategies, faculty leaders can maximize their cooperative effectiveness and face the challenges of a new millennium.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    DEFF Research Database (Denmark)

    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....

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

    DEFF Research Database (Denmark)

    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....

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

    OpenAIRE

    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...

  20. 我国事故灾难应急处置对策研析%Research and Analysis on the Emergency Disposal of Catastrophic Accident

    Institute of Scientific and Technical Information of China (English)

    张春艳

    2012-01-01

    This paper describes the concept of emergency disposal of catastrophic accident,and the principles and processes of the emergency disposal of catastrophic accident.The article is aimed at our country′s emergency disposal of catastrophic accident and proposes suggestion including that accident disaster plan compilation should be added to risk management,vulnerability analysis and capacity evaluation,as well as emergency education,propaganda,training and drills about catastrophic accident.%本文就事故灾难应急处置的相关概念以及事故灾难应急处置应遵循的原则和流程进行了阐述,并对我国事故灾难应急处置提出了事故灾难的预案编制应加入风险管理、脆弱性分析和能力评估分析的内容以及事故灾难的应急教育、宣传、培训和演练等方面的对策。

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

    International Nuclear Information System (INIS)

    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)

  2. Bedside ultrasound in pediatric emergency medicine.

    Science.gov (United States)

    Levy, Jason A; Noble, Vicki E

    2008-05-01

    Bedside emergency ultrasound has been used by emergency physicians for >20 years for a variety of conditions. In adult centers, emergency ultrasound is routinely used in the management of victims of blunt abdominal trauma, in patients with abdominal aortic aneurysm and biliary disease, and in women with first-trimester pregnancy complications. Although its use has grown dramatically in the last decade in adult emergency departments, only recently has this tool been embraced by pediatric emergency physicians. As the modality advances and becomes more available, it will be important for primary care pediatricians to understand its uses and limitations and to ensure that pediatric emergency physicians have access to the proper training, equipment, and experience. This article is meant to review the current literature relating to emergency ultrasound in pediatric emergency medicine, as well as to describe potential pediatric applications.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    International Nuclear Information System (INIS)

    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)

  5. Radiological accidents: education for prevention and confrontation

    International Nuclear Information System (INIS)

    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

  6. How Much are Emergency Medicine Specialists’ Decisions Reliable in the Diagnosis and Treatment of Pediatric Fractures?

    Directory of Open Access Journals (Sweden)

    Mohsen Mardani-Kivi

    2016-01-01

    Full Text Available Background: Considering the importance of an early diagnosis and proper decision-making in regards to the treatment of pediatric distal radius and elbow fractures, this study examines emergency medicine specialists’ accuracy in the diagnosis and treatment of these patients. Methods: From 2012 and 2013, children less than 14 years old who were referred to an academic hospital emergency department with elbow or distal radius fractures were enrolled. Initially, patients were examined by an emergency medicine specialist and then they were referred to an orthopedic surgeon. Type of fracture and the proposed treatment of two specialists were compared. Results: In total, there were 108 patients (54 patients in each group with a mean age of 8.1+3.3 years. Identical diagnosis in 48 cases (88.9% of distal radius and 36 cases (66.7% of elbow trauma were observed. We found a difference between diagnosis of the two specialists in diagnosing lateral condyle of the humerus fracture in the elbow group and growth plate fracture in the distal radius fracture group, but the differences were not significant. Among 108 patients, 70 patients (64.8% received identical treatment. Conclusion: Although the emergency medicine specialists responded similarly to the orthopedic specialists in the diagnosis of pediatric distal radius and elbow fractures, diagnosis of more complicated fractures such as lateral condylar humoral fractures, distal radius growth plate and for choosing the proper treatment option, merits further education.

  7. Nuclear accident and medical staff

    International Nuclear Information System (INIS)

    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. Public Health Education for Emergency Medicine Residents

    OpenAIRE

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    OpenAIRE

    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...

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

    OpenAIRE

    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. Road traffic accident: An emerging public health problem in Assam

    Directory of Open Access Journals (Sweden)

    Pranab Jyoti Bhuyan

    2013-01-01

    Full Text Available Background: In the northern states, there is hardly any scientific study except road traffic accidents (RTAs statistics obtained by the Ministry of Home whereas the main way of transportation is by road. There is the increasing load of motor vehicles on the already dilapidated roadways which has resulted in the increasing trend of RTAs in Assam. Objectives: To find out the prevalence, probable epidemiological factors and morbidity and mortality pattern due to RTAs in Dibrugarh district. Materials and Methods: Descriptive study was carried out in Dibrugarh district from September 1998 to August 1999 under the department of Community Medicine. The information was collected from Assam Medical College and Hospital and cross checked with the police report. A medical investigation including interview, clinical and radiological investigation was carried out; in case of fatality, post-mortem examination was examined in details. An on the spot investigation was carried out in accessible RTAs to collect the probable epidemiological factors. Results: RTAs affected mainly the people of productive age group which were predominantly male. Majority of the RTAs were single vehicle accidents and half of the victims were passengers. Accident rate was maximum in twilight and winter season demanding high morbidity and mortality. Head and neck, U.limb and L.limb were commonly involved. Conclusion: RTAs is a major public health problem in Assam which needs more scientific study.

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

    International Nuclear Information System (INIS)

    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

  16. Advanced training in pediatric emergency medicine in the United States, Canada, United Kingdom, and Australia : An international comparison and resources guide

    NARCIS (Netherlands)

    Babl, FE; Weiner, DL; Bhanji, F; Davies, F; Berry, K; Barnett, P

    2005-01-01

    Pediatric emergency medicine is an important subspecialty of pediatrics and emergency medicine. It is a well-established subspecialty in some countries and less well developed or evolving in others. We set out to develop a resource guide and document the current status of pediatric emergency medicin

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

    OpenAIRE

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  19. Emergency/disaster medical support in the restoration project for the Fukushima nuclear power plant accident.

    Science.gov (United States)

    Morimura, Naoto; Asari, Yasushi; Yamaguchi, Yoshihiro; Asanuma, Kazunari; Tase, Choichiro; Sakamoto, Tetsuya; Aruga, Tohru

    2013-12-01

    The Fukushima Daiichi Nuclear Power Plant (1F) suffered a series of radiation accidents after the Great East Japan Earthquake on 11 March 2011. In a situation where halting or delaying restoration work was thought to translate directly into a very serious risk for the entire country, it was of the utmost importance to strengthen the emergency and disaster medical system in addition to radiation emergency medical care for staff at the frontlines working in an environment that posed a risk of radiation exposure and a large-scale secondary disaster. The Japanese Association for Acute Medicine (JAAM) launched the 'Emergency Task Force on the Fukushima Nuclear Power Plant Accident' and sent physicians to the local response headquarters. Thirty-four physicians were dispatched as disaster medical advisors, response guidelines in the event of multitudinous injury victims were created and revised and, along with execution of drills, coordination and advice was given on transport of patients. Forty-nine physicians acted as directing physicians, taking on the tasks of triage, initial treatment and decontamination. A total of 261 patients were attended to by the dispatched physicians. None of the eight patients with external contamination developed acute radiation syndrome. In an environment where the collaboration between organisations in the framework of a vertically bound government and multiple agencies and institutions was certainly not seamless, the participation of the JAAM as the medical academic organisation in the local system presented the opportunity to laterally integrate the physicians affiliated with the respective organisations from the perspective of specialisation.

  20. Disposition of Patients Before and After Establishment of Emergency Medicine Specialists

    Directory of Open Access Journals (Sweden)

    Payman Asadi

    2014-09-01

    Full Text Available Introduction: Emergency department (ED as the fundamental part of hospital has a specific importance due to admitting the most various and sensitive group of patients. The aim of the ED is presenting services with highest quality in the least time. To reach this goal establishment of an emergency medicine specialist who performs assessment, resuscitation, stabilization, detection, and maintenance of emergency patients is noteworthy. The aim of this study was evaluating the effect of establishing the emergency medicine specialists on the performance of ED in Poursina Hospital, Rasht, Iran.  Methods: In this cross-sectional study files of all patients hospitalized in the ED of Poursina, Rasht, Iran, through 2005-2012 were evaluated. Variables such as age, gender, cause of refer and number of hospitalization, number of discharging from department, percentage of bed occupation and daily bed occupation, time of hospitalization, number of discharging under six hours, number of transportation to other wards or hospitals, and the rate of bed circulation in the ED were assessed, too. Data was gathered through hospital information system and analyzed using SPSS 20. Results: Through 2005 to 2012 number of admitted patients in the ED has increased so that the most admitted number was related to 2012 (p=0.0001. The present of discharged patients under six hours and the rate of direct discharging before the presence of emergency medicine specialists have increased from 15.5% and 58.9% to 23.4% and 61.2% in after their presence, respectively(p=0.001. Transporting to other wards and hospitals were also decreased from 41.1% to 38.8% (p=0.0001. The occupied beds percentage after presenting of emergency medicine specialists has noticeably decreased compared to the past, while bed turnover rate increased. In other words, the bed turnover mean has increased from 354.5±108.4 during 2005-2008 to 637.7±30.8 through 2009-2012 (p=0.002. Also, during 2005-2008 the

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. The accident analysis in the framework of emergency provisions

    International Nuclear Information System (INIS)

    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.)

  4. 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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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.)

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  8. 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

    Institute of Scientific and Technical Information of China (English)

    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。

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  10. National Health and Hospital Network for Australia's future: implications for Emergency Medicine.

    Science.gov (United States)

    FitzGerald, Gerry; Ashby, Richard

    2010-10-01

    The proposals arising from the agreement reached between the Rudd government and the States and Territories (except Western Australia) in April 2010 represent the most fundamental realignment of health responsibilities since the creation of Medicare in 1984. They will change the health system, and the structures that will craft its future direction and design. These proposals will have a significant impact on Emergency Medicine; an impact from not only the system-wide effects of the proposals but also those that derive from the specific recommendations to create an activity-based funding mechanism for EDs, to implement the four hour rule and to develop a performance indicator framework for EDs. The present paper will examine the potential impact of the proposals on Emergency Medicine to inform those who work within the system and to help guide further developments. More work is required to better evaluate the proposals and to guide the design and development of specific reform instruments. Any such efforts should be based upon a proper analysis of the available evidence, and a structured approach to research and development so as to deliver on improved services to the community, and on improved quality and safety of emergency medical care.

  11. National Health and Hospital Network for Australia's future: implications for Emergency Medicine.

    Science.gov (United States)

    FitzGerald, Gerry; Ashby, Richard

    2010-10-01

    The proposals arising from the agreement reached between the Rudd government and the States and Territories (except Western Australia) in April 2010 represent the most fundamental realignment of health responsibilities since the creation of Medicare in 1984. They will change the health system, and the structures that will craft its future direction and design. These proposals will have a significant impact on Emergency Medicine; an impact from not only the system-wide effects of the proposals but also those that derive from the specific recommendations to create an activity-based funding mechanism for EDs, to implement the four hour rule and to develop a performance indicator framework for EDs. The present paper will examine the potential impact of the proposals on Emergency Medicine to inform those who work within the system and to help guide further developments. More work is required to better evaluate the proposals and to guide the design and development of specific reform instruments. Any such efforts should be based upon a proper analysis of the available evidence, and a structured approach to research and development so as to deliver on improved services to the community, and on improved quality and safety of emergency medical care. PMID:21040482

  12. Racial and ethnic disparities in the clinical practice of emergency medicine.

    Science.gov (United States)

    Richardson, Lynne D; Babcock Irvin, Charlene; Tamayo-Sarver, Joshua H

    2003-11-01

    There is convincing evidence that racial and ethnic disparities exist in the provision of health care, including the provision of emergency care; and that stereotyping, biases, and uncertainty on the part of health care providers all contribute to unequal treatment. Situations, such as the emergency department (ED), that are characterized by time pressure, incomplete information, and high demands on attention and cognitive resources increase the likelihood that stereotypes and bias will affect diagnostic and treatment decisions. It is likely that there are many as-yet-undocumented disparities in clinical emergency practice. Racial and ethnic disparities may arise in decisions made by out-of-hospital personnel regarding ambulance destination, triage assessments made by nursing personnel, diagnostic testing ordered by physicians or physician-extenders, and in disposition decisions. The potential for disparate treatment includes the timing and intensity of ED therapy as well as patterns of referral, prescription choices, and priority for hospital admission and bed assignment. At a national roundtable discussion, strategies suggested to address these disparities included: increased use of evidence-based clinical guidelines; use of continuous quality improvement methods to document individual and institutional disparities in performance; zero tolerance for stereotypical remarks in the workplace; cultural competence training for emergency providers; increased workforce diversity; and increased epidemiologic, clinical, and services research. Careful scrutiny of the clinical practice of emergency medicine and diligent implementation of strategies to prevent disparities will be required to eliminate the individual behaviors and systemic processes that result in the delivery of disparate care in EDs. PMID:14597493

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

    International Nuclear Information System (INIS)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    OpenAIRE

    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.

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. Influence of radiation accident on human being health and its medical emergency%核事件对人类健康的影响及医学应急

    Institute of Scientific and Technical Information of China (English)

    苏虹

    2011-01-01

    核电站已成为解决能源问题的重要途径之一,但核事件的发生则会给人类带来深重灾难,如何针对核事件的危害而采取有效预防和应急,已成为全球发展面临的重要公共卫生问题.本文将从世界重大核事件的回顾、核事件对人类健康的影响,以及核事件的医学应急和公众防护方面进行综述.%Nuclear power plant is one of the important way to solve the energy problem, but nuclear accident could bring the extremely serious disaster onto the human being. It has been the key for taking the effective actions promptly to meet the hazards resulted from nuclear accident. In order to prevent the accident and protect the human being health, we would sum up the messages as follows, review of serious nuclear accidents in the world, analysis on influence of radiation accident on human being health and its medical emergency.

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

    International Nuclear Information System (INIS)

    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

  3. [Evolutionary medicine: an emergent basic science].

    Science.gov (United States)

    Spotorno, Angel E

    2005-02-01

    Evolutionary Medicine is an emergent basic science that offers new and varied perspectives to the comprehension of human health. The application of classic evolutionary theories (descent with modification, and natural selection) to the human organism, to its pathogens, and their mutual co-evolution, provides new explanations about why we get sick, how we can prevent this, and how we can heal. Medicine has focused mainly on the proximate or immediate causes of diseases and the treatment of symptoms, and very little on its evolutionary or mediate causes. For instance, the present human genome and phenotypes are essentially paleolithic ones: they are not adapted to modern life style, thus favoring the so-called diseases of civilization (ie: ateroesclerosis, senescence, myopia, phobias, panic attacks, stress, reproductive cancers). With the evolutionary approach, post-modern medicine is detecting better the vulnerabilities, restrictions, biases, adaptations and maladaptations of human body, its actual diseases, and its preventions.

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

    Science.gov (United States)

    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

  5. Communication and industrial accidents

    OpenAIRE

    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...

  6. Characteristics of evidence-based medicine training in Royal College of Physicians and Surgeons of Canada emergency medicine residencies - a national survey of program directors

    OpenAIRE

    Bednarczyk, Joseph; Pauls, Merril; Fridfinnson, Jason; Weldon, Erin

    2014-01-01

    Background Recent surveys suggest few emergency medicine (EM) training programs have formal evidence-based medicine (EBM) or journal club curricula. Our primary objective was to describe the methods of EBM training in Royal College of Physicians and Surgeons of Canada (RCPSC) EM residencies. Secondary objectives were to explore attitudes regarding current educational practices including e-learning, investigate barriers to journal club and EBM education, and assess the desire for national coll...

  7. Electronic Whiteboards in Emergency Medicine

    DEFF Research Database (Denmark)

    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...

  8. [Diagnosis and treatment of diving accidents. New German guidelines for diving accidents 2014-2017].

    Science.gov (United States)

    Jüttner, B; Wölfel, C; Liedtke, H; Meyne, K; Werr, H; Bräuer, T; Kemmerer, M; Schmeißer, G; Piepho, T; Müller, O; Schöppenthau, H

    2015-06-01

    In 2015 the German Society for Diving and Hyperbaric Medicine (GTÜM) and the Swiss Underwater and Hyperbaric Medical Society (SUHMS) published the updated guidelines on diving accidents 2014-2017. These multidisciplinary guidelines were developed within a structured consensus process by members of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), the Sports Divers Association (VDST), the Naval Medical Institute (SchiffMedInst), the Social Accident Insurance Institution for the Building Trade (BG BAU), the Association of Hyperbaric Treatment Centers (VDD) and the Society of Occupational and Environmental Medicine (DGAUM). This consensus-based guidelines project (development grade S2k) with a representative group of developers was conducted by the Association of Scientific Medical Societies in Germany. It provides information and instructions according to up to date evidence to all divers and other lay persons for first aid recommendations to physician first responders and emergency physicians as well as paramedics and all physicians at therapeutic hyperbaric chambers for the diagnostics and treatment of diving accidents. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose and the following key action statements: on-site 100% oxygen first aid treatment, still patient positioning and fluid administration are recommended. Hyperbaric oxygen (HBO) recompression remains unchanged the established treatment in severe cases with no therapeutic alternatives. The basic treatment scheme recommended for diving accidents is hyperbaric oxygenation at 280 kPa. For quality management purposes there is a need in the future for a nationwide register of hyperbaric therapy.

  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

    OpenAIRE

    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.

    OpenAIRE

    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. Nuclear accidents and epidemiology

    International Nuclear Information System (INIS)

    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

  12. Feedback in the Emergency Medicine Clerkship

    OpenAIRE

    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 ...

  13. Feedback in the Emergency Medicine Clerkships

    OpenAIRE

    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...

  14. Nanotechnology in medicine emerging applications

    CERN Document Server

    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

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

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

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

    Science.gov (United States)

    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

  18. Electronic Whiteboards in Emergency Medicine

    DEFF Research Database (Denmark)

    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...

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

    OpenAIRE

    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 ...

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Accident investigation and analysis

    NARCIS (Netherlands)

    Kampen, J. van; Drupsteen, L.

    2013-01-01

    Many organisations and companies take extensive proactive measures to identify, evaluate and reduce occupational risks. However, despite these efforts things still go wrong and unintended events occur. After a major incident or accident, conducting an accident investigation is generally the next ste

  3. Evaluation of emergency medicine training programs in Egypt: Trainees’ perspective

    Directory of Open Access Journals (Sweden)

    T. Montaser*

    2013-12-01

    Conclusions: Egyptian Emergency medicine trainees are not satisfied with their training and owing that to the unclear vision toward Emergency medicine as specialty from the policy makers and lack of professional staff responsible for education and evaluation. It is highly recommended that the training and mentoring go hand in hand and trainees should take part in the continuous evaluation process.

  4. The Progress of Emergency Medicine in Taiwan, China, and Hong Kong: Perspective from Publications in Emergency Medicine Journals, 1992–2011

    Directory of Open Access Journals (Sweden)

    Ching-Hsing Lee

    2014-01-01

    Full Text Available Study Objective. The progress of emergency medicine (EM in Taiwan, China, and Hong Kong was evaluated from the perspective of publications in EM journals. Methods. This was a retrospective study. All articles published from 1992 to 2011 in all journals in the EM category in the 2010 Journal Citation Reports (JCR were included. A computerized literature search was conducted using the SciVerse Scopus database. The slope (β of the linear regression was used to evaluate the trends in the numbers of articles as well as the ratios to the total number of EM journal articles. Results. The trends in the numbers of articles from Taiwan, China, and Hong Kong were 6.170, 1.908, and 2.835 and the trends in the ratios of their publication numbers to the total number of EM journal articles were 15.0 × 10−4, 4.60 × 10−4, and 6.80 × 10−4, respectively. All P-values were <0.01. The mean, median, and 75th percentiles of the number of citations in all EM journals were greater than those of these three areas. Conclusions. The publications from Taiwan, China, and Hong Kong have increased at a higher rate than those of the overall EM field in the past 20 years and indicated the rapid progress in these three areas.

  5. Interpreter services in emergency medicine.

    Science.gov (United States)

    Chan, Yu-Feng; Alagappan, Kumar; Rella, Joseph; Bentley, Suzanne; Soto-Greene, Marie; Martin, Marcus

    2010-02-01

    Emergency physicians are routinely confronted with problems associated with language barriers. It is important for emergency health care providers and the health system to strive for cultural competency when communicating with members of an increasingly diverse society. Possible solutions that can be implemented include appropriate staffing, use of new technology, and efforts to develop new kinds of ties to the community served. Linguistically specific solutions include professional interpretation, telephone interpretation, the use of multilingual staff members, the use of ad hoc interpreters, and, more recently, the use of mobile computer technology at the bedside. Each of these methods carries a specific set of advantages and disadvantages. Although professionally trained medical interpreters offer improved communication, improved patient satisfaction, and overall cost savings, they are often underutilized due to their perceived inefficiency and the inconclusive results of their effect on patient care outcomes. Ultimately, the best solution for each emergency department will vary depending on the population served and available resources. Access to the multiple interpretation options outlined above and solid support and commitment from hospital institutions are necessary to provide proper and culturally competent care for patients. Appropriate communications inclusive of interpreter services are essential for culturally and linguistically competent provider/health systems and overall improved patient care and satisfaction. PMID:18571358

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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)

  8. Approach to Reptile Emergency Medicine.

    Science.gov (United States)

    Long, Simon Y

    2016-05-01

    This article summarizes the physiology and anatomy of reptiles, highlighting points relevant for emergency room veterinarians. Other systems, such as the endocrine and immune systems, have not been covered. The many other aspects of reptile species variation are too numerous to be covered. This article provides an overview but encourages clinicians to seek additional species-specific information to better medically diagnose and treat their reptile patients.

  9. Communication and industrial accidents

    NARCIS (Netherlands)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  12. 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

    Directory of Open Access Journals (Sweden)

    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

  13. 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

    Directory of Open Access Journals (Sweden)

    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

  14. Potential role for psychological skills training in emergency medicine: Part 1 - Introduction and background.

    Science.gov (United States)

    Lauria, Michael J; Rush, Stephen; Weingart, Scott D; Brooks, Jason; Gallo, Isabelle A

    2016-10-01

    Psychological skills training (PST) is the systematic acquisition and practice of different psychological techniques to improve cognitive and technical performance. This training consists of three phases: education, skills acquisition and practice. Some of the psychological skills developed in this training include relaxation techniques, focusing and concentration skills, positive 'self-suggestion' and visualisation exercises. Since the middle of the 20th century, PST has been successfully applied by athletes, performing artists, business executives, military personnel and other professionals in high-risk occupations. Research in these areas has demonstrated the breadth and depth of the training's effectiveness. Despite the benefits realised in other professions, medicine has only recently begun to explore certain elements of PST. The present paper reviews the history and evidence behind the concept of PST. In addition, it presents some aspects of PST that have already been incorporated into medical training as well as implications for developing more comprehensive programmes to improve delivery of emergency medical care.

  15. Nitrous oxide in emergency medicine.

    Science.gov (United States)

    O'Sullivan, I; Benger, J

    2003-05-01

    Safe and predictable analgesia is required for the potentially painful or uncomfortable procedures often undertaken in an emergency department. The characteristics of an ideal analgesic agent are safety, predictability, non-invasive delivery, freedom from side effects, simplicity of use, and a rapid onset and offset. Newer approaches have threatened the widespread use of nitrous oxide, but despite its long history this simple gas still has much to offer. "I am sure the air in heaven must be this wonder-working gas of delight". Robert Southey, Poet (1774 to 1843)

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

    Science.gov (United States)

    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

  17. 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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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)

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Creation and Assessment of a Bad News Delivery Simulation Curriculum for Pediatric Emergency Medicine Fellows.

    Science.gov (United States)

    Chumpitazi, Corrie E; Rees, Chris A; Chumpitazi, Bruno P; Hsu, Deborah C; Doughty, Cara B; Lorin, Martin I

    2016-01-01

    Background  Bad news in the context of health care has been broadly defined as significant information that negatively alters people's perceptions of the present or future. Effectively delivering bad news (DBN) in the setting of the emergency department requires excellent communication skills. Evidence shows that bad news is frequently given inadequately. Studies show that trainees need to devote more time to developing this skill through formalized training. This program's objectives were to utilize trained standardized patients in a simulation setting to assist pediatric emergency medicine (PEM) fellows in the development of effective, sensitive, and compassionate communication with patients and family members when conveying bad news, and to recognize and respond to the patient/parent's reaction to such news. Methods PEM fellows participated in a novel curriculum utilizing simulated patients (SPs) acting as the patient's parent and immersive techniques in a realistic and supportive environment. A baseline survey was conducted to ascertain participant demographics and previous experience with simulation and DBN. Experienced, multi-disciplinary faculty participated in a training workshop with the SPs one week prior to course delivery. Three scenarios were developed for bad news delivery. Instructors watched via remote video feed while the fellows individually interacted with the SPs and then participated in a confidential debriefing. Fellows later joined for group debriefing. Fellow characteristics, experience, and self-perceived comfort pre/post-course were collected.   Results Baseline data demonstrated that 78% of fellows reported DBN two or more times per month. Ninety-three percent of fellows in this study were present during the delivery of news about the death of a child to a parent or family member in the six-month period preceding this course. Fellows' self-reported comfort level in DBN to a patient/family and dealing with patient and parent emotions

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

    Directory of Open Access Journals (Sweden)

    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

  2. [Switch from emergency medicine to disaster medicine].

    Science.gov (United States)

    Morikawa, Kentaro; Shimizu, Keiki

    2016-02-01

    Disaster medical system in Japan has been changing after huge disaster attack. Disaster Medical Assistance Team (DMAT) was established on 1995 after the Hanshin-Awaji Great Earthquake and played important role in the Great Eastern Japan Earthquake on 2011. The action of DMAT is specialized within acute phase. Continual medical aid activity is required from acute phase to chronic phase. After DMAT evacuation, Japan Medical Association Team (JMAT), Japanese Red Cross Teams, Medical university teams and many other medical teams work sequentially in the disaster area. On the other hand, unbalance in the disaster area is occurred. Disaster medical coordinator accommodates that unbalance situation. Development of receive system for many medical assistance teams will be required.

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

    International Nuclear Information System (INIS)

    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)

  4. D-dimer testing: advantages and limitations in emergency medicine for managing acute venous thromboembolism.

    Science.gov (United States)

    Siragusa, Sergio

    2006-01-01

    D-dimer values can be rapidly determined and used for the management of acute venous thromboembolism (VTE). However, its role in the setting of emergency still remains unclear and inappropriate testing is a significant clinical problem. This review discusses the currently used assays, clinical indications, and limitations of D-dimer measurement. Studies in English language were identified by searching PubMed from December 1985 to December 2005. Available literature on D-dimer was identified from Medline, along with cross referencing from the reference lists of major articles and reviews on this subject. Among 56 articles collected, 14 papers, 4 overviews and 1 systemic review were selected accordingly to predefined criteria. Data synthesis shows that D-dimer testing has sufficient diagnostic accuracy for ruling out acute VTE if used in combination with standardised clinical judgement. D-dimer seems to be also a useful tool for managing suspected VTE patients in absence of immediate imaging. Attention should be paid to exclude conditions that may affect the accuracy of the test, such as concomitant disease, heparin administration and symptom duration >15 days. Although enzyme-linked immunosorbent assay determination has the highest accuracy, immunoturbidimetric assay seems the most suitable on an emergency basis because of its rapid performance. In conclusion, at present D-dimer testing can be safely used in the management of acute VTE in emergency medicine. However, because of its heterogeneity related to the method used and setting implemented, it is preferable to assess D-dimer accuracy before its implementation in management strategies for VTE. PMID:16941816

  5. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    OpenAIRE

    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...

  6. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    OpenAIRE

    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 ...

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

    Directory of Open Access Journals (Sweden)

    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

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

    International Nuclear Information System (INIS)

    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. Updated tool for nuclear criticality accident emergency response

    International Nuclear Information System (INIS)

    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

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

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    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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)

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    Aaronson, Emily L.; Wittels, Kathleen A.; Nadel, Eric S.; Schuur, Jeremiah D.

    2015-01-01

    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. PMID:26594271

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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.)

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    Ho Ting Wong

    2015-08-01

    Full Text Available 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.

  3. 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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    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)

  5. [Organisation of emergency medicine in France].

    Science.gov (United States)

    Braun, Françis

    2015-01-01

    The French emergency medicine infrastructure (structures de médecine d'urgence) ensures patients care from the very location of the distress to the appropriate hospital department: medical care in the field, by hospital clinical teams (the services mobiles d'urgence et de réanimation [SMUR]), is a key characteristic of our medical emergency response system. Response to medical distress revolves around information about not only the location and characteristics of the medical need, but also the availability of adapted hospital services. Gathering and transmitting this information is the prerogative of the service d'aide médicale d'urgence (SAMU) and its telephone dispatch center (Centre 15). For patients coming directly to the hospital, the emergency room (ER), a former underfunded and neglected hospital service, has become a key point of access. The ER is now responsible, after providing immediate first line care, to guide the patient through the care system. As such they are equipped with short term hospitalization units designed to enable up to 24h patient observation before orientation. This ensemble, networked at the level of a health territory, ensures the quality, safety, and efficacy that the population is entitled to demand.

  6. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

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

    International Nuclear Information System (INIS)

    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. Free Open Access Meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002-2013).

    Science.gov (United States)

    Cadogan, Mike; Thoma, Brent; Chan, Teresa M; Lin, Michelle

    2014-10-01

    Disruptive technologies are revolutionising continuing professional development in emergency medicine and critical care (EMCC). Data on EMCC blogs and podcasts were gathered prospectively from 2002 through November 2013. During this time there was a rapid expansion of EMCC websites, from two blogs and one podcast in 2002 to 141 blogs and 42 podcasts in 2013. This paper illustrates the explosive growth of EMCC websites and provides a foundation that will anchor future research in this burgeoning field.

  9. Emerging paradigms in mind-body medicine.

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Experience and lessons learned from emergency disposal of Fukushima nuclear power station accident%日本福岛核电站核事故应急处置的经验和教训

    Institute of Scientific and Technical Information of China (English)

    徐卸古; 甄蓓; 杨晓明; 陈肖华

    2012-01-01

    After Fukushima nuclear accident , we visited the related medical aid agencies for nuclear accidents and con -ducted investigations in disaster-affected areas in Japan. This article summarizes the problems with emergency disposal of Fukushima nuclear accident while disclosing problems that should be solved during the emergency force construction for nu -clear accidents.%日本福岛核事故后,应日本同行的邀请,我们访问了日本核医学应急的相关单位,并到相关地区进行了考察.本文探讨了日本福岛核事故应急处置过程中存在的问题,提出了我国核应急力量建设过程中应注意的问题及相关对策.

  12. Nanorobots: The Emerging tools in Medicinal

    Directory of Open Access Journals (Sweden)

    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.

  13. Public health education for emergency medicine residents.

    Science.gov (United States)

    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

  14. Personalized medicine and the role of health economics and outcomes research: issues, applications, emerging trends, and future research.

    Science.gov (United States)

    O'Donnell, John C

    2013-01-01

    The decade since the completion of the sequencing of the human genome has witnessed significant advances in the incorporation of genomic information in diagnostic, treatment, and reimbursement practices. Indeed, as case in point, there are now several dozen commercially available genomic tests routinely applied across a wide range of disease states in predictive or prognostic applications. Moreover, many involved in the advancement of personalized medicine would view emerging approaches to stratify patients in meaningful ways beyond genomic information as a signal of the progress made. Yet despite these advances, there remains a general sense of dissatisfaction about the progress of personalized medicine in terms of its contribution to the drug development process, to the efficiency and effectiveness of health care delivery, and ultimately to the provision of the right treatment to the right patient at the right time. Academicians, payers, and manufacturers alike are struggling not only with how to embed the new insights that personalized medicine promises but also with the fundamental issues of application in early drug development, implications for health technology assessment, new demands on traditional health economic and outcomes research methods, and implications for reimbursement and access. In fact, seemingly prosaic issues such as the definition and composition of the term "personalized medicine" are still unresolved. Regardless of these issues, practitioners are increasingly compelled to find practical solutions to the challenges and opportunities presented by the evolving face of personalized medicine today. Accordingly, the articles comprising this Special Issue offer applied perspectives geared toward professionals and policymakers in the field grappling with developing, assessing, implementing, and reimbursing personalized medicine approaches. Starting with a framework with which to characterize personalized medicine, this Special Issue proceeds to

  15. Personalized medicine and the role of health economics and outcomes research: issues, applications, emerging trends, and future research.

    Science.gov (United States)

    O'Donnell, John C

    2013-01-01

    The decade since the completion of the sequencing of the human genome has witnessed significant advances in the incorporation of genomic information in diagnostic, treatment, and reimbursement practices. Indeed, as case in point, there are now several dozen commercially available genomic tests routinely applied across a wide range of disease states in predictive or prognostic applications. Moreover, many involved in the advancement of personalized medicine would view emerging approaches to stratify patients in meaningful ways beyond genomic information as a signal of the progress made. Yet despite these advances, there remains a general sense of dissatisfaction about the progress of personalized medicine in terms of its contribution to the drug development process, to the efficiency and effectiveness of health care delivery, and ultimately to the provision of the right treatment to the right patient at the right time. Academicians, payers, and manufacturers alike are struggling not only with how to embed the new insights that personalized medicine promises but also with the fundamental issues of application in early drug development, implications for health technology assessment, new demands on traditional health economic and outcomes research methods, and implications for reimbursement and access. In fact, seemingly prosaic issues such as the definition and composition of the term "personalized medicine" are still unresolved. Regardless of these issues, practitioners are increasingly compelled to find practical solutions to the challenges and opportunities presented by the evolving face of personalized medicine today. Accordingly, the articles comprising this Special Issue offer applied perspectives geared toward professionals and policymakers in the field grappling with developing, assessing, implementing, and reimbursing personalized medicine approaches. Starting with a framework with which to characterize personalized medicine, this Special Issue proceeds to

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Feedback in the Emergency Medicine Clerkships

    Directory of Open Access Journals (Sweden)

    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.

  19. International Federation for Emergency Medicine point of care ultrasound curriculum.

    Science.gov (United States)

    Atkinson, Paul; Bowra, Justin; Lambert, Mike; Lamprecht, Hein; Noble, Vicki; Jarman, Bob

    2015-03-01

    To meet a critical and growing need for a standardized approach to emergency point of care ultrasound (PoCUS) worldwide, emergency physicians must be trained to deliver and teach this skill in an accepted and reliable format. Currently, there is no globally recognized, standard PoCUS curriculum that defines the accepted applications, as well as standards for training and practice of PoCUS by specialists and trainees in emergency medicine. To address this deficit, the International Federation for Emergency Medicine (IFEM) convened a sub-committee of international experts in PoCUS to outline a curriculum for training of specialists in emergency PoCUS. This curriculum document represents the consensus of recommendations by this sub-committee. The curriculum is designed to provide a framework for PoCUS education in emergency medicine. The focus is on the processes required to select core and enhanced applications, as well as the key elements required for the delivery of PoCUS training from introduction through to continuing professional development and skill maintenance. It is designed not to be prescriptive but to assist educators and emergency medicine leadership to advance PoCUS education in emergency medicine no matter the training venue. The content of this curriculum is relevant not just for communities with mature emergency medicine systems but in particular for developing nations or for nations seeking to develop PoCUS training programs within the current educational structure. We anticipate that there will be wide variability in how this curriculum is implemented and taught, reflecting the existing educational environment, resources and goals of educational programs. PMID:26052968

  20. Emergency preparation and maneuver of HFETR

    International Nuclear Information System (INIS)

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    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.)

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

    OpenAIRE

    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 ...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  8. An innovative longitudinal curriculum to increase emergency medicine residents’ exposure to rarely encountered and technically challenging procedures

    Directory of Open Access Journals (Sweden)

    Grall KH

    2014-07-01

    Full Text Available Kristi H Grall,1 Lisa R Stoneking,1 Lawrence A DeLuca,1 Anna L Waterbrook,1 T Gail Pritchard,2,3 Kurt R Denninghoff1 1Department of Emergency Medicine, The College of Medicine, The University of Arizona, 2Office Medical Student Education, 3Office of Graduate Medical Education, The College of Medicine, The University of Arizona, Tucson, AZ, USA Background: Procedural skills have historically been taught at the bedside. In this study, we aimed to increase resident knowledge of uncommon emergency medical procedures to increase residents’ procedural skills in common and uncommon emergency medical procedures and to integrate cognitive training with hands-on procedural instruction using high- and low-fidelity simulation. Methods: We developed 13 anatomically/physiologically-based procedure modules focusing on uncommon clinical procedures and/or those requiring higher levels of technical skills. A departmental expert directed each session with collaboration from colleagues in related subspecialties. Sessions were developed based on Manthey and Fitch’s stages of procedural competency including 1 knowledge acquisition, 2 experience/technical skill development, and 3 competency evaluation. We then distributed a brief, 10-question, online survey to our residents in order to solicit feedback regarding their perceptions of increased knowledge and ability in uncommon and common emergency medical procedures, and their perception of the effectiveness of integrated cognitive training with hands-on instruction through high- and low-fidelity simulation. Results: Fifty percent of our residents (11/22 responded to our survey. Responses indicated the procedure series helped with understanding of both uncommon (65% strongly agreed [SA], 35% agreed [A] and common (55% SA, 45% A emergency medicine procedures and increased residents’ ability to perform uncommon (55% SA, 45% A and common (45% SA, 55% A emergency medical procedures. In addition, survey results

  9. Integrative medicine and systemic outcomes research: issues in the emergence of a new model for primary health care.

    Science.gov (United States)

    Bell, Iris R; Caspi, Opher; Schwartz, Gary E R; Grant, Kathryn L; Gaudet, Tracy W; Rychener, David; Maizes, Victoria; Weil, Andrew

    2002-01-28

    Clinicians and researchers are increasingly using the term integrative medicine to refer to the merging of complementary and alternative medicine (CAM) with conventional biomedicine. However, combination medicine (CAM added to conventional) is not integrative. Integrative medicine represents a higher-order system of systems of care that emphasizes wellness and healing of the entire person (bio-psycho-socio-spiritual dimensions) as primary goals, drawing on both conventional and CAM approaches in the context of a supportive and effective physician-patient relationship. Using the context of integrative medicine, this article outlines the relevance of complex systems theory as an approach to health outcomes research. In this view, health is an emergent property of the person as a complex living system. Within this conceptualization, the whole may exhibit properties that its separate parts do not possess. Thus, unlike biomedical research that typically examines parts of health care and parts of the individual, one at a time, but not the complete system, integrative outcomes research advocates the study of the whole. The whole system includes the patient-provider relationship, multiple conventional and CAM treatments, and the philosophical context of care as the intervention. The systemic outcomes encompass the simultaneous, interactive changes within the whole person. PMID:11802746

  10. Radiological accidents, scenarios, planning and answers

    International Nuclear Information System (INIS)

    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

  11. Pediatric Abdominal Pain: An Emergency Medicine Perspective.

    Science.gov (United States)

    Smith, Jeremiah; Fox, Sean M

    2016-05-01

    Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. PMID:27133248

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

    International Nuclear Information System (INIS)

    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)

  13. A time and motion study of patients presenting at the accident and emergency department at Mater Dei Hospital

    Directory of Open Access Journals (Sweden)

    Ellul Robert

    2011-10-01

    Full Text Available Abstract Background To carry out a time and motion study of patients presenting at the Emergency Department (ED by measuring waiting times at the ED dept throughout the day. The objectives were: • to determine whether waiting times are prolonged, and • if prolonged, at which station(s bottlenecks occur most often in terms of duration and frequency. Results will be compared to the United Kingdom guidelines of stay at the emergency department. Methods A group of 11 medical students monitored all patients who attended ED between 0600 hours on the 25th August and 0600 hours on the 1st September 2008. For each 24 hour period, students were assigned to the triage room and the 3 priority areas where they monitored all patient-related activity, movement and waiting times so that length of stay (LOS could be recorded. The key data recorded included patient characteristics, waiting times at various ED process stages, tests performed, specialist consultations and follow up until admitted, discharged, or referred to another hospital area. Average waiting times were calculated for each priority area. Bottle-necks and major limiting factors were identified. Results were compared against the United Kingdom benchmarks - i.e. 1 hour until first assessment, and 4 hours before admitting/discharge. Results 1779 patients presented to the ED in the week monitored. As expected, patients in the lesser priority areas (i.e. 2 & 3 waited longer before being assessed by staff. Patients requiring laboratory and imaging investigations had a prolonged length of stay, which varied depending on specific tests ordered. Specialty consultation was associated with longer waiting times. A major bottleneck identified was waiting times for inpatient admission. Conclusions In conclusion, it was found that 30.3% of priority 1 patients, 86.3% of priority 2 patients and 76.8% of priority 3 patients waited more than 1 hour for first assessment. We conclude by proposing several changes

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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    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

  16. Transport accidents among children and adolescents at the emergency service of a teaching hospital in the southern zone of the city of São Paulo☆☆☆

    Science.gov (United States)

    Gorios, Carlos; de Souza, Renata Maia; Gerolla, Viviane; Maso, Bruno; Rodrigues, Cintia Leci; Armond, Jane de Eston

    2014-01-01

    Objective to describe the victim profile and circumstances of transport accidents involving children and adolescents who were attended at a teaching hospital in the southern zone of the city of São Paulo. Methods this was an individual observational case series study among patients up to the age of 19 years who were attended at a hospital in the southern zone of the city of São Paulo, state of São Paulo, Brazil, due to traffic accidents. The files notifying suspected or confirmed cases of violence and accidents (SIVVA files) covering January to December 2012 were analyzed. Results among the 149 cases notified, 64.4% related to males and 35.6% to females. The transport accidents were predominantly among males, irrespective of age. The main injury diagnoses were superficial head trauma (24.8%) followed by multiple non-specified trauma (36.4%), in both sexes. Conclusion transport accidents among children and adolescents occurred more often among males. The main transport accidents among the children and adolescents attended as emergency cases were caused by motor vehicles and motorcycles. Among the accident victims, the largest proportion was attended because of being run over. PMID:26229833

  17. Internal medicine and emergency admissions: from a national hospital discharge records (SDO study to a regional analysis

    Directory of Open Access Journals (Sweden)

    Filomena Pietrantonio

    2016-02-01

    Full Text Available In Italy, the number of internists has grown by 10% since 1990 reaching 11,435 units, they manage 39,000 beds in 1060 Internal Medicine (IM wards. The Internists are expected to ensure a cost-effective management of poly-pathological and complex patients. A collaborative study between the Federation of Associations of Hospital Doctors on Internal Medicine (FADOI and the Consortium for Applied Health Economics Research (C.R.E.A. Sanità based on data from hospital discharge records has been conducted starting from November 2014. In this article the preliminary results are shown with focus on emergency admissions characteristics to contribute to define the role of hospital IM. Evaluation is performed comparing emergency and planned admissions, IM impact on hospital admissions, availability of community-based healthcare services, diagnosis-related groups (DRGs weight in IM and regional differences in managing hospital admissions with focus on IM department. In 2013 IM wards discharged 1,073,526 patients (16.18% of the total discharged by hospitals with a total economic value of 3,426,279.88 € (average DRG 3882.80 €, from 3682.19 to 4083.42. The average length of stay (LOS in IM was 9.3 days. IM covers 27% of admissions from Emergency Room. Determinants significantly affecting the emergency admissions are old age and comorbidities of the patients that also have a role in increasing LOS. 55% of Italian hospital admissions are emergency admissions. Hospitalization rates in emergency are systematically higher than those in election and the greatest differences are in the regions with inefficiently organized regional network. The role of the hospital IM appears central in the offer of beds to the emergency room by accepting 27% of urgent admissions. The increasing impact of IM on hospital management will put the internists as authoritative stakeholders in health policy.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  20. Dementia and Traffic Accidents

    DEFF Research Database (Denmark)

    Petersen, Jindong Ding; Siersma, Volkert; Nielsen, Connie Thurøe;

    2016-01-01

    BACKGROUND: As a consequence of a rapid growth of an ageing population, more people with dementia are expected on the roads. Little is known about whether these people are at increased risk of road traffic-related accidents. OBJECTIVE: Our study aims to investigate the risk of road traffic......-related accidents for people aged 65 years or older with a diagnosis of dementia in Denmark. METHODS: We will conduct a nationwide population-based cohort study consisting of Danish people aged 65 or older living in Denmark as of January 1, 2008. The cohort is followed for 7 years (2008-2014). Individual's personal...... data are available in Danish registers and can be linked using a unique personal identification number. A person is identified with dementia if the person meets at least one of the following criteria: (1) a diagnosis of the disease in the Danish National Patient Register or in the Danish Psychiatric...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Adjusting ability and sensibility for an accident

    International Nuclear Information System (INIS)

    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)

  4. Accidents and human factors

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    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

  6. Owning the cost of emergency medicine: beyond 2%.

    Science.gov (United States)

    Lee, Michael H; Schuur, Jeremiah D; Zink, Brian J

    2013-11-01

    This article evaluates current evidence on the cost of emergency care. First, we reviewed data from national data sets and found that aggregate spending on emergency care is 5% to 6% of national health expenditures but could be as high as 10%. These figures are significantly higher than those previously published. Second, we reviewed the literature on economic models of the cost of emergency care and found that the results are inconclusive and incomplete. As an alternative, we discussed activity-based cost accounting and concluded that it is a promising research methodology for emergency medicine. We conclude by advocating for a strategy to demonstrate the value and strategic importance of emergency medicine rather than minimizing its role in national health care costs.

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

    Energy Technology Data Exchange (ETDEWEB)

    Frush, Karen [Duke University School of Medicine, DUMC, Department of Pediatrics, Box 3701, Durham, NC (United States)

    2014-10-15

    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.)

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  10. Back to basics: emergency medicine in dentistry.

    Science.gov (United States)

    Malamed, S F

    1997-04-01

    It is important that all members of the dental office staff be trained to promptly recognize and efficiently manage emergency situations. This paper discusses how to prepare a dental office and staff for emergencies. It also describes several emergencies that may occur in dental offices and discusses methods of handling them.

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

    OpenAIRE

    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...

  12. Effectiveness of emergency medicine in longitudinal integrated clerkships

    OpenAIRE

    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. ...

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

    Directory of Open Access Journals (Sweden)

    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.

  14. The core content of emergency medical services medicine.

    Science.gov (United States)

    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

  15. An Innovative Educational and Mentorship Program for Emergency Medicine Women Residents to Enhance Academic Development and Retention.

    Science.gov (United States)

    Bhatia, Kriti; Takayesu, James Kimo; Arbelaez, Christian; Peak, David; Nadel, Eric S

    2015-11-01

    Given the discrepancy between men and women's equal rates of medical school matriculation and their rates of academic promotion and leadership role acquisition, the need to provide mentorship and education to women in academic medicine is becoming increasingly recognized. Numerous large-scale programs have been developed to provide support and resources for women's enrichment and retention in academic medicine. Analyses of contributory factors to the aforementioned discrepancy commonly cite insufficient mentoring and role modeling as well as challenges with organizational navigation. Since residency training has been shown to be a critical juncture for making the decision to pursue an academic career, there is a need for innovative and tailored educational and mentorship programs targeting residents. Acknowledging residents' competing demands, we designed a program to provide easily accessible mentorship and contact with role models for our trainees at the departmental and institutional levels. We believe that this is an important step towards encouraging women's pursuit of academic careers. Our model may be useful to other emergency medicine residencies looking to provide such opportunities for their women residents. PMID:25915003

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Review article: Crisis resource management in emergency medicine.

    Science.gov (United States)

    Carne, Belinda; Kennedy, Marcus; Gray, Tim

    2012-02-01

    Effective team management is a core element of expert practice in emergency medicine. Thus far, training in emergency medicine has focussed predominantly on proficiency in medical and technical skills, with emergency physicians acquiring these 'non-technical' skills in an ad hoc manner or by trial and error with varying levels of success. This paper describes a set of behaviours that, when practised in conjunction with medical and technical expertise, can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of an ED. Teaching and practice of these behaviours is now a core element of training and skills maintenance in other high-risk areas, such as aviation, and is becoming part of the routine training for anaesthetists. They address areas, such as communication, leadership, knowledge of environment, anticipation and planning, obtaining timely assistance, attention allocation and workload distribution. We outline the application of these behaviours in the speciality of emergency medicine, and suggest that the teaching and practice of crisis resource management principles should become part of the curriculum for training and credentialing of emergency medicine specialists.

  18. Nurses' attitudes towards suicidal behaviour--a comparative study of community mental health nurses and nurses working in an accidents and emergency department.

    Science.gov (United States)

    Anderson, M

    1997-06-01

    The purpose of this study was to explore and compare the attitudes towards suicidal behaviour of community mental health nurses (CMHNs) and registered nurses working in an accidents and emergency (A&E) department. The sample consisted of 80 nurses working in the same locality. An instrument was designed using statements from Domino's 'Suicide Opinion Questionnaire' (SOQ) and new statements based on a comprehensive survey of research in this area. The instrument contained four attitudinal categories consisting of; acceptability; morality and mental illness; professional role, work and care; and communication and attention. Results reveal that both groups of nurses held generally positive attitudes towards suicidal behaviour, contrasting with previous studies where more negative attitudes amongst nurses were found. A t-test showed no statistically significant differences between the two groups of nurses in any of the four attitudinal categories. Attitudes were significantly different in accordance with nurses' length of experience and age within both groups. Further research is needed in this area if nurses are to develop their role alongside other professionals working towards the objectives of suicide prevention policies.

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

    Science.gov (United States)

    Gokulakrishnan, P; 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: (i) the Road Side Unit (RSU) constructs a Prediction Report (PR) based on the status of the vehicles and traffic in the highway roads, (ii) the RSU generates an Emergency Warning Message (EWM) based on an abnormal PR, (iii) the RSU forms a VBN structure and (iv) the RSU disseminates the EWM to the vehicles that holds the high Risk Factor (RF) and travels in High Risk Zone (HRZ). These vehicles might reside either within the RSU's coverage area or outside RSU's coverage area (reached using VBN structure). The RAP scheme improves the performance of EWM dissemination in terms of increase in notification and decrease in end-to-end delay. The RAP scheme also reduces infrastructure cost (number of RSUs) by formulating and deploying the VBN structure. The RAP scheme with VBN structure improves notification by 19 percent and end-to-end delay by 14.38 percent for a vehicle density of 160 vehicles. It is also proved from the simulation experiment that the performance of RAP scheme is promising in 4-lane highway roads.

  20. Authority structure and industrial accidents

    OpenAIRE

    As, Sicco van

    2001-01-01

    This paper deals with the influence of organizational characteristics on safety. Accidents are actually caused by individual mistakes. However the underlying causes of accidents are often organizational. The general hypothesis is that the authority structure is a main cause of accident-proneness within organizations. On one side, the most obvious model for a safe organization would be the ideal-typical bureaucracy. On the other side, potential problems are little flexibility and control is ba...

  1. Radiation accidents and defence of population

    International Nuclear Information System (INIS)

    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

  2. 49 CFR 835.11 - Obtaining Board accident reports, factual accident reports, and supporting information.

    Science.gov (United States)

    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....

  3. Management of traumatic wounds in the Emergency Department: position paper from the Academy of Emergency Medicine and Care (AcEMC) and the World Society of Emergency Surgery (WSES).

    Science.gov (United States)

    Prevaldi, Carolina; Paolillo, Ciro; Locatelli, Carlo; Ricci, Giorgio; Catena, Fausto; Ansaloni, Luca; Cervellin, Gianfranco

    2016-01-01

    Traumatic wounds are one of the most common problems leading people to the Emergency Department (ED), accounting for approximately 5,4 % of all the visits, and up to 24 % of all the medical lawsuits. In order to provide a standardized method for wound management in the ED, we have organized a workshop, involving several Italian and European experts. Later, all the discussed statements have been submitted for external validation to a multidisciplinary expert team, based on the so called Delphi method. Eight main statements have been established, each of them comprising different issues, covering the fields of wound classification, infectious risk stratification, tetanus and rabies prophylaxis, wound cleansing, pain management, and suture. Here we present the results of this work, shared by the Academy of Emergency Medicine and Care (AcEMC), and the World Society of Emergency Surgery (WSES). PMID:27330546

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

    Science.gov (United States)

    Boutis, Kathy; Thomas, Karen E

    2016-01-01

    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

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

    OpenAIRE

    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...

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

    OpenAIRE

    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 ...

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

    OpenAIRE

    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...

  8. An eMERGE Clinical Center at Partners Personalized Medicine

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

    Science.gov (United States)

    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

  10. 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.

    Science.gov (United States)

    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 %.

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

    International Nuclear Information System (INIS)

    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)

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  15. Emergency Treatment and Prevention Measures of Chlorine Gas Accidents%氯气事故的处置措施与预防

    Institute of Scientific and Technical Information of China (English)

    朱亚菲

    2012-01-01

    主要介绍氯气的制备发展史,及其物理、化学性质。通过实例说明氯气泄漏事故给人民的生命、财产造成极大的损失和对环境造成的严重污染和破坏。对氯气泄漏后的应急处置方法和泄漏预防措施进行简要概述。%Introduced the history of the development of the preparation of chlorine, the physical and chemical property of chlorine. Through several examples that the leakage accidents of chlorine gas threat people's life , brought a great loss of property and cause serious pollution and destruction to the environment. A brief overview was taken in this thesis that the disposal method and the leakage prevention measures of chlorine for the consequence of the chlorine leaking emergency.

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

    OpenAIRE

    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...

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

    Science.gov (United States)

    Duan, Weili; He, Bin

    2015-07-10

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

  20. Emergency Medicine Resident Perceptions of Medical Professionalism

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

    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)

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

    OpenAIRE

    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...

  4. Comparative analysis on emergency management for leakage explosion accidents of urban oil and gas pipeline%城市油气管道泄漏爆炸重大案例应急管理对比研究

    Institute of Scientific and Technical Information of China (English)

    李晶晶; 朱渊; 陈国明; 李修峰

    2014-01-01

    The extraordinary serious accident of Dongying-Huangdao oil pipeline leakage explosion in Qingdao , Shandong, has aroused public concern nationwide about urban oil and gas pipeline safety .In recent years, acci-dents in urban oil and gas pipeline frequently occurred , which seriously indicate the major problems existed in se-curity management .Comparative analysis was carried out based on similar accident investigation , between sewer network explosion in Guadalajara Mexico and Dongying-Huangdao oil pipeline leakage explosion in Qingdao Shang-dong .According to the accident-causing theory , the developing trend of accident was explored and chain model was established .Combined the concept of emergency management , common issues were analyzed during the process from pre-warning and pre-control , emergency disposal , assessment and recovery .Control measures were proposed in each stage of emergency management , by learning from the lessons of accidents , in order to reduce the probabili-ty of accidents and enhance the capability of emergency manage .%青岛东黄输油管道泄漏爆炸特别重大事故,引起公众对城市油气管道安全的普遍关注。近年来,城市油气管道事故频繁发生,反映出我国在城市地下管道安全管理方面存在较大问题。基于国内外管道相似事故调研,选取墨西哥瓜达拉哈拉管道泄漏爆炸事故和青岛东黄输油管道泄漏爆炸事故进行对比分析。基于事故致因理论,探究事故发展模式,建立事故链模型。结合应急管理思想,从预警预控、应急处置、评估恢复角度分析事故应急管理过程的共性失误。最后,针对应急管理各阶段共性失误提出防范措施,对提高类似事故的应急管理能力具有一定的参考意义。

  5. 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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

    Wiler, Jennifer L; Granovsky, Michael; Cantrill, Stephen V; Newell, Richard; Venkatesh, Arjun K; Schuur, Jeremiah D

    2016-03-01

    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. PMID:26973757

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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 ...

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. MDCT findings in sports and recreational accidents

    International Nuclear Information System (INIS)

    Background. Sports and recreational accidents involving critical areas of the body occur commonly in the general population. Reports on their demographics and recommendations for screening procedures are, however, few. Purpose. To assess injuries of the craniofacial area, spine, and torso resulting from sports and recreational accidents with multidetector computed tomography (MDCT) as primary imaging method in a Level I trauma center. Material and Methods. All emergency room CT requests over a time span of 105 months were reviewed retrospectively for trauma mechanism and injury. Patients were identified using an electronic picture archiving and communications system (PACS), and MDCT studies interpreted by two radiologists independently. Results. Of a total of 5898 patients, 492 patients (301 boys/men, 191 girls/women, age range 2-76 years, mean 33.5 years, median 29.5 years) with sports or recreational accidents emerged. A total of 102 traumatic findings were diagnosed, thereof 72 (71%) serious. The three most commonly encountered serious injuries were intracranial injury, fractures of facial bones, and vertebral injuries. The three most common injury mechanisms were bicycling, horseback riding, and team ball sports. Patients from recreational activities were on average significantly younger (29.2 years) than those from sports accidents (36.9 years; P < 0.001). Only age groups <21 years and 41-50 years differed in injury severity from the other age groups (P = 0.004 and P = 0.063, respectively). Of all trauma mechanisms, only bicycling had a significantly increased risk of injury (P < 0.001). Conclusion. Injuries in sports and recreational accidents presented with an overall incidence of 21%, of which 71% are serious. The most common mechanisms of injury were bicycling, horseback riding, and team ball sports. The largest incidence of serious injury involved bicycling. Because of the high probability of a serious injury and the high energies that are often involved

  13. MDCT findings in sports and recreational accidents

    Energy Technology Data Exchange (ETDEWEB)

    Bensch, Frank V; Koivikko, Mika P; Koskinen, Seppo K (Dept. of Radiology, Toeoeloe Hospital, Helsinki (Finland)), email: frank.bensch@hus.fi

    2011-12-15

    Background. Sports and recreational accidents involving critical areas of the body occur commonly in the general population. Reports on their demographics and recommendations for screening procedures are, however, few. Purpose. To assess injuries of the craniofacial area, spine, and torso resulting from sports and recreational accidents with multidetector computed tomography (MDCT) as primary imaging method in a Level I trauma center. Material and Methods. All emergency room CT requests over a time span of 105 months were reviewed retrospectively for trauma mechanism and injury. Patients were identified using an electronic picture archiving and communications system (PACS), and MDCT studies interpreted by two radiologists independently. Results. Of a total of 5898 patients, 492 patients (301 boys/men, 191 girls/women, age range 2-76 years, mean 33.5 years, median 29.5 years) with sports or recreational accidents emerged. A total of 102 traumatic findings were diagnosed, thereof 72 (71%) serious. The three most commonly encountered serious injuries were intracranial injury, fractures of facial bones, and vertebral injuries. The three most common injury mechanisms were bicycling, horseback riding, and team ball sports. Patients from recreational activities were on average significantly younger (29.2 years) than those from sports accidents (36.9 years; P < 0.001). Only age groups <21 years and 41-50 years differed in injury severity from the other age groups (P = 0.004 and P = 0.063, respectively). Of all trauma mechanisms, only bicycling had a significantly increased risk of injury (P < 0.001). Conclusion. Injuries in sports and recreational accidents presented with an overall incidence of 21%, of which 71% are serious. The most common mechanisms of injury were bicycling, horseback riding, and team ball sports. The largest incidence of serious injury involved bicycling. Because of the high probability of a serious injury and the high energies that are often involved

  14. 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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    Science.gov (United States)

    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

  16. Medical emergency provisions in case of large-scale radiation accidents (literature review)

    International Nuclear Information System (INIS)

    Problems of planning population protection in case of severe radiation accidents are considered. Attention is paid to the state of these problems in the USSR and other contries as well as to IAEA directives. The Three Mile Island and Chernobyl accidents are used for illustration purposes. Organization of medical help during radiation accidents, provided for in national regulations and experience gained during Chernobyl NPP accident are considered. Conclusion is made on the necessity of forcasting accident consequences with regard to local, social, economical, geographic and other conditions. Availability of medical provision plans, related to elimination of accident aftereffects and skill training, is obligatory

  17. Toward a definition of teamwork in emergency medicine.

    Science.gov (United States)

    Fernandez, Rosemarie; Kozlowski, Steve W J; Shapiro, Marc J; Salas, Eduardo

    2008-11-01

    The patient safety literature from the past decade emphasizes the importance of teamwork skills and human factors in preventing medical errors. Simulation has been used within aviation, the military, and now health care domains to effectively teach and assess teamwork skills. However, attempts to expand and generalize research and training principles have been limited due to a lack of a well-defined, well-researched taxonomy. As part of the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," a subset of the group expertise and group assessment breakout sections identified evidence-based recommendations for an emergency medicine (EM) team taxonomy and performance model. This material was disseminated within the morning session and was discussed both during breakout sessions and via online messaging. Below we present a well-defined, well-described taxonomy that will help guide design, implementation, and assessment of simulation-based team training programs. PMID:18828831

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    The aim of the study was (1) to describe hormone responses in insulin-induced hypoglycaemia and (2) to investigate if a combined treatment with intravenous glucose and intramuscular glucagon (group A) would improve glucose recovery as compared to treatment with intravenous glucose alone (group B...

  1. Severe accident management. Optimized guidelines and strategies

    International Nuclear Information System (INIS)

    the accident progression in near future, to identify the currently most critical tasks as well as upcoming tasks, and to qualify the emergency response team to make informed decisions for the severe accident mitigation based on state-of-the-art knowledge. In this paper, this severe accident management concept is introduced and explained. It is also shown that AREVA is able to apply this methodology to other (including non-OEM) plant types, thus providing a comprehensive safety analysis of the existing plant state with already available safety systems and instrumentation. In addition, the possible need and potential for hardware refitting can be assessed as well. Finally, the severe accident management procedures are then established or updated accordingly. (author)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    P Gokulakrishnan

    Full Text Available 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: (i the Road Side Unit (RSU constructs a Prediction Report (PR based on the status of the vehicles and traffic in the highway roads, (ii the RSU generates an Emergency Warning Message (EWM based on an abnormal PR, (iii the RSU forms a VBN structure and (iv the RSU disseminates the EWM to the vehicles that holds the high Risk Factor (RF and travels in High Risk Zone (HRZ. These vehicles might reside either within the RSU's coverage area or outside RSU's coverage area (reached using VBN structure. The RAP scheme improves the performance of EWM dissemination in terms of increase in notification and decrease in end-to-end delay. The RAP scheme also reduces infrastructure cost (number of RSUs by formulating and deploying the VBN structure. The RAP scheme with VBN structure improves notification by 19 percent and end-to-end delay by 14.38 percent for a vehicle density of 160 vehicles. It is also proved from the simulation experiment that the performance of RAP scheme is promising in 4-lane highway roads.

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

    Science.gov (United States)

    Gokulakrishnan, P; 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: (i) the Road Side Unit (RSU) constructs a Prediction Report (PR) based on the status of the vehicles and traffic in the highway roads, (ii) the RSU generates an Emergency Warning Message (EWM) based on an abnormal PR, (iii) the RSU forms a VBN structure and (iv) the RSU disseminates the EWM to the vehicles that holds the high Risk Factor (RF) and travels in High Risk Zone (HRZ). These vehicles might reside either within the RSU's coverage area or outside RSU's coverage area (reached using VBN structure). The RAP scheme improves the performance of EWM dissemination in terms of increase in notification and decrease in end-to-end delay. The RAP scheme also reduces infrastructure cost (number of RSUs) by formulating and deploying the VBN structure. The RAP scheme with VBN structure improves notification by 19 percent and end-to-end delay by 14.38 percent for a vehicle density of 160 vehicles. It is also proved from the simulation experiment that the performance of RAP scheme is promising in 4-lane highway roads. PMID:26636576

  5. Adult emergence inhibition and adulticidal activities of medicinal plant extracts againstAnopheles stephensiListon

    Institute of Scientific and Technical Information of China (English)

    AbdulAbduzZahir; AbdulAbdulRahuman; AsokanBa=gavan; GandhiElango; Chinnaperumal Kamaraj

    2010-01-01

    Objective:To determine the adult emergence inhibition (EI) and adulticidal activities of hexane, chloroform, ethyl acetate, and acetone leaves extracts of Anisomeles malabarica (A. malabarica), Euphorbia hirta (E. hirta), Ocimum basilicum (O. basilicum), Ricinus communis (R. communis), Solanum trilobatum (S. trilobatum), Tridax procumbens (T. procumbens)and seeds ofGloriosa superba (G. superba) againstAnopheles stephensi (An. stephensi).Methods: The EI and adulticidal trials were carried out according to World Health Organization (WHO) procedures with slight modifications. The extracts were diluted in dimethyl sulphoxide in order to prepare a serial dilution of test dosages (15.625, 31.25, 62.5, 125, 250, 500 and1 000μg/mL). Five duplicate trials were carried out for every sample concentration, and for each trial a negative control was included and the mortality was determined after24 h of exposure.Results: The highestEI activity was found in ethyl acetate extracts ofA. malabarica, chloroform extracts ofO. basilicum, S.trilobatum, acetone of extract ofR. communis, T. procumbens, and seed extract ofG. superba withEI50 values143.12, 119.82, 157.87, 139.39, 111.19, and134.85 μg/mL, and the effective adulticidal activity was observed in chloroform, acetone extracts ofG. superba, T. procumbens, R. communis, S.trilobatum and ethyl acetate extract ofO. basilicum with LD50 values120.17, 108.77, 127.22, 163.11, 118.27, and93.02μg/mL, respectively. Chi-square value was significant atP<0.05 level.Conclusions: These results should encourage further efforts to investigate the compounds that might possess good EI and adulticidal properties when isolated in pure form.

  6. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  7. Evaluation of Emergency Medicine Community Educational Program

    Directory of Open Access Journals (Sweden)

    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.

  8. Quality Assurance in Emergency Medicine - A Caribbean Perspective

    OpenAIRE

    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...

  9. Psychical and social effects related to post-accident situations: some training of Chernobyl accident

    International Nuclear Information System (INIS)

    Some preliminary considerations on the psychic and societal dimensions related to post-accident situations connected to large scale and heavy land contamination are presented. This is done with the objective of exploring the role that these dimensions could play in the elaboration of new radiological protection principles and concepts in order to restore confidence among affected populations after a nuclear accident. It is important to facilitate the return to normal or, at least, acceptable living conditions, as soon as reasonably achievable, and to prevent the possible emergence of a post-accident crisis. A scheme is proposed for understanding the dynamics of the various phases after an accident, taking into account the collective response to the consequences as well as, the response to the countermeasures. (Author)

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Electricity-caused deathly accidents in households and their misinterpretation

    Energy Technology Data Exchange (ETDEWEB)

    Erkrath, K.D.; Weiler, G.

    1982-12-17

    In this report results are presented which indicate the problems which are connected with the primary diagnosis and to which the emergency physician finds himself confronted. Comparable with a wrong diagnosis in the case of a fatal CO intoxication, the source of danger remains also in case of an undetected fatal accidents due to electricity which occured in the household, and consequently the physician might one day be accused of manslaughter caused by criminal negligence, if another fatal accident occurs. This article gives five selected examples which shall help the emergency physician and the coroner to consider the death due to electric shock as a possible cause of death when a fatal accident occurs in a household. Between 1974 and 1981 autopsy was made in 40 persons, who had died in accidents due to electric shock, in the Institut fuer Rechtsmedizin des Universitaetsklinikums Essen. Of these cases 26 were identified as accidents which had occurred in the household.

  12. Statistical modelling of the frequency and severity of road accidents

    DEFF Research Database (Denmark)

    Janstrup, Kira Hyldekær

    management tool.Initially models were built by using existing traffic accident data collected by the police and emergency rooms in Denmark. The data registered by the police was collected on traffic accidents occurred on Danish roads in the period between 2002 and 2008. The emergency room data were collected...... to be the most relevant factor related to the lack of intention to report future cycling accidents. Secondly, the factors: concerns about family distress and social image and preference to allocate time to other activities are both associated with non-reporting intentions (Paper 3). 5) New information about...

  13. Decision support system for emergency management of oil spill accidents in the Mediterranean Sea

    Science.gov (United States)

    Liubartseva, Svitlana; Coppini, Giovanni; Pinardi, Nadia; De Dominicis, Michela; Lecci, Rita; Turrisi, Giuseppe; Cretì, Sergio; Martinelli, Sara; Agostini, Paola; Marra, Palmalisa; Palermo, Francesco

    2016-08-01

    This paper presents an innovative web-based decision support system to facilitate emergency management in the case of oil spill accidents, called WITOIL (Where Is The Oil). The system can be applied to create a forecast of oil spill events, evaluate uncertainty of the predictions, and calculate hazards based on historical meteo-oceanographic datasets. To compute the oil transport and transformation, WITOIL uses the MEDSLIK-II oil spill model forced by operational meteo-oceanographic services. Results of the modeling are visualized through Google Maps. A special application for Android is designed to provide mobile access for competent authorities, technical and scientific institutions, and citizens.

  14. Being first on the scene of an accident--experiences of 'doing' prehospital emergency care.

    Science.gov (United States)

    Elmqvist, Carina; Brunt, David; Fridlund, Bengt; Ekebergh, Margaretha

    2010-06-01

    Prehospital emergency care includes the care and treatment of patients prior to them reaching hospital. This is generally a field for the ambulance services, but in many cases firemen or police can be the ones to provide the first responses. The aim of this study was to describe and understand experiences of being the first responder on the scene of an accident, as described by policemen, firemen and ambulance staff. A lifeworld perspective was used in four different traumatic situations from southern Sweden. The data consisted of 13 unstructured interviews with first responders. The phenomenological analysis showed that experiences of being the first responder on the scene of an accident is expectations of doing a systematic course of action, dressed in the role of a hero, and at the same time being genuine in an interpersonal encounter. This entails a continuous movement between 'being' and 'doing'. It is not a question of either - or, instead everything is to be understood in relation to each other at the same time. Five constituents further described the variations of the phenomenon; a feeling of security in the uncertainty, a distanced closeness to the injured person, one moment in an eternity, cross-border cooperation within distinct borders and a need to make the implicit explicit. This finding highlights the importance of using policemen and firemen in doing life support measures while waiting for the ambulance staff, and would in turn increase the importance of the relationship between the different professionals on the scene of an accident. PMID:19732398

  15. Emerging applications of radioisotopes in nuclear medicine

    International Nuclear Information System (INIS)

    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

  16. Compilation and response key points of emergency plan for dangerous chemical poisoning accident attention and response points%危险化学品中毒事故应急预案编制与响应关注要点

    Institute of Scientific and Technical Information of China (English)

    邢娟娟

    2011-01-01

    大工业的发展导致各类职业中毒事件的发生日益严重,除人员伤亡等影响外,也会对于社会公众安全带来影响.应急预案编制中强调应急准备的重要性和针对性.职业危害事故识别和分类分级处理以及对于社会公共安全影响的危机处理能力是应急工作中应该关注的重要内容.应急响应中强调第一目击者的处理能力的培养、现场的实时监测、事故报告与事态演变的持续预警、有效应急资源应对危机处理的能力.%The development of great industry lead to the occurrence of all kinds of occupational poisoning event, in addition to the increasingly serious casualties, the social public security will also be affected. Emergency plancom-pilation stressed in the the importance and relevance of emergency preparedness. Occupational hazard accidents I-dentification, classification and grading disposal, and the ability of handling crisis for public safety influence were the important content that should be focused on in emergency work. Emergency response stressed in the training of first witnesses processing ability that should be focused on in emergency work, on-site real-time monitoring, the accident report and the early warning of evolution, and the ability to effectively deal with crisis disposal of emergency resources.

  17. 急诊护理常见纠纷原因探析及防范对策%Investigation and precaution measure on the common causes of emergency medical accidents

    Institute of Scientific and Technical Information of China (English)

    傅清华

    2012-01-01

      Emergency treatment is the high risk area for medical accidents and disputes, ease to mistakes and accidents. In this paper, the reason was analyzed and the corresponding improvement measures were proposed. The purpose is to improve nurses' awareness and reduce nursing disputes.%  急诊是医疗事故和纠纷的高风险区,容易发生差错事故。现对其原因进行分析并提出相应改进措施,目的在于提高护士的认识,减少护理纠纷的发生。

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

    Science.gov (United States)

    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

  19. Nuclear law and radiological accidents

    International Nuclear Information System (INIS)

    Nuclear activities in Brazil, and particularly the radiological accident of Goiania, are examined in the light of the environmental and nuclear laws of Brazil and the issue of responsibility. The absence of legislation covering radioactive wastes as well as the restrictions on Brazilian States to issue regulations covering nuclear activities are reviewed. The radiological accident and its consequences, including the protection and compensation of the victims, the responsibility of the shareholders of the Instituto Goiano de Radioterapia, operator of the radioactive source, the provisional storage and the final disposal at Abadia de Goias of the radioactive waste generated by the accident are reviewed. Finally, nuclear responsibility, the inapplicability of the Law 6453/77 which deals with nuclear damages, and the state liability regime are analysed in accordance with the principles of the Brazilian Federal Constitution. (author)

  20. Assessment of Spatial Unevenness of Road Accidents Severity as Instrument of Preventive Protection from Emergency Situations in Road Complex

    Science.gov (United States)

    Petrov, A.; Petrova, D.

    2016-08-01

    Emergency situations in road complex are road traffic accidents (RA) with severe consequences. These are incidents connected with the death and injury of large number of people. The most common reasons for this are the collision of three or more cars, the collision of buses with trains at railroad crossings, the fall of the buses in the mountain gorge, and other similar cases. Is it possible to predict such events? How to build a preventive protection against such emergencies? We have to understand that emergencies in a road complex are qualitative expression of the quantitative processes that characterize the general state of road safety in the region. In this regard, at the level of state monitoring of emergency situations it is important to understand in general - in which region the situation is more complicated and in which is more favorable. This knowledge helps to more efficiently reallocate resources intended to solve the problems of road safety provision. The consequence of this is improvement of the quality of preventive protection from the emergencies in the road complex. The article presents quantitative values of severity of accidents in the Russian Federation regions and the Pareto chart distribution of cumulates of the accident severity for the Russian Federation. On the basis of the complex assessment of the spatial non-uniformity of the accident severity results it offers two important recommendations, implementation of which will alleviate the issue of formation of emergency situations in the road of the Russian Federation on the basis of the complex assessment of the spatial nonuniformity of the accident severity results.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Gallahue, Fiona E; Betz, Amy E; Druck, Jeffrey; Jones, Jonathan S; Burns, Boyd; Hern, Gene

    2015-11-01

    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.

  3. Road characteristics and bicycle accidents.

    Science.gov (United States)

    Nyberg, P; Björnstig, U; Bygren, L O

    1996-12-01

    In Umeå, Sweden, defects in the physical road surface contributed to nearly half of the single bicycle accidents. The total social cost of these injuries to people amount to at least SEK 20 million (SEK 60,000 or about USD 8,500 per accident), which corresponds to the estimated loss of "eight life equivalents a year". Improved winter maintenance seems to have the greatest injury prevention potential and would probably reduce the number of injuries considerably, whereas improved road quality and modification of kerbs would reduce the most severe injuries. A local traffic safety program should try to prevent road accidents instead of handling the consequences of them. In accordance with Parliament decisions on traffic we would like to see increased investment in measures favoring bicycle traffic, where cycling is seen as a solution, not as a problem.

  4. Study on generic intervention levels for protecting the public in a nuclear accident or radiological emergency

    International Nuclear Information System (INIS)

    After a nuclear accident or radiological emergency, several social and economical factors shall be considered for the actions to protect the public and to recover the environment. The application of the radiological protection principles on practices in intervention situations may lead to adoption of protective measures disproportional to the involved risk, compromising the resources available to more effective actions. This causes a negative impact on the population and may conduct to discredit about the protective measures and the lost of confidence on the authorities. In this context, the principles of radiological protection for interventions should be studied and analyzed for being adequately applied in accident situations or radiological emergencies that involves the country. These principles are constantly improved and the concept of generic intervention level plays an important role in the decision-making to protect the public. The costs involved to the protective measures for the public in Brazil were studied and cost benefit analysis techniques were applied to estimate the generic intervention levels for public protection applicable in the country. These results were compared to those values internationally recommended, as well to values obtained in a similar study accomplished for Japan. It was also performed a sensibility analysis of the results regarding a value and a simple analysis of the results considering the costs of the several protective measures. (author)

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

    Science.gov (United States)

    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

  6. Fatal motorcycle accidents and alcohol

    DEFF Research Database (Denmark)

    Larsen, C F; Hardt-Madsen, M

    1987-01-01

    A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC......); 59% above 0.08%. In all cases where a pillion passenger was killed, the operator of the motorcycle had a BAC greater than 0.08%. Of the killed counterparts 2 were non-intoxicated, 2 had a BAC greater than 0.08%, and 4 were not tested. The results advocate that the law should restrict alcohol...

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

    Directory of Open Access Journals (Sweden)

    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.

  8. A unified emergency care system for the early management of emergencies in medicine.

    Science.gov (United States)

    Morgan-Jones, D; Hodgetts, T J

    1999-06-01

    Emergency medicine is increasingly compartmentalised. The Unified Emergency Care System (UECS) requires the user to consider every option for emergency care for each patient, in a logical manner that transcends these artificial compartments and recognises the relative priority of concomitant medical, surgical, environmental and toxicological problems. The system is presented as a series of icons, allowing considerations to be made at a glance. Drop shadows refer the user to detailed management protocols for specific conditions. The system follows the logical sequence of quick history, quick look, primary survey with resuscitation and secondary survey. Established management principles of airway-breathing-circulation-disability (ABCD) are incorporated. The complexity of the management algorithms increases from first aider through medic, paramedic, and primary care physician to emergency physician. The stepwise care facilitates seamless immediate medical care between providers, teamwork, and the development of a structured series of training programmes. PMID:10420340

  9. A Review of the Courses on Emergency Preparedness and Medical Procedures in Case of a Nuclear Accident Organised in Zagreb, Croatia

    International Nuclear Information System (INIS)

    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 doctors is more than insufficient, especially if any action for treatment of radiation victims will ever be needed. The specialized 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)

  10. Emergency preparedness: medical management of nuclear accidents involving large groups of victims

    International Nuclear Information System (INIS)

    The treatment of overexposed individuals implies hospitalisation in a specialized unit applying hematological intense care. If the accident results in a small number of casualties, the medical management does not raise major problems in most of the countries, where specialized units exist, as roughly 7% of the beds are available at any time. But an accident which would involved tens or hundreds of people raises much more problems for hospitalization. Such problems are also completely different and will involve steps in the medical handling, mainly triage, (combined injuries), determination of whole body dose levels, transient hospitalization. In this case, preplanning is necessary, adapted to the system of medical care in case of a catastrophic event in the given Country, with the main basic principles : emergency concerns essentially the classical injuries (burns and trauma) - and contamination problems in some cases - treatment of radiation syndrome is not an emergency during the first days but some essential actions have to be taken such as early blood sampling for biological dosimetry and for HLa typing

  11. Acidentes e violência na infância: evidências do inquérito sobre atendimentos de emergência por causas externas - Brasil, 2009 Accidents and violence in childhood: survey evidence of emergency care for external causes - Brazil, 2009

    Directory of Open Access Journals (Sweden)

    Deborah Carvalho Malta

    2012-09-01

    Full Text Available Compreender as características e a magnitude das causas externas (acidentes e violência em crianças de 0 a 9 anos de idade torna-se cada vez mais importante em Saúde Pública. O objetivo do presente artigo foi analisar os atendimentos de emergência por causas externas em crianças. Utilizaram-se dados do Sistema de Vigilância de Violências e Acidentes em Serviços Sentinelas de Urgência e Emergência (Inquérito VIVA, realizado em 74 serviços de urgência do Distrito Federal e 23 capitais no ano 2009. Analisaram-se dados de 7.123 crianças: 6.897 (96,7% vítimas de acidentes e 226 (3,3% de violência. Em comparação às vítimas de violência, os atendimentos por acidentes foram mais frequentes entre crianças de 2 a 5 anos, de pele branca e ocorridos no domicílio (p Understanding the characteristics and magnitude of accidents and violence due to external causes in children from 0 to 9 years of age is becoming ever more important in Public Health. The scope of this paper was to analyze emergency care for accidents due to external causes in children. The Sentinel Urgency and Emergency Services of the Violence and Accident Vigilance System (VIVA Survey, performed in 74 urgency services in the Federal District and 23 State capitals in 2009 was used. Data of 7,123 children were analyzed: 6,897 (96.7% victims of accidents and 226 (3.3% of violence. In comparison with victims of violence, the visits for accidents were more frequent among white children from 2 to 5 years old occurring in the home (p < 0.05. Among the accidents, falls and burns predominated in the 0 to 1group, while traffic accidents were most frequent in the 6 to 9-year-old age group (p < 0.001. With respect to violence, the visits for neglect and physical assault predominated, respectively, in extreme age groups, with someone in the family being the perpetrator (p < 0.001. Information on the occurrence of external causes in children may support health promotion policies

  12. 'Present nuclear emergency responses in India: tracing requirements and guidelines suggested after Fukushima accident in regards to public and plant safety

    International Nuclear Information System (INIS)

    In this poster the primary initiative is to educate the public at large and instill confidence about the present Emergency Response Systems of DAE and the imminent agencies in India. Poster attempts to analyse present regulatory and safety systems, mechanisms like plant and site emergency response plans are in place to handle radiation emergencies and how public will not be affected in any manner. In India also we needed some supplementary provisions to cope up with major disasters in Nuclear Power Plants (NPP) apart from the existing one. Some of the NPPs are not under the UN safeguards, which can not import Uranium also need extra care and protection. Regulatory and safety functions of Atomic Energy in India are carried out by the Atomic Energy Regulatory Board (Atomic Energy Regulatory Board), the poster attempts to explain the present regulatory and safety mechanism under Atomic Energy Regulatory Board. We have the plant and site emergency response plans in place. The well planned functioning of these is demonstrated here. India is equipped with detail plans of emergency response system, to handle the radiation emergencies in public domain even at the locations where DAE facility is not available

  13. Road Accident Trends in Africa and Europe

    DEFF Research Database (Denmark)

    Jørgensen, N O

    1997-01-01

    The paper decribes trends and suggests prediction models for accident risks in African and European countries......The paper decribes trends and suggests prediction models for accident risks in African and European countries...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Current and future directions in clinical fatigue management: An update for emergency medicine practitioners.

    Science.gov (United States)

    Cheng, Yi Han; Roach, Gregory D; Petrilli, Renee Ma

    2014-12-01

    Physicians worldwide are working round the clock to meet the demands of healthcare systems, especially in acute medical settings such as EDs. Demanding shift work schedules cause fatigue and thus deterioration in mood and motor performance. This article explores the effects of sleep deprivation, focusing on cognition, executive decision-making and the implications for clinical care. Humans are capable of functioning and even adapting to sleep restriction; however, clinicians should be aware of pitfalls and absolute minimums for sleep. Fatigue management training shows promise in enhancing safety in aviation and might have a role in medical shift work. Strategic napping improves performance during night shift in the ED, but does not fully negate fatigue. Drugs offer limited benefit for performance under sleep-deprived conditions, and whenever possible, sleep and/or strategic napping takes precedence.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

  1. Careers and Emerging Opportunities in Visual Communication in Medicine: Medical photography in Norway.

    Science.gov (United States)

    Kjersem, Bård

    2015-06-01

    The community of medical photographers in Norway is relatively small. Except for one they are all employed with titles such as research technicians, department engineers, senior consultants and skilled workers. At the present there is no formal education in medical photography. The most common educational attainment for photographers is the Journeyman's certificate. Until recently, the requirement for employment for photographers at Norwegian hospitals was the Journeyman's Certificate. However, the Institutt for Klinisk Medisin at University in Oslo recently advertised a vacancy for a departmental Engineer to run its photographic and video services. The post required that the candidates possess either a Bachelor's degree in a relevant subject. This is the first vacancy in medical photography in nine years. The Norwegian health services have been reformed in the direction of New Public Management (NPM). To utilise the resources effectively, tasks that normally would be performed by one health profession are shifted to another with a different or lower education and training. There are reasons to believe that the shift of medical photography from professional photographers to other health personnel without specialist training or qualifications is an attempt to utilise resources more effectively. During the next two years a mixed methods research will be carried out to explore the current situation for medical photography in Norway.

  2. Acidentes e violências: caracterização dos atendimentos no pronto-socorro de um hospital universitário Accidents and violence: characteristics of the medical cares in the emergency room's university hospital

    Directory of Open Access Journals (Sweden)

    José Luís Guedes dos Santos

    2008-09-01

    Full Text Available Este artigo, de caráter exploratório-descritivo, tem como objetivo caracterizar os atendimentos por acidentes e violências realizados no pronto-socorro de um hospital universitário localizado no interior do Rio Grande do Sul (RS. Os dados foram obtidos a partir dos registros de um sistema de vigilância, denominado "Observatório de Acidentes e Violência", existente nos serviços de urgência e emergência no RS, que atuam como sentinela desses agravos. Os resultados mostraram que os adultos jovens, com baixo nível de instrução e não-trabalhadores são as principais vítimas de acidentes e violências. Quanto ao tipo de ocorrência, destacaram-se os acidentes de trânsito e acidentes domésticos, gerando como agravos mais constantes ferimentos na cabeça e fraturas de fêmur. Com relação ao sexo, embora para alguns tipos de acidentes e violências a predominância tenha variado entre eles, o conjunto dos dados mostrou maior vulnerabilidade masculina, em especial nos casos de violência interpessoal. Nesse sentido, as consequências dos acidentes e violências para o sistema de saúde e para a sociedade apontam a necessidade de aprimoramento dos sistemas de informações de morbimortalidade por causas externas, visando subsidiar políticas públicas de prevenção e melhoria no atendimento às vítimas.This article, of an exploratory-descriptive character, aims to characterize the medical care provided in cases of accidents and violence in the emergency room of a university hospital, located in the interior of the state of Rio Grande do Sul (RS. The data were obtained from the registers of a monitoring system called "Observatório de Acidentes e Violência" (Observatory of Accidents and Violence, which exists in the urgency and emergency services in RS and acts as a sentry of these injuries. The results showed that young adults who are non-workers and have low schooling are the main victims of accidents and violence. The most frequent

  3. State institution 'Republican research centre of radiation medicine and human ecology': concept of development and its role in solution of medical problems of consequences of the Chernobyl accident

    International Nuclear Information System (INIS)

    At present, the Centre is the head institution, which provides specific medical assistance to population affected by the Chernobyl catastrophe. It also carries out research work defined by the State Program of the Republic of Belarus on liquidating consequences of the Chernobyl catastrophe within the period of 2001-2005 and up to 2010, sub-items 'Medical Assistance and Recuperation, Mother and Child Care, Hereditary Illnesses' and 'Radiation Protection and Dosage Monitoring of Population'. The aim of the Concept of the development of the Centre is to maintain and promote the health of the people exposed to multicomponent and prolonged impact of irradiation after Chernobyl accident and other negative factors of the environment of anthropogenic and man-caused nature, by means of realization of scientifically-grounded measures on minimizing of direct and indirect losses of society due to morbidity and mortality decrease. The ecological situation in the Republic and necessity of liquidation of medical consequences of the Chernobyl disaster demand to conduct long-term dynamic monitoring of state of health of big cohorts of people. At present, this problem is solved by clinical examination of population affected by irradiation. This is the base of preventive activity directed to decrease medical consequences of the Chernobyl catastrophe. In the Republic of Belarus, clinical examination of suffering population is carried out at all levels - republican, regional, local, - in clinics. To monitor the state of health of the population and to obtain correct data of medico-biological consequences of the catastrophe, Belarus State Register of people exposed to irradiation due to Chernobyl accident, was established and is functioning. At present, State Register provides information supply of the conducted clinical examination. The concentration in one institution of functions of managing staff, quality control of clinical examination and scientific inspection of the State

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  7. Characteristics of motorcyclists involved in accidents between motorcycles and automobiles

    OpenAIRE

    Amanda Lima de Oliveira; Andy Petroianu; Dafne Maria Villar Gonçalves; Gisele Araújo Pereira; Luiz Ronaldo Alberti

    2015-01-01

    Introduction: traffic accidents are one of the main causes of death and disability, with motorcyclists representing the great majority of both the victims and the perpetrators. Objective: this work studied the characteristics of motorcyclists injured in accidents involving motorcycles and automobiles. Method: this study sought to interview 100 motorcyclists who had been injured in collisions between motorcycles and automobiles, and who were undergoing emergency hospital treatment in the regio...

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

    Science.gov (United States)

    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

  9. Critical drug shortages: implications for emergency medicine.

    Science.gov (United States)

    Mazer-Amirshahi, Maryann; Pourmand, Ali; Singer, Steven; Pines, Jesse M; van den Anker, John

    2014-06-01

    Prescription drug shortages have become increasingly common and more severe over the past decade. In addition, reported shortages are longer in duration and have had a greater effect on patient care. Some of the causes of current drug shortages are multifactorial, including the consolidation of drug manufacturers, quality problems at production plants that restrict the supply of drugs, and a lack of financial incentives for manufacturers to produce certain products, particularly generic medications. Generic injectable medications are most commonly affected by shortages because the production process is complex and costly for these drugs, and profit margins are often smaller than for branded medications. Many commonly used emergency department (ED) generic injectables have been affected by shortages, including multiple resuscitation and critical care drugs. Several reports have shown that shortages can potentially have major effects on the quality of medical care, including medication errors, treatment delays, adverse outcomes, and increased health care costs. Currently, no published data exist outside of case reports that directly link ED-based drug shortages to overall patient safety events; however, there are several examples in the ED where first-line therapies for life-saving medications have been in short supply, and alternatives have higher rates of adverse events, narrower therapeutic indexes, or both. Aside from increasing notification about shortages, the U.S. Food and Drug Administration has little power to coerce manufacturers to produce medications during a shortage. Therefore, ED providers must learn to mitigate the effects of shortages locally, through active communication with pharmacy staff to identify safe and effective alternatives for commonly used medications when possible. Particularly given the effect on critical care medications, therapeutic alternatives should be clearly communicated to all staff so that providers have easy access to this

  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

    Directory of Open Access Journals (Sweden)

    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. Drug use and the severity of a traffic accident

    NARCIS (Netherlands)

    Smink, BE; Ruiter, B; Lusthof, KJ; de Gier, JJ; Uges, DRA; Egberts, ACG

    2005-01-01

    Several studies have showed that driving under the influence of alcohol and/or certain illicit or medicinal drugs increases the risk of a (severe) crash. Data with respect to the question whether this also leads to a more severe accident are sparse. This study examines the relationship between the u

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

    Directory of Open Access Journals (Sweden)

    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

  13. Evaluation of an accident management strategy of emergency water injection using fire engines in a typical pressurized water reactor

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soo Yong; Ahn, Kwang Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    Following the Fukushima accident, a special safety inspection was conducted in Korea. The inspection results show that Korean nuclear power plants have no imminent risk for expected maximum potential earthquake or coastal flooding. However long- and short-term safety improvements do need to be implemented. One of the measures to increase the mitigation capability during a prolonged station blackout (SBO) accident is installing injection flow paths to provide emergency cooling water of external sources using fire engines to the steam generators or reactor cooling systems. This paper illustrates an evaluation of the effectiveness of external cooling water injection strategies using fire trucks during a potential extended SBO accident in a 1,000 MWe pressurized water reactor. With regard to the effectiveness of external cooling water injection strategies using fire engines, the strategies are judged to be very feasible for a long-term SBO, but are not likely to be effective for a short-term SBO.

  14. Accident Simulation: Design and Results

    OpenAIRE

    Idasiak, Vincent; David, Pierre

    2007-01-01

    International audience The French legislation regulates the functioning of factories that may be dangerous towards their environment. This legislation imposes the creation of an Internal Operation Plan (P.O.I.) on the plant managers. Those plans describe the proceedings that have to be implemented in case of an accident. Within a framework involving our laboratory and a gas company we have designed a software to create, maintain and execute P.O.I.s . In this paper, in addition to the softw...

  15. Organization of the French emergency teams in the event of a radiological accident

    Energy Technology Data Exchange (ETDEWEB)

    Dumon, F. [Faculte de Pharmacie, 13 - Marseille (France); Pizzocaro, Y. [CSP, Risques Technologiques, 83 - Toulon (France)

    2001-07-01

    Nowadays, the intervention in ionizing environment is increasingly probable. It is still rare, but with the development of the nuclear programme of electricity production which was held in the french past and the significant rise in the use of the radioelements, as well in the medical field as industrial, the radioactive risk cannot be neglected. Technical and human resources, brought by mobile emergency teams called CMIR, were thus implemented to ensure either the safety of only hard-working exposed to the ionizing radiations, but also that of the population. In France, the organization of the public authorities in the event of nuclear accident, fixed by Directives of the Prime Minister which relate to nuclear safety, protection against radiation, the law and order and the civil safety, is described in Particular Plan for Intervention (PPI). (author)

  16. Accident analysis and DOE criteria

    International Nuclear Information System (INIS)

    In analyzing the radiological consequences of major accidents at DOE facilities one finds that many facilities fall so far below the limits of DOE Order 6430 that compliance is easily demonstrated by simple analysis. For those cases where the amount of radioactive material and the dispersive energy available are enough for accident consequences to approach the limits, the models and assumptions used become critical. In some cases the models themselves are the difference between meeting the criteria or not meeting them. Further, in one case, we found that not only did the selection of models determine compliance but the selection of applicable criteria from different chapters of Order 6430 also made the difference. DOE has recognized the problem of different criteria in different chapters applying to one facility, and has proceeded to make changes for the sake of consistency. We have proposed to outline the specific steps needed in an accident analysis and suggest appropriate models, parameters, and assumptions. As a result we feed DOE siting and design criteria will be more fairly and consistently applied

  17. Modeling, simulation and emergency response

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, T.J.

    1985-01-01

    The Department of Energy's Atmospheric Release Advisory Capability (ARAC) has been developed at the Lawrence Livermore National Laboratory to provide a national capability in emergency response to radiological accidents. For the past two years the system has been undergoing a complete redesign and upgrade in software and hardware. Communications, geophysical databases, atmospheric transport and diffusion models and experienced staff form the core of this rapid response capability. The ARAC system has been used to support DOE commitments to radiological accidents including the Three Mile Island accident, the COSMOS satellite reentries, the TITAN II missile accident and several others. This paper describes the major components of the ARAC system, presents example calculations and discusses the interactive process of the man-machine environment in an emergency response system.

  18. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    Directory of Open Access Journals (Sweden)

    Susan R. Wilcox

    2016-05-01

    Full Text Available 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 clinical questions. EM attendings at key teaching hospitals for seven EM residency training programs in the northeastern United States were invited to participate in this survey study. We performed correlation and regression analyses to evaluate the relationship between attendings’ scores on the assessment instrument and their training, education, and comfort with ventilation. Results: Of 394 EM attendings surveyed, 211 responded (53.6%. Of respondents, 74.5% reported receiving three or fewer hours of ventilation-related education from EM sources over the past year and 98 (46% reported receiving between 0-1 hour of education. The overall correct response rate for the assessment tool was 73.4%, with a standard deviation of 19.9. The factors associated with a higher score were completion of an EM residency, prior emphasis on mechanical ventilation during one’s own residency, working in a setting where an emergency physician bears primary responsibility for ventilator management, and level of comfort with managing ventilated patients. Physicians’ comfort was associated with the frequency of ventilator changes and EM management of ventilation, as well as hours of education. Conclusion: EM attendings report caring for mechanically ventilated patients frequently, but most receive fewer than three educational hours a year on mechanical ventilation, and nearly half receive 0-1 hour. Physicians’ performance on an assessment tool for mechanical ventilation is

  19. The Role of Patients' Stories in Emergency Medicine Triage.

    Science.gov (United States)

    Roscoe, Lori A; Eisenberg, Eric M; Forde, Colin

    2016-09-01

    Emergency medicine is a communicative activity, and characteristics such as incomplete information, time pressure, and the potentially serious consequences of errors complicate effective communication and decision making. The present study examined the triage process as an interpretive activity driven in part by the patient's story. Of four identified communication processes in the emergency department (ED), the "handoff" of patients between shifts has been identified as especially problematic since missing contextual details from patients' stories increased the probability of errors. The problematic nature of patient handoffs led to our interest in triage, the initial site of interpretation and decision making. Triage distinguishes patients with emergent medical conditions requiring immediate care from those who can more safely wait for medical attention. We report results from 110 hours of observing the triage process and semistructured interviews with 16 triage nurses in a Level I Trauma Center in an urban teaching hospital in the southeastern United States. Field notes and interview transcripts were analyzed and coded to explore decision rules and information sources used in triage decision making. Triage nurses generally discounted patients' stories in favor of information from visual cues and vital signs. Patients' stories tended to influence the triage process only in certain cases when the story contained information that was not readily apparent, such as a recent organ transplant. Triage nurses' reliance on "gut feeling," however, might be a kind of narrative sense-making that combines observable and measurable clinical facts with the narrative competence to utilize intuition and past experience. PMID:26882466

  20. An Entry Point of the Emergency Response Robot for Management of Severe Accident of the Nuclear Power Plant

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jaiwan; Jeong, Kyungmin [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-05-15

    In this paper, from the view point of DID (defense-in depth), we discuss the entry point of the nuclear emergency response robot to cope with a nuclear disaster. A Japanese nuclear disaster preparedness robot system was developed, after the JCO criticality accident in 1999, to cope with INES (International Nuclear and Radiological Event Scale) Level 3 serious incidents. INES Level 3 means the loss of DID (defense-in-depth) functions. It also indicates that ESF (engineered safety features) and ECCS (emergency core cooling system) resources, which are used to prevent serious incidents from escalating to severe accidents (core melt-down), have been almost exhausted. In the unit 1 reactor accident of Fukushima Daiichi Nuclear Power Plant, escalation from INES Level 1 (Out of Limiting Condition for Operation) to INES Level 5 (serious core melting-down) took less than two hours. Major facts are briefly described here in based on data gathered immediately after the tsunami over Fukushima Daiichi Nuclear Power Plant. Ο 15:35 on March 11, 2nd tsunami arrived. - 15:37, SBO (station black out) Ο 15:42, Interprets as a SBO (INES Level 1) - Loss of DC power for Instrumentation (Unknown of reactor water level) Ο 16:36, Loss of ECCS function (INELS Level 5) (Entry into a BDBA status) The Moni ROBO-A robot of the Japan Nuclear Safety Technology Center (NUSTEC) was a nuclear disaster preparedness robot developed after the JCO criticality accident. It was the only robot that had been steadily maintained and was available at the time of the Fukushima Daiichi Nuclear Power Plant accident. However, it was not helpful in mitigating the accident because it is assumed to have arrived at J-Village after the accident had been escalated to INES Level 5 or higher. Based on the paper by S. Kawatsuma of JAEA and response data gathered immediately after the tsunami, it is estimated that the NUSTEC's Moni ROBO-A arrived at J-Village after the designed entry point for INES Level 3

  1. An Entry Point of the Emergency Response Robot for Management of Severe Accident of the Nuclear Power Plant

    International Nuclear Information System (INIS)

    In this paper, from the view point of DID (defense-in depth), we discuss the entry point of the nuclear emergency response robot to cope with a nuclear disaster. A Japanese nuclear disaster preparedness robot system was developed, after the JCO criticality accident in 1999, to cope with INES (International Nuclear and Radiological Event Scale) Level 3 serious incidents. INES Level 3 means the loss of DID (defense-in-depth) functions. It also indicates that ESF (engineered safety features) and ECCS (emergency core cooling system) resources, which are used to prevent serious incidents from escalating to severe accidents (core melt-down), have been almost exhausted. In the unit 1 reactor accident of Fukushima Daiichi Nuclear Power Plant, escalation from INES Level 1 (Out of Limiting Condition for Operation) to INES Level 5 (serious core melting-down) took less than two hours. Major facts are briefly described here in based on data gathered immediately after the tsunami over Fukushima Daiichi Nuclear Power Plant. Ο 15:35 on March 11, 2nd tsunami arrived. - 15:37, SBO (station black out) Ο 15:42, Interprets as a SBO (INES Level 1) - Loss of DC power for Instrumentation (Unknown of reactor water level) Ο 16:36, Loss of ECCS function (INELS Level 5) (Entry into a BDBA status) The Moni ROBO-A robot of the Japan Nuclear Safety Technology Center (NUSTEC) was a nuclear disaster preparedness robot developed after the JCO criticality accident. It was the only robot that had been steadily maintained and was available at the time of the Fukushima Daiichi Nuclear Power Plant accident. However, it was not helpful in mitigating the accident because it is assumed to have arrived at J-Village after the accident had been escalated to INES Level 5 or higher. Based on the paper by S. Kawatsuma of JAEA and response data gathered immediately after the tsunami, it is estimated that the NUSTEC's Moni ROBO-A arrived at J-Village after the designed entry point for INES Level 3. According to

  2. The 2015 Academic College of Emergency Experts in Indias INDO-US Joint Working Group White Paper on Establishing an Academic Department and Training Pediatric Emergency Medicine Specialists in India.

    Science.gov (United States)

    Mahajan, Prashant; Batra, Prerna; Shah, Binita R; Saha, Abhijeet; Galwankar, Sagar; Aggrawal, Praveen; Hassoun, Ameer; Batra, Bipin; Bhoi, Sanjeev; Kalra, Om Prakash; Shah, Dheeraj

    2015-12-01

    The concept of pediatric emergency medicine (PEM) is virtually nonexistent in India. Suboptimally organized prehospital services substantially hinder the evaluation, management, and subsequent transport of the acutely ill and/or injured child to an appropriate facility. Furthermore, the management of the ill child at the hospital level is often provided by overburdened providers who, by virtue of their training, lack experience in the skills required to effectively manage pediatric emergencies. Finally, the care of the traumatized child often requires the involvement of providers trained in different specialities, which further impedes timely access to appropriate care. The recent recognition of Doctor of Medicine in Emergency Medicine as an approved discipline of study as per the Indian Medical Council Act provides an unprecedented opportunity to introduce PEM as a formal academic program in India. PEM has to be developed as a 3 year superspeciality course after completion of MD Diplomate of National Board (DNB) Pediatrics or MD DNB in EM. The National Board of Examinations that accredits and administers postgraduate and postdoctoral programs in India also needs to develop an academic program DNB in PEM. The goals of such a program would be to impart theoretical knowledge, training in the appropriate skills and procedures, development of communication and counseling techniques, and research. In this paper, the Joint Working Group of the Academic College of Emergency Experts in India (JWG ACEE India) gives its recommendations for starting 3 year DM DNB in PEM, including the curriculum, infrastructure, staffing, and training in India. This is an attempt to provide an uniform framework and a set of guiding principles to start PEM as a structured superspeciality to enhance emergency care for Indian children.

  3. Study on Emergency Disposal of Fire and Explosion Accident of Oil Depot and Gas Station%石油库站着火爆炸事故的应急处置研究

    Institute of Scientific and Technical Information of China (English)

    陈蜀海

    2012-01-01

    由于油料特殊的物化性质,在库站储存、收发过程中极易造成火灾、爆炸事故,从而导致重大人员伤亡及财产损失。论文针对油罐火灾、罐(槽)车火灾、输油管线破裂火灾、加油站火灾及电器火灾五种事故形式,在深入分析其各自特点的基础上,提出了切实可行的应急处置方案,为石油库站火灾事故应急抢险方案制定、具体实施提供了重要参考。%Because of special physical and chemical property of oil, in the process of oil storage and transportation, fire and explosion accidents incidentally were led to cause severe casualty and loss. Focusing on the characteristic and dangerous degree of main types of oil accident, feasible emergency disposal measure was put forward. The work done laid the solid foundation on the operation of first aid repair of gasoline transportation and storage.

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

    Directory of Open Access Journals (Sweden)

    David Levy

    2014-02-01

    Full Text Available 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 performance on the RISE with performance on the AOBEM Part 1. The study group consisted of osteopathic EM residents in their PGY-4 year of training who took both examinations during that same year. Methods: We examined data from 2009 to 2012 from the National Board of Osteopathic Medical Examiners (NBOME. The NBOME grades and performs statistical analyses on both the RISE and the AOBEM Part 1. We used the RISE exam scores, as reported by percentile rank, and compared them to both the score on the AOBEM Part 1 and the dichotomous outcome of passing or failing. A receiver operating characteristic (ROC curve was generated to depict the relationship. Results: We studied a total of 409 residents over the 4-year period. The RISE percentile score correlated strongly with the AOBEM Part 1 score for residents who took both exams in the same year (r¼0.61, 95% confidence interval [CI] 0.54 to 0.66. Pass percentage on the AOBEM Part 1 increased by resident percent decile on the RISE from 0% in the bottom decile to 100% in the top decile. ROC analysis also showed that the best cutoff for determining pass or fail on the AOBEM Part 1 was a 65th percentile score on the RISE. Conclusion: We have shown there is a strong correlation between a resident’s percentile score on the RISE during their PGY-4 year of residency training and first-time success on the AOBEM Part 1 taken during the same year. This information may be useful for osteopathic EM residents as an indicator as to how well

  5. Authority structure and industrial accidents

    NARCIS (Netherlands)

    As, Sicco van

    2001-01-01

    This paper deals with the influence of organizational characteristics on safety. Accidents are actually caused by individual mistakes. However the underlying causes of accidents are often organizational. The general hypothesis is that the authority structure is a main cause of accident-proneness wit

  6. Complementary and Alternative Medicine

    Science.gov (United States)

    ... 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 ...

  7. Essentials of Pediatric Emergency Medicine Fellowship: Part 4: Beyond Clinical Education.

    Science.gov (United States)

    Wolff, Margaret; Carney, Michele; Eldridge, Charles; Zaveri, Pavan; Kou, Maybelle

    2016-08-01

    This article is the third in a 7-part series that aims to comprehensively describe the current state and future directions of pediatric emergency medicine fellowship training from the essential requirements to considerations for successfully administering and managing a program to the careers that may be anticipated upon program completion. This article focuses on the skills beyond clinical training required of pediatric emergency medicine physicians including teaching, leadership, teamwork, and communication. PMID:27490731

  8. Exploring the Value of Technology to Stimulate Interprofessional Discussion and Education: A Needs Assessment of Emergency Medicine Professionals

    OpenAIRE

    Riley, Jennifer; McGowan, Melissa; Rozmovits, Linda

    2014-01-01

    Background The emergency department (ED) is an environment fraught with increasing patient volumes, competing priorities, fluctuating information, and ad hoc interprofessional clinical teams. Limited time is available to reflect on and discuss clinical experiences, policies, or research with others on the involved team. Online resources, such as webcasts and blogs, offer an accessible platform for emergency shift workers to engage in interprofessional discussion and education. Objective Our o...

  9. [E-learning in medicine: appraisal and perspectives. Example of an educational website about echocardiography in anaesthesia, intensive care and emergencies: www.echorea.org].

    Science.gov (United States)

    Muller, M; Duperret, S; Viale, J-P

    2008-10-01

    Internet is a mode of quick and more and more easily approachable communication. Its use as support of education allows an enrichment of the master-pupil relation by its availability, its interactivity and the multiplicity of its means. Medicine benefits particularly from these new means of virtual companionship. This review offers to characterize means and constraints of the use of Internet in medical education, and to illustrate these purposes by an example of site created for the teaching of ultrasound use in anaesthesia, intensive care and emergency. PMID:18835685

  10. Radiodosimetry and preventive measures in the event of a nuclear accident. Proceedings of an international symposium

    International Nuclear Information System (INIS)

    An international symposium on Radiodosimetry and Preventive Measures in the Event of a Nuclear Accident was held in Cracow, Poland, from 26 to 28 May 1994. The symposium was organized by the Polish Society for Nuclear Medicine, and co-sponsored by the IAEA. Over 40 experts from Belarus, Latvia, Lithuania, Germany, Poland, the Russian Federation, Sweden and Switzerland participated. The aim of the Symposium was to review models of iodine kinetics used in the calculation of internal radiation doses to the thyroid after the Chernobyl accident, to discuss internal and external radiation dose to the thyroid in terms or risk of thyroid cancer, and to present data on the incidence rate of thyroid cancer in the selected iodine deficient area in Poland. A part of the symposium was dedicated to the physiological basis of iodine prophylaxis and emergency planning for a nuclear accident. Recommendations of the IAEA on preventive measures in the event of a nuclear accident were also addressed. These proceedings contain the full text of the eight invited papers presented at the symposium. Refs, figs, tabs

  11. Nuclear emergency plan and preparedness in Japan

    International Nuclear Information System (INIS)

    The Japanese nuclear emergency plan and preparedness has been reinforced on the basis of lessons learned from the accident at the Three Mile Island-2 nuclear power plant in March 1079 and the Chernobyl accident in 1986. The framework for measures against a nuclear emergency, currently in place is briefly presented. In Japan, the responsibility for the population's protection in case of accidents lies upon prefectural governments. The national government is providing financial and technical support to prefectural governments. To facilitate the technical support for emergency situations, a significant effort has been made to develop computerized support systems: a radiological dose prediction code system SPEEDI and an accident evaluation code COSTA. This enables the prefectural governments to prepare their local emergency response systems by establishing communication networks, emergency medical treatment organizations and radiation monitoring schemes, and also nuclear emergency education, training and exercises. 2 tab., 2 figs., 2 refs

  12. Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study

    Directory of Open Access Journals (Sweden)

    Golzari Samad EJ

    2011-06-01

    Full Text Available Abstract Background Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The purpose of our study was to determine success rates of bag-mask ventilation and tracheal intubation performed by emergency medicine residents before and after completing their anesthesiology curriculum. Methods A prospective descriptive study was conducted at Nikoukari Hospital, a teaching hospital located in Tabriz, Iran. In a skills lab, a total number of 18 emergency medicine residents (post graduate year 1 were given traditional intubation and bag-mask ventilation instructions in a 36 hour course combined with mannequin practice. Later the residents were given the opportunity of receiving training on airway management in an operating room for a period of one month which was considered as an additional training program added to their Anesthesiology Curriculum. Residents were asked to ventilate and intubate 18 patients (Mallampati class I and ASA class I and II in the operating room; both before and after completing this additional training program. Intubation achieved at first attempt within 20 seconds was considered successful. Successful bag-mask ventilation was defined as increase in ETCo2 to 20 mm Hg and back to baseline with a 3 L/min fresh gas-flow and the adjustable pressure limiting valve at 20 cm H2O. An attending anesthesiologist who was always present in the operating room during the induction of anesthesia confirmed the endotracheal intubation by direct laryngoscopy and capnography. Success rates were recorded and compared using McNemar, marginal homogeneity and paired t-Test tests in SPSS 15 software. Results Before the additional training program in the operating room, the participants had intubation and bag-mask ventilation success rates of 27.7% (CI 0.07-0.49 and 16.6% (CI 0-0.34 respectively. After the additional training program in the

  13. Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

    Directory of Open Access Journals (Sweden)

    Teresita M. Hogan

    2014-07-01

    Full Text Available Introduction: The demands of our rapidly expanding older population strain many emergency departments (EDs, and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. Methods: Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. Results: 173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score. Attitudes trended to more negative in successive post-graduate year (PGY levels. Conclusion: EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels. [West J Emerg Med. 2014;15(4:511–517.

  14. Risk and protection factors in fatal accidents.

    Science.gov (United States)

    Dupont, Emmanuelle; Martensen, Heike; Papadimitriou, Eleonora; Yannis, George

    2010-03-01

    This paper aims at addressing the interest and appropriateness of performing accident severity analyses that are limited to fatal accident data. Two methodological issues are specifically discussed, namely the accident-size factors (the number of vehicles in the accident and their level of occupancy) and the comparability of the baseline risk. It is argued that - although these two issues are generally at play in accident severity analyses - their effects on, e.g., the estimation of survival probability, are exacerbated if the analysis is limited to fatal accident data. As a solution, it is recommended to control for these effects by (1) including accident-size indicators in the model, (2) focusing on different sub-groups of road-users while specifying the type of opponent in the model, so as to ensure that comparable baseline risks are worked with. These recommendations are applied in order to investigate risk and protection factors of car occupants involved in fatal accidents using data from a recently set up European Fatal Accident Investigation database (Reed and Morris, 2009). The results confirm that the estimated survival probability is affected by accident-size factors and by type of opponent. The car occupants' survival chances are negatively associated with their own age and that of their vehicle. The survival chances are also lower when seatbelt is not used. Front damage, as compared to other damaged car areas, appears to be associated with increased survival probability, but mostly in the case in which the accident opponent was another car. The interest of further investigating accident-size factors and opponent effects in fatal accidents is discussed. PMID:20159090

  15. Study on the radiological assessor's responsibility in radiological accident and emergency response%辐射事故应急情况下放射评估者的职责

    Institute of Scientific and Technical Information of China (English)

    张建峰; 苏旭; 李文红; 拓飞

    2013-01-01

    目的:探讨放射评估者在辐射事故应急现场中承担的任务和职责.方法:根据国际原子能机构技术报告中提出的相关建议以及我国的具体情况,分析放射评估者在辐射事故应急中所担负的任务和职责.结果:明确放射评估者在不同辐射应急中的任务和职责.结论:通过对放射评估者的任务和职责讨论,以便在实际工作中更好地履行职责,从而减轻辐射事故对人体和环境造成的损害.%Objective:To discuss the radiological assessor's tasks and responsibility when the radiological emergency and accident occurred.Methods:According to the technical reports from International Atomic Energy Agency (IAEA) and specific circumstances in China,it analyzed the task and responsibility which radiological assessor should take.Results:It defined the tasks and responsibility of radiological assessor.Conclusion:Radiological assessor will carry out their task and responsibility well in practice to reduce the damage to personnel and environmental in radiological accident.

  16. 深水钻井井喷事故情景构建及应急能力评估%Scenario design of blowout accidents in deepwater drilling and emergency capacity assessment

    Institute of Scientific and Technical Information of China (English)

    殷志明; 张红生; 周建良; 李迅科

    2015-01-01

    Deepwater oil and gas development faces enormous risks and challenges. Especially when blowout out of control ac-cident occurs in the development process, the emergency rescue will be very dififcult. Scenario design approach for major accidents is used to build blowout scenarios in the drilling of a deepwater exploratory well in the South China Sea, covering the whole process from overlfow to blowout out of control, ifre and explosion of platform, platform overturn and sinking, underwater emergency well shut-in and relief well digging, spilled oil recycling and ecological restoration. The demands for engineering technology, equipment and staff for the emergency rescue are analyzed and evaluated and suggestions on the research of emergency rescue technology in the next stage in China are provided. The research results can be a reference for the independent building of emergency rescue engineering technique system in well control of deepwater drilling in China.%深水油气开发面临着巨大的风险和挑战,尤其是在油气开发过程中如果发生井喷失控事故,应急救援将十分困难。采用重大事故情景构建方法,建立南中国海某深水探井在钻井期间发生井喷失控事故情景,包括从溢流发生到井喷失控、平台发生火灾爆炸、平台倾覆沉没、水下应急封井及打救援井、溢油回收处理及生态恢复,并对应急救援必须的工程技术、设备、人员等需求进行分析和评估,对我国下一阶段开展应急救援技术研究提出建议。研究结果对我国自主建立深水钻井井控应急救援工程技术体系有一定参考意义。

  17. Differences in the perception of characteristics of excellence of clinical tutors among residents and consultants at an emergency medicine residency program a qualitative research

    Directory of Open Access Journals (Sweden)

    Muna Saleem Aljahany

    2013-01-01

    Full Text Available Introduction: Defining exactly what characterizes a clinical tutor as excellent and another less effective, is an important task in assessing the effectiveness of clinical training and guiding faculty development. Aim: We aimed to evaluate those characteristics and measure differences in their perception among accomplished and non-accomplished consultants and residents in the Emergency Department. We also compared perceptions between the different groups of participants. Methods: The characteristics measured were extracted from an extensive search of previously published studies summarized in a review article. A qualitative study was conducted, using a 20 item questionnaire piloted from the refined characteristics (good indicator of reliability; Cronbach′s Alpha = 0.86. The questionnaire was distributed among all consultants and residents in Saudi Board of Emergency Medicine. Results: No significant difference between consultants′ and residents′ perception was found. "Sincere" was an exception 87.8% versus 55.1%, P = 0.013. Consultants′ specifications did not seem to affect perception on overall scores and its component sub-scores. Conclusion: Since results showed no relation between accomplished and non-accomplished consultants in perceiving those qualities, we excluded the lack of knowledge of those characteristics as a cause of being accomplished or non-accomplished. We suggest a greater dedication from program developers towards creating more opportunities to involve more consultants in basic Emergency Medicine training.

  18. 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; Synthese sur l'organisation des pouvoirs publics en cas d'urgence et en situation post-evenementielle (suite a un accident nucleaire ou a un attentat radiologique) en france et a l'etranger

    Energy Technology Data Exchange (ETDEWEB)

    Kayser, O. [SGDSN/PSEIPPS, Bureau NRBC, 75 - Paris (France)

    2010-07-01

    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

  19. International law problems for realisation of the IAEA conventions on notification and assistance in the case of a nuclear accident

    Energy Technology Data Exchange (ETDEWEB)

    Petrov, M.M.

    1993-12-31

    The Chernobyl accident underscored the need for an early warning system and international assistance plan in case of a nuclear accident. Shortly after Chernobyl, two conventions were adopted under the auspices of the IAEA. The convention on Early Notification of a Nuclear Accident, in force since 1986, establishes an early warning system for all nuclear accidents whose effects might cross national boundaries. Under the convention on Assistance in the Case of a Nuclear accident or radiological Emergency,in force since 1987, countries must facilitate prompt assistance in case of a nuclear accident or radiological emergency, to minimize it`s consequences. Issues with the conventions are described.

  20. The Chief Resident Role in Emergency Medicine Residency Programs

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    Hafner, John W. Jr., MD, MPH

    2010-05-01

    Full Text Available Study Objectives: Although other specialties have examined the role of the chief resident (CR, the role and training of the emergency medicine (EM CR has largely been undefined.Methods: A survey was mailed to all EM CRs and their respective program directors (PD in 124 EM residency programs. The survey consisted of questions defining demographics, duties of the typical CR, and opinions regarding the level of support and training received. Multiple choice, Likert scale (1 strong agreement, 5 strong disagreement and short-answer responses were used. We analyzed associations between CR and PD responses using Chi-square, Student’s T and Mann-Whitney U tests.Results: Seventy-six percent of CRs and 65% of PDs responded and were similar except for age (31 vs. 42 years; p<0.001. CR respondents were most often male, in year 3 of training and held the position for 12 months. CRs and PDs agreed that the assigned level of responsibility is appropriate (2.63 vs. 2.73, p=0.15; but CRs underestimate their influence in the residency program (1.94 vs. 2.34, p=0.002 and the emergency department (2.61 vs. 3.03, p=0.002. The majority of CRs (70% and PDs (77% report participating in an extramural training program, and those CRs who participated in training felt more prepared for their job duties (2.26 vs. 2.73; p=0.03.Conclusion: EM CRs feel they have appropriate job responsibility but believe they are less influential in program and department administration than PD respondents. Extramural training programs for incoming CRs are widely used and felt to be helpful. [West J Emerg Med. 2010; 11(2:120-125.

  1. The 2014 Academic College of Emergency Experts in India′s Education Development Committee (EDC White Paper on establishing an academic department of Emergency Medicine in India - Guidelines for Staffing, Infrastructure, Resources, Curriculum and Training

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    Praveen Aggarwal

    2014-01-01

    Full Text Available Emergency medicine services and training in Emergency Medicine (EM has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers′ eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India has been a powerful advocate for developing Academic EM in India. The ACEE′s Education Development Committee (EDC was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM.

  2. Investigation of epidemic characteristics and emergency nursing on patients suffered from traffic accidents%交通事故伤害患者流行病学特点及急救护理的调查研究

    Institute of Scientific and Technical Information of China (English)

    唐灵芝; 陈由珠; 李云燕

    2008-01-01

    目的 了解交通伤患者的性别、年龄、受伤部位、车祸发生的时间等特征,为临床救护提供依据.方法 以2005年6月至2007年6月收治的2 955例交通事故伤害的急诊患者为研究对象,进行回顾性、描述性统计分析.结果 交通伤比例高的时间段为5~11月、双休日、每年3个长假,1 d内以11:00~13:00、16:00~19:00为多.交通伤患者男多于女,年龄以16~35岁的青年最多,伤害部位以头面部和四肢为主,需立即实施抢救措施者945例.结论 应加强节假日、双休日、中晚班急诊护理人员的配备,保证有足够的人力参与抢救;同时应加强护士急救意识、各种穿刺能力、抢救技能以及应急应变能力训练,进一步规范交通伤的救治.%Objective To understand the sex,age,injured portion,time of accident on patients suf-fered from traffic accidents in order to provide evidences for clinical emergency rescue.Methods For retrospective analysis and descriptive statistics,2955 patients who suffered from traffic accidents between Jun 2005 and Jun 2007 were as study objects.Results The periods with high traffic wounds were in May to September,weekends,three long holidays.Among a day,accidents happened more in 11Am to 13Pro,16Pm to 19Pm.Male patients were more than females.16 to 35 year old young people were at most.Injured portions were mainly in head,face and four limbs.945 patients needed emergency rescue immediately.Conclusion In order to have sufficient poople to take part in rescues,emergency nurses for holidays,weekends,mid and night duties should be prepared in-creasingly.Meanwhile,nurses'emergency consciousness,various kinds puncture techniques,rescuing and strin-gency skills should be strengthened.Remedy for traffic wounds should be further specified.

  3. Accidents in Children under ten: analysis of admittions at First Aid Emergency Public Centers in São Luis, MA.

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    Sergiane Maia MACIEL

    2015-02-01

    Full Text Available Objective: To analyze accidents in children under ten admitted at First Aid Emergency Public Centers in São Luis, MA. Methods: Quantitative study with a sample of 166 children from August to November 2011. They were evaluated demographic, socio-economical and variable data related to the accident. In comparison to the main variable categorical, we used the Chi-square test. Results: The age categories included 51.8% of children aged 6-9, 35.5% between 2-5 and 12.7% were smaller or equal to one. It was predominant the male sex (69.9%; the countryside origin (53.6%; the children admitted had family income to 1 minimum wage (60.2%. The most frequent accidents were: falls (55.4%, transportation accidents (21.1% and burns (12.7%. The accidents occurred mainly at homes (63.3%, on weekends (39.2% and in the afternoon (53.6%. In relation to falls accidents, burns and strange body, there was some significance statistic at age (p = 0.001. Conclusions: We conclude that most of the accidents suffered by children in Sao Luis, MA who looked for First Aid Emergency Public Centers were low to the average seriousness at 82.0% of hospitalization for a period from 1 to 4 days.

  4. Nuclear emergency plan and preparedness in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, T.; Nozawa, M.; Tajima, E.

    1994-12-31

    The Japanese nuclear emergency plan and preparedness has been reinforced on the basis of lessons learned from the accident at the TMI-2 nuclear power plant in March, 1979 and the Chernobyl Accident in 1986. Responsibility to protect the inhabitants in case of accidents lies upon prefectural governments. The national government is providing financial and technical support to prefectural governments. To facilitate technical support for emergency situations, a significant effort has been made to develop computerized support systems: a radiological dose prediction code system SPEEDI and an accident evolution code COSTA. Prefectural governments prepare their local emergency response systems by establishing communication networks, emergency medical treatment organizations and radiation monitoring schemes, and also nuclear emergency education, training and exercises.

  5. [Mild brain injuries in emergency medicine].

    Science.gov (United States)

    Liimatainen, Suvi; Niskakangas, Tero; Ohman, Juha

    2011-01-01

    Diagnostics and correct classification of mild brain injuries is challenging. Problems caused by insufficient documentation at the acute phase become more obvious in situations in which legal insurance issues are to be considered. A small proportion of patients with mild brain injury suffer from prolonged symptoms. Medical recording and classification of the brain injury at the initial phase should therefore be carried out in a structured manner. The review deals with the diagnostic problems of mild brain injuries and presents a treatment protocol for adult patients at the acute phase, aiming at avoiding prolonged problems. PMID:22238915

  6. [Mild brain injuries in emergency medicine].

    Science.gov (United States)

    Liimatainen, Suvi; Niskakangas, Tero; Ohman, Juha

    2011-01-01

    Diagnostics and correct classification of mild brain injuries is challenging. Problems caused by insufficient documentation at the acute phase become more obvious in situations in which legal insurance issues are to be considered. A small proportion of patients with mild brain injury suffer from prolonged symptoms. Medical recording and classification of the brain injury at the initial phase should therefore be carried out in a structured manner. The review deals with the diagnostic problems of mild brain injuries and presents a treatment protocol for adult patients at the acute phase, aiming at avoiding prolonged problems.

  7. Virtual Alternative to the Oral Examination for Emergency Medicine Residents

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    McGrath, Jillian

    2015-02-01

    Full Text Available Introduction: The oral examination is a traditional method for assessing the developing physician’s medical knowledge, clinical reasoning and interpersonal skills. The typical oral examination is a face-to-face encounter in which examiners quiz examinees on how they would confront a patient case. The advantage of the oral exam is that the examiner can adapt questions to the examinee’s response. The disadvantage is the potential for examiner bias and intimidation. Computer-based virtual simulation technology has been widely used in the gaming industry. We wondered whether virtual simulation could serve as a practical format for delivery of an oral examination. For this project, we compared the attitudes and performance of emergency medicine (EM residents who took our traditional oral exam to those who took the exam using virtual simulation. Methods: EM residents (n=35 were randomized to a traditional oral examination format (n=17 or a simulated virtual examination format (n=18 conducted within an immersive learning environment, Second Life (SL. Proctors scored residents using the American Board of Emergency Medicine oral examination assessment instruments, which included execution of critical actions and ratings on eight competency categories (1-8 scale. Study participants were also surveyed about their oral examination experience. Results: We observed no differences between virtual and traditional groups on critical action scores or scores on eight competency categories. However, we noted moderate effect sizes favoring the Second Life group on the clinical competence score. Examinees from both groups thought that their assessment was realistic, fair, objective, and efficient. Examinees from the virtual group reported a preference for the virtual format and felt that the format was less intimidating. Conclusion: The virtual simulated oral examination was shown to be a feasible alternative to the traditional oral examination format for

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

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    Eric S. Holmboe

    2015-10-01

    Full Text Available 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.

  9. How mobile robots have helped at Chernobyl and other accidents

    Energy Technology Data Exchange (ETDEWEB)

    Meieran, H.B.

    1988-04-01

    The use of mobile robots at several recent accidents including Chernobyl is described. The robots assumed, with varying degrees of success, many of the tasks and missions that are normally conducted by the emergency response team. Lessons learned from the experiences, together with operational and performance problems are discussed. (U.K.).

  10. Two decades of radiological accidents direct causes, roots causes and consequences

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    Rozental Jose de Julio

    2002-01-01

    Full Text Available Practically all Countries utilize radioisotopes in medicine, industry, agriculture and research. The extent to which ionizing radiation practices are employed varies considerably, depending largely upon social and economic conditions and the level of technical skills available in the country. An overview of the majority of practices and the associated hazards will be found in the Table IV to VII of this document. The practices in normal and